<![CDATA[UCSF Department of Surgery News ]]>https://surgery.ucsf.edu/news--events.aspxUCSF NewsenMon, 24 Jun 2019 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=82569 <![CDATA[Dr. Minnie M. Sarwal Named Co-Principal Investigator on Chan Zuckerberg Initiative, "A Comprehensive Single Cell Atlas of the Human Kidney"]]> Today, the Chan Zuckerberg Initiative (CZI) announced $68 million in funding to support the Human Cell Atlas and its selection of 38 collaborative science teams to launch CZI's Seed Networks for a Human Cell Atlas projects. These collaborative groups bring together scientists, computational biologists, software engineers, and physicians to support the continued development of the Human Cell Atlas (HCA), an international effort to map all cells in the human body. Minnie M. Sarwal M.D., Ph.D., FRCP, DCH, Director of the Sarwal Lab, and professor and director of Precision Transplant Medicine in the UCSF Department of Surgery, was named a Co-Principal Investigator on one of the groups receiving funding, "A Comprehensive Single Cell Atlas of the Human Kidney".  

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=82569
Fri, 21 Jun 2019 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=82517 <![CDATA[Yvonne Kelly, MD Awarded Jon Fryer Resident Scientist Scholarship by American Society of Transplant Surgeons ]]> Yvonne Kelly, MD has been awarded the prestigious Jon Fryer Resident Scientist Scholarship by the American Society of Transplant Surgeons (ASTS) for 2019-2020. The award was presented at the 2019 American Transplant Congress earlier this month in Boston, Massachusetts. The scholarship is supported by the ASTS Foundation in order to foster innovation and research in the fields of transplantation and transplant immunobiology.  

Dr. Kelly is a fourth year general surgery resident at UCSF currently in her first of two professional development years. She is completing her research fellowship in the UCSF Transplantation Research Lab, under the mentorship of Qizhi Tang, PhD and Peter Stock, MD, PhD.

The project supported by the grant will focus on understanding the immunogenicity of the parathyroid gland, which has recently emerged as a novel adjunct to enhance the engraftment and survival of pancreatic islet cell transplants. The Department of Surgery Chair, Julie Ann Sosa, MD, MA, FACS, described the research as "exploring the intersection between transplant and endocrine surgery, the next frontier!"

Dr. Kelly was also the recipient of the "Poster of Distinction" Award at the conference for her innovative research.

Asts Ceremony Img 7750

Yvonne Kelly Poster

Project Summary

Over the last decade, there has been increased use of pancreatic islet transplantation to restore normoglycemia in patients with Type 1 diabetes. However widespread application has been limited by several barriers, particularly the sensitivity of islets to ischemia. Conversely, another highly vascularized endocrine tissue, the parathyroid gland, engrafts at very high success rates (>90%) in thousands of patients every year in the intramuscular site, a site considered to be too harsh for islets given its lack of vascularity. The success in parathyroid autotransplantation has been attributed to an unusually high percentage (3-5%) of CD45-CD34+ vascular endothelial progenitor cells resident in these glands. Over the last year and a half, our lab has been exploring the novel idea of parathyroid and islet co-transplantation with both human islets and stem-cell derived insulin producing cells (SCIPCs) in the intramuscular and subcutaneous sites in preclinical mouse models of diabetes. We have seen statistically significant improvement in islet engraftment and function and unprecedented reversal of diabetes and restoration of normoglycemia. As the possibility of islet and parathyroid composite transplants moves from bench to bedside, it will be important to understand how the parathyroid is supporting and protecting the islet cells. There are sparse published data suggesting the parathyroid has little to no MHC expression and can remain functional in an allotransplant setting for several months without immunosuppression. This study aims to further our knowledge of the interaction between the parathyroid and the immune system, a relationship which could prove key to islet protection and survival.

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- by Alexi Callen https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=82517
Thu, 20 Jun 2019 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=82541 <![CDATA[Hobart W. Harris, MD, MPH Inducted into the Gold-Headed Cane Society]]> Hobart W. Harris, M.D., M.P.H., professor and chief of the Division of General Surgery, Hobart W. Harris, MD, MPH, was inducted into the Gold-Headed Cane Society as an Honorary Member for 2019. The ceremony took place on May 20th. Dr. Harris was on one of two UCSF faculty to receive the award this year. The original gold-headed cane has long been a symbol in English medicine. Dr. Andre Campbell of the Department of Surgery presented the award.

 Hobart Harris Golden Cane

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=82541
Thu, 20 Jun 2019 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=82516 <![CDATA[General Surgery Resident Zachary Matthay, M.D. Awarded CTSI TL1 Postdoctoral Fellowship]]> Zachary Matthay, M.D., a rising PGY-3 and soon to be general surgery research resident, has been awarded a CTSI TL1 Postdoctoral Fellowship. Dr. Matthay has been mentored and supported in his career by Lucy Kornblith, M.D.Peter G. Stock, M.D., Ph.D.M. Margaret Knudson, M.D. and Pamela Derish, M.A.

The CTSI TL1 postdoctoral fellowship seeks to train exceptional postdoctoral fellows and provide them with the methodologic, analytic, leadership and team science skills required to conduct transformative early translational research. Fellows receive advanced didactic training relevant to the conduct of translation research, support from senior mentors and peers in the conduct of their research through regular works-in-progress sessions, a faculty seminar series focused on translational research, and career development support through one-on-one mentoring from established translational investigators as well as other structured activities. Fellows also receive a stipend commensurate to the PGY/postdoctoral fellow status, as well as tuition assistance for didactic training and support for travel to scientific meetings.

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=82516
Thu, 20 Jun 2019 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=82519 <![CDATA[Tasce Bongiovanni, MD Awarded LHS K12 Career Development Grant and Named 2019 John A. Watson Scholar]]> Tasce Bongiovanni 342 RetinaTasce Bongiovanni, M.D., MPP, MHS, a second-year trauma and surgical critical care fellow at ZSFG in trauma and emergency surgery and soon to be USCF faculty member, has been awarded a Learning Health Systems (LHS) K12 Career Development Grant and named to the Class of 2019 John A. Watson Faculty Scholars. Dr. Bongiovanni is a previous graduate of the UCSF General Surgery Residency Program

On August 1, Dr. Bongiovanni will begin her appointment as assistant professor in the Division of General Surgery. She will be joining the acute care surgery service at UCSF Parnassus, staffing the surgical ICU as a surgical critical care intensivist while taking trauma call at ZSFG.

Dr. Bongiovanni's mentors and faculty instrumental in her career development award include: from the Department of Surgery, Elizabeth C. Wick, M.D.Hobart W. Harris, M.D., M.P.H.Emily Finlayson, M.D., M.S. and the Department Chair, Julie Ann Sosa, M.D., M.A., FACS; and two professors of Medicine, Andrew Auerbach, MD and Niraj Sehgal, MD, MPH

After a highly productive career as a surgical trainee, Dr. Bongiovanni ascends to the faculty as a young surgeon-scientist with two highly coveted and prestigious awards.

Learning Health Systems (LHS) K12 Grant

The Learning Health Systems (LHS) K12 Selection Committee selected Dr. Bongiovanni to receive a K12 Scholar Award and to participate in the UCSF K Scholars Program. She was among the top ranked candidates in a very competitive field. 

The Learning Health System (LHS) K12 is a new K12 program to support the career development of scientists at UCSF and affiliates who conduct patient-centered outcomes research (PCOR) within learning health systems in order to help accelerate the translation of research and evidence into practice. In a LHS, knowledge generation is embedded in the daily practice of health care delivery, and serves to catalyze continuous improvement to enhance patient well-being and health outcomes. The program is  supported by the Agency for Healthcare Research and Quality (AHRQ), the Department of Epidemiology and Biostatistics and CTSI.

Dr. Bongiovanni's research will focus on developing strategies to decrease opioid exposure in treating post-operative pain. It will have a direct, population-level impact by informing interventions aimed at providing adequate post-operative analgesia with non-opioid medications in order to reduce opioid abuse and associated morbidity and mortality and inform further hospital-wide measures to develop a continuum of care for patients regarding holistic pain control in the perioperative setting. 

John A. Watson Faculty Scholar

Dr. Bongiovanni was also recently named a 2019 John A. Watson Faculty Scholar and a recipient of the UCSF School of Medicine Dean's Diversity Funds Award. Her selection for the honor, along with six additional faculty members in other departments, was announced by the School of Medicine Dean Talmadge E. King, Jr., MD.

The Dean's Diversity Fund was established to support the recruitment and retention of faculty who share the university's commitment to diversity and the institution's responsibility to care for underserved and vulnerable populations.  The awards are named after John A. Watson, PhD, a pioneer for diversity, an inspiring mentor, and a tenacious scientist whose service to the UCSF School of Medicine spanned forty-six years. During his tenure as dean of admissions in the 1970s, he rapidly increased the number of women and minority students in the entering medical school classes.

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=82519
Wed, 19 Jun 2019 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=82409 <![CDATA[Mary McGrath, Carter Lebares, and Courtney Green Honored with UCSF Excellence and Innovation Awards in Graduate Medical Education]]> Faculty members Mary McGrath, M.D. and Carter Lebares, M.D., and general surgery resident Courtney Green, M.D.,MAEd each received the UCSF Excellence and Innovation Award in Graduate Medical Education (208-19) at the end-of-year GME Celebration on June 17th at the Kalmanovitz Library on the UCSF Parnassus Heights campus. 

Award recipients have demonstrated a commitment to advancing graduate medical education at UCSF through educational and clinical quality improvement, service excellence, and innovation, and have demonstrated excellence in: 

  • Educational leadership in his/her department, at UCSF, and/or nationally
  • Participation in innovative GME-related projects
  • Extraordinary efforts to address resident/fellow needs and well-being
  • Other contributions to improving graduate medical education at UCSF and/or national

Mary McGrath Receives UCSF Excellence And Innovation Award In Graduate Medical Education Award



Carter Lebares Receives UCSF Excellence And Innovation Award In Graduate Medical Education Award



Courtney Green Receives UCSF Excellence And Innovation Award In Graduate Medical Education Award

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=82409
Wed, 19 Jun 2019 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=82531 <![CDATA[ American Association of Endocrine Surgeons Awards Quan-Yang Duh, M.D. Oliver Cope Meritorious Achievement Award]]> UCSF Endocrine surgeon Quan-Yang Duh, M.D. was awarded the Oliver Cope Meritorious Achievement Award from the American Association of Endocrine Surgeons (AAES). The ceremony took place at the organization's annual meeting on April 7, 2019. The Cope award is highest honor given by the AAES and has been awarded only nine times in its history.
The award was presented to Dr. Duh by another luminary in the field, Orlo Clark, M.D., professor emeritus of surgery at UCSF, and widely recognized as the father of endocrine surgery. Clark was introduced by UCSF endocrine surgeon Wen T. Shen, M.D., M.A. Clark, himself a former Cope Award recipient, served as a mentor to Dr. Duh.
UCSF is the only institution to have two of its members receive the Cope Award, a truly remarkable distinction.

Quan Duh 2

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=82531
Tue, 18 Jun 2019 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=82239 <![CDATA[Muriel Steele Society Announces Awards Honoring Pioneering and Influential Women in Surgery]]> This spring, the Muriel Steele Society announced the inaugural recipients of its two annual awards honoring pioneering and influential women in surgery. Please join us in congratulating all of these inspiring women!

The Muriel Steele Society Award

Kukreja Jasleen 200The Muriel Steele Society Award is voted on by the senior residents and given annually at the Chief Resident Graduation to a woman faculty member who embodies the spirit of Muriel Steele - a woman working to identify and address the unmet needs among our surgical patients and whose research and/or clinical work is shifting the paradigms within our field in order to positively impact the experiences and outcomes of our current and future patients.

This year, the inaugural MSS Award was given to Jasleen Kukreja, MD, MPH. Dr. Kukreja immigrated to the US from India at the age of 19 after receiving her Masters Degree in molecular biology and biochemistry. She went on to get a second bachelors degree from UC Irvine, complete medical school at UCLA and residency in general surgery at the Brigham and Women's Hospital. She was the first woman to graduate from the Cardiothoracic Surgery Fellowship at UCSF and went on pursue advanced training in minimally invasive lobectomy at Cedars-Sinai.

At UCSF, she has been a true pioneer, leading the way in minimally invasive lung resections, expanding the breadth of the cardiothoracic surgery program, catapulting the lung transplant program to the elite level at which it now operates, and pushing the boundaries with ex-vivo lung perfusion and ECMO. In addition to all this, her dedication to her patients is unmatched; she is easily one of the most available, responsive, detail oriented, and caring physicians at this institution. She continually strives to improve patient experiences and outcomes and perfectly embodies the trailblazing spirit of Muriel Steele.

The Muriel Steele Society Honor Roll

The annual Muriel Steele Society Honor Roll celebrates influential and inspiring women faculty, fellows and residents in surgery and surgical sub-specialties. Current trainees (both residents and medical students) are invited to nominate women who have had a positive impact on their training and the nominees are recognized at our annual Women in Surgery Reception. This years nominees are listed below.

UCSF General Surgery

  • Nancy Ascher, MD, PhD
  • Tasce Bongiovanni, MD, MPP, MHS
  • Hillary Braun, MD
  • Ariane Christie, MD
  • Isabelle Chumfong Le Leannec, MD, MEng
  • Patricia Conroy, MD
  • Emily Finlayson, MD, MS
  • Clara Gomez-Sanchez, MD
  • Barbara Hamilton, MD
  • Jade Hiramoto, MD
  • Yvonne Kelly, MD
  • Lucy Kornblith, MD
  • Elizabeth Lancaster, MD
  • Carter Lebares, MD
  • Marisa Pulcrano, MD
  • Sanziana Roman, MD
  • Amanda Sammann, MD, MPH
  • Carolyn Seib, MD, MAS
  • Nichole Starr, MD, MPH
  • Lygia Stewart, MD
  • Elaine Tseng, MD
  • Mika Varma, MD
  • Lan Vu, MD
  • Laura Wong, MD, PhD
  • Gavitt Woodard, MD

UCSF East Bay General Surgery

Katherine Stern, MD 

UCSF ENT

Nina Zhao, MD 

UCSF OB/GYN

Joanne Gras, DO 

UCSF OMFS

Jennifer Perkins, DDS, MD 

UCSF Ophthalmology

Julie Schallhorn, MD, MS 

UCSF Orthopedics

Nicole Schroeder, MD 

UCSF/CHO Orthopedics

Coleen Sabatini, MD, MPH 

Kaiser Oakland General Surgery

Francisca Maertens, MD 

UCSF Urology

Sima Porten, MD, MPH
Bogdana Schmidt, MD, MPH

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=82239
Tue, 18 Jun 2019 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=26294 <![CDATA[Joyce Trompeta Ph.D., PNP Awarded Fulbright U.S. Scholar Grant from U.S. State Department]]> Fulbright Scholar Program

Joyce A. Trompeta, Ph.D., PNP, Assistant Professor in the Department of Surgery, has been awarded a Fulbright U.S. Scholar grant from the U.S. State Department's Bureau of Educational and Cultural Affairs / Japan-United States Educational Commission.

Joyce A Trompeta Phd PnpDr. Trompeta will examine the organ donation and transplantation attitudes, beliefs, and knowledge among a population key to Japan's future - Japanese university students, as well as faculty and healthcare providers who often are the ones who promote and request organ donation consent. Her research will be conducted at Kumamoto University, Japanese Red Cross Kumamoto Hospital, and various academic institutions throughout Japan. Findings from this Fulbright research will provide a better understanding as to why Japan has the lowest organ donation rates in the world and identify areas of education targeted to both young and older generations. 

Kumamoto Model (KM)

Dr. Trompeta has created The Kumamoto Model (KM) that is a strategic plan to increase deceased organ donations in Kumamoto Prefecture in Japan. The KM's mission is: to change the Japanese' social climate regarding organ donation consent, to establish Japan's self-sufficiency for transplantation by increasing the availability of organs, create an efficient organ procurement organization, and develop culturally tailored organ donation educational programs.

After several invited lectures given by Dr. Trompeta on her research findings on "Importance of Family Discussion to Increase Organ Donation" last year, there were five deceased organ donations (2.84 per million population) in Kumamoto—the most in its history, and the most of any of Japan's 47 prefectures. Family Discussion about organ donation is now a directive to be addressed during National Family Day in November. The KM is supported by Governor Kabashima and "Kumamon" as the Ambassador of Organ Donation, with the developed slogan: Extend Life. Do the Honor. Be an Organ Donor.

About Joyce A. Trompeta, Ph.D., PNP

Dr. Trompeta's program of research examines factors related to organ donation and health disparities, including organ donation practices, medical exclusion related to race and ethnicity, and reasons why donors are unwilling to donate. She developed the Organ Donation & Transplantation Knowledge Survey (ODTK), which is psychometrically valid for evaluating knowledge about organ donation and transplantation.

She has served on the Boards of the Organ Procurement and Transplantation Network (OPTN) / United Network for Organ Sharing (UNOS) - Minority Affairs Committee (MAC), and the International Transplant Nurses Society (ITNS). Currently, she is on the Council Board of the International Society of Organ Donation & Procurement (ISODP) as US representative, and President-Elect for ITNS.

As UCSF's International Pacific Rim's Surgical and Medical Liaison, Dr. Trompeta has developed outreach programs to four Hawaiian Islands promoting solid organ transplantation and organ donor awareness. She has developed outreach clinics in Hawaii for UCSF's Interstitial Lung Disease and Lung Transplantation Program, and UCSF's Kidney/Pancreas Transplant Program. 

About the Fulbright Program

The Fulbright Program, which aims to increase mutual understanding between the people of the United States and the people of other countries, is the flagship international educational exchange program sponsored by the U.S. government. The presidentially appointed 12-member Board is responsible for supervising the Fulbright Program worldwide and approving the selection of all Fulbright recipients, and is made possible through funds appropriated annually by the U.S. Congress.

As a grantee, Dr. Trompeta will join the ranks of distinguished participants in the Program. Fulbright alumni have become heads of state, judges, ambassadors, cabinet ministers, CEOs, and university presidents, as well as leading journalists, artists, scientists, and teachers. They include 59 Nobel Laureates, 84 Pulitzer Prize winners, 72 MacArthur Fellows, 16 Presidential Medal of Freedom recipients, and thousands of leaders across the private, public and non-profit sectors. Since its inception in 1946, more than 380,000 "Fulbrighters" have participated in the Program. 

Senator Fulbright's goal of developing international understanding depends on a commitment from Fulbright grantees to establish open communication and long-term cooperative relationships. As a Fulbright recipient and a representative of the United States, Dr. Trompeta will have the opportunity to work collaboratively with international partners in educational, political, cultural, economic, and scientific fields. Her award exemplifies the qualities of service, leadership, and excellence that have been hallmarks of this Program for more than 70 years. 

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=26294
Mon, 17 Jun 2019 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=82530 <![CDATA[Insoo Suh, M.D. Guides Stanford Endocrine Surgeons through their First Scarless Transoral Thyroidectomy]]> A Thai physician developed the transoral thyroidectomy in 2014 and published an article about it in 2016; since then, the procedure has spread to a handful of medical centers in the United States. To learn how to perform the surgery, Lin reached out to Insoo Suh, MD, assistant professor of surgery at University of California-San Francisco, who has completed about 25 of the procedures.

She observed Suh perform the surgery at UCSF, then practiced the technique on cadavers. When it came time for Torres' surgery, which took place April 16, Suh guided Lin through it. Robin Cisco, MD, an assistant professor of surgery at Stanford who had observed the procedure in Thailand, also aided with the surgery.  

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- by News Staff https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=82530
Wed, 12 Jun 2019 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=81963 <![CDATA[Global Vascular Guidelines for Chronic Limb-Threatening Ischemia (CLTI) Published by International Team]]> Conte 27Mar2019 High Res

The Global Vascular Guidelines for the Treatment of Chronic Limb-Threatening Ischemia (CLTI), an initiative to standardize and improve the quality of care of patients with CLTI worldwide, has been published in the Journal of Vascular Surgery (JVS), as a supplement to the June 2019 edition.

The global effort was spearheaded by a trio of internationally renowned vascular surgeons who served as co-editors of the publication: Michael S. Conte, M.D., Professor and Chief of the Division of Vascular & Endovascular Surgery at UCSF,  Andrew W. Bradbury, MD of the University of Birmingham, United Kingdom, and Philippe Kolh, MD of the University Hospital of Liège in Belgium. All three major international vascular surgical societies—the European Society for Vascular Surgery (ESVS), the Society for Vascular Surgery (SVS), and the World Federation of Vascular Societies (WFVS)—combined efforts, along with nearly 60 experts all over the world, to put together the exhaustive compendium over the last 4 years with the intent to globally improve care for CLTI. 

Chronic limb-threatening ischemia (CLTI) is a new term coined in the guidelines in place of critical limb ischemia, which is defined as a severe obstruction of the arteries that markely reduces blood flow to the hands, feet, and legs, and has progressed to the point of severe pain, skin ulcers, and/or sores. It is the final stage of peripheral artery disease (PAD), which results from a progressive thickening of an artery's lining that raises the risk of heart attack, stroke and death. According to the report, "CLTI is a highly morbid disease, incurring significant mortality, limb loss, pain, and diminished health-related quality of life among those afflicted." Treatment is required immediately in order to re-establish blood flow to the affected areas, and above all to preserve the limb.

The guidelines represent a synthesis of the treatments used to treat this debilitating condition, and emphasize the importance of a structured approach to decision-making on revascularization, taking into account Patient risk, Limb severity and ANatomic complexity (PLAN) in that order. A new anatomic classification system, the Global Anatomic Staging System (GLASS), is proposed to replace prior schemes that were primarily lesion-based, rather than limb-based.

According to Dr. Conte in his statement to the SVS, "By improving the staging of CLTI, we believe that optimal care pathways can be defined and based on more accurate clinical and epidemiologic evidence going forward…with the continuous evolution of vascular technology, we must remain focused on the primary goals of treatment, in contradistinction to a lesion-centric emphasis on technical success."

Overall recommendations from the guidelines emphasize the need for comprehensive assessments for CLTI, optimal medical therapy, and prompt revascularization for patients with advanced CLTI, in addition to utilizing an individualized approach for each patient.

Read the SVS press release

Read the full text of the GVG on the JVS website

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- by Lauren Washburn https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=81963
Fri, 31 May 2019 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=81762 <![CDATA[Muriel Steele Society Announces Launch of New Website]]> Muriel Steele Society News StoryWe are pleased to announce that the Muriel Steele Society website has officially launched! The Muriel Steele Society (MSS) was established in honor of Muriel Steele, MD, the first woman surgeon at San Francisco General Hospital (SFGH) — now Zuckerberg San Fransisco General (ZSFG). Throughout her career, Dr. Steele experienced significant prejudice and overcame enormous obstacles on the road to becoming a phenomenal surgeon.

MSS is an inclusive community dedicated to inspiring, supporting, and promoting women surgeons so they can thrive at all stages of their careers. We are comprised of committees spanning numerous areas that work together seamlessly to promote the wellness of members, provide mentorship across all levels of training from medical students to junior faculty, and to conduct research on issues that hamper progress towards gender parity and greater diversity, equity, and inclusion for surgery.

The website has been established to aid in the society's efforts to reach out to women surgeons at UCSF and beyond. It serves to highlight events and special lectureships, keeps our network of members connected, and informs the community about issues that the MSS is actively working on. The website will also serve as a vehicle for promoting women surgeons by celebrating their achievements, complementing our social media presence on Twitter.

Madhulika Varma - 144xKornblith, LucyThe website was conceptualized by the MSS leadership, Mika Varma, MD, Professor and Chief of Colorectal Surgery, and Lucy Kornblith, MD, Assistant Professor, ZSFG Trauma and Surgical Critical Care. Content is generated by the MSS Communications Committee. We welcome any news stories and articles you wish to share with our community. 

Lastly, we would like to thank Richard N. Barg, J.D., MBA for his skill and dedication in developing the website. 

Visit the Muriel Steele Society Website

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- by   https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=81762
Thu, 30 May 2019 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=81746 <![CDATA[Efficacy of Mindfulness-Based Cognitive Training in Surgery: Additional Analysis of the Mindful Surgeon Pilot Randomized Clinical Trial]]> In this pilot randomized clinical trial of 21 first-year surgery residents led by PI Carter Lebares, MD,  director of the UCSF Center for Mindfulness in Surgery, taking a modified mindfulness-based stress reduction class was associated with higher mindfulness, lower stress, better executive function scores, faster motor skills, and unique activation of neural substrates associated with executive control and self-awareness during an emotional regulation task compared with control participants. Mindfulness-based stress reduction appeared to mitigate stress and enhance executive function in surgery residents, supporting the value of larger, more definitive trials of this promising intervention for surgeons.

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https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=81746
Thu, 30 May 2019 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=81747 <![CDATA[MedicalResearch.com Interview with Dr. Carter Lebares: Can Mindfulness-Based Training Reduce Stress and Burnout in Surgeons?]]> What is the background for this study? Dr. Lebares: This study was inspired by extensive evidence of the effectiveness of mindfulness-based interventions (MBIs) for mitigating stress and enhancing performance in other high-stress populations like police and the military. We know that overwhelming stress is related to burnout and to cognitive errors – two critical issues within surgery, today. This prompted us to tailor and streamline an MBI specifically for surgeons, and to test it in our trainees.

MedicalResearch.com: What are the main findings?

Dr. Lebares: This was a pilot study, as recommended by the NIH and in line with research in sustainable implementation practices. As such, we primarily tested intervention feasibility and the study methodology in preparation for an adequately-powered multicenter trial of efficacy.

That said, our effect-size findings are really exciting and suggest several promising areas of mindfulness-based interventions' impact for surgeons. In particular stress, mindfulness, working memory capacity and cognitive control (which includes attention, vigilance and 'set shifting', or the ability to focus in a complex environment). These findings reflect statistically significant impacts seen in other high-stress and high performance groups in these same domains. They are highly relevant areas of impact for our profession.

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- by Medical Research News Staff https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=81747
Thu, 23 May 2019 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=81708 <![CDATA[California Institute for Regenerative Medicine Awards Dr. Peter Stock $11M Grant to Conduct Clinical Trial for Treatment of Type 1 Diabetes]]>

The California Institute for Regenerative Medicine (CIRM) awarded $11.08 Million to Dr. Peter Stock at the University of California San Francisco (UCSF) to conduct a clinical trial for treatment of Type 1 Diabetes (T1D)...

The trial will be using parathyroid glands to aid in the success and viability of the transplant procedure.  Co-transplantation of islets and parathyroid glands, from the same donor, substantially increases beta cell survival, potentially enabling adequate long-term insulin production and removing the need for multiple donors.  Additionally, the co-transplantation will occur in the patient's forearm, which allows for easier monitoring and improves the effectiveness and accessibility of islet transplants for patients.

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- by Yimy Villa https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=81708
Mon, 20 May 2019 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=81590 <![CDATA[Incorporation of a Molecular Prognostic Classifier Improves Conventional Non-Small Cell Lung Cancer Staging]]>

Despite adoption of molecular biomarkers in the management of non-small cell lung cancer (NSCLC), the recently adopted 8th Edition staging utilized only clinicopathologic characteristics, and validated improvement in risk stratification of early-stage disease remains elusive. We therefore evaluated the integration of a clinically-validated molecular prognostic classifier into conventional staging....

Incorporation of a molecular prognostic classifier significantly improved identification of high-risk patients and survival predictions compared to conventional staging. TNMB may lead to improved survival of early-stage disease through more effective application of adjuvant therapy.

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=81590
Wed, 15 May 2019 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=81556 <![CDATA[Elizabeth Lancaster, MD Winner of APDS Best Resident Paper Award at Surgical Education Week 2019]]> UCSF general surgery resident Elizabeth Lancaster, M.D. received the APDS (Association of Program Directors in Surgery) Best Resident Paper Award for presentation of her paper, Residents as Key Effectors of Change in Improving Opioid Prescribing Behavior, at Surgical Education Week 2019 in Chicago, IL.

With mentors Dr. Kenzo Hirose and Dr. Liza Wick, Dr. Lancaster developed a quality improvement program focused on improving post-operative analgesia prescribing patterns amongst general surgery residents. Her paper highlights the important role of residents in the quality improvement process and the power of educational interventions for changing behavior. 


Research Highlights

There is a national imperative to curb the flow of opioids into our communities.  In academic medical centers, the majority of discharge opioid prescriptions are written by residents who receive predominantly ad hoc, peer-to-peer education on perioperative analgesia. We aimed to reduce opioid overprescribing after common general surgical operations through a resident led quality improvement project that involved formal educational interventions and feedback on prescribing habits.
Results: After our educational intervention, residents' impression of the appropriate number of opioid pills necessary after common general surgical operations decreased significantly, as measured by surveys pre- and post-intervention. Electronic health record data regarding actual opioid prescribing behavior shows significant discrepancy from the survey responses, but does show a significant decrease in the quantity of opioids prescribed for most evaluated operations following the educational intervention.
Conclusions: Opioid prescribing is an ideal target for resident led education and quality improvement. Residents' attitudes towards appropriate opioid prescribing tends to differ from actual prescribing habits. Our results demonstrate that a well-scoped, resident-driven quality improvement program can lead to change in both attitudes and practice surrounding opioid prescribing.

Read Abstract

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- by Alexi Callen https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=81556
Tue, 14 May 2019 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=81512 <![CDATA[Amar Nijagal, MD Recipient of UCSF Liver Center Pilot/Feasibility Award]]> Nijagal Amar 300x375Amar Nijagal, M.D., an Assistant Professor in the Department of Surgery, was awarded a Pilot/Feasibility Award from the UCSF Liver Center, of which he is now an associate member. An external advisory board comprised of leading liver scientists evaluated applications for this award. Dr. Nijagal's research proposal, "The Role of Monocytes on The Resolution of Perinatal Hepatic Inflammation", was among three chosen for this highly competitive award.

Dr. Nijagal's laboratory focuses on perinatal inflammation of the liver as it can have life-threatening consequences, particularly in infants and young children. An example of a hepatic inflammatory process occurring in infancy is biliary atresia (BA), an obliterative cholangiopathy that rapidly progresses from inflammation to hepatic fibrosis and liver failure.

The fact that BA is such an aggressive disease in neonates compared to inflammatory liver diseases in adults suggests that the mechanisms responsible for restoring tissue homeostasis following inflammation are impaired in affected infants. Dr. Nijagal's research team will be investigating the contribution of specific monocyte subsets to the resolution of perinatal hepatic inflammation, thereby uncovering therapeutic strategies that can be applied to treat infants and children with BA.

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=81512
Sat, 11 May 2019 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=81584 <![CDATA[A Daughter's Gift to Her Mother Saves Two Lives]]> Just 42 years old, Erosalyn Deveza was drifting toward death. Her kidneys were barely functioning. She was constantly exhausted. She had vertigo and vomited frequently. She was tethered to a home dialysis machine for eight hours each night as she slept. A kidney transplant was the only thing that could save her, but it was unlikely to happen in time in the United States. No one on Deveza's side of the family could provide an organ through a living donation, doctors said, because all were at risk for the same kidney disease. It was too dangerous to leave any of them with a single kidney. Other family and friends were not a match.

This is a story of a daughter's answer to her mother's illness, an idea so obvious yet so inventive that it had never happened before, and hasn't since.

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- by Lenny Bernstein https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=81584
Wed, 8 May 2019 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=81450 <![CDATA[Gavitt A. Woodard, MD, Awarded Intuitive Surgical Robotics Fellowship from AATS Foundation]]> Gaw Headshot 2017Gavitt A. Woodard, M.D., a cardiothoracic surgery fellow at UCSF, has been awarded an Intuitive Surgical Robotics Fellowship from the American Association of Thoracic Surgeons (AATS) Foundation. This opportunity provides advanced robotic training and certification to a select group of fellows each year. Dr. Woodard will attend the course with her sponsoring faculty mentor Johannes Kratz, M.D. who leads the Thoracic Robotic Surgery Program at UCSF. 

While a general surgery resident at UCSF, Dr. Woodard received her Robotic Qualification Equivalency Certificate (QEC) from Intuitive Surgical. She now becomes the third UCSF thoracic fellow to receive the AATS fellowship award; prior recipients include Melissa H. Coleman, M.D. and Dr. Kratz.

The UCSF thoracic robotic surgery program is the largest such program on the west coast with an average of 125 cases performed annually.

Over the course of her training, Dr. Woodard has benefited from excellent mentorship from the Thoracic Oncology Program including David M. Jablons, M.D., Michael Mann, M.D. and Dr. Kratz.

After completion of her residency, Dr. Woodard plans to pursue an academic career in thoracic surgery, with a research focus in early stage lung cancer development.

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=81450
Mon, 6 May 2019 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=78306 <![CDATA[Johannes Kratz, MD Recipient of the Inaugural ImmunoX Hellman Family Clinical-Translational Research Development Award]]> Johannes -Kratz -200x 200

UCSF surgeon-scientist Johannes R. Kratz, M.D. was awarded the Inaugural Hellman Family Clinical-Translational Research Development Award from the Bakar ImmunoX initiative. This development award embeds a young investigator in an ImmunoX CoLab for two years in order to rapidly translate clinical insights into molecular-level understanding of disease. Dr. Kratz was given this prestigious award for the study of tumor immune populations in high-risk early-stage lung cancer.  

The Kratz Lab focuses on the genetic and immunological mechanisms that drive early-stage, surgically resectable thoracic malignancies. These malignancies include lung cancer, esophageal cancer, and thymic cancer. The lab uses novel high-dimensional techniques such as genomic DNA and RNA sequencing, single-cell RNAseq, CyTOF, and patient-derived organoids to unravel the complex genetic nature of early-stage thoracic malignancies and nuanced immunological landscapes that nurture the growth of these malignancies. The knowledge gained from these investigations is being used to identify novel therapeutic targets and therapies for patients with early-stage, yet deadly thoracic malignancies. 

Dr. Kratz's research is supported by a world-renowned leader in thoracic oncology, David M. Jablons, M.D., Program Leader in Thoracic Oncology, Chief of General Thoracic Surgery, and Director of the Thoracic Oncology Lab at UCSF.

Learn More about the Award (UCSF MyAccess Login Required)

Ucsf Bakar Immunox Copy

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=78306
Fri, 3 May 2019 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=81394 <![CDATA[Shahram Aarabi, M.D., MPH Joins Department of Surgery Faculty in UCSF East Bay Surgery Program]]> Shahram Aarabi, M.D News StoryShahram Aarabi, M.D., MPH has joined the Department of Surgery faculty as an assistant professor in the UCSF East Bay Surgery Program. Dr. Aarabi received his M.D. from New York University and completed his general surgery residency, surgical critical care fellowship, and vascular surgery fellowship at the University of Washington.

Dr. Aarabi was Medical Director of Vascular Services at the University of Washington Valley Medical Center where he established protocols for the screening and surveillance of peripheral arterial disease (PAD). He also collaborated with the Division of Trauma Surgery and the Department of Mechanical Engineering to develop novel devices for the care of critically ill patients, resulting in the award of a $1.5 million Department of Defense grant.

Dr. Aarabi will be building a peripheral vascular surgery program at Highland Hospital in Oakland and will continue his clinical research focused on vascular trauma and surgical innovation. Dr. Aarabi is a member of the Society for Vascular Surgery and will be inducted as a Fellow of the American College of Surgeons later this year.

Please join us in welcoming Dr. Aarabi to UCSF!

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=81394
Thu, 2 May 2019 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=81384 <![CDATA[Dr. Donald D. Trunkey, Renowned Trauma Surgeon and Former Chief of Surgery at SFGH, Passes Away at 81]]> Trunkey -Donald -10-January -2008The Department of Surgery is deeply saddened to announce the passing of our friend and colleague, Dr. Donald D. Trunkey who died on Wednesday at the age of 81. Dr. Trunkey was an internationally renowned trauma surgeon and is considered the father of modern trauma systems. He served as Chief of Surgery at San Francisco General Hospital from 1978 until 1986. He was then appointed Professor and Chair of the Department of Surgery at the OHSU School of Medicine, a position he held until 2001. 

Following a first-year internship at the University of Oregon School of Medicine and a two-year stint in Germany as a general medical officer in the U.S. Army, Dr. Trunkey completed his general surgery training at UCSF in 1971. Dr. Trunkey returned to UCSF a year later after an NIH fellowship as a member of the faculty, pursuing a career in trauma surgery. He served as Chief of the Burn Center at San Francisco General and established a laboratory to study mechanisms of shock at the cellular level. Dr. Trunkey was a founding member of the Homeland Security Department as well as the National Foundation for Trauma Care. He served as Chair of The American College of Surgeons Committee on Trauma and helped establish the Advanced Trauma Life Support Course. His dedication is to the field is captured in Dr. Trunkey: An Advocate for Injured Patients, a Legend in Trauma Care

Dr. Trunkey was a towering figure on the Trauma Service at San Francisco General. His yeoman service, innovation and leadership at the General was memorialized by Dr. William Schechter, Professor Emeritus at UCSF, in The History of The Surgical Service at San Francisco General Hospital, "The Trunkey Years, 1978-1986".  

Dr. Trunkey served in the first Gulf War in 1991, stationed in Riyadh, Saudi Arabia during Operation Desert Storm and Desert Shield. His commentary in the March 1993 edition of Archives of Surgery, "Lessons Learned," served as a model for how U.S. Department of Defense trauma personnel are trained today.

Dr. Peggy Knudson, one of Dr. Trunkey's protégés, currently Professor of Surgery at UCSF and Medical Director for the Military Health System (MHS) Strategic-ACS Partnership, recalled his outsized influence on her career: 

"Dr. Donald Trunkey was a father figure to me in my professional life. He encouraged me to dedicate my career to the care of the injured back in the day when trauma surgery as a discipline was still in its infancy. I had the great privilege of traveling and teaching with him across Australia and again in Germany where he worked tirelessly to assure the highest care possible for injured American troops. Trunkey as a figure was larger than life and the news of his passing has saddened the trauma community around the world." 

Dr. Trunkey's presence will be sorely missed. The Department's heartfelt condolences go out to his family, friends, and colleagues. 

Donald Trunkey In The OR

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- by Richard Barg
https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=81384
Thu, 2 May 2019 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=81618 <![CDATA[The Kidney Project Earns Kidneyx Award to Make Home Dialysis Better for Patients]]>

As one of 15 inaugural winners of the KidneyX Redesign Dialysis Phase I competition, announced April 29, 2019 in Washington DC, a team led by UCSF's Shuvo Roy, PhD, and VUMC nephrologist William Fissell, MD, will receive $75,000 to accelerate the development of their proposed implantable dialysis device. More importantly, they will work closely with leadership of the U.S. Food and Drug Administration (FDA), Medicare, and HHS to accelerate the translation of their concept into a patient-ready device. KidneyX will award $500,000 to three teams as part of Phase II of the competition in the spring of 2020.

Roy is a faculty member in the Department of Bioengineering and Therapeutic Sciences, a joint department of the Schools of Pharmacy and Medicine, and a member of UCSF's new Health Innovation via Engineering (HIVE) program.

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- by Levi Gadye and Nicholas Weiler https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=81618
Thu, 25 Apr 2019 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=81449 <![CDATA[Leonardo Ferreira Receives Future of Science Fund Scholarship from Keystone Symposia on Molecular and Cellular Biology]]> UCSF molecular immunologist Leonardo M.R. Ferreira, Ph.D.,@enhancerleo, a postdoctoral scholar in the laboratories of Dr. Qizhi Tang and Dr. Jeffrey Bluestone at UCSF, received a Future of Science Fund Scholarship from the Keystone Symposia on Molecular Biology to attend one of the organization's meetings in Breckenridge, Colorado, on "Uncovering Mechanisms of Immune-Based Therapy in Cancer and Autoimmunity". Keystone Symposia on Molecular and Cellular Biology has a 47-year history of convening open, peer-reviewed conferences that connect the scientific community and accelerate life science discovery.

Dr. Ferreira was also selected to present his work at the program session "Finding a Cure for Cancer". His presentation, "Chimeric Antigen Receptors for Dissecting Treg Biology and Next-gen Treg Therapy", reported on his ongoing work on a new approach to engineering custom-made antigen-specific regulatory T cells as "living drugs" for autoimmune disorders and organ transplant rejection.

Dr. Ferreira's faculty mentors are Qizhi Tang, Ph.D., Professor and Director of the Transplantation Research Laboratory and Tang Lab in the UCSF Department of Surgery, and Jeffrey A. Bluestone, Ph.D., A.W. and Mary Margaret Clausen Distinguished Professor of Metabolism and Endocrinology and Director of the Hormone Research Institute in the Diabetes Center and Sean N. Parker Autoimmune Research Laboratory.

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=81449
Wed, 17 Apr 2019 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=81282 <![CDATA[Winners Announced for Presentations at 32nd Annual J. Engelbert Dunphy Resident Research Symposium]]> The 32nd Annual J. Engelbert Dunphy Resident Research Symposium was held Wednesday, April 17, 2019 at UCSF Medical Center at Mission Bay. The program showcased the laboratory research of residents, fellows, and medical students in the Department of Surgery, and honors the life and accomplishments of J. Engelbert Dunphy, M.D., a legendary surgeon and a former chair of the UCSF Department of Surgery.

This year's J. Engelbert Dunphy Visiting Professor, Dr. Lillian Kao, Professor and Division Chief of Acute Care Surgery at the University of Texas Health Science Center at Houston (UTHealth), delivered a highly engaging keynote presentation titled, "Academic Surgery and the Art of the Pivot."

Symposium Winners 2019

2019 Presentation Winners 

Best Abstract Presentation

Eva Mae Gillis-Buck

"A Role for Aire-Expressing Cells in Maternal-Fetal Tolerance "

Best Abstract Presentation

Quoc-Hung Nguyen, MD

"Fetal Molecular Therapies to Treat Neurological Disease in Mice with Lysosomal Storage Disorders "

Outstanding Abstract Presentation

Greg Haro, MD

"Novel Microtubule and PARP Inhibitor Drug Attenuates Neointimal Hyperplasia in a Rat Model of Arterial Injury"

Outstanding Abstract Presentation

Kelly Mahuron, MD

"Layilin is Enriched in Tumor-Infiltrating CD8+ T Cells in Human Cancer and Contributes to Anti-Tumor Immunity" 

Best Quick-Shot Presentation

Iris Liu

"Deep Immune Profiling of High- vs. Low-Risk Lung Adenocarcinoma"

Best Quick-Shot Presentation

Andrew Wisneski, MD

"Biomechanics of Ascending Thoracic Aortic Aneurysm: Computational Modeling and Pursuit of Wall Stress Based Rupture Risk"

Outstanding Quick-Shot Presentation

Arya Zarinsefat, MD

"An Analysis of Differentially Hydroxymethylated Genes in HIV-Infected Kidney Transplants Undergoing Acute Rejection"

Visit the Resident Research Symposium Page

32nd Annual Resident Research Symposium Program 

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- by Alexi Callen https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=81282
Tue, 16 Apr 2019 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=81564 <![CDATA[Treating Excess of One Hormone Shows Promise for Decreasing the Risk of Obstructive Sleep Apnea]]> Treating the overproduction of one hormone may be a way to help a subset of the millions of Americans who suffer from obstructive sleep apnea, according to a new study.

People with obstructive sleep apnea stop breathing for short periods while they are sleeping, which leads to a poor night's sleep and debilitating fatigue during the day. Most people with the condition need to use dental devices or CPAP (continuous positive airway pressure) machines to sleep at night.

But researchers at UC San Francisco have found that treating a condition in the adrenal glands causing an excess of aldosterone, a hormone that maintains electrolyte balance and blood pressure, may be an effective way to help people reduce the risk of obstructive sleep apnea.

UCSF endocrine surgeons Insoo Suh, MD, and Quan-Yang Duh, MD, didn't set out to study sleep apnea. Suh and Duh specialize in the treatment of primary aldosteronism (also known as Conn's syndrome), a disease in which one or both of the adrenal glands overproduce the hormone aldosterone, and were looking into the question of whether this hormone plays a role in obesity. Obesity is a major factor in obstructive sleep apnea, which meant that many of the surgeons' patients were living with that condition as well.

To his surprise, Suh found that treating patients for excess hormone didn't help their obesity – but did relieve their sleep apnea.

Suh found himself in cluster of interconnected conditions. "There are multiple bidirectional arrows connecting hypertension, obesity, and obstructive sleep apnea," says Suh. "Now we're introducing aldosterone into this equation."

The results of the initial study led him to look into the literature and see if there was any evidence of an independent relationship between aldosterone and obstructive sleep apnea.

"We found that there were small but intriguing studies that suggested a link," says Suh. "Given the prevalence of sleep apnea, it is certainly worth looking into further." Obesity is certainly a primary cause of obstructive sleep apnea, but Suh says the data show there must be other factors at play. "There's a prevalence of about 5 to10 percent for obstructive sleep apnea across cultures and countries, independent of diet, geography, and developmental status of countries," he says. "That points to other causes we haven't identified yet."

The study's initial results indicate that aldosterone might be one factor. If he's right, it could have broad health benefits, helping patients with high blood pressure as well as obstructive sleep apnea.

Until recently, primary aldosteronism was thought to be rather rare, affecting only 1 percent of the population.

"But now, based on bigger population-based studies, we're able to identify a greater number of patients with risk factors for primary aldosteronism and get them referred to an endocrinologist," says Suh.

That has led to much greater awareness of primary aldosteronism, and many more diagnoses.

a photo of an older man and woman sleeping

Primary aldosteronism is the leading cause of secondary hypertension in the U.S. Suh estimates that up to 1 in 20 people with hypertension may have aldosteronism. Depending on the source of excess aldosterone, surgery or blood pressure medications that block aldosterone provide very effective treatments.

"One broader health question here is 'can we identify more cases of aldosteronism by looking at patients with obstructive sleep apnea and high blood pressure?'"  says Suh. And if so, is some fraction of high blood pressure and obstructive sleep apnea the result of a very treatable condition?

Suh is quick to caution that his study was preliminary, drawn largely from comparing information in charts and medical records, and arose from a study that wasn't designed to do a thorough investigation of sleep apnea.

"We're excited by the results and it's in a relatively large number of patients with primary aldosteronism," he says. He's currently designing future studies that would involve sleep studies and other more explicit measures of sleep apnea, and follow patients through treatment to determine outcomes.

"I suspect we'll find a compelling link between primary aldosteronism and obstructive sleep apnea," Suh says. And he hopes that understanding that link will result in identifying more patients with the condition, and help hundreds of thousands of Americans get a better night's sleep.

ABOUT SLEEP APNEA

Sleep apnea is a disorder in which your breathing is interrupted for periods of 10 seconds or more while you are asleep. These interruptions may occur hundreds of times a night, causing you to gasp for air and disrupting your sleep.

There are two main types of sleep apnea:

Obstructive Sleep Apnea
This is the most common type of sleep apnea. It is characterized by an obstruction or narrowing of the nasal passages and throat during sleep. Patients tend to wake up repeatedly to gasp for air.

Central Sleep Apnea
This type of sleep apnea is believed to be related to a malfunction of the brain's normal signal to breathe. The level of carbon dioxide in the blood rises, which may cause you to wake up.

Learn More at UCSF Health

Research Paper

View at Journal of Surgical Research:

Treatment of Primary Aldosteronism Reduces the Probability of Obstructive Sleep Apnea

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- by Robin Marks https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=81564
Sun, 14 Apr 2019 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=81295 <![CDATA[Living Transplant Donors Need Long-Term Monitoring, Too]]> UCSF Researchers Recommend Creation of National Donor Registry

While organ transplant recipients receive continual care as the end-stage treatment to their condition, attention also should be given to living donors, who can suffer from hypertension, diabetes and other disorders after donation, according to a study by researchers at UC San Francisco. 

As reported online April 12, 2019, in JAMA Network Open, by aggregating data from publicly available clinical studies, the researchers found that nearly one in seven kidney donors experienced a potentially adverse event that may be related to their donation.

"Our findings are significant for the transplant community," said co-senior author Minnie Sarwal, MD, PhD, professor of surgery, medicine and pediatrics at UCSF. "We want to encourage donation, yet making the process more transparent for outcomes and safer by improved monitoring for donors, which does not exist long term, also appears to be of critical importance."

Solid organ transplant is the preferred treatment for most end-stage organ diseases, and about 6,000 adults in the United States and 30,000 worldwide are living donors annually. However, some living kidney donors develop postoperative kidney failure and enter the organ donation system as potential recipients on the transplant waiting list, and this group also is at increased long-term risk for cardiovascular and end-stage renal disease, as well as all-cause mortality, compared to matched nondonors eligible to donate.

Sarwal High ResIn the new paper, Sarwal and her colleagues analyzed 20 clinical transplant studies complied between 1963 and 2016 and housed in ImmPort, a clinical and molecular data repository hosted by the National Institute of Allergy and Infectious Diseases, to review 9,558 donors, referring to their final data set as "ImmTransplant." To validate the study's accuracy, they used data collected from 1987 to 2016 and stored in the U.S. national transplant registry maintained by the Organ Procurement and Transplantation Network administered by the United Network for Organ Sharing.

While no recorded events occurred in 85.3 percent of donors, the most common adverse events were hypertension (806 cases, 8.4 percent), diabetes (190, 2 percent), proteinuria (171, 1.8 percent) and lack of bowel movements post-surgery (147, 1.5 percent). Relatively few events (269) occurred in the first two years after donation, and of the 1,746 events occurring from two to 40 years after, 1,575 cases (90.2 percent) were nonsurgical.

U.S. transplant programs are required to follow up with donors for only two years after transplant.

Further, the researchers found that living kidney donors can experience renal or cardiovascular issues that increase their likelihood of renal failure without first experiencing intermediate events. Complications or conditions soon after donation also may not be predictive of long-term renal function or vice versa. As such, long-term systematic renal monitoring and routine regular checkups for living kidney donors is recommended. 

Sarwal said this study supplements ongoing research while a nationwide registry is being established to improve the recruitment, awareness, education and long-term health management of potential living donors, per an initiative launched after a June 2016 White House organ donation and transplant summit.

Demographic characteristics from the study also can provide insights into donation patterns and potential strategies to better inform living donors, said Sarwal, treasurer of The Transplantation Society, an organization whose goal is to provide global leadership in transplantation. 

For example, living kidney donations increase in U.S. women as their age enters the childbearing range (age 25). As kidney donation increases the risk of hypertension and preeclampsia in pregnancies, living donors in this age range should be better informed and counseled. 

"We hope these findings supplement well-informed discourse for living organ donation among potential donors, recipients, clinicians, researchers and the public," said lead author Jieming Chen, PhD, a former postdoctoral researcher at UCSF now with Genentech. "We've curated the transplant datasets in ImmPort as an initial proof of concept of its utility and applications so that the collection, curation and secondary analyses of other publicly available transplant data can be built on."

Authors: Co-senior author Atul Butte, Sanchita Bhattacharya, Marina Sirota and Sunisa Laiudompitak, of UCSF; Henry Schaefer, of ESAC Inc.; and Elizabeth Thomson and Jeff Wiser, Northrop Grumman Information Systems Health IT.

Funding: The research was supported by the National Institute of Allergy and Infectious Diseases (ImmPort contract HHSN316201200036W), National Institute of Diabetes and Digestive and Kidney Diseases (grant R01 DK109720-02), National Library of Medicine (grant K01 LM012381), and Health Resources and Services Administration (contract 234-2005-370011C).

Disclosures: Wiser worked on ImmPort during the study and is currently employed at Medidata Solutions, but no aspect of his employment is related to the work in this manuscript. Sarwal is the founder of KITBio and Organ-I; has performed sponsored research and/or served on the scientific advisory boards for Bristol Myers Squibb, Astellas, Genentech, Immucor, Natera and Nephcure; and is affiliated with The Transplantation Society, American Society of Transplantation, International Pediatric Transplant Association, American Society of Nephrology and National Kidney Foundation. Butte reported grants and personal fees from the National Institutes of Health, the Bakar Family, and Priscilla Chan and Mark Zuckerberg during the study; grants and personal fees from Genentech, and personal fees, consisting of honoraria and travel for scientific talks, from Merck, Eli Lilly and Company, Roche, Pfizer, Bayer, American Academy of Allergy, Asthma and Immunology, American Transplant Congress, The Transplantation Society, United Network for Organ Sharing, and AbbVie outside the submitted work; personal fees from NuMedii, where he is also founder, consultant and shareholder, and where his spouse serves as CEO, outside the submitted work; and he owns shares in Google, Microsoft, Apple, Amazon, Facebook and CVS. 

UC San Francisco (UCSF) is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care. It includes top-ranked graduate schools of dentistry, medicine, nursing and pharmacy; a graduate division with nationally renowned programs in basic, biomedical, translational and population sciences; and a preeminent biomedical research enterprise. It also includes UCSF Health, which comprises three top-ranked hospitals – UCSF Medical Center and UCSF Benioff Children's Hospitals in San FranciscoOakland– as well as Langley Porter Psychiatric Hospital and Clinics, UCSF Benioff Children's Physicians and the UCSF Faculty Practice. UCSF Health has affiliations with hospitals and health organizations throughout the Bay Area. UCSF faculty also provide all physician care at the public Zuckerberg San Francisco General Hospital and Trauma Center, and the SF VA Medical Center. The UCSF Fresno Medical Education Program is a major branch of the University of California, San Francisco's School of Medicine.

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- by Scott Maier https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=81295
Thu, 11 Apr 2019 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=81281 <![CDATA[Resident Research Symposium Headlined by UTHealth Professor Lillian S. Kao Set for April 17th at UCSF Mission Bay]]> Kao - high resThe 32nd Annual J. Engelbert Dunphy Resident Research Symposium will be held Wednesday, April 17, 2019 at UCSF Medical Center at Mission Bay beginning at 8:30 a.m. The Department of Surgery is honored to have UTHealth professor Lillian S. Kao, MD, MS as this year's visiting Dunphy Professor.

The J. Engelbert Dunphy Resident Research Symposium showcases the laboratory research of residents, fellows, and medical students in the Department of Surgery and honors the life and accomplishments of J. Engelbert Dunphy, M.D., a legendary surgeon and a former chair of the UCSF Department of Surgery.

Dr. Lillian Kao is Professor and Division Chief of Acute Care Surgery at McGovern Medical School at the University of Texas Health Science Center at Houston (UTHealth). She is also the Director of the Memorial Hermann Red Duke Texas Trauma Institute. Her interests include quality improvement, dessemination and implementation of research, and development of a learning healthcare system and learning healthcare scholars. Dr. Kao, current president of the Association for Academic Surgery Foundation, is renowned for her work in the field.

Schedule Overview

Wednesday, April 17, 2019

8:30 am - Resident Presentations
2:15 pm - Keynote Presentation
3:30 pm - Awards Presentation

Location

UCSF Medical Center at Mission Bay
Betty Irene Moore Women's Hospital and Bakar Cancer Hospital
1855 4th St.
William and Susan Oberndorf Auditorium (1st floor - Room A1602B)
San Francisco, CA 94158

For More Information

Visit the Resident Research Symposium Page for Complete Details

32nd Annual Resident Research Symposium Program 

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- by Alexi Callen https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=81281
Mon, 1 Apr 2019 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=81581 <![CDATA[ Innovator Q&A: Endocrine Surgeon Insoo Suh, M.D.]]> Insoo Suh, M.D., is Assistant Professor of Surgery at UCSF and Co-Founder of Prescient Surgical. After completing a fellowship in endocrine surgery at UCSF, Dr. Suh particiated in the Stanford University Biodesign Innovation Fellowship program in 2011 before joining faculty at UCSF. We sat down with him to learn more about his journey as a physician-innovator. Tell me about a device you're working on and the problem you're trying to address. Laparoscopy and other minimally invasive techniques have revolutionized our field in so many ways, but there definitely still remains room for improvement.

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- by Stacy Kim https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=81581
Fri, 29 Mar 2019 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=81144 <![CDATA[Department of Surgery Holds Faculty Retreat March 1-2, 2019 at San Francisco Film Center on the Presidio
]]> The Department of Surgery held a faculty retreat on March 1-2, 2019 at the San Francisco Film Center on the Presidio. Faculty took time out from their hectic personal and professional lives to participate. Throughout the event, their enthusiasm, caring, passion for patients, science, education, and service shined.

The event was facilitated by Peter Coughlan, PhD, with support from members of the Better Lab, led by Amanda Sammann, MD, a UCSF trauma surgeon, and Stanford Design Impact. The committee organizing the event also included Syreeta Shepherd, Mike Panion, MBA, Stanley J. Rogers, MD, Sanziana A Roman, MD, and Emily Finlayson, MD, MS.

The keynote speaker for the event was Ken Fulk, "a designer of experiences" renowned for his layered interiors and over-the-top parties. Fulk leads a team of architects, designers, branding and event specialists based in San Francisco and New York.

Mission Statement

The Department of Surgery announced a new departmental mission statement at the retreat:

Transforming surgery through creativity, equity, and community

To showcase the mission, the Department has created a set of fun stickers displaying the mission statement in five color versions that it will be distribute to all divisions.

Stickers 2 28 19 Page 1 Stickers 2 28 19 Page 2 Stickers 2 28 19 Page 3
Stickers 2 28 19 Page 4 Stickers 2 28 19 Page 5  

Faculty Retreat Photo 1

Attendees at 2019 Department of Surgery Retreat at the San Francisco Film Center on the Presidio

Faculty Retreat Photo 2

Tweet From Sanziana Roman

Ken Fulk

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=81144
Fri, 29 Mar 2019 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=81141 <![CDATA[Peter A. Schneider, M.D. Joins Department of Surgery Faculty]]> Schneider 27Mar2019 High Res

We are pleased to announce that Peter A. Schneider, M.D. has joined the Department of Surgery faculty as professor of surgery in the Division of Vascular & Endovascular Surgery. Dr. Schneider received his MD from the Johns Hopkins School of Medicine and completed his general surgery residency and vascular surgery fellowship at the University of California San Francisco.

Dr. Schneider was the founding member and chief of the Division of Vascular Surgery at Kaiser Permanente in Hawaii from 1994-2018. At Kaiser, he developed a Diabetic Limb Treatment Program to improve limb salvage, an aneurysm screening and surveillance program for patients with aneurysms and a registry for patients with carotid disease used for surveillance. He oversaw the development of the first endovascular operating room in the Kaiser system.

Dr. Schneider has served as National Principal Investigator for numerous clinical trials. Over 25 years, he has been a strong proponent of clinical research in vascular disease and has participated extensively in trial design, oversight, core lab analysis, events committees, data analysis, follow up, presentation, and publication. This includes pioneering procedures in several first-in-human trials. He has performed and taught surgery in a dozen other countries.

Dr. Schneider is a Fellow of the American College of Surgeons, Distinguished Fellow of the Society for Vascular Surgery, Fellow of the International Society of Vascular Surgery, a past president of Western Vascular Society and has authored several textbooks including Endovascular Skills, the 4th edition, to be published later this year. 

Please join us in warmly welcoming Dr. Schneider to our Department!

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=81141
Wed, 27 Mar 2019 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=81101 <![CDATA[Julius Guccione, Jr., PhD Inducted into American Institute for Medical and Biological Engineering (AIMBE) College of Fellows]]> Julius Guccione, Jr., Ph.D., Professor of Surgery and Co-Director of the UCSF Cardiac Biomechanics Lab, was inducted into the American Institute for Medical and Biological Engineering (AIMBE) College of Fellows at its annual meeting in Washington, DC, on March 25, 2019. Guccione was one of four UCSF faculty members inducted this year. Comprised of just the top two percent of engineers in the field, election to the AIMBE College of Fellows is among the highest professional distinctions accorded to medical and biological engineers.

Guccione's research focuses on the development of devices for treating heart failure using 3D modeling and simulation. As a bioengineer, he has played a critical role in collaborating with clinicians to bring novel surgical procedures to patients, such as the 3D Living Heart Project. He also serves as a research mentor for the department's NIH-funded Biodevice Innovation training program for research residents, and as a faculty adviser for UCSF Surgical Innovations.

Guccione was nominated, reviewed, and elected by peers and members of the College of Fellows for his outstanding contributions to the development, validation, and dissemination of a unified foundation for cardiovascular in silico medicine.

Julius Guccione Jr Receiving Award

Butte, Guccione, Kortemme, and Link Inducted Into American Institute for Medical and Biological Engineering (Precision Medicine at UCSF)

Julius Guccione, Jr. Inducted into Medical and Biological Engineering Elite (Official AIMBE Press Release) 

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- by Stacy Kim https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=81101
Mon, 25 Mar 2019 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=81081 <![CDATA[Hillary Braun, MD Awarded Prestigious Resident Research Scholarship by American College of Surgeons (ACS)]]> Hillary Braun, MD, a third-year (PGY-3) general surgery resident at UCSF, has been awarded a prestigious two-year resident research scholarship by the American College of Surgeons for 2019-2021. The scholarships are supported by the generosity of Fellows, Chapters, and friends of the College, to encourage residents to pursue careers in academic surgery. 

Dr. Braun's research will focus on  the impact of domestic and international travel for transplantation on disparities in U.S. solid organ transplantation with the goal of generating data to inform national policy around these issues. 

Dr. Braun has had an extremely productive career, having already co-authored 38 Resident Publications, 94 Posters & Oral Presentations and written individual Book Chapters in five medical treatises. She has also received numerous grant funding awards.

Dr. Braun credits her mentors, Nancy L. Ascher, M.D., Ph.D.Peter G. Stock, M.D., Ph.D., John P. Roberts, M.D. and Ryutaro Hirose, M.D., as having had a major impact on her career as well as the faculty, staff, and fellows in the division of transplant who have been exceptionally supportive throughout her entire time at UCSF.

Research Project Summary

The purpose of my research project is to characterize the impact of domestic and international travel for transplantation on the organ transplant system in the United States (US). Each year in the US, more than 30,000 solid organ transplants are performed, but the demand for organs continues to outpace the supply, and as a result, nearly 7000 people die each year awaiting transplant. Organs are allocated according primarily to disease severity (liver) and waiting time (kidney) and are distributed within arbitrary geographic regions in the US.

Patients awaiting transplant, therefore, face different waiting times according to the area of the country in which they reside. Patients who have the means to travel - either within the US or from foreign countries to the US - are technically permitted to do so, but it is hypothesized that their presence may cause increased competition within regions and detrimentally impact the wait-listed patients who do not have the luxury of mobility.

In the U.S., as many as 10% of individuals listed for kidney or liver transplantation travel to regions outside of their home region where it is perceived they may have a better chance at a more timely transplant. International travelers, referred to as non-citizen, non-residents (NCNR), make up approximately 2% of the transplant population each year, but the amount of transplants performed in these patients is highly variable according to region.

The proposed study will utilize data available from the United Network for Organ Sharing (UNOS) and the Scientific Registry of Transplant Recipients (SRTR). These organizations provide comprehensive demographic and outcomes data on organ donors, transplant candidates, and transplant recipients. The research will address three primary aims in both liver and kidney transplant populations:

  1. Compare demographics of domestic travelers, international travelers, and non-traveler patients
  2. Compare outcomes of domestic travelers, international travelers, and non-traveler patients
  3. Determine the impact of domestic and NCNR travelers on wait-listed transplant candidates in the Destination regions.

The overall goal is to generate data to inform national policy around domestic and international travel for transplantation.

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=81081
Fri, 22 Mar 2019 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=81071 <![CDATA[Department of Surgery Has Strong Presence at Northern California ACS Meeting 2019]]> Acs NorcalThe UCSF Department of Surgery had a strong presence at the annual educational meeting of the Northern California American College of Surgeons held on March 15-16, 2019 at the Claremont Hotel Club and Spa in Berkeley, CA. Department faculty moderated numerous panel discussions and learners were selected for podium presentations based on their submission of high-quality research abstracts.

UCSF general surgery residents  Andrew Wisneski and Anamaria Robles had amongst the highest scoring abstracts, landing them as finalists in the basic science category of the 4th Annual Thomas R. Russell Surgical Trainee Abstract Competition. Jhoanne Bautista, a resident research fellow, and Joel Ramirez, a fourth-year medical student and rising vascular intern, delivered quick-shot presentations. 

UCSF East-Bay residents Genna Beattie, MD, Caitlin Cohan, MD, and Sora Ely, MD, also had amongst the highest scoring abstracts, landing them as finalists in the 4th Annual Thomas R. Russell Surgical Trainee Abstract Competition. Kara Rothenberg, MD, and Sora Ely, MD, delivered quick-shot presentations. UCSF-East general surgery residents Sean Curran, MD, Katherine Stern, MD, and Maggie Brooke, MD, held their own representing UCSF-East Bay in the Lap Bowl Resident Team Surgical Skill Competition.

UCSF General Surgery Residency (San Francisco)

Jhoanne Bautista Joel Ramirez

UCSF-Eastbay General Surgery Residency


Table of UCSF Participants

Name

UCSF Position

Presentation/Involvement

Anamaria Robles

Resident

Russell Competition Finalist; "The impact of pro-inflammatory states on the fibrin-platelet balance following injury."

Andrew Wisneski

Resident

Russell Competition Finalist: "Biomechanics of ascending thoracic aortic aneurysm: Pursuit of wall stress based rupture risk."

Genna Beattie

Resident

East-Bay

Russell Competition Finalist: "Predicting Respiratory Distress Sydrome in Sever Blunt Trauma: The Utility of Interleukin-18."

Caitlin Cohan

Resident

East-Bay

Russell Competition Finalist: "Impact of Phosphatidylserine Bloack on Organ Dysfunction in Hemorrhagic Shock."

Sora Ely

Resident

East-Bay

Russell Competition Finalist: "Benefit of Preoperative Antibiotic Use in Outpatient Cholecystectomy may not Outweigh Risks."

Jhoanne Bautista

Resident

Quick shot presentation; "Using scRNA sequencing to direct engineering of the human neo-thymus from stem cells."

Joel Ramirez

M4/rising vascular intern

Quick shot presentation; "Depression predicts non-home discharge after abdominal aortic aneurysm repair."

Kara Rothenberg

Resident East-Bay

Quick shot presentation; "Interaction of Frailty and Postoperative Complications on Unplanned Readmission following Elective Outpatient Surgery."

Sora Ely

Resident East-Bay

Quick shot presentation; "Trends in Lung Cancer Resection Preoperative Workup after Thoracic Surgery Regionalization."

Sean Curran
Katherine Stern
Maggie Brooke

Residents East-Bay

UCSF-East Bay Team - 3rd Biennial Lap Bowl: Resident Team Surgical Skills Competition

Wen T. Shen

Faculty

Committee Chair for District 1, NorCal ACS, interviewed applicants for FACS

Kelley Bullard

Faculty East-Bay

District 1, NorCal ACS, interviewed applicants for FACS

Tammy Chang

Faculty

Chair and Moderator of Thomas Russell Trainee Abstract Competition

Rebecca Plevin

Faculty

Panelist, "Patient initiated conflict panel discussion: Strategies for residents and faculty"

Andre Campbell

Faculty

Panelist, "Diversity and inclusion in surgery- The return on investment."

Jonathan Carter

Faculty

Panelist, "Metabolic & Bariatric Surgery Accreditation & Quality Improvement Program"

Barnard Palmer

Faculty East-Bay

Moderator and Panelist, "Resident Wellness Programs"

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=81071
Mon, 18 Mar 2019 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80973 <![CDATA[Amar Nijagal, MD Awarded Franklin H. Martin, MD, FACS Faculty Research Fellowship from American College of Surgeons]]> Pediatric surgeon-scientist Amar Nijagal, M.D., Assistant Professor in the Division of Pediatric Surgery, has been awarded the 29th Franklin H. Martin, MD, FACS Faculty Research Fellowship from the American College of Surgeons. His research will study the role of neutrophils and monocytes during the initiation and resolution of neonatal liver inflammation.  

Dr. Nijagal's laboratory is focused on the immune regulation of liver development and perinatal liver inflammation.  Using an infectious model of neonatal liver inflammation, Dr. Nijagal's group has made the striking observation that the depletion of either neutrophils or inflammatory monocytes (iMos) results in worse survival of infected neonatal mice; the depletion of both populations, however, rescues mice from liver injury and death. Based on these preliminary data, Dr. Nijagal and his team hypothesize that neutrophils and monocytes work in concert to regulate neonatal inflammation and tissue repair. This line of investigation has direct implications for biliary atresia, a devastating neonatal cholangiopathy that can lead to liver fibrosis and liver failure within a matter of months. 

Dr. Nijagal's research is supported by American Pediatric Surgical Association and his mentors, Jackie Maher, MD, William and Mary Ann Rice Memorial Distinguished Professor of Medicine, and Chief of the Division of Gastroenterology at ZSFGH, AND Cliff Lowell, MD PhD, Professor and Chair of the Department of Laboratory Medicine at UCSF.

 

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80973
Fri, 15 Mar 2019 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80903 <![CDATA[Department of Surgery Welcomes New Class of Plastic Surgery Residents on Match Day 2019]]> The UCSF Plastic Surgery Residency Program welcomes our new residents. The class of 2027 is comprised of three outstanding women, ready to embark on their surgical journey. We are incredibly proud of our new residents and all of their accomplishments. We hope to empower them during their time here at UCSF and we're excited to see them grow into remarkable surgeons.  They're all exceptional and will be an amazing addition to our team.   

UCSF Department Of Surgery
PGY-1 Categorical Plastic Surgery Residents (2019-20)

Jodi LapidusNisha Parmeshwar Micaela Rosser

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80903
Fri, 15 Mar 2019 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80865 <![CDATA[Department of Surgery Welcomes New Class of General Surgery Residents on Match Day 2019]]> The Department of Surgery warmly welcomes our eight new general surgery categorical residents comprising the Class of 2026. We congratulate this diverse, highly accomplished group for matching into our program. We look forward to the arrival of our new intern class in June and are honored to be part of their journey as they train to become future leaders in academic surgery.  

UCSF Department Of Surgery
PGY-1 Categorical General Surgery Residents (2019-20)

Brian, RileyChu, Simon Decker, Hannah Godier-Furnemont, Amandine Sorrentino, ThomasStephens, Caroline Trang, Karen Wang, Jane

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- by Rachelle Bresnahan and Alexi Callen https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80865
Fri, 15 Mar 2019 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80886 <![CDATA[Department of Surgery Welcomes New Class of UCSF-East Bay General Surgery Residents on Match Day 2019]]> The General Surgery Residency Program at UCSF-Eastbay is proud to welcome our seven new general surgery categorical residents comprising the Class of 2026. Congratulations to this group of exceptional physicians for matching with us in Oakland. We are thrilled for their arrival in June and feel privileged to embark with them on their journey towards successful careers in surgical leadership.  

UCSF East-Bay Surgery Program
PGY-1 Categorical General Surgery Residents (2019-20)

Nathan AlcasidPhillip Brennan Jessica Dzubnar Hyunjee Kwak Valerie MaiKirea Mazzolini Cynthia Susai

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80886
Fri, 8 Mar 2019 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80853 <![CDATA[The Muriel Steele Society Invites You to Celebrate International Women's Day at UCSF]]> Mss GraphicThe Muriel Steele Society invites you to celebrate International Women's Day at UCSF by recognizing our fantastic women surgeons and supporting initiatives that help us achieve gender equity that enable all of us to excel. 

To stimulate frank discussions about gender parity, inclusion and diversity, we'd like to share the lecture of Joan Reede, MD, MS, MPH, MBA, delivered at the American College of Surgeons (ACS) Clinical Congress in 2018. 

Olga M. Jonasson, MD, Lecture: A path toward diversity, inclusion, and excellence | The Bulletin 

Each time a woman stands up for herself, without knowing it possibly, without claiming it, she stands up for all women.

-----Maya Angelou


Iwd 2019 Mss Copy



Madhulika Varma - 144x

Madhulika G. Varma MD
Professor and Chief
Section of Colorectal Surgery
University of California San Francisco
Co-chair, Muriel Steele Society




Kornblith, LucyLucy Zumwinkle Kornblith, MD
Assistant Professor in Residence, Department of Surgery
Trauma & Surgical Critical Care
Zuckerberg SF General Hospital
University of California San Francisco
Co-chair, Muriel Steele Society

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80853
Tue, 26 Feb 2019 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80799 <![CDATA[Aaron R. Jensen, M.D., MEd, FACS, FAAP Joins Department of Surgery Faculty]]> Jensen Aaron 08 07 15We are pleased to announce that pediatric and trauma surgeon Aaron R. Jensen, M.D., MEd, FACS, FAAP has joined the Department of Surgery faculty as an assistant professor and Associate Director of the Pediatric Surgery Fellowship. Dr. Jensen will be based at UCSF Benioff Children's Hospital Oakland, where he will serve as Associate Trauma Medical Director.  Dr. Jensen trained at the University of Washington in General Surgery prior to completing fellowships in Pediatric Surgery, Minimally Invasive Surgery, and Surgical Critical Care at the Children's Hospital Los Angeles.  

Dr. Jensen's research is focused on decreasing the impact of injury in children and includes development and evaluation of injury prevention programs, trauma epidemiology, outcomes research related to critical treatments, and innovative approaches to using simulation-based training to improve teamwork during trauma resuscitation. Dr. Jensen is an NIH-funded Principal Investigator who has also received funding from the Eastern Association for the Surgery of Trauma (EAST). 

Dr. Jensen has been recognized by the American College of Surgeons through his selection to the Future Trauma Leaders program. He participates nationally in trauma quality improvement initiatives to improve trauma care for children in the U.S. and has been nationally recognized for his outstanding teaching and educational research activities. 

Please join us in congratulating Dr. Jensen on his appointment and in welcoming him to UCSF!

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80799
Tue, 26 Feb 2019 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80745 <![CDATA[Arya Zarinsefat, M.D. Recipient of Prestigious UCSF-Gladstone Center For AIDS Research (CFAR) Mentored Scientist Award]]> Arya Zarinsefat, M.D., a UCSF general surgery resident and research fellow in the Sarwal Lab, has been awarded a prestigious UCSF-Gladstone Center For AIDS Research (CFAR) Mentored Scientist Award.  Dr. Zarinsefat's research will focus on better understanding the genes and process of rejection in kidney transplantation of HIV-infected recipients. The study will apply an innovative method of discovering rejection in HIV-infected kidney transplants by performing DNA cytosine methylation sequencing of plasma samples of individuals with rejection.

Methyl-Seq is a novel next-generation sequencing method that utilizes restriction enzymes involved with cleavage of methylated DNA sites. These digested DNA are then sequenced and analyzed for methylated sequence reads. Methylated DNA has long been known to be an epigenetic marker for gene expression. In addition, this technology does not utilize assessment of peripheral blood mononuclear cells, which can be variably affected by the underlying HIV state and concomitant antiviral and immunosuppressive medications.

The hypothesis is that HIV-infected kidney transplant recipients with rejection will have a unique genetic signature in comparison to patients without rejection. This novel sequencing methodology will be utilized to better understand and map the genes involved with this process.

Dr. Zarinsefat is being co-mentored by Dr. Minnie Sarwal (expertise in sequencing and biomarker development), and Dr. Peter Stock (transplant surgery in HIV positive recipients) who has tapped him to establish a university-wide database of all HIV-infected transplant recipients, and to follow their long term outcomes. 

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80745
Tue, 26 Feb 2019 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80803 <![CDATA[Leonardo Ferreira, Ph.D. Recipient of Jeffrey G. Klein Family Diabetes Fellowship for Study of Engineered Regulatory T Cells]]> UCSF molecular immunologist Leonardo M.R. Ferreira, Ph.D.,@enhancerleo, a postdoctoral scholar in the laboratories of Dr. Qizhi Tang and Dr. Jeffrey Bluestone at UCSF, has been awarded the 2019 Jeffrey G. Klein Family Diabetes Fellowship to study engineered regulatory T cells (Tregs). 

The proposal, titled "Designing next-generation regulatory T cell therapies for type 1 diabetes",supports translational immunology research in type 1 diabetes (T1D). Specifically, Dr. Ferreira will investigate design principles, mechanisms, and associated function of chimeric antigen receptor-modified Tregs (CAR Tregs). CAR technology has greatly expedited the generation of antigen-specific T cells for cancer therapy (CAR T cells). A CAR consists of an antigen-binding domain linked to a signaling domain, driving T cell activation upon target recognition. Tregs limit unwanted and excessive immune responses, minimizing damage to healthy tissues. The proposed work will dissect the requirements of repurposing CAR technology to generate antigen-specific Tregs.

The proposal addresses a major gap in understanding CAR Tregs and will form the basis for developing cell-based treatments for T1D and other disorders caused by unwanted immune reactivity.

About Dr. Leonardo Ferreira

Molecular immunologist Leonardo M.R. Ferreira, PhD is a Postdoctoral Scholar in the UCSF Department of Surgery, Transplant Research Laboratory, and in the UCSF Diabetes Center, Sean N. Parker Autoimmune Research Laboratory. Dr. Ferreira completed his PhD at Harvard University, and has since moved to UCSF to complete his postdoctoral training in immunology. Currently, Dr. Ferreira is working towards developing designer cell therapies to establish immune tolerance in autoimmune disease and transplant rejection.

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80803
Tue, 26 Feb 2019 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80806 <![CDATA[CRISPR Gene Editing Makes Stem Cells 'Invisible' to Immune System]]> Technique Prevents Transplant Rejection in the Lab, a Major Advance for Stem Cell Therapies 

Human heart muscle.Human heart muscle cells derived from triple-engineered stem cells that are "invisible" to the immune system. The red is troponin, a protein that participates in cardiac muscle contraction. The blue is the cell's nucleus. Researchers hope cells like these will eventually be used to treat heart failure. Credit: Xiaomeng Hu.


UC San Francisco scientists have used the CRISPR-Cas9 gene-editing system to create the first pluripotent stem cells that are functionally "invisible" to the immune system, a feat of biological engineering that, in laboratory studies, prevented rejection of stem cell transplants. Because these "universal" stem cells can be manufactured more efficiently than stem cells tailor-made for each patient – the individualized approach that dominated earlier efforts – they bring the promise of regenerative medicine a step closer to reality. 

"Scientists often tout the therapeutic potential of pluripotent stem cells, which can mature into any adult tissue, but the immune system has been a major impediment to safe and effective stem cell therapies," said Tobias Deuse, M.D., the Julien I.E. Hoffman, MD, Endowed Chair in Cardiac Surgery at UCSF and lead author of the new study, published Feb. 18 in the journal Nature Biotechnology.

The immune system is unforgiving. It's programmed to eradicate anything it perceives as alien, which protects the body against infectious agents and other invaders that could wreak havoc if given free rein. But this also means that transplanted organs, tissues or cells are seen as a potentially dangerous foreign incursion, which invariably provokes a vigorous immune response leading to transplant rejection. When this occurs, donor and recipient are said to be – in medical parlance – "histocompatibility mismatched."

UCSF 20170710 Space 178A

"We can administer drugs that suppress immune activity and make rejection less likely. Unfortunately, these immunosuppressants leave patients more susceptible to infection and cancer," explained Professor of Surgery Sonja Schrepfer, M.D., Ph.D. the study's senior author and director of the UCSF Transplant and Stem Cell Immunobiology (TSI) Lab at the time of the study.

In the realm of stem cell transplants, scientists once thought the rejection problem was solved by induced pluripotent stem cells (iPSCs), which are created from fully-mature cells – like skin or fat cells – that are reprogrammed in ways that allow them to develop into any of the myriad cells that comprise the body's tissues and organs. If cells derived from iPSCs were transplanted into the same patient who donated the original cells, the thinking went, the body would see the transplanted cells as "self," and would not mount an immune attack.

But in practice, clinical use of iPSCs has proven difficult. For reasons not yet understood, many patients' cells prove unreceptive to reprogramming. Plus, it's expensive and time-consuming to produce iPSCs for every patient who would benefit from stem cell therapy. 

"There are many issues with iPSC technology, but the biggest hurdles are quality control and reproducibility. We don't know what makes some cells amenable to reprogramming, but most scientists agree it can't yet be reliably done," Deuse said. "Most approaches to individualized iPSC therapies have been abandoned because of this." 

Deuse and Schrepfer wondered whether it might be possible to sidestep these challenges by creating "universal" iPSCs that could be used in any patient who needed them. In their new paper, they describe how after the activity of just three genes was altered, iPSCs were able to avoid rejection after being transplanted into histocompatibility-mismatched recipients with fully functional immune systems.

"This is the first time anyone has engineered cells that can be universally transplanted and can survive in immunocompetent recipients without eliciting an immune response," Deuse said.

The researchers first used CRISPR to delete two genes that are essential for the proper functioning of a family of proteins known as major histocompatibility complex (MHC) class I and II. MHC proteins sit on the surface of almost all cells and display molecular signals that help the immune system distinguish an interloper from a native. Cells that are missing MHC genes don't present these signals, so they don't register as foreign. However, cells that are missing MHC proteins become targets of immune cells known as natural killer (NK) cells.

Lewis Lanier, PhD, study co-author.Lewis Lanier, PhD, study co-author.

Working with professor Lewis Lanier, PhD – study co-author, chair of UCSF's Department of Microbiology and Immunology, and an expert in the signals that activate and inhibit NK cell activity – Schrepfer's team found that CD47, a cell surface protein that acts as a "do not eat me" signal against immune cells called macrophages, also has a strong inhibitory effect on NK cells. 

Believing that CD47 might hold the key to completely shutting down rejection, the researchers loaded the CD47 gene into a virus, which delivered extra copies of the gene into mouse and human stem cells in which the MHC proteins had been knocked out. 

CD47 indeed proved to be the missing piece of the puzzle. When the researchers transplanted their triple-engineered mouse stem cells into mismatched mice with normal immune systems, they observed no rejection. They then transplanted similarly engineered human stem cells into so-called humanized mice – mice whose immune systems have been replaced with components of the human immune system to mimic human immunity – and once again observed no rejection.

Additionally, the researchers derived various types of human heart cells from these triple-engineered stem cells, which they again transplanted into humanized mice. The stem cell-derived cardiac cells were able to achieve long-term survival and even began forming rudimentary blood vessels and heart muscle, raising the possibility that triple-engineered stem cells may one day be used to repair failing hearts.

"Our technique solves the problem of rejection of stem cells and stem cell-derived tissues, and represents a major advance for the stem cell therapy field," Deuse said. "Our technique can benefit a wider range of people with production costs that are far lower than any individualized approach. We only need to manufacture our cells one time and we're left with a product that can be applied universally." 

Authors: Additional authors on the paper include Xiaomeng Hu (co-first author), Alessia GravinaDong Wang and Grigol Tediashvili of UCSF, University Heart Center Hamburg, Cardiovascular Research Center Hamburg and the German Center for Cardiovascular Research; Victor J. Garcia of the University of North Carolina School of Medicine; and Mark M. Davis of Stanford University and the Howard Hughes Medical Institute. Lewis Lanier is the American Cancer Society Professor and Chair in the Department of Microbiology and Immunology; the J. Michael Bishop, MD, Distinguished Professor in Microbiology and Immunology; and director of the Parker Institute for Cancer Immunotherapy at UCSF.

Funding: Research was supported by grants from the Deutsche Forschungsgemeinschaft, the Fondation Leducq, the Max Kade Foundation, the California Institute for Regenerative Medicine, the National Institutes of Health and the Parker Institute for Cancer Immunotherapy. 

Conflicts: The authors declare no competing financial interests. 

UC San Francisco (UCSF) is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care. It includes top-ranked graduate schools of dentistry, medicine, nursing and pharmacy; a graduate division with nationally renowned programs in basic, biomedical, translational and population sciences; and a preeminent biomedical research enterprise. It also includes UCSF Health, which comprises three top-ranked hospitals – UCSF Medical Center and UCSF Benioff Children's Hospitals in San Francisco and Oakland – as well as Langley Porter Psychiatric Hospital and Clinics, UCSF Benioff Children's Physicians and the UCSF Faculty Practice. UCSF Health has affiliations with hospitals and health organizations throughout the Bay Area. UCSF faculty also provide all physician care at the public Zuckerberg San Francisco General Hospital and Trauma Center, and the SF VA Medical Center. The UCSF Fresno Medical Education Program is a major branch of the University of California, San Francisco's School of Medicine.

Reprinted with Permission from UCSF News Services

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- by Jason Alvarez (UCSF News Services)
https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80806
Mon, 25 Feb 2019 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80790 <![CDATA[Department of Surgery Has Banner Year at 2019 Pacific Coast Surgical Association Meeting]]> Kp1xck4l 400X400The UCSF Department of Surgery had a banner year at the Pacific Coast Surgical Association (PCSA) annual meeting in Tuscon, Arizona on February 15-18, 2019

Seven department faculty were voted in as active members:

  • Jade Hiramoto
  • Elizabeth Wick
  • Carter Lebares
  • Rita Mukhtar
  • Amar Nijagal
  • Ankit Sarin
  • Aaron Jensen

Our UCSF faculty and learners were also recognized for their outstanding research, with a number of abstracts being chosen for podium presentations, several garnering awards.* Our medical student, Norah Liang, mentored by Dr. Lan Vu, of Pediatric Surgery, won her award competing with residents and fellows, making this achievement all the more impressive. Dr. Whitney Goering was awarded the "Resident Prize for Northern CA Caucus" and received the 2nd Place Resident Prize for the PCSA overall. Dr. Aaron Jensen won the PSCA New Member Prize.

Quan DuhThis was a banner year for UCSF (especially for UCSF women) nominated and accepted as new members and selected for podium presentations and awards, continuing the long tradition of UCSF's active involvement in and recognition of excellence at PCSA.  

--- Quan-Yang Duh, M.D., Past President, Pacific Coast Surgical Association.

NameUCSF PositionPaper / Podium Presentation
Tasce Bongiovanni Fellow Introducing Complementary Alternative Medicine in the Intensive Care Unit: Are providers ready?
Whitney Goering * Fellow The Importance of Operative Team Expertise - the Presence of a Dedicated Specialty Nurse analysis of 11,005
(Awarded Resident Prize for Northern CA Caucus)
Received the 2nd Place Resident Prize for the PCSA overall
Monica Jain Fellow A Model for Institutional Adoption of Innovative Surgical Techniques
Aaron Jensen * Faculty Parenteral Nutrition Prolongs Hospital Stay in Children with Non-Operative Blunt Pancreatic Injury: A Propensity-Matched Analysis - (Awarded PSCA New Member Prize)
Elizabeth Lancaster Resident Opioids and Endocrine Surgery: None Might Be Better than Some

Norah Liang

Student Predicting Respiratory Infections In Children With Congenital Cystic Lung Lesions Using Computed Tomography Imaging
Norah Liang * Student Diaphragmatic Excursion on Ultrasound is Associated with Respiratory Outcomes Following Repair of Congenital Diaphragmatic Hernia (Awarded "Mini-Podium Award")
Anne Stey Fellow Predictors of Tracheostomy Timing in Critically Injured Patients
Michael Zobel Resident Surgical Management of Children with Hypoglycemia due to Congenital Hyperinsulinism or Insulinoma



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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80790
Wed, 13 Feb 2019 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80733 <![CDATA[Department of Surgery Shines at Academic Surgical Congress 2019 Highlighted by Three Prestigious Individual Awards]]> The UCSF Department of Surgery was among the strong performers at the 14th Annual Academic Surgical Congress held in Houston, Texas on February 5-7, 2019, placing sixth in quality scores among academic medical centers that submitted at least 10 abstracts and three prestigious awards.

The Association for Academic Surgery is the world's largest organization dedicated exclusively to the promotion of surgical research. The Association for Academic Surgery and Society of University Surgeons host the yearly Academic Surgical Congress, the premier gathering place for young surgeon-scientists in academic surgery. 

Nguyen, Quoc-Hung (Key)Quoc-Hung "Key" Nguyen, MD, a UCSF general surgery resident and a research fellow in the basic science lab of Tippi MacKenzie, M.D., was awarded the AAS Outstanding Resident Research Award in the category, Basic Science, for his abstract, "In Utero Enzyme Replacement Therapy in Sly Syndrome Penetrates Blood-Brain Barrier and Induces Long-Term Immunologic Tolerance". His abstract earned the highest score among 294 submitted in this category.  Dr. Nguyen was also selected as the winner of the AAS Outstanding Resident/Fellow Presentation Award as a result of winning a resident and fellow quickshot competition among plenary presenters who were invited to compete.

Simon ChuSimon N. Chu, M.S., a 4th Year UCSF medical student and a Howard Hughes Medical Institute Research Fellow in the laboratory of Qizhi Tang, Ph.D., was awarded the 2019 Association for Academic Surgery Outstanding Medical Student Award. Chu is co-mentored by transplant surgeon Peter G. Stock, M.D., Ph.D.  Chu's talk, entitled "Immunologic Profiling of Rejection Risk in HIV-Positive Solid Organ Transplant Recipients," was selected by a panel of judges comprising the past-presidents of the AAS as the winner of this prestigious award.  

"This conference was a wonderful opportunity to showcase the work of our amazing residents and students."  --- Tippi MacKenzie, M.D.

A Strategic Push to Underwrite Resident Research Travel

The  Department has recently expanded resident research travel budgets, an initiative intended to enable general surgery and plastic surgery residents to share their research, with a key focus on presenting at three major national and regional surgical conferences: the Academic Surgical Congress, the American College of Surgeons, and the Pacific Coast Surgical Association.  

Aas Logo 400X400

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80733
Wed, 13 Feb 2019 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80731 <![CDATA[Quoc-Hung "Key" Nguyen, MD Receives Two Prestigious Research Awards from Association for Academic Surgery]]> Quoc-Hung "Key" Nguyen, MD, a UCSF general surgery resident and a research fellow in the basic science laboratory of Tippi MacKenzie, M.D., received two prestigious awards at the 14th Annual Academic Surgical Congress held in Houston, Texas on February 5-7, 2019. His participation was underwritten by the Department of Surgery Resident Travel Fund, recently established by the Department to promote excellence in resident research and participation in major surgical conferences.

Dr. Nguyen's abstract, "In Utero Enzyme Replacement Therapy in Sly Syndrome Penetrates Blood-Brain Barrier and Induces Long-Term Immunologic Tolerance" was ranked in the top 1% of all 1609 abstracts accepted, meriting its selection as a plenary presentation at the conference.

Dr. Nguyen was also awarded the AAS Outstanding Resident Research Award in the category of Basic Science for the abstract, which earned the highest score  among the 294 submitted in this category.  Dr. Nguyen was also selected as the winner of the AAS Outstanding Resident/Fellow Presentation Award by virtue of winning a resident and fellow quickshot competition among plenary presenters who were invited to compete. He received both awards at a formal ceremony on February 7th

Tippi MacKenzie - 144b_padilla.jpgDr. Nguyen's research interests, which include fetal molecular diagnosis and therapy with a focus on rare and fatal diseases such as Sly Syndrome, are funded by a T32 grant from the Center for Reproductive Sciences. Dr. Nguyen has been fortunate to have several influential mentors, Dr. Tippi Mackenzie as a scientific mentor, and Dr. Benjamin Padilla as a clinical mentor. 


"Dr. Nguyen has been an instrumental member of my lab over the last 2 years, and has generated exciting data with the potential to advance the field of fetal molecular therapy.  He is a promising young surgeon scientist with a bright career in academic pediatric surgery ahead of him."  --- Tippi MacKenzie, M.D.

About the Association for Academic Surgery

The Association for Academic Surgery is the world's largest organization dedicated exclusively to the promotion of surgical research. The Association for Academic Surgery and Society of University Surgeons host the yearly Academic Surgical Congress, the premier gathering place for young surgeon-scientists in academic surgery. 

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80731
Wed, 13 Feb 2019 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80708 <![CDATA[Simon N. Chu, M.S. Recipient of Association for Academic Surgery Outstanding Medical Student Award]]> Simon N. Chu, M.S., a 4th Year UCSF medical student and a Howard Hughes Medical Institute Research Fellow in the laboratory of Qizhi Tang, Ph.D., has been awarded the 2019 Association for Academic Surgery Outstanding Medical Student Award at the 14th Annual Academic Surgical Congress held in Houston, Texas on February 5-7, 2019. Chu is co-mentored by transplant surgeon Peter G. Stock, M.D., Ph.D. Chu is also a member of the PRIME Program in Medicine for the Urban Underserved.

Chu was selected to compete in the Association's national medical student oral abstract presentation competition. Competitors were invited based on their submission as one of the top-10 scoring abstracts of the conference. Chu's talk, entitled "Immunologic Profiling of Rejection Risk in HIV-Positive Solid Organ Transplant Recipients," was selected by a panel of judges comprising the past-presidents of the AAS as the winner of this prestigious award. 

Simon Chu Ataascjpg


Chu's research in the Transplantation Research Laboratory focuses on improving the safety and efficacy of solid-organ transplantation in persons living with HIV. People living with HIV have a higher incidence of morbidities from several conditions, including end-stage liver disease. While HIV infection was once considered an absolution contraindication for transplantations, surgeons at UCSF led the first large multi-site clinical trial of transplantation in people with HIV, opening the door for life-saving transplants in this patient population. However, HIV+ transplant recipients were found to have a 2-3 fold higher rejection rate compared to individuals without the virus.

Aiming to better understand this unexpected phenomenon, Chu identified immunological correlates and biological pathways responsible for enhanced acute cellular rejection in HIV+ recipients. These findings offer a window to understanding the complex immune system of HIV+ transplant recipients and may aid in the development of new immunosuppression strategies.  

About the Association for Academic Surgery

The Association for Academic Surgery is the world's largest organization dedicated exclusively to the promotion of surgical research. The Association for Academic Surgery and Society of University Surgeons host the yearly Academic Surgical Congress, the premier gathering place for young surgeon-scientists in academic surgery. 

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80708
Mon, 4 Feb 2019 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80694 <![CDATA[Emily Finlayson, MD, MS, FACS, Named Vice Chair for Faculty Affairs and Development in the UCSF Department of Surgery]]> We are pleased to announce that Emily Finlayson, M.D., M.S., FACS, professor of Surgery, Medicine (Geriatrics), and Health Policy at the University of California San Francisco has been named the new Vice Chair for Faculty Affairs and Development in the Department of Surgery. Dr. Finlayson received her MD at Harvard Medical School and MS from the Center for Evaluative Clinical Sciences at Dartmouth Medical School. She completed her general surgery residency at UCSF and her fellowship in colorectal surgery at the Mayo Clinic. Her NIH-funded work includes population-based analyses, clinical trials, and qualitative research on surgical outcomes focused on frail older adults.

Dr. Finlayson is founder and Program Director of the UCSF Center for Surgery in Older Adults and is a nationally recognized thought leader in the field. Most recently, she was senior author of a seminal paper in JAMA Surgery demonstrating that breast cancer surgery in female nursing home residents was an overused surgical modality generally conferring no clinical benefit.

In her role as the inaugural Vice Chair for Faculty Affairs and Development, Dr. Finlayson will lead efforts to ensure faculty success through development, promotion, diversity, recruitment, and retention. She will collaborate with the School of Medicine and University leadership to advance these objectives. Dr. Finlayson will also oversee the Department's Merit & Promotions process and serve as a member of the Chair's Leadership Council, which provides strategic advice and policy recommendations to the Chair, and partner with the Department's to be named Vice Chair of Diversity, Equity & Inclusion to foster an organizational culture grounded on these important principles.

Dr. Finlayson has demonstrated a strong commitment to the career development of academic surgeons, mentoring students, residents, fellows, and junior faculty who have gone on to launch successful academic careers. As Director of the Department of Surgery's Faculty Mentoring Program, Dr. Finlayson has been instrumental in the development and implementation of robust career plans for incoming faculty and as lead mentor for the Clinical Discovery & Health Services Research track on the Resident Research Committee.

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80694
Thu, 24 Jan 2019 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80658 <![CDATA[Deborah M. Stein, MD, MPH, FACS, FCCM Appointed Chief of Surgery at Zuckerberg San Francisco General]]> Stein _Deborah Copy (2)

We are pleased to announce that Deborah M. Stein, MD, MPH, FACS, FCCM, currently the R Adams Cowley, MD Professor in Shock and Trauma at the University of Maryland School of Medicine, has been appointed Chief of Surgery at Zuckerberg San Francisco General Hospital and Trauma Center (ZSFG), commencing May 13, 2019. 

Dr. Stein currently serves as the Co-Director of the Neurotrauma Center for the State of Maryland and as the Chief of Trauma at the R Adams Cowley Shock Trauma Center in Baltimore.  Her national service includes active participation in major trauma, critical care, and surgical societies, including as an Executive Board Member and Secretary for the Eastern Association for the Surgery of Trauma, Geriatric Committee Chair for the American Association for the Surgery of Trauma, and Chair of the Research Committee for the American College of Surgeons' Committee on Trauma.  Dr. Stein's research interests are in the fields of traumatic brain injury, hemorrhagic shock, biomechanics of injury, and functional outcomes following traumatic injury.  She has authored over 190 peer-reviewed articles and is currently Principal Investigator or Co-Principal Investigator for 6 federally funded grants.  

Dr. Stein earned her Bachelor of Arts degree from Cornell University, her Medical Degree from Albert Einstein College of Medicine, and her Master of Public Health from Johns Hopkins University Bloomberg School of Public Health with certificates in both Injury Control and Health Policy.  She completed her general surgery residency at Long Island Jewish Medical Center, Albert Einstein College of Medicine, and a fellowship in Trauma/Surgical Critical Care at the R Adams Cowley Shock Trauma Center at the University of Maryland Medical Center. Dr. Stein is certified by the American Board of Surgery in General Surgery and in Surgical Critical Care. She also holds subspecialty certifications from the United Council for Neurologic Subspecialties in Neurocritical Care, and is a fellow of the American College of Surgeons and the American College of Critical Care Medicine. 

"We are thrilled to have Dr. Stein join us at ZSFG," said Susan Ehrlich, MD, MPP, CEO of Zuckerberg San Francisco General. " She brings a wealth of experience, talent and leadership to our community, joining our talented team of trauma and general surgeons.  We look forward to working with her in serving our patients and the community."  

We would also like to thank Dr. Shant Vartanian for his service as interim Chief of Surgery at ZSFG since July 2017.

Please join us in congratulating Dr. Stein on her appointment and welcoming her to UCSF!

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80658
Mon, 17 Dec 2018 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80551 <![CDATA[Andre Campbell, M.D. Elected to Board of Governors Executive Committee of the American College of Surgeons ]]> Andre Campbell - 144xUCSF trauma surgeon Andre R. Campbell, MD, FACS, FACP, FCCM has been elected to the Board of Governors Executive Committee for the American College of Surgeons, a prestigious honor. His election was announced at the 2018 Annual Meeting of American College of Surgeons Clinical Congress in October.

Dr. Campbell is professor of surgery, division of general surgery; director of the surgery clerkship; and director of the surgical critical care fellowship at UCSF. He will be the Education Pillar Lead on the Executive Committee.


New Regents, Board of Governors Executive Committee Members Elected


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https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80551
Mon, 10 Dec 2018 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80555 <![CDATA[Symposium Celebrating Women Surgeons Around the World]]> UCSF endocrine surgeon Sanziana A. Roman, M.D., FACS, was the organizer of a symposium centered on the experiences of women surgeons from around the world. In an article published in the December 2018 edition of the World Journal of Surgery, seven women surgeons drawn from diverse geographical backgrounds recounted their personal stories told in compelling narratives.

Dr. Roman is professor of surgery in the UCSF Division of General Surgery. She also holds the positions of Director of Learning and Teaching in the Procedural Specialties and Dean's Diversity Leader for Leadership Equity and Inclusion in the UCSF School of Medicine.

Following are excerpts of the article including Dr. Roman's own personal story.

A catalog of social media citing the article on Twitter appears here

Introduction

We must thank Dr. Sanziana Roman for organizing this symposium about women in surgery. Powerful testimonials from women surgeons, from Europe to the United States, from Africa to Australia and Asia. Each of them is different, as it reflects the culture of the place where their career took place. However, they all have in common the struggle to establish themselves in the surgical profession, traditionally a male-dominated field.

Over the last two decades, the situation has clearly improved. Today in most medical schools about 50% of the students are women, and a similar percentage is present in many surgical residency programs. Twenty-one Departments of Surgery in the United States are led by women, a major change as compared to only 5 years ago. Much more must be done to establish a work environment where women are as welcomed and respected as men; where they are accepted as surgeons, and not as women surgeons, treasuring the contribution they can give.

We do hope that this symposium will be inspirational for women and men in the surgical field and be enlightening and educational for all, promoting a culture of collegiality and mutual understanding. The glass ceiling has been cracked, it is now time to break it for good.

Marco G. Patti, MD, FACS

Past President, International Society of Surgery

I am an American surgeon

Sanziana Roman MD FACS, USA

The patient had a large cortisol producing adrenal adenoma, and the retroperitoneal tissue was difficult to negotiate. I was performing a posterior retroperitoneoscopic adrenalectomy in our usual endocrine surgery operating room. As I was operating, I mentally acknowledged a proud moment in noting that, on this particularly salient date, March 8 2017, with the exception of the assisting junior resident, all other people in the room were women. As the case proceeded, I noticed that the resident became distracted by two men who had entered the room without any warning and started speaking to him directly.

"Hello, Dr Roman. We are visiting surgeons from X, and are hoping to observe this operation, since we have not seen this approach before." The resident was embarrassed. "I am sorry, but I am not the attending; she is." he said and pointed toward me. I looked at the visiting men and greeted them "Hello! You are welcome to stay and watch, we just started the case." The men seemed confused. They stared at me for a moment, said "Thank you", walked out of the room, and never returned. It was a surprising move. "I suppose they figured they didn't really have anything to learn from a woman." I said loudly, and continued the operation.

I entered medical school in the mid-1990s with a clear goal of becoming a surgeon. My family was not supportive. "Why don't you chose something nice and more suited for a woman?" my grandmother would ask. Being unconventional was just fine with me, and I never regretted my decision. I always felt that as long as I shared some of the attributes of surgeons, such as dexterity, cognition and a dose of fearlessness, this career path was a good fit for me. Residency felt like an equalizer for men and women. We all worked hard, much like soldiers in trenches; we covered and cared for each other, and felt a camaraderie that was unparalleled. The work was hard and the hours long. On-call nights were mostly every other or, at best, every third. The earliest we ever went home after a call night was 7 p.m. the following day. Depressive symptoms and burnout were common among residents, and we more often confided in each other rather than discuss it with the residency director or seek professional counseling. There was significant fear of being stigmatized, seen as weak, and potentially having negative effects on one's career. We knew that many medical licensing questionnaires ask specifically about having been diagnosed with mental problems, and none of us would ever want to have to acknowledge that. Despite changes in resident hours and efforts to remake training programs over the last couple of decades, depression rates in residents do not seem to have changed much. In a recent prospective longitudinal study by Guille et al. which assessed 3121 interns across all specialties from 44 medical institutions, including almost half women participants, depressive symptoms markedly increased during the internship year and were significantly higher for women than men [1]. Work-family conflicts accounted for a large component of this increase, and had a much stronger effect on women than on men.

Important life events during surgical residency, such as marriage and having children, were very different for women and men. During my training, most women I knew were single, and having a child during residency was taboo. While having a family and children during residency is more common today for women in training, it comes at a significant price. In one of the most in-depth cross-sectional and longitudinal surveys of surgical trainees in the U.S. including most approved residency training programs and more than 4000 general surgical residents, the National Study of Expectations and Attitudes of Residents in Surgery (NEARS), researchers were able to cull valuable information from residents over several years [2]. Compared with men, women in postgraduate years (PGYs) 1–5 were less likely to be married (28.2–47.3% vs. men 49.6–67.6%) or have children (4.6–18.0% vs. men 19.0–45.8%) (P < .001). Women who married during PGY1-3 had more concerns about their performance at work, while men who were married were more likely to be happy at work. Women who had a first child during PGY1-3 were more likely to feel overwhelmed and worry about financial security than other women, and be less happy to be at work. Conversely, men who had a child were more likely to feel supported by the faculty, compared to those who did not have children [3, 4].

In a recent follow-up, 8 years after the initial NEARS survey administration, the researchers found that nearly a quarter of categorical general surgery residents do not finish their training, and they were able to determine which surgical residents were most at risk for attrition [5]. Being a woman was independently predictive of non-completion, however there were several programmatic and personal characteristics which were associated with this. For example, the lowest non-completion rate for men was among interns at small community programs who were White, non-Hispanic, and married (6%). The lowest non-completion rate for women was among interns training at smaller academic programs (11%). The highest attrition occurred at large programs with more than seven chief residents, and being a minority woman with family close by was a strong predictor of non-completion.

These studies underline some of the difficulties women encounter in becoming surgeons. However, what they cannot measure are the daily impediments, the macro- and microaggressions which slowly accumulate over time. Yes, after nearly two decades of being a surgeon, I still get confused for being a nurse by patients and other doctors. I eventually developed a comeback for being called a "nurse", which I use even today: "I am not the nurse, I am the surgeon, but thank you for the compliment." If I walk in the hallway and cross paths with a male colleague, there is a low chance that he will say "hello" to me first. If I do not say anything, we pass without greeting each other. This does not happen when I encounter other women colleagues. If I walk with a male colleague and encounter another male surgeon, it is much more likely that there will be a greeting initiated than if I was walking alone, often with the acknowledgement glance toward the male, first, then me. I notice these things because they have been recurrent and persistent over time; small as they may seem, unconscious perhaps, these microagressions contribute to a culture of isolation, and a sense of lack of camaraderie.

Over the years, I have come to realize something important. I am not just a surgeon. I am a "woman surgeon". What does that mean? As a woman surgeon, I feel I must fit certain gender expectations, otherwise, I may be punished. For example, there is always the expectation that I would be friendly and in a good mood. I should be chatty on the floors with the nurses and the patients. I need to be relatable, however, too much friendliness, and I lose my authority as a surgeon. There is a very fine line which has to be walked, and, as a woman, I am aware of this every waking moment of my professional life. Don't be too forceful, but don't seem weak; be friendly, but don't let them take advantage of it. Smile no matter what, otherwise I will be viewed as cold. In other words, I better comply with gender norms and schemas. This expectation has been studied and reported in other specialties. A meta-analysis of 45 studies—including more than 100,000 patients (70% of whom were female), and over 4000 physicians (one-third female)—assessed whether there was a difference in patients' satisfaction with male versus female physicians [6]. Patients generally appreciated a "patient-centered" encounter, often rating highly time spent with the physician, if the physician listened more, and seemed to have compassion. These traits have been shown to be more often associated with women physicians; however, patients assimilated the "patient-centeredness" in female physicians as expected female behavior, and did not see it as a sign of a "good physician", yet gave male physicians who displayed patient-centered qualities "better doctors" evaluations. As a consequence, female physicians did not get appropriate credit for being professionally competent, and had lower patient evaluations relative to male physicians for similar behavior.

I have experienced this in my professional life as well. On numerous occasions, patients listen carefully to my explanations, my diagnostics, the description of the surgical procedures, possible complications, recovery, prognoses, and at the end of our time together, they ask "So, who will be doing my surgery?" Engrossed in their concern and focused listening, they seem to forget who I am, and seem surprised when I remind them that I AM the surgeon. The "woman surgeon". And then, they understand.

Having complications as a woman surgeon is worse than for male colleagues. This has been shown in a recent study from Harvard which studied whether a surgeon's gender influenced the way referring physicians interpreted their ability, and documented the implications for gender inequality in surgery [7, 8]. The researcher analyzed Medicare data on referrals by doctors to surgeons, and then looked at what happened to doctors' referral rates for up to 18 months after one of their patients died during a surgery. She found that referrals dropped by more than half after a patient died after having an operation by a female surgeon, yet this change in referrals was not noted when the death occurred with a male surgeon. More concerning, analyzing referral data for other women surgeons in the same specialty and the same area, the author found that a bad outcome from one woman surgeon biased referrals to other women surgeons in general; this was not seen with men. This means that having one bad experience with one woman surgeon, shaped referring physicians' views on all women surgeons. Interestingly and corollary, using referral volumes after a surgery as the proxy for the doctors' views of the surgeons' talent, if a patient had a good outcome, the referring physicians were more optimistic about a male surgeon's ability, than about a female surgeon's ability.

This type of bias can account to some degree for other inequalities between women and men surgeons. Professional recognitions, awards, and invitations to give prestigious grand rounds or lectures have been noted to lag behind for women surgeons. Even the simple way that women speakers may be introduced is more often by their first name rather than by their professional title. This phenomenon came to mainstream attention with several articles, including one in the Washington Post which highlighted a study by Files et al. who retrospectively analyzed videotaped grand rounds speakers at two different locations of the Mayo Clinic academic departments of medicine and noted how the professional title of the speaker was used in presentations and introductions [9]. In more than 300 instances, female introducers were more likely to use professional titles when introducing any speaker during the first form of address compared with male introducers (96.2 vs. 65.6%; p < 0.001) [10]. Females introducing female speakers utilized formal titles nearly all the time compared with males introducing male speakers (75% of the time). When the introducer was female and the speaker male, formal titles were used nearly all the time, while male introducers of female speakers utilized professional titles in less than half of instances. I personally have experienced this multiple times, not just at introductions of presentations, but also during meetings and conferences. Usually, a senior male member of the department would routinely call me by my first name during professional public meetings, while calling other men colleagues by their formal "Doctor" name. What made it worse was that he would mispronounce my name repeatedly, even though we had worked together for more than a decade and I had tried to correct him in private. Many may think this is a small thing. I disagree. Words are powerful, and their implications are not lost on those who listen. The perception is that of lesser status, competence or expertise. These microaggressions are a strong warning signal of stalling the trajectory of women's career path, rate of advancement to leadership positions, promotions and compensation.

My salary has always been lower commensurate to that of my male peers. When a woman starts her first job at a lower salary, this number will impact future remuneration; it anchors one at a certain place and makes it very difficult to jump ahead. When a woman negotiates for herself, she is seen as aggressive. Negotiation is not a gender appropriate behavior, and women may be punished for it, both by men and other women. Behavior which is seen outside of societal norms for a woman will lead to negative effects. This is just one of the implicit biases which are common in medicine and surgery. Two recent comprehensive studies on physician incomes have demonstrated large and increasing disparities by gender. In the first annual physician compensation report in April 2017 by Doximity—which is the largest social network in medicine, with 70% of all U.S. physicians as members—the gender pay gap in reported compensation of more than 36,000 physicians showed 20% lower pay for women in surgical specialties [11]. A second recent study analyzed the salaries of more than 10,000 academic physicians working at 24 public medical schools. The authors showed that, after adjusting for demographics, faculty rank, scientific authorship, NIH funding, clinical trial participation and Medicare reimbursement, among 1334 surgical specialty faculty, women made less than men by $12,000–65,000 per year, and the gap has been widening over time [12]. Many explanations have been put forth as to why this disparity persists. Differences in clinical volumes have been cited often. Factors which may lead to lower clinical volumes include women spending more time with each patient in clinic than men; higher household and child-rearing responsibilities for women, sometimes necessitating possible part time work; greater difficulty in finding mentors; inequitable allocation of institutional resources, such as nurses, administrative assistants, space; fewer opportunities for advancement; implicit or explicit bias; lower salary negotiation for women, among others. I believe that women start their careers at a lower salary, and over time, fall behind more and more, given many of the reasons enumerated above. The fact that salary disparities exist in most professions in society will only make achieving equity harder. For example, even in tennis, where very prominent players often are equally popular, Roger Federer was paid for winning a tournament more than $731,000, while Serena Williams made $495,000 for winning the same tournament [13].

While we have encountered many challenges, there are many benefits to being a woman surgeon in America today. With several great "pioneer" women having paved the way, the path to progress is widening. The American College of Surgeons has named three women presidents within the last 12 years, including the current president. The number of women who serve as Chairs of Departments of Surgery in the U.S. is now at 21, having rapidly increased over the last decade. Several national societies, including venerable ones who have traditionally been male dominated, understand that diversity and inclusion in surgery is not only inevitable, but long overdue and advantageous. Culling talent universally from among all genders (cis-, trans-, pan-, a- or gender fluid), and opening new opportunities equally will make our profession much stronger, drive forward science and discovery faster, and ultimately help our patients have better outcomes. Societies such as the Association of Women Surgeons, the American Surgical Association, and the American College of Surgeons, to name a few, are not only bringing awareness about the difficulties of women surgeons, but are actively working toward better integration and promotion through organized courses for women surgeons and trainees in leadership, negotiations and career development. Sponsorship and mentorship for women has become more widely available. Social media platforms, such as Doximity, Facebook, and Twitter, have created national and global arenas of communication, activism and engagement. Movements such as #ILookLikeASurgeon, #HeforShe, #NYerORCoverChallenge have brought together thousands of women and men participants from across the globe and have allowed us all to have a voice in ways which I could not even imagine 20 years ago. While much work remains to be done, the progress is palpable, and there are many women and men surgeons who understand that together we can build a more equitable and better world for the future.

As I finished the operation, and left the OR to speak to the patient's family, I thought about my encounter with the visiting surgeons. I was sad that they had denied themselves an opportunity to see women surgeons in a different way. As I walked the hall, lulled by the rhythmic tapping of my wooden silver OR clogs, I was startled out of my reverie by the cheerful voice of a male nurse calling loudly behind me: "Happy International Women's Day, Dr. Roman!" "Thank you", I said with a smile.

References

Guille C, Frank E, Zhao Z et al (2017) Work-family conflict and the sex difference in depression among training physicians. JAMA Intern Med 177(12):1766–1772 

2. Yeo H, Viola K, Berg D et al (2009) Attitudes, training experiences, and professional expectations of US general surgery residents: a national survey. JAMA 302(12):1301–1308

3. Sullivan M, Yeo H, Roman S et al. (2013) Striving for work-life balance: effect of marriage and children on the experience of 4402 US General Surgery residents Ann Surg 257(3):571–576

4. Chen M, Yeo H, Roman S et al (2013) Life events during surgical residency have different effects on women and men over time. Surgery 154(2):162–170

5. Yeo H, Abelson J, Mao J et al (2017) Who makes it to the end? A novel predictive model for identifying surgical residents at risk for attrition Ann Surg 266(3):499–507

6. Hall J, Blanch-Hartigan D, Roter D et al (2011) Patient's satisfaction with male vs. female physicians: a meta-analysis. Med Care 49(7):611–617

7. https://scholar.harvard.edu/files/sarsons/files/sarsons_jmp_01.pdf

8. https://www.vox.com/science-and-health/2017/11/23/16686532/surgeon-mistakes-gender-wage-gap

9. https://www.washingtonpost.com/national/health-science/why-are-female-doctors-introduced-by-first-name-while-men-are-called-doctor/2017/06/23/b790ddf2-4572-11e7-a196-a1bb629f64cb_story.html?utm_term=.5497d0638d84

10. Files J, Mayer A, Ko M et al (2017) Speaker introductions at internal medicine grand rounds: forms of address reveal gender bias. J Women's Health 26(5):413–419

11.https://s3.amazonaws.com/s3.doximity.com/careers/2017_physician_compensation_report.pdf

12. Jena A, Olenski A, Blumenthal D et al (2016) Sex difference in physician salary in public medical schools. JAMA Int Med 176(9):1294–1304

13. https://www.nytimes.com/2016/04/13/sports/tennis/equal-pay-gender-gap-grand-slam-majors-wta-atp.html

Symposium Celebrating Women Surgeons Around the World (full article) 

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80555
Mon, 10 Dec 2018 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80557 <![CDATA[Julie Ann Sosa, MD, MA, FACS Delivers 8th Annual Joseph A. Ignatius, MD Lecture in Surgery at Stanford University]]> Julie Ann Sosa, MD, MA, FACS, Leon Goldman, MD, Distinguished Professorship in Surgery and chair of the UCSF Department of Surgery, delivered the 8th Annual Joseph A. Ignatius, MD Lecture in Surgery at Stanford University on October 30, 2018. The topic was "The rise of thyroid cancer and its evolving management: When is less more?" Dr. Sosa is a world-renowned endocrine surgeon with a major focus in thyroid cancer and clinical outcomes research.

Ignatius Lecture

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80557
Fri, 7 Dec 2018 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80513 <![CDATA[Bian Wu, MD and Edward Kim, MD Receive Prestigious Awards for Teaching Excellence]]> Edward "Ed" Kim, M.D., an associate professor of surgery in the Division of General Surgery and Bian Wu, M.D., a clinical fellow in the Division of Vascular & Endovascular Surgery, are the recipients of prestigious teaching awards, reflecting their outstanding didactic skills and abiding commitment to the education of medical students and residents.

Each were nominated by Ogonna Nnamani, a 3rd year medical student at UCSF.

Wu And Kim

Ed Kim, M.D. - The Henry J. Kaiser Award for Excellence in Teaching 

Dr. Ed Kim, a colorectal surgeon, who is also Director of the UCSF Surgical Skills Center, was a recipient of The Henry J. Kaiser Award for Excellence in Teaching for 2018. The School of Medicine describes the storied history and significance of the award in these terms:

Since 1969, the School of Medicine has recognized exceptional faculty instructors through these annual awards. They bestow significant academic distinction, as well as a modest monetary award for the winners. The Henry J. Kaiser Awards for Excellence in Teaching are significant as only medical students and residents can nominate any faculty who teaches medical students and/or residents.

Dr. Kim's students were effusive in their praise for his teaching skills and ability to modulate between humor and candid assessment, firm but fair.

Dr. Edward Kim has been, without a doubt, the most influential instructor in my MS3 year. His passion for medical student and resident teaching is invigorating, from his weekly seminars to impromptu rounds to the OR. He instills a pride and work ethic to physicianship that I had never experienced before, one that both challenged and re-affirmed my conception of being a doctor. His weekly seminars were hilarious and high-yield, while his style on impromptu rounds and in cases was brutally honest, yet fair and comprised of actionable feedback.

Coming into the rotation, I had not thought about pursuing surgery because of work-life balance, but because of the rotation and my time with Dr. Kim, I've come to realize that that was a premature decision. Having relayed these thoughts to him, he set aside time at the end of his busy clinic to share his thoughts on life as a surgical resident and attending. His honest and encouraging words in that interaction are things I still think about frequently. I cannot understate the positive impact he made on the surgery rotation, and on my career choice of going into surgery.

 Ed Kim and Ogonna Nnamani

Bian Wu, M.D. - Bridges Award Recipient for Inspirational Teaching

Dr. Bian Wu received a Bridges Curriculum Award for inspirational teaching. These annual awards represent an honor to recipients, as they are based on nominations from 1st- and 2nd-year medical students recognizing outstanding instructors. 

Remarkably, Dr. Wu has been the recipient of eight teaching awards since 2012, a remarkable accomplishment for a physician at this nascent stage of his career. Dr. Wu's students painted a glowing portrait of him as a remarkably gifted and dedicated educator.

Dr. Bian Wu is an exceptional educator, clinician, and person. He went above and beyond in every way possible for his patients, members of the healthcare team and medical students… He was an excellent teacher and made sure that we understood the pathophysiological processes of disease, clinical reasoning, and management... The relationships that Dr. Wu established with his patients was very moving to see, and as a result, he provided the best possible care to his patients. His unwavering commitment to his patients and our team, intelligence, attention to detail and exceptional work ethic inspired me to take my clinical skill-set to the next level. Dr. Wu is truly one of a kind... He has made an indelible mark on my career, and he is the person that I hope to emulate down the road in every way possible.

Bian Wu

Group Photo 3

Wu Osullivan And Medical Student

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80513
Fri, 7 Dec 2018 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80541 <![CDATA[Quan-Yang Duh, M.D. Receives Inaugural Trailblazer Award from Society of Asian Academic Surgeons ]]>

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80541
Fri, 7 Dec 2018 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80509 <![CDATA[Lucy Kornblith, M.D. Recipient of 5-Year $1M NIH K23 Award for Study of Post-Injury Platelet Biology]]> Lucy Kornblith In LabUCSF trauma surgeon Lucy Kornblith, M.D. has been awarded a 5-Year $1M National Institutes of Health (NIH) K23, Mentored Patient-Oriented Research Award to study to post-injury platelet biology. The award, through the National Institute of General Medical Studies, will support Dr. Kornblith's research through 2023. 

The grant titled "Post-Injury Platelet Biology: Mechanisms and Outcomes", supports translational patient-oriented research. Specifically, Dr. Kornblith will investigate causal pathways, mechanisms, and associated outcomes of altered post-injury platelet biology in a prospective observational trauma cohort through collection of biospecimens and detailed clinical data.

Dr. Kornblith's proposal represents an innovative approach to studying post-injury platelet biology because it incorporates methods that have not previously been applied together in trauma populations.

The proposal addresses a major gap in understanding of the role of platelets in trauma-induced coagulopathy and will form the basis for identifying associated molecular mechanisms and investigating targeted platelet-based treatments in reduction of morbidity and mortality for hemorrhaging trauma patients.

About Dr. Lucy Kornblith

Surgeon-scientist Lucy Zumwinkle Kornblith, MD is an Assistant Professor in the UCSF Department of Surgery, Division of General Surgery, Trauma and Surgical Critical Care at Zuckerberg San Francisco General (ZSFG).

Dr. Kornblith completed her general surgery residency training at UCSF, remaining there to complete fellowships in Surgical Critical Care and Trauma & Emergency Surgery at ZSFG, the region's largest Level 1 Trauma Center. She was previously awarded a Trauma Research Scholarship for her studies of post-injury platelet biology by the Eastern Association for the Surgery of Trauma (EAST) and more recently was recruited as an investigator for Phase 2 of Landmark CLOTT Study. 

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80509
Thu, 6 Dec 2018 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80455 <![CDATA[S. Ariane Christie, MD Receives Excellence in Research Award from American College of Surgeons ]]> S. Ariane Christie, MD, a general surgery resident at UCSF, received an Excellence in Research Award from the Scientific Forum Committee of the American College of Surgeons (ACS) in the category of Global Surgery.

The award was for her abstract, "Feasibility of a Cellular Telephone Follow-up Program After Injury in Sub-Saharan Africa", which had previously been selected as an oral presentation at the 2018 Owen H. Wangensteen Scientific Forum program. Dr. Christie received her honor at a formal awards ceremony on October 23rd. 

Dr. Christie received her medical degree from Johns Hopkins School of Medicine in Baltimore, MD and is currently a PGY-4 general surgery resident at UCSF. Her research interests include validation and implementation of novel applications of technology to establish evidenced-based trauma systems and care in diverse settings.

Over the course of her training, Dr. Christie has benefited from an excellent mentorship team including Dr. Mitchell Cohen, Dr. Alan Hubbard, Dr. Rachael Callcut, Dr. Alain Chichom-Mefire, Dr. Rochelle Dicker and Dr. Catherine Juillard. Over the past two years, her research focus has been on developing sustainable trauma surveillance and treatment in Cameroon. After completion of her residency, Dr. Christie's plans to pursue an academic career in trauma surgery and critical care, with a focus on global surgery.

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80455
Thu, 6 Dec 2018 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80560 <![CDATA[Dr. Leonardo Ferreira Talks CRISPR, HIV, and Engineering Cells as Therapies for Immune Disorders on Talk Show 'Cognitum' on NewTV]]> Molecular immunologist and human genome engineer Leonardo M.R. Ferreira, Ph.D., a postdoctoral scholar in the laboratories of Dr. Qizhi Tang (Department of Surgery) and Dr. Jeffrey Bluestone (Diabetes Center) at UCSF, was interviewed about his research on the talk show 'Cognitum' on NewTV.

'Cognitum' is a show dedicated to exploring the present and future of science and technology. Over the course of two episodes, Dr. Ferreira expounded his work as a pioneer in the use of genome editing in human blood cells and discussed his current efforts to engineer regulatory T cells (Tregs) as living drugs.

In the first episode, Dr. Ferreira explained how he is using CRISPR/Cas9 technology to edit the genome of human blood stem cells and T cells to create cells resistant to HIV infection, a potential long-term treatment for AIDS.

In the second episode, Dr. Ferreira delved further into the development of immune cell therapies, discussing his ongoing work on genetically modifying Tregs using chimeric antigen receptors (CARs). The goal is to create Tregs with defined specificities in therapeutic quantities to re-establish immune tolerance in type 1 diabetes and prevent organ transplant rejection.

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80560
Thu, 6 Dec 2018 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80450 <![CDATA[Rachael Callcut, MD, MSPH Named Chair of Research and Scholarship Committee for EAST]]> Trauma Surgeon Rachael Callcut, MD, MSPH has been named Chair of the Research and Scholarship Committee for the Eastern Association for the Surgery of Trauma (EAST) Trauma, for a three-year a term to commencing January 19, 2019.

The Research and Scholarship Committee promotes the mentorship and development of young surgeon scientists through a variety of initiatives. The Chair is an integral part the leadership team at EAST, a prestigious and highly sought after position.

Dr. Callcut is an associate professor of surgery in the UCSF Division of General Surgery and is based at Zuckerberg San Francisco General Hospital and Trauma Center. She is also Director of Data Science and Program Director of the Smarter Health Artificial Intelligence (AI) Initiative in the Center for Digital Health Innovation. Her research in the field of AI innonvation was was recently recognized by GE Healthcare in the development of new applications and smart devices built on the Edison platform. 

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80450
Thu, 6 Dec 2018 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=81595 <![CDATA[Dr. Rachael Callcut Partners with UCSF Radiology Colleagues and GE Healthcare on AI Initiatives]]> Dr. Rachael Callcut, Associate Professor of Surgery at the University of California, San Francisco (UCSF) Medical Center and Director of Data Science for the Center for Digital Health Innovation, partnered with her radiology colleagues and GE Healthcare to create an initial algorithm that can detect pneumothorax, a condition which strikes nearly 74,000 Americans each year[1] and can be deadly if not diagnosed quickly and accurately.[2] The challenge: a patient with this condition could wait between two to eight hours for his or her X-Ray to be read.[3]

Today, Dr. Callcut and the UCSF team's use case and data science approach has become a suite of algorithms, known as Critical Care Suite* on the mobile Optima XR240amx X-Ray system, powered by the Edison platform, that can alert the clinical team of potential pneumothorax cases as soon as the patients are scanned, so they can prioritize reading them.

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=81595
Wed, 5 Dec 2018 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80574 <![CDATA[Sonja Schrepfer, MD, PhD and Tobias Deuse, MD Awarded 4-Year $3M NIH R01 Grant to Study Role of Cardiomyocytes in Heart Repair]]> Sonja Schrepfer, M.D., Ph.D. and Tobias Deuse, M.D. have been awarded a 4-Year $3M NIH R01 Grant to study the role of cardiomyocytes in heart repair. Dr. Schrepfer is an associate professor and director of the UCSF Transplant and Stem Cell Immunobiology (TSI) Lab. Dr. Deuse, a renowned heart surgeon, is associate professor and director of minimally-invasive cardiac surgery at UCSF and a principal investigator in the TSI lab. 

The study will generate hypo-immunogenic cardiomyocytes that could be used therapeutically for regenerating tissues but are engineered to avoid rejection by patients that receive them. In particular, we will provide proof- of-concept that hypo-immunogenic cardiomyocytes do not provoke a host immune response and rejection and could survive and engraft into the host myocardium, resulting in improved cardiac function of the failing heart. The results of this research could offer a universally acceptable "off-the-shelf" product using pluripotent cells and their derivatives for generating or regenerating specific tissues and organs. (NIH Reporter)

Hypo-Immunogenic Cardiomyocytes for Myocardial Repair (study details)

About the TSI Lab

The Transplant and Stem Cell Immunobiology (TSI) Laboratory uses multiple research directions to answer complex questions about stem cell therapy, heart and lung transplantation, and cardiovascular disease. The laboratory focuses on the immunogenicity of allogeneic stem cells, tissues, and organs, and is interested in designing methods to prevent immunological recognition and rejection of such materials. The TSI Lab  investigates mechanisms implicated in the development cardiovascular disease with the dual aims of prevention and cure, encompassing basic science (e.g. identifying novel molecules involved in pluripotent stem cell immunogenicity) to translational medicine (e.g. developing drugs that may be useful in reducing myointimal hyperplasia).

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80574
Wed, 5 Dec 2018 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80418 <![CDATA[UCSF Trauma Surgeons Among Leading Voices Working to Stem Tide of Gun Violence in the U.S.]]> Trauma surgeons at Zuckerberg San Francisco General Hospital and Trauma Center have been among the strongest proponents for physicians speaking out on the issue of gun violence and conducting research to reduce suffering and prevent needless and tragic deaths. They have harnessed the power of Twitter in the service of community outreach and effecting social change.

Notably, Rachael A. Callcut, M.D., MSPH was among the group that created the Twitter handle, @ThisIsOurLane and Andre Campbell, M.D.appearing on TV and in other media outlets, has reprised the role he played in the YouTube shootings at San Bruno as a powerful public spokesman and voice of conscience. In one way or another, all the ZSFG trauma surgeons, through their research, their outstanding care of patients and their public advocacy on Twitter, are making an out-sized difference.

Timlane3

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https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80418
Tue, 4 Dec 2018 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80419 <![CDATA[Rebecca Plevin, MD Named Director of San Francisco Wraparound Project at ZSFG]]> Plevin Rebecca 2UCSF trauma surgeon Rebecca Plevin, M.D. has been named the new director of the San Francisco Wraparound Project, the acclaimed hospital-based violence intervention program based at Zuckerberg San Francisco General Hospital.

Dr. Plevin received her M.D. from the University of Southern California Keck School of Medicine and completed her residency in general surgery at the University of Washington. 

She then completed a fellowship at UCSF in surgical critical care and trauma and emergency general surgery at Zuckerberg San Francisco General Hospital. Her research focus is on injury prevention, most notably in underserved and vulnerable populations.

About the SF Wraparound Project

The San Francisco Wraparound Project works to reduce injury and criminal recidivism among the most vulnerable citizens of San Francisco. It serves as a vital point of entry, providing mentorship and risk-reduction resources to its clients. Adaobi Nwabuo, MBBS, MPH, the Injury Prevention Coordinator at ZSFG, is the Program Manager.

 

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80419
Tue, 4 Dec 2018 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80456 <![CDATA[Lucy Kornblith, MD Recruited as Investigator for Phase 2 of Landmark CLOTT Study]]> Lucy Kornblith In LabThe National Trauma Institute recently issued an update on the progress of CLOTT Study, a 2nd phase that will more closely investigate the role of platelet biology in post-traumatic pulmonary embolism. To that end, UCSF surgeon-scientist Lucy Kornblith, M.D. has been recruited by principal investigator M. Margaret "Peggy" Knudson, M.D., FACS

Following a productive investigation of the incidence of pulmonary thrombi after injury and the role of clot breakdown in the development of post-traumatic pulmonary embolism, the CLOTT study group (Consortium of Leaders in the Study of Traumatic Thromboembolism) is continuing with a second phase of research and Dr. Peggy Knudson has recruited Dr. Lucy Kornblith to assist in adding investigations of the role of platelet biology in post-traumatic pulmonary embolism.

"There's been a lot of focus over the years on the fibrin and clotting factor side of clot formation and breakdown in trauma," said Dr. Kornblith, Assistant Professor of Trauma and Surgical Critical Care at San Francisco General Hospital, University of California San Francisco. "Now that researchers are beginning to understand that, we're shifting some focus to look at the platelet side."

Engaging in a combination of clinical research and bench science, Dr. Kornblith and her colleagues perform translational investigations from selected trauma patient blood samples as well as from a control group of healthy patients. They then conduct bench science in the lab with those samples.

"It is important to get blood samples at the earliest point possible, as the trauma patients come through the door, because we consider those samples the native coagulation milieu," Kornblith explained. "Most patients have not had significant interventions between the time of their traumatic injury and the time they get to the hospital. As we take samples later, they've received fluids and blood products and medications, and possibly had surgeries and interventions that change the biology, so that first sample is important."

A key goal of Phase 2 of the CLOTT Study is to determine "if there are biologic phenotypes of how platelets behave after injury that are associated with bad outcomes including clotting outcomes."  Kornblith expects to have preliminary results soon, but 1-2 years will likely be required to gather sufficient data to have a more complete picture.

About the CLOTT Study

Research by the CLOTT study group is supported by a grant from the Defense Medical Research and Development Program and managed by the National Trauma Institute and the Coalition for National Trauma Research (CNTR). During the AAST clinical congress, Dr. Kornblith presented her current research representing a subgroup of Phase 2 CLOTT investigation. She recently received a $1 million Patient-Oriented Research Career Development Award from the National Institute of General Medical Sciences of the National Institutes of Health, to support her research through 2023.

Read full story at National Trauma Institute

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80456
Mon, 29 Oct 2018 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80284 <![CDATA[UCSF Surgical and Critical Care NP Fellowship Achieves Accreditation with Distinction from ANCC ]]> The UCSF Surgical and Critical Care Nurse Practitioner Fellowship Program, a joint program of the Department of Surgery, Department of Anesthesia, and UCSF Health, was recently awarded the Accreditation with Distinction, the highest recognition awarded by the American Nurses Credentialing Center's Accreditation Program:

UCSF Surgical and Critical Care Fellowship Program is accredited with distinction as a Practice Transition Program by the American Nurses Credentialing Center's Commission on Accreditation.

The Surgical and Critical Care Nurse Practitioner Fellowship Program is led by nurse practitioners Kerry Decker, RN, MS, ANP-BC and Thomas Farley, RN, NP, ACNP-BCAssistant Clinical Professor of Nursing, and overseen by a distinguished roster of faculty. The UCSF program is the first Critical Care program for advanced practice registered nurses (APRNs) in the state of California, and the first Surgical APRN program nationwide to achieve this distinction.

Ancc Ptap Distinction Logo V4 Bw

UCSF Health News Release

UCSF Health is proud to announce that UCSF Surgical and Critical Care Nurse Practitioner Fellowship Program has achieved accreditation with distinction from the American Nurses Credentialing Center (ANCC).  

ANCC Practice Transition Accreditation validates hospital based residency or fellowship programs that transition nurses or advanced practice registered nurses (APRNs) into new practice settings that meet rigorous, evidence-based standards for quality and excellence. Nurse Practitioners in the UCSF Surgical and Critical Care Nurse Practitioner Fellowship gain experience that allow the fellow to acquire specific post graduate skills in managing surgical and critically ill patients in the tertiary acute hospital setting. It prepares licensed and certified AG‐ACNPs to provide care for adults in critical care and surgery settings through focused clinical rotations emphasizing advanced assessment, planning, negotiation, and collaboration skills necessary to delivery safe, high quality care. 

"The nurse practitioner preceptors, physicians, and health administrative executives are extremely proud of this achievement and what the ANCC accreditation conveys to the Critical Care and Surgical NP Fellowship at UCSF Health. Transition programs are extremely valuable to engage new providers in the complexities of current health care delivery and uniqueness of the specialty care required", said Mitchel Erickson NP, Director of Advanced Practice, UCSF Health. 

"ANCC accreditation gives fellows assurance that UCSF Health offers an elevated transition program with a clear course of instruction and enables our transitioning advanced practice nurses gain the skills and confidence needed to perform effectively within a new practice setting", states Kerry Decker, NP, Co-director of the Fellowship Program at UCSF Health.

ANCC's internationally renowned credentialing programs certify nurses in specialty practice areas; recognize healthcare organizations for promoting safe, positive work environments; and accredit providers and approvers of continuing nursing education.  

UCSF Surgical and Critical Care Nurse Practitioner Fellowship Program is the first Critical Care APRN program in California and the first Surgical APRN program in the country to achieve this designation.

UCSF Surgical and Critical Care Care Fellowship Leadership

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80284
Fri, 26 Oct 2018 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80200 <![CDATA[Michael Conte, MD Awarded 4-year $1.7M NIH U01 Grant to Fund National Center in Diabetic Foot Consortium]]> Conte Michael CopyMichael S. Conte, MD, chief of the Division of Vascular and Endovascular Surgery at UCSF, and one of nation's leading vascular surgeons, was awarded a 4-year, $1.7M U01 grant by the National Institute of Diabetes, Digestive, and Kidney Diseases (NIDDK), a unit of the NIH, to fund one of 6 national centers in the Diabetic Foot Consortium. 

Conte and podiatrist Alexander Reyzelman, DPM, a co-investigator on the grant, are co-Directors of the UCSF Center for Limb Preservation.

The NIDDK research is being carried out via a network of Clinical Research Units (CRUs). The UCSF Diabetic Foot CRU is comprised of teams at UCSF Medical Center at Parnassus and Zuckerberg San Francisco General Hospital (ZSFG), and builds on the work of the UCSF Center for Limb Preservation, UCSF Diabetes Center, UCSF Center for Vulnerable Populations, UCSF Clinical and Translational Science Institute (CTSI), the Center for Type 2 Diabetes Translational Research (CDTR) of the NIDDK.  

Diabetic foot ulcers (DFU) are a debilitating complication for up to a quarter of the nearly 30 million individuals in the U.S. who have diabetes and the cause of most non-traumatic lower leg amputations. New diagnostic and therapeutic modalities are sorely needed for this major public health problem, but advances thus far have been hampered by challenges in clinical trial design and execution. The UCSF DFU will conduct innovative studies in a socio-economic ethnically diverse patient population and will generate high quality data for the national consortium.  

Dr. Conte views the research as having great potential to improve the care of patients with diabetes at risk of foot and leg amputation:

This new NIH program represents a tremendous opportunity to advance the science and care of vulnerable patients with DFU, a major unmet need. This award reflects the high quality clinical care and scientific expertise of our team at UCSF, ZSFG, and the Center for Limb Preservation. We are excited to amplify our ongoing work through the NIDDK Consortium.

Co-Investigators on the study include podiatrists Monara Dini, DPM and Alexander Reyzelman, Dean Schillinger, MD, chief of the UCSF Division of General Internal Medicine at ZSFG and founding Director of the UCSF Center for Vulnerable Populations, and vascular surgeon Shant Vartanian, MD.

Project Information at NIH RePORTER 

NIDDK Workshop on Biomarkers for the Diabetic Foot Consortium

Related Story at UCSF News

Saving Limbs and Toes From the Grip of Diabetes With Clinic's New Approach

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- by Lauren Washburn and Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80200
Fri, 19 Oct 2018 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80238 <![CDATA[Qizhi Tang, Ph.D. One of Featured Speakers at 1st Annual UCSF Immuno"XX": Women in Immunology Symposium]]> Immunologist Qizhi Tang, Ph.D., professor and director of the Department of Surgery's Transplantation Research Lab and Tang Lab, is one of the featured speakers at the first annual UCSF Immuno"XX": Women in Immunology Symposium on October 22, 2018 and will lead the session on Tolerance and Immunity.  

Immuno"XX" is focused on two goals: 1) providing a platform to highlight female scientists from UCSF, and 2) building a community of female immunologists to facilitate collaborations and provide career building opportunities. Synapse, the UCSF student newspaper, recently published an article about the the genesis of the conference.

Where is the XX in immunology? Less than 30% of faculty in the UCSF Immunology department are women. That's 13% less female representation than the UCSF-wide faculty demographic, where men still hold the majority.

This event was inspired by three students in the immunology graduate program, Camilia Azimi, Casey Burnett, and Tara Mcintyre, who said they were frustrated as first years by the lack of diversity at the faculty mentorship level. They decided to bring awareness by promoting the scientific accomplishments of women within the UCSF community. 

Ucsf 20180829 Tang 049 Copy

The ImmunoX Initiative

The conference is hosted by hosted by the UCSF Bakar ImmunoX Initiative, of which Dr. Tang is a co-founder and co-developer. UCSF News called the initiative  a "radical collaboration across UCSF" in a recent article:

UC San Francisco is launching the Bakar ImmunoX Initiative, an innovative research program that will promote collaborative, cutting-edge research and data sharing to catalyze discoveries about the central role of the immune system in human health and harness its power to treat a wide range of diseases.

Boosted by a significant new gift from the Gerson Bakar Foundation, ImmunoX aims to break down the barriers that traditionally separate immunology research by disease area, and instead organize the UCSF immunology community around a set of collaborative "CoProjects" that will tackle fundamental questions in the field.

These CoProjects will be conducted within the UCSF CoLabs (previously referred to as Central Research Laboratories), an integrated research platform currently in development. The CoLabs are a pillar of the University's reimagining of its original campus at Parnassus Heights as a next-generation hub for research, education and patient care. The CoLabs will provide scientists across the University with access to a shared ecosystem of state-of-the-art research facilities for processing clinical tissue samples; performing single-cell genomic, proteomic, and imaging experiments; and analyzing and curating the resulting data.

The UCSF Department of Surgery is a high volume leader in solid organ transplants nationwide, making it well-positioned to unravelling the mechanisms of organ transplant rejection and tolerance.

A  driving force behind the initiative is the search for immune patterns across human disease.

The initiative was inspired by a growing recognition that immune cells throughout the body use common tools and programs to respond to many different situations. These include deciding whether to fight off a viral infection or merely contain it when a full response could damage sensitive tissues, or recognizing which bacteria pose a threat and which are helpful and beneficial to the organism's health.

"We are coming to understand the immune system as the adjudicator of all tissue, the peacemaker as well as the destroyer," said Matthew "Max" Krummel, PhD, a UCSF professor of pathology and one of the leaders in developing ImmunoX...

To pursue such immune-based therapies for a range of human diseases, Krummel developed the ImmunoX Initiative with colleagues Mark Anderson, MD, PhD, of the UCSF Diabetes CenterMark Ansel, PhD, and Jason Cyster, PhD, of the Department of Microbiology and Immunology; Jeroen Roose, PhD, of the Department of Anatomy; and Qizhi Tang, PhD, of the Department of Surgery.

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80238
Wed, 17 Oct 2018 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80237 <![CDATA[Sanziana A. Roman, M.D. Interviewed by UCSF School of Medicine for Global Diversity Awareness Month]]> Roman, SSanziana A. Roman, M.D., FACS, professor of surgery and Dean's Diversity Leader for Leadership Equity and Inclusion at UCSF, was interviewed by the School of Medicine (SOM) in conjunction with "Global Diversity Awareness Month", October 2018. Differences Matter is a multi-year, multi-faceted School of Medicine initiative designed to make UCSF the most diverse, equitable and inclusive academic medical system in the country. Here is the full interview by Lesley Snyder, originally published on the SOM website:

Tell me a bit about your background.

I am very thankful for where I am and what I am able to do every day. I grew up in a communist country (Romania) during the height of communism. There were many years when we didn't have our basic needs met. I came to the States in high school and feel like I am living the American dream, because I am here at UCSF, being able to do what I love, and understanding what it means to come from nothing. I love being in San Francisco and at UCSF. I identify as LGBT, so living here and doing this work in such a creative, thoughtful place, is a dream.

October is Diversity Month! Tell me about your work as a Dean's Diversity Leader in the School of Medicine's Differences Matter program.

My work as a Dean's Diversity Leader focuses on the Leadership Equity and Inclusion pillar. We lack clear guidelines about how these important leadership positions are assigned. Some departments are more transparent than others. Dean King has taken important steps in putting rules in place about search committees, as it pertains to women and URM composition, but making sure that there is equity in leadership positions at UCSF – including Division Chiefs, Vice Chairs, Residency Directors, and Chairs – and that there are opportunities for all to advance, is integral to our goal of becoming the most diverse, equitable, and inclusive academic medical center in the country.

I work with Dr. Renee Navarro and Dr. Catherine Lucey on this pillar. The first task has been to come up with guidelines that are based in best practices currently in existence, that we can put forth to the Chairs for adoption across the School of Medicine. Hopefully other schools of at UCSF will eventually adopt these guidelines. We have created a committee with senior faculty that have history, knowledge, and academic weight within the school, to inquire within the clinical departments and come up with a point by point list of what is being done and what should change.

We are also looking at faculty development. How are our URM faculty and women being developed at UCSF? How are endowed chairs awarded? Do we have demographic data on our leadership? Each department has to put together a Diversity Report – how do we analyze those results and how can we assure there is advancement? The more we understand who we are, what we're made of, and what challenges we have, the better informed we will be to carve our way forward.

What is your personal commitment to advancing diversity, equity, and inclusion at UCSF?

My team is very mindful of the diversity of our colleagues. In hiring for the surgery department, our Chair thinks about this issue and has championed a search committee for every recruitment, irrespective of the seniority of the role. She seeks the best candidates across all demographics and geography, and seeks out opportunities for URM via postings to national minority societies and makes sure the roles are available broadly, so we have a diverse applicant pool to choose from.

We have been very thoughtful about hiring to represent our patient population. We recently hired a Spanish-American clinician, since we have many Spanish-speaking patients. In our patient interactions, we are very thoughtful about health equity – how are we treating patients of different backgrounds, not just clinically, but based on their personal beliefs. We have designed specific procedures for people that take these values into account, including scar-free surgery.

What are some resources students, faculty, and staff can take advantage of to learn more about DEI efforts at UCSF and/or become allies?

We have terrific opportunities to learn, train and explore diversity and inclusion at UCSF. In regards to learners, we need to be mindful about how we incorporate diversity into training, because we don't want people to be fatigued; rather, these concepts should become fully integrated into our culture. It is really about making sure we operate in an environment where everyone feels they belong, and we empower people to be there for each other. When people see things that are unjust, they need to feel as if they can say something. Allyship is really important. Making people – especially those in positions of power – aware of their privilege, is where it starts. People who have a lot of privilege don't tend to think actively about it. This is not surprising, since we all have our own experiential story. However, making them aware that not everyone is so lucky, allows you to be more aware and thoughtful. Doing the right thing should be built into our definition of professionalism and humanism, and at the core of medical practice.

What is a fun fact your colleagues may not know about you?

Before I went to medical school, I was a professional opera singer. I recently got back into performing with some of my surgical colleagues. Who knew that coming to UCSF would bring back the music in my life!

Thank you, Sanziana. Keep on singing!

Interviewed by Lesley Snyder

 

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80237
Tue, 16 Oct 2018 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80231 <![CDATA[Gregory P. Victorino, M.D. Appointed Chief of UCSF-East Bay Surgery Program]]> RNF9283 Victorino Gregory TwitterGregory P. Victorino, M.D., currently the Interim Chief of the UCSF East-Bay Surgery Program, has been appointed to the position of Chief. Victorino, a highly regarded trauma surgeon and professor of surgery, is also Director of Trauma Services at Highland Hospital. His leadership  was crucial to the designation of Highland Hospital as a Level 1 Trauma Center serving the East Bay.

Victorino has deep roots in the community with a strong record of clinical outreach. In 2016, he was named Outstanding Physician of the Year by the Alameda Health System. He is also a dedicated teacher and mentor to UCSF-East Bay general surgery residents, and a respected thought leader. His body of professional work includes more than 80 peer-reviewed publications.

Victorino completed his undergraduate degree at UC Berkeley in 1986 and earned his MD at the University of Pittsburgh. He returned to the Bay Area in 1991, completing a general surgery residency at UC Davis-East Bay in 1998, followed by a trauma-critical care fellowship at UC Davis. Soon thereafter, he joined the UCSF Department of Surgery as a faculty member.

Victorino succeeds Alden H. Harken, M.D., professor emeritus of surgery, who retired in 2017 after 14 years of leading the program, and whose energy and innovation have created a lasting legacy.

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80231
Mon, 3 Sep 2018 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=79997 <![CDATA[Department of Surgery Welcomes New Clinical Fellows for the 2018-19 Academic Year]]> The Department of Surgery warmly welcomes our new clinical fellows for the 2018-19 academic year, a diverse group of accomplished surgeons bringing a rich array of experiences from leading institutions. The UCSF Department of Surgery is one of the leading surgical departments in the world with a rich history of scientific, educational, and clinical advancements. It is also one of the largest clinical services at UCSF. In this rarefied learning environment, these clinical fellows will have the opportunity to work as integral members of multidisciplinary clinical teams and learn state-of-the-art surgical techniques in their chosen speciality.

ABDOMINAL TRANSPLANTATION

Zachary Dietch MD MBA Zachary C. Dietch, M.D., MBA
Clinical Fellow (PGY-6)
Abdominal Transplant Surgery
Seiji Yamaguchi MD Seiji Yamaguchi, M.D. 
Clinical Fellow (PGY-6)
Abdominal Transplant Surgery

 BREAST SURGICAL ONCOLOGY

Daphne Ly Photo Daphne P. Ly, M.D. 

Clinical Fellow (PGY-6)
Breast Surgical Oncology

Jami D Rothman MD Scm Jami D. Rothman, MD, ScM 

Clinical Fellow (PGY-6)
Breast Surgical Oncology

 ENDOCRINE SURGERY

Monica Jain Photo

Clinical Fellow (PGY-6)
Endocrine Surgery


Treitl Daniela 303Hr

Clinical Fellow (PGY-6)
Endocrine Surgery

LIMB PRESERVATION

Kevinpham

  Clinical Fellow (PGY-4)
  Limb Preservation

   

MICROSURGERY 

Srinivasa Dhivya

  Clinical Fellow (PGY-6)
  Microsurgery

   

MINIMALLY INVASIVE GI / BARIATRIC SURGERY

Ryanpicedit Ryan Macht M.D., M.S. 

Clinical Fellow (PGY-6)
Minimally Invasive & Bariatric Surgery

   

SURGICAL CRITICAL CARE (ACGME)

Clinical Fellow (PGY-6)
Surgical Critical Care

Clinical Fellow (PGY-6)
Surgical Critical Care

THORACIC SURGERY (ACGME)

  Clinical Fellow (PGY-6)
  Thoracic Surgery

   

VASCULAR SURGERY (ACGME)

  Bian Wu, M.D. 
  Clinical Fellow (PGY-6)
  Vascular Surgery
   
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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=79997
Fri, 31 Aug 2018 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=79980 <![CDATA[FDA Awards UCSF and Stanford 5-year $6.7M P50 Pediatric Device Consortia (PDC) Grant]]>

Michael Harrison, MD, Professor Emeritus of Surgery, Pediatrics, Obstetrics, Gynecology and Reproductive Sciences at the University of California, San Francisco (UCSF), Shuvo Roy, PhD, Professor of Bioengineering & Therapeutic Sciences at UCSF, and James Wall, MD, Assistant Professor of Surgery at Stanford University have been awarded a five-year $6.7 million Pediatric Device Consortia (PDC) P50 grant from the U.S. Food and Drug Administration (FDA). The UCSF-Stanford PDC is one of five centers selected to participate in the national program aimed at accelerating the development and availability of medical devices designed specifically for kids, whose access to state-of-the-art medical technology lags 5-10 years behind adults.

Advancing Pediatric Device Development 

Located in the heart of Silicon Valley, the UCSF-Stanford PDC will leverage the strengths of UCSF's program in surgical device innovation, Stanford's renowned Biodesign program, Northern California's top two children's hospitals, and a rich network of device industry and entrepreneurial partners to support pediatric device innovators through the total product development lifecycle. Features of the joint initiative include concept-stage market and value analysis assessments; comprehensive in-house engineering and product development services; regulatory, patenting, and business planning services; and commercialization strategy advising. 


James Wall MdThe grant will also provide $250,000 in seed funding through an annual Accelerator competition and support for a demonstration project that utilizes "real world evidence," or patient data routinely collected from a variety of sources (e.g., EHR, claims activity, product registries, etc.), to augment the evidence base available for regulatory decision-making.

Meeting the Challenge

Navigating the device development pathway is challenging, particularly for pediatric device innovators, as the small market sizes often ward off interest from investors and larger corporations. That's where the PDC steps in – offering assistance through each stage of development to individual entrepreneurs, academic physicians and researchers, trainees, and startups, primarily through its weekly Innovators Forum and Pediatric Device Accelerator. The UCSF PDC held its first Accelerator competition in November 2017, awarding eight seed grants ranging from $20,000 to $50,000 to pediatric device innovators across the country. The funds and personalized advising have allowed the projects to make significant strides, namely three that have progressed to the clinical testing stage: 

  • UC Berkeley spinout InkSpace Imaging, recipient of a $50,000 Accelerator Award, is developing flexible MRI coils for pediatric patients and will begin their first clinical study later this year. The PDC's internal staff assisted the device developers in navigating the IRB process, finding clinical collaborators at UCSF, and matching them with a commercialization mentor from the PDC's deep network of advisors. 
  • Tabla, a handheld acoustic pneumonia detection device invented by UCSF MD/PhD candidate Adam Rao, is being used to collect data from patients with cardiogenic pulmonary edema to determine whether it can detect daily lung fluid changes associated with heart failure exacerbation. They also plan to collect data on pneumonia patients in an upcoming study. In addition to funding, the PDC helped recruit a machine learning engineer and clinical research coordinator to the team.
  • Utilizing its proprietary 3D printing technology, UNYQ is creating custom-fit braces for children with the chest wall defect pectus carinatum. The PDC linked UNYQ and UCSF pediatric surgeon Benjamin Padilla, MD, who will serve as a clinical collaborator. The team is currently enrolling patients in a pilot trial at UCSF. 

A Strong Legacy of Device Innovation 

Pediatric Device Consortia Grant Program

In 2009, the UCSF PDC became part of the first cohort of academic medical centers to receive FDA funding to launch programs dedicated to stimulating and supporting pediatric device development. The 2018 grant award makes UCSF the longest running continually funded consortium of this type. Under the leadership of Drs. Harrison and Roy, the UCSF PDC has advanced 10 internally developed devices to first-in-human trials and guided three to market availability. Collectively, the technologies incubated have attracted over $30 million in external funding. The UCSF PDC has also been a catalyst for establishing a thriving ecosystem in medical device innovation at UCSF, paving the way for programs such as UCSF Surgical InnovationsUC Berkeley-UCSF Master of Translational Medicine, and the Rosenman Institute at QB3.  

Since its founding in 2000, Stanford Biodesign has established an internationally recognized model for device development, having launched 45 successful startup companies whose technologies have now reached over a million patients. Dr. Wall, who serves as Assistant Director of the Byers Center for Biodesign Innovation Fellowship, will be the PI for Stanford and will mentor one fellow per year to apply the Biodesign process to pediatric-specific technologies.

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- by Stacy Kim https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=79980
Sun, 26 Aug 2018 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=79760 <![CDATA[Tammy T. Chang, MD, PhD Awarded NASA and National Science Foundation Grants to Study Microgravity in Biological Systems]]> Surgeon-scientist Tammy T. Chang, MD, PhD, principal investigator in the The Chang Laboratory for Liver Tissue Engineering, has been awarded grants by two prestigious federal funders of research, the NASA Space Biology Program, and the National Science Foundation (NSF) in collaboration with the Center for the Advancement of Science in Space (CASIS). 

Dr. Chang is a gastrointestinal surgeon who takes care of patients primarily in an acute care setting.  She holds an appointment as an assistant professor in the Division of General Surgery. Dr. Chang's research is focused on microgravity as it impacts biological systems  in a simulated environment on Earth in the NASA research and aboard the International Space Station in the NSF grant. 

In the NASA grant, Dr. Chang, one of six awardees new to the Space Biology Program, will use liver organoids generate in simulated microgravity on Earth to investigate the molecular basis of three-dimensional cellular organization and vasculogenesis enabled by the microgravity environment.

In The NSF/CASIS funded project, she and her research team will use the organoids as building blocks to create larger self-organized structures by leveraging the sustained microgravity onboard the International Space Station, pro-angiogenic biomaterials, and physiologic microfluidic flow.  The goal is to benefit human health on Earth by developing novel human stem cell-derived functional liver tissues that can be implanted as an alternative or adjunct to liver transplantation.

Dr. Chang believes her work could one day alter the treatment of end-stage liver disease and reduce the need for liver transplants with concomitant improvements to the social fabric:

As a surgeon-scientist, my long-term goal is to develop novel tissue-based therapies for the treatment of end-stage liver disease and to translate discoveries in the laboratory into surgical procedures that benefit patients in the operating room. The NASA Space Biology and NSF/CASIS projects are aimed at investigating whether microgravity may be key tool for developing thick vascularized tissues that may be implanted as functional tissue replacement therapy.  If successful, the results of this research will represent a breakthrough in our ability to generate thick vascularized tissues for therapeutic implantation and may spur development of an entirely new space-based biomedical industry. Moreover, having large functional tissue engineered constructs with "off-the-shelf" availability could alleviate the morbidity and mortality associated with organ failure as well as the social injustices linked transplant tourism and organ trafficking.
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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=79760
Sat, 25 Aug 2018 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=79624 <![CDATA[Laura J. Esserman, MD, MBA Selected as 2018 OncLive Giant of Cancer Care in Cancer Diagnostics]]> Laura J Esserman MD MBA Is The Onclive 2018 Giant Of Cancer Care In Cancer Diagnostics

Laura J. Esserman, MD, MBA was selected as the 2018 OncLive® "Giant of Cancer Care" in Cancer Diagnostics. Dr. Esserman is professor of Surgery and Radiology at UCSF and director of the UCSF Carol Franc Buck Breast Care Center. She was chosen by an elite committee of her peers based on her long history of outstanding work in the field as noted in the announcement:

  • Dr. Esserman led efforts to address harms of screening including overdiagnosis, and proposed tools including the development of molecular diagnostics to help reclassify tumors as indolent lesions of epithelial origin or ultralow risk.
  • She leads the I-SPY Trials, a groundbreaking national public-private collaboration designed to reduce the time and cost for drug development, to find the right drug for the right patient earlier in the disease course when cure is possible.
  • She led the creation of the University of California-wide, and now national, Athena Breast Health Network, which integrates clinical care and research, and follows 150,000 women from screening through treatment and outcomes. This spawned the WISDOM study to determine weather personalized screening has higher healthcare value than the standard of annual screening.
  • Dr. Esserman was included as one of TIME magazine's 100 Most Influential People of 2016 and was the recipient of the 2016 Stanford Business School Ernest C. Arbuckle Award and the 2016 Personalized Medicine World Conference Luminary Award.

The official announcement headlined, "OncLive Salutes 21 Visionaries With Giants of Cancer Care Award" reflected the significance of the honor:  

Twenty-one changemakers have been selected to receive a 2018 OncLive Giants of Cancer Care® award. The august group represents the largest class of inductees since the awards program was established in 2013. Recipients must be catalysts for change, demonstrating great accomplishment, imagination, inspiration, courage, and—perhaps most important—a true sense of urgency. The 2018 winners were recognized on Thursday, May 31, during an exclusive celebration at the Adler Planetarium in Chicago, Illinois.

This year, a record number of individuals were nominated to receive the Giants award. These exceptional physicians and researchers have challenged the reigning paradigms in oncology with their innovative and groundbreaking contributions to patient care, clinical practice, and translational research. This year also marks the program's largest international contingent, with almost 2 dozen nominees from outside the United States.

A 7-member advisory board chaired by Patrick I. Borgen, MD, reviewed the career achievements of the nominees, narrowing the field to 171 trailblazers, who were then voted on by an elite selection committee of distinguished oncologists and hematologists.

 

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=79624
Thu, 23 Aug 2018 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=79882 <![CDATA[Hoping to Save Limbs and Toes, California Moves to Curtail Diabetes]]> Dr Alexander Reyzelman Right Confers With Michael Rubenstein A Diabetes Patient Photo By David Gorn Calmatters
Dr. Alexander Reyzelman treats diabetes patient Michael Rubenstein. Photo by David Gorn/CALmatters

The word "amputation" threw a chill down Michael Rubenstein's spine.

The 67-year-old diabetic from San Mateo still winces at the thought. "They told me I'd need to cut it off right about here," he said, sawing his hand across his left shin.

Series Logo The Hidden Cure WellnessTwo months after that diagnosis, he's on an exam table at the Center for Limb Preservation at UC San Francisco, his leg still whole, the threat of gangrene and amputation gone and his mood a lot less bleak and fearful. "Yeah, it turns out I didn't need that," he said.

Many others are not so lucky. More than 12,000 Californians lost limbs or toes to diabetes in 2016, state data show. More than 2.5 million people in the state have been diagnosed with adult diabetes, or Type 2, and risk a similar fate if it goes unchecked. That's especially true for low-income patients, who may lack regular preventive medical services. They're 10 times as likely as their wealthier counterparts to lose a toe, foot or leg, according to one study.

That disparity is part of the impetus for a new diabetes prevention program for patients in Medi-Cal, the state's version of the federal Medicaid health program for low-income residents. The rate of diabetes in California grew from 8.7% of the population in 2010 to 10.2% in 2016, while amputations increased by almost a third.

"Most of those amputations are unnecessary," said Alexander Reyzelman, co-director of the UCSF clinic that saved Rubenstein's left leg with procedures to increase blood flow.

The state has set aside $5 million annually for five years to help Medi-Cal patients at risk for diabetes, a chronic condition that can lead to blindness, heart disease and stroke, among other ills. The money will fund a program, beginning in January, intended to improve their diets, lower their blood sugar and make them aware of such potentially dire consequences as amputation. 

Preventing or curtailing the progress of the disease could save taxpayers an estimated $45 million a year in treatment costs, according to the Davis-based nonprofit Public Health Advocates, which urged lawmakers to create the program.

Participants will have a year's access to trained peer coaches, who'll teach them to eat less sugar and fewer other carbohydrates and increase fiber with more fruit and vegetables. The coaches will also help foster other lifestyle changes, such as giving up smoking and exercising more. The regimen is based on a federal program that the Center for Disease Prevention and Control says can cut the risk of diabetes by more than half.

The effort is part of an overall state approach that goes beyond medication, aimed at producing a healthier population that requires less expensive public care. About a third of Californians receive their care through Medi-Cal.

About 25,000 people a year are expected to join the program.

"This gives us the opportunity to intervene before they become really sick," said Flojaune Cofer, director of state policy and research at Public Health Advocates.

"Once they have the disease, that's when it gets expensive," with added medications and significantly more tests, she said. "We think this model can be duplicated in many ways. It could be useful for asthma, it could be useful for hypertension."

People with diabetes can develop poor blood flow to their extremities and suffer nerve damage and lack of feeling, most often in their legs and feet. In some cases, the result is gangrene. In some of those instances, amputation may be the only way to save a life.

The increase in diabetes and the threat of amputation are "a silent, sinister crisis," said David Armstrong, a podiatric surgeon teaching at the University of Southern California's Keck School of Medicine. "The problem is getting bigger and bigger, and you can't fight it by just chopping off a leg."

Amputation can cause as many health problems as it solves, according to Reyzelman: "When you lose a leg to amputation, 50 to 70% of patients will die within five years. You don't want to lose a leg."

Experts say a multidisciplinary approach can bring patients back from the brink of amputation. Vascular surgeons, podiatrists and reconstructive microsurgeons have joined forces to treat diabetes at medical centers across the state, including those at UCSF, UCLA, UC San Diego, UC Davis and USC.

The hope is that more patients can walk away like Rubenstein: intact.

"If I needed to get an amputation, I was willing to do that," Rubenstein said. "But I certainly didn't want that. Who would want that? Absolutely no one, that's who."

Reprinted coutesy of CALmatters.org, an independent public interest journalism venture covering California state politics and government. This is the third article in a series on state efforts to foster healthy living as a way to reduce chronic illness.

Hoping to save limbs and toes, California moves to curtail diabetes (Original Story at CALmatters)

Related Story at UCSF News

Saving Limbs and Toes From the Grip of Diabetes With Clinic's New Approach

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- by David Gorn, CALmatters https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=79882
Thu, 23 Aug 2018 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=79806 <![CDATA[UCSF General Surgery Residency Program Ranked No. 1 in Western U.S. in Annual Doximity Survey]]> The UCSF General Surgery Residency was ranked No. 1 in research output and by reputation among sister programs in California and across the western U.S. in the Doximity 2018-19 annual survey. Nationally, the program placed in the 99th percentile for research output

The residency program is led by Department Chair Julie Ann Sosa, M.D., M.A., FACS, Program Director Linda M. Reilly, M.D., Associate Directors Ryutaro Hirose, M.D., Kenzo Hirose, M.D., and Lygia Stewart, M.D., and Administrative Director Rachelle Bresnahan.

Graduating Chiefs And Leadership News Story

Top Ranked General Surgery Residencies (2018-19)

Western U.S.

Doximity Navigator

Research Output

  1. University of California (San Francisco)
  2. UCLA David Geffen School of Medicine/UCLA Medical Center
  3. University of Washington
  4. Stanford Health Care-Sponsored Stanford University
  5. Oregon Health & Science University
  6. University of California Davis Health
  7. University of Southern California/LAC+USC Medical Center
  8. University of Colorado
  9. University of California (Irvine)
  10. University of California (San Diego) Medical Center

Reputation

  1. University of California (San Francisco)
  2. University of Washington
  3. Stanford Health Care-Sponsored Stanford University
  4. UCLA David Geffen School of Medicine/UCLA Medical Center
  5. Oregon Health & Science University
  6. University of Southern California/LAC+USC Medical Center
  7. University of California Davis Health
  8. University of Colorado
  9. University of California (San Diego) Medical Center
  10. Mayo Clinic College of Medicine and Science (Arizona)

Large Public Hospitals Across U.S.

Research Output

  1. University of California (San Francisco)
  2. UCLA David Geffen School of Medicine/UCLA Medical Center
  3. University of Michigan Health System
  4. UPMC Medical Education (Pittsburgh)
  5. New York University School of Medicine
  6. University of Washington
  7. Stanford Health Care-Sponsored Stanford University
  8. Emory University School of Medicine
  9. Oregon Health & Science University
  10. University of Illinois College of Medicine at Chicago

Reputation

  1. University of Michigan Health System
  2. University of California (San Francisco)
  3. University of Texas Southwestern Medical School
  4. University of Washington
  5. Stanford Health Care-Sponsored Stanford University
  6. Emory University School of Medicine
  7. UPMC Medical Education (Pittsburgh)
  8. New York University School of Medicine
  9. UCLA David Geffen School of Medicine/UCLA Medical Center
  10. Oregon Health & Science University

National Rankings

Research Output

  1. Johns Hopkins University
  2. Massachusetts General Hospital
  3. University of California (San Francisco)
  4. Duke University Hospital
  5. UCLA David Geffen School of Medicine/UCLA Medical Center
  6. Washington University/B-JH/SLCH Consortium
  7. University of Michigan Health System
  8. Brigham and Women's Hospital
  9. McGaw Medical Center of Northwestern University
  10. UPMC Medical Education (Pittsburgh)

Reputation

  1. Massachusetts General Hospital
  2. Johns Hopkins University
  3. University of Michigan Health System
  4. Washington University/B-JH/SLCH Consortium
  5. University of California (San Francisco)
  6. Vanderbilt University Medical Center
  7. Brigham and Women's Hospital
  8. Duke University Hospital
  9. University of Pennsylvania Health System
  10. University of Washington

Note: Doximity received more than 315,000 peer nominations, ratings and hand-written reviews to determine its top residency programs for the 2018-19 "Doximity Residency Navigator". The data shown above was current as of July 24, 2018.  Data for research output may change between surveys and may affect ranking after publication of initial results.

Related Links

Doximity Releases 2018-2019 Residency Navigator

Doximity Residency Navigator - Residency Programs (Clinician Login Required for Full Search)

Doximity Residency Navigator - Residency Research Methodology

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=79806
Wed, 22 Aug 2018 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80032 <![CDATA[The New Transportation Revolution: UCSF Research Team to Track Injuries Involving Electronic Scooters]]> "When technology enters transportation, people forget that it also becomes public health. It becomes something where human lives are at stake." --- Dr. Catherine Juillard, UCSF trauma surgeon at Zuckerberg San Francisco General Hospital (ZSFG)

Rsz Juillard CatherineThe New York Times, NBC Nightly News and UCSF News Center report on the controvery surrounding the influx of new vehicles such as motor-assisted scooters and mopeds into urban areas, and their impact on safety, notably here in San Francisco. Many in this class are shared or "just-in-time" vehicles that users rent on the spot, some maybe for the first time. 

Catherine Juillard, M.D., MPH., a trauma surgeon and assistant professor in the UCSF Department of Surgery at ZSFG, and Christopher Colwell, MD, a UCSF professor and chief of emergency medicine at ZSFG, will be studying the impact of their on public safety at a very granular level, distinguishing, for example, among injuries that involve electric bikes, mo-peds and scooters, hoverboards, Segways, and unicycles. The goal of this research is to eventually provide Chris Colwell headshotlawmakers and analysts with the data that will inform sound regulation and public policy. 

Juillard told the New York Times:

"I can say that several years ago that I didn't see these types of injuries happening, and now I do," said Dr. Juillard, who is also a professor researching injury prevention at the University of California, San Francisco. "But we have to do the hard work of looking at the data to determine if there's truly a trend."

Colwell, who sees a wide range of injuries that many not necessarily require surgery, added:

"I'm quite confident that we were seeing five to 10 injuries from this a week, and I'm probably underestimating that," Dr. Colwell said. "We saw one or zero a month before the increase in electric scooters."

The UCSF researchers have teamed with Megan Wier, an epidemiologist with the San Francisco Department of Public Health and the Vision Zero SF Injury Prevention Research (VZIPR) Collaborative to study this emergent issue and its impact. The NY Times described the somewhat frenetic process to develop standardized data-collection.

With the clock ticking, Ms. Wier and her colleagues combed through months of police and hospital records to help inform the classifications. But she believes the most useful injury patterns will emerge only after a data schema is established and the scooters return to San Francisco.

NBC Nightly News also covered the story in its national broadcast, underscoring the importance of this issue across the U.S. and internationally. NBC interviewed both Juillard and Colwell for the story as did UCSF News.

Related Links

Health Officials Prepare to Track Electric Scooter Injuries      New York Times
Scooter Safety: UCSF Doctors to Track New Injuries UCSF News
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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80032
Wed, 1 Aug 2018 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80215 <![CDATA[Unveiling of Wraparound Mural in Ward 3M]]> The Wraparound Project recently unveiled a new mural in Ward 3M of the Zuckerberg San Francisco General. This mural was designed by Wraparound clients who participated in an Art workshop facilitated by Marco Razo and generously funded by Bank of America. The Art Workshop fast became a safe, welcoming space for clients to express themselves while learning a new skill. Participants in this workshop have gone on to showcase their work in galleries across the city. As an added benefit, participants also partook in workshop development - learning the vital resume writing and interview skills necessary for employment. 

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- by Adaobi Nwabuo https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=80215
Thu, 19 Jul 2018 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=78972 <![CDATA[Endocrine Surgeon Insoo Suh, MD Pioneers New Hybrid Surgical Option for "Hidden Scar" Thyroidectomy]]> Insoo At Conference

Insoo Suh, M.D., FACS, assistant professor of endocrine surgery and noted surgical innovator, presented his experiences using "scarless" transoral endoscopic thyroid and parathyroid surgery to a national audience at the 2018 meeting of the American Association of Endocrine Surgeons (AAES). Minimally invasive and remote access thyroid surgery has been evolving with the transoral endoscopic thyroidectomy vestibular approach (TOETVA) emerging as a true "scarless" thyroidectomy. Dr. Suh helped pioneer this technique and is among the first surgeons in the U.S. to utililze it. 

Dr. Suh also discussed his experiences with a new hybrid procedure using a TransOral and Submental Technique (TOaST) technique, a refinement that pairs the transoral approach with a small easily hidden incision just under the chin, offering patients an additional surgical option with a number of potential benefits including:

  • Decrease in postoperative complications and patient discomfort
  • The ability to accommodate larger thyroid specimens
  • Maintaining virtually all of the cosmetic benefits of traditional scarless surgery

Toast

Related Publication

The first case report on the use of the TOaST technique was recently published at:

Chen Y, Chomsky-Higgins K, Nwaogu I, Seib CD, Gosnell JE, Shen WT, Duh QY, Suh I, Hidden in Plain Sight: Transoral and Submental Thyroidectomy as a Compelling Alternative to "Scarless" Thyroidectomy, Journal of laparoendoscopic & advanced surgical techniques. Part A, May-07-2018; [Epub ahead of print]. PubMed

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=78972
Tue, 17 Jul 2018 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=79582 <![CDATA[Bay Area Girl Undergoes First-Ever Pediatric Heart Transplant At UCSF]]> Peter Kouretas MD PhdCBS SF Bay Area (KPIX) reports on the first-ever pediatric heart transplant at UCSF. The surgical team was led by Peter Kouretas, M.D., Ph.D., associate professor of surgery and surgical director of Pediatric Heart Transplantation at UCSF. 

The first-ever pediatric heart transplant at UCSF Benioff Children's Hospital may have just saved a young Bay Area girl's life.

It's been tough for 11-year-old Andrea to keep up with other students during gym class in Walnut Creek.

"I would feel short of breath, I would need to take a break more often than other people would," she says. 

Andrea has a rare form of cardiomyopathy, which is a genetic disease that makes it difficult for the heart to pump blood. But thanks to a new team of doctors at UCSF, she has a new outlook and a new heart. 

"For Andrea's family to trust us to be our very first heart transplant program here, we needed to be able to do this and say we can do this," says Dr. Jeffrey Gossett Director of the Pediatric Heart Transplant Program.

On Monday, the hospital celebrated with Andrea's family. They are moving to a transitional home nearby so doctors can monitor her for two weeks.

"It's just the beginning of the road also, it was very, very stressful," says her father, Calin. "But we're very happy that the outcome has been this beautiful princess you see here who is feeling good."

Because Andrea also has a heart rhythm problem that complicates her condition, doctors said she had a 30 percent chance of dying within one year. Now she has a 95 percent chance of survival.

"Activity level, functionally – they'll get back to normal and lead a good functioning life," said Dr. Pete Kouretas, Surgical Director of the program.

Read full story at CBS SF Bay Area (KPIX)

 

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=79582
Sat, 14 Jul 2018 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=79706 <![CDATA[Trauma Surgeon Lucy Kornblith, M.D. Recipient of (EAST) Trauma Research Scholarship]]> Trauma Surgeon Lucy Kornblith, M.D. has been awarded the Eastern Association for the Surgery of Trauma (EAST) Trauma Research Scholarship to study post-injury platelet biology. Dr. Kornblith is a graduate of the UCSF General Surgery Residency Program and subsequently completed fellowships in Surgical Critical Care and Trauma Surgery, and Trauma and Emergency Care at UCSF. She will be joining the UCSF General Surgery Faculty August 1, 2018 and will be based at Zuckerberg San Francisco General.

Dr. Kornblith described how this award is advancing her career aspirations as an academic surgeon in the field of trauma:

My ultimate career goal is to become an independently funded trauma surgeon-scientist. The EAST Research Scholarship gives me the opportunity to perform critical preliminary investigations toward identifying the mechanistic role of platelets and platelet-endothelial interactions in trauma-induced coagulopathy. In an atmosphere of scarce funding opportunities, this scholarship will allow me to build a scientific foundation upon which I can study post-injury platelet biology to ultimately reduce the morbidity and mortality associated with post-injury hemorrhage through novel platelet-based therapies.

Dr. Lucy Zumwinkle Kornblith: Recipient of the 2018 EAST Trauma Research Scholarship (Official Announcement)

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=79706
Tue, 10 Jul 2018 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=79515 <![CDATA[Nancy Ascher, MD, PhD Invited to Serve on WHO Task Force on Donation and Transplantation of Human Organs and Tissues]]> Nancy Ascher, M.D., Ph.D., the world-renowned organ transplant surgeon and a former Chair of the UCSF Department of Surgery, has also been invited to serve on the WHO Task Force on Donation and Transplantation of Human Organs and Tissues, an international multidisciplinary task force of 31 experts spanning the fields of medicine, surgery, ethics, law, patients' rights, public administration and health systems. The task force is charged with establishing the fundamentals of ethical transplantation, providing guidance to health ministries and governments pertaining to legislation, registries, organ procurement, patient management, and standards of care. 

 

 

As outgoing President of the The Transplantation Society (TTS), Dr. Ascher also delivered the Presidential Address to the 27th International Congress of The Transplantation Society in Madrid, Spain on July 4th entitled, Ensuring the Future of Transplantation - How Will We Protect Our Women?

Dr. Ascher, the Congress Chair, gave a second lecture, Holy Grail of Work-Life Balance": Mindfulness, emotional intelligence and well-being in a session focused on developing a successful career in transplantation. UCSF was well represented at the Congress with more than 60 invited talks and abstracts.

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=79515
Mon, 2 Jul 2018 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=78580 <![CDATA[Department of Surgery Welcomes Endocrine Surgeon and Diversity Leader Sanziana A. Roman, MD to Faculty]]> The Department of Surgery welcomes endocrine surgeon Sanziana A. Roman, M.D., FACS to the faculty as a professor of Surgery in the Section of Endocrine Surgery, Division of General Surgery. Dr. Roman also has been appointed Director of Learning and Teaching in the Procedural Specialties and Dean's Diversity Leader for Leadership Equity and Inclusion in the School of Medicine at UCSF. 

Dr. Roman's clinical interest is in endocrine and minimally invasive surgery, with a focus in thyroid and adrenal diseases, including pediatric and adult endocrine tumors. She is one of only a few high-volume adrenal surgeons in the country performing posterior retroperitoneoscopic adrenalectomy (PRA), a procedure she helped to pioneer.

Dr. Roman is the author of more than 180 peer-reviewed publications in outcomes analysis, cost-effectiveness/decision analysis, meta-analysis, and survey-based methodologies, as well as clinical, translational and stem cell research.

 

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=78580
Fri, 29 Jun 2018 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=79576 <![CDATA[Trauma Surgeon Andre Campbell, M.D. Vents Frustration over Toll of Pervasive Daily Gun Violence in Nation's ERs ]]>

UCSF trauma surgeon Andre Campbell, M.D., who was on the trauma team that treated victims injured in the shooting at the YouTube headquarters in California, vented his frustration over decades of gun violence in a press conference about the shooting.  As reported by CNN, Campbell challenged the news media to look beyond the sensational events and address the pervasive omnipresent gun violence that is a daily occurrence in the U.S. Campbell was widely praised in social media for stance as well as his decades of service as a trauma surgeon and mentorship to many generations of medical students and surgical residents at UCSF. 

"To think that after we've seen Las Vegas, Parkland, the Pulse nightclub shooting, that we would see an end to this, but we have not," Campbell, an attending trauma surgeon at Zuckerberg San Francisco General Hospital and Trauma Center, told reporters.

"Gun violence happens every day throughout the United States. It happens here in San Francisco. It happens in the Bay Area. It happens all over the country," Campbell said. "But I don't see you guys out here because I'd like to make sure that people know that we got a serious problem that we need to address." 
"I don't have all the answers ... at least we're having a discussion about it nationally," he said. "This is a real problem."
"This is a terrible day in the United States," said Campbell, a professor of surgery at the University of California, San Francisco, School of Medicine."I didn't see all these cameras out here ... last week when I was here," he said. 

"That's the problem, when something like this happens, which is terribly unfortunate, then you guys come out," Campbell said. "The reality is we have to deal with this all the time. We have to deal with the families."

"We kind of quietly do our job and we don't say a whole lot," he said. "But today just seemed like it was a day where people wanted to hear what was going on."

 "We as trauma providers, we are just saddened by the fact that this is a persistent problem. "It happens with such regularity. It's unbelievable," he said of gun violence. 

"We need to work together to find a solution," Campbell said.

 

 

 

 

 

 

 

Listen to KQED Interview with Dr. Andre Campbell

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https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=79576
Wed, 27 Jun 2018 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=79470 <![CDATA[Residency Program Director Linda M. Reilly, MD Honored with 2018 UCSF Excellence and Innovation Award in Graduate Medical Education]]> Linda M. Reilly, M.D., Program Director of the UCSF General Surgery Residency Program, was named a 2018 Recipient of the UCSF Excellence and Innovation Award in Graduate Medical Education (GME). The award was presented at the UCSF GME Celebration and QI Symposium on June 18th at the UCSF Kalmanovitz Library at Parnassus Heights. Dr. Reilly is a vascular surgeon and professor in the Division of Vascular & Endovascular Surgery.

Award recipients have demonstrated a commitment to advancing graduate medical education at UCSF through educational and clinical quality improvement, service excellence, and innovation. Awardees demonstrate excellence in the following areas: 

  • Educational leadership in his/her department, at UCSF, and/or nationally
  • Participation in innovative GME-related projects
  • Extraordinary efforts to address resident/fellow needs and well-being
  • Other contributions to improving graduate medical education at UCSF and/or nationally

Reilly GME Awards 259 Copy

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=79470
Wed, 20 Jun 2018 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=78670 <![CDATA[Storied Medical Educator Patricia O'Sullivan, EdD Honored with Lifetime Achievement in Mentoring Award]]> Patricia S. O'Sullivan, EdD, professor of Surgery and Medicine at UCSF, received the 2018 Lifetime Achievement in Mentoring Award from the Faculty Mentoring Program at an award celebration on June 13th at the Lange Room in the UCSF Parnassus Library. 

Dr. O'Sullivan is director of the Office of Research and Development in Medical Education (RaDME) and holds the Endowed Chair for Surgical Education at UCSF. Her teaching and mentoring excellence have enriched the careers of faculty and trainees spanning a multitude of programs in the Department of Surgery including Resident ResearchMedical Student Surgical EducationSurgical Skills CenterCenter for Surgery in Older Adults, and Center for Mindfulness in Surgery.

Dr. O'Sullivan's scholarship has been described as one that "focuses on faculty development and assessment. Believing in a continuum between development and scholarship, she oversees opportunities at UCSF for individuals to gain skills and develop their scholarship."

UCSF 20180613 Sullivan 068 700W

 

 

 

Read full announcement

Patricia O'Sullivan Receives 2018 UCSF Lifetime Mentoring Award (UCSF News) 

Interview with Patricia S. O'Sullivan
Learn more about her philosphy and teaching innovations

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=78670
Mon, 18 Jun 2018 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=79465 <![CDATA[Surgical Innovations and TheraNova Forge Partnership to Speed MedTech Devices to Market]]> UCSF Surgical Innovations and San Francisco-based medical device developer TheraNova have formed a partnership that will allow for co-development of medical device technologies between them. UCSF innovators will now have a streamlined mechanism to collaborate with TheraNova engineers, which will help speed commercialization of products. The agreement formalizes a longstanding collaborative relationship between Surgical Innovations and TheraNova, providing access to the respective expertise and capabilities of each group, notably:

  • The partnership agreement establishes mechanisms for collaboration and access to expertise at both sites, enabling supported technologies to benefit from UCSF's intellectual and clinical environment and TheraNova's comprehensive product development capabilities.
  • TheraNova projects and spin-outs will benefit from UCSF expertise and collaborators for clinical trials and academic grants.
  • UCSF technologies will be supported by TheraNova's certified manufacturing facilities, product development expertise and fundraising experience. The agreement also outlines provisions for the development of joint inventions.

As a major source of medtech innovation in San Francisco, UCSF has an unparalleled environment for device invention at the doorstep of Silicon Valley. We have world-class clinical KOLs, state-of-the-art research facilities, leading translational bioengineers and passionate trainees working at the frontier of patient care," says Hanmin Lee, MD, surgeon-in-chief of UCSF Benioff Children's Hospital San Francisco and Surgical Innovations' clinical lead.

In addition to TheraNova, Surgical Innovations has industry partnerships with Zeus Industrial Products and ANSYS. The program plans to continue expanding its portfolio of industry partners to put more resources and expertise into the hands of its physician-inventors and accelerate the path to patient care.

"UCSF has a long history of collaborating with external partners to translate our research into actual products," says UCSF professor of bioengineering Shuvo Roy, PhD. "TheraNova has resources in every step of the device development process, and we look forward to utilizing their expertise and working together to accelerate groundbreaking innovation to patients."

Read the TheraNova press release (PR Newswire)

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- by Stacy Kim https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=79465
Sat, 16 Jun 2018 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=79559 <![CDATA[Highlights of 2018 UCSF Naffziger Surgical Society Meeting in San Francisco]]> The UCSF Howard C. Naffziger Surgical Society, the alumni society of graduates of the UCSF General Surgery Residency Program and associate members, held its 2018 meeting May 10-11 in San Francisco. Proceedings kicked with a Women in Surgery event at the home of Shelley Marks, the past President of the Society.

The Naffziger Day Symposium generated substantive discussion of the history and future of surgical training and practice, while celebrating the common lineage of graduates of the UCSF Department of Surgery. Symposium speakers included UCSF Department of Surgery Chair Julie Ann Sosa, MD, MA, FACS, Lygia Stewart, MD of UCSF, Edward Chen, MD of Emory University, John Renz, MD, PhD of Univ. of Chicago, Robert E. Glasgow, MD of Univ. of Utah, Sunil Bhoyrul, MD of Scripps Memorial Hospital La Jolla, Jerry Goldstone, MD, FACS, FRCSE (hon) of Case Western Reserve; and the featured guest lecturer, Gerard M. Doherty, MD a Professor at Harvard Medical School and Surgeon-in-Chief at Brigham Health and Dana-Farber Cancer Institute. Following the symposium, there was a celebration dinner honoring the outgoing class of graduating Chief Residents.  

 

 

Lawrence Way Effect

View the Slides from Dr. Sunil Bhoyrul's Talk

Women in Surgery Event

IMG 5623 Shelley Marks Home 1

IMG 5633 Women In Surgery 2

Naffziger Day

Naffziger Day 2018 Group Picture For Story

Endocrine Surgeons Naffizger Day

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=79559
Fri, 15 Jun 2018 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=79563 <![CDATA[Bill Browder Gives Riveting Account of Russia Experiences at 21st Maurice Galante Lecture]]> The 21st Maurice Galante Lecture was given by Bill Browder, founder and CEO of Hermitage Capital Management, on June 13th at UCSF Mission Bay in Byers Auditorium in Genentech Hall. Browder was the largest foreign investor in Russia until 2005, when he was denied entry to the country for exposing corruption in Russian state-owned companies. 

In 2009, Browder's Russian lawyer, Sergei Magnitsky, was killed in a Moscow prison after uncovering and exposing high-level corruption committed by Russian government officials. In February 2015, Browder published the New York Times bestseller Red Notice: How I Became Putin's No.1 Enemy,  recounting his battles with the Russian government and work to seek justice for Magnitsky and others like him. The lecture was followed by a book signing and reception. 

 

 

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=79563
Fri, 15 Jun 2018 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=78063 <![CDATA[Trauma Surgeon Peggy Knudson, MD Leads First Large-scale Investigation of Pulmonary Clots after Injury]]> Dr Knudson 960X350 1026A

The CLOTT (Coalition of Leaders in Thromboembolism) study group, led by trauma surgeon M. Margaret "Peggy" Knudson, M.D., FACS, has begun enrolling patients in a landmark clinical trial looking at the treatment and prevention of post-traumatic pulmonary embolism. The study, which includes  investigators at 17 Level 1 trauma centers, is funded by a $4.25M grant from the Defense Medical Research and Development Program (DMRDP). 

Dr. Knudson, the study's principal investigator, is a professor of surgery and member of the UCSF Department of Surgery at Zuckerberg San Francisco General Hospital (ZSFG). She also serves as Medical Director for the Military Health System (MHS) Strategic-ACS Partnership. Dr. Knudson describes the study as the first large scale investigation of pulmonary clots after injury, one that has the ability to change how PE patients are cared for and how to prevent the potentially lethal complication.

The National Trauma Institute highlighted some of the key goals of the study:

The group will compare the safety of observation vs. treatment of asymptomatic peripheral pulmonary clots discovered on computed tomography angiography (CTA). Additionally, they aim to define the role of post-injury fibrinolysis shutdown in the development of post-traumatic pulmonary embolism (PE). 

Investigators have begun to enroll injured civilian adult patients in the age range of 18-40 years who are at risk for PE. The study will characterize the risk factors for those with symptomatic, central PE versus those with asymptomatic, peripheral thrombi. Five of the trauma centers in the study will analyze blood samples with thromboelastography (TEG) in order to better characterize the failure of clot lysis (fibrinolytic shutdown) in injured patients.

"This will be the first large scale investigation of pulmonary clots after injury and has the ability to change how we care for and prevent this potentially lethal complication."  Principal Investigator Peggy Knudson, MD

View full clinical trial abstract (The Pathogenesis of Post-Traumatic Pulmonary Embolism: A Prospective Multi-center Investigation by the CLOTT Study Group)

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=78063
Thu, 14 Jun 2018 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=78691 <![CDATA[Nature Article by Willenbring Lab Demonstrates How Liver Cells Switch Identities to Grow New Tissue]]> In the medieval ages, alchemists dedicated their lifetimes searching for the formula that would transform ordinary metals into gold. In our bodies, several cases of "cellular alchemy" have been reported. Known as transdifferentiation, this process consists of one specialized cell type transmuting into a different one. 

Until now, this phenomenon had only been observed in the context of replenishing cells lost from pre-existing structures. Now, UCSF researchers, led by Holger Willenbring, MD, PhD, professor of surgery and associate director of the Liver Center at UCSF, and a member of the Eli and Edythe Broad Center of Regeneration Medicine and Stem Cell Research, show, for the first time, that transdifferentiation can also occur to generate a structure that failed to be built in development. 

The researchers made these findings in a mouse model of Alagille syndrome (ALGS), a rare, inherited genetic disorder where the bile ducts, responsible for delivering bile made in the liver to the intestine, are either not formed or of insufficient diameter. The resulting accumulation of bile in the liver can cause irreparable damage, with 50 percent of patients requiring a liver transplant. 

In breakthrough research published May 2, 2018 in the journal Nature, Willenbring and colleagues generated mice lacking Notch signaling required to form biliary ducts during development, and observed that in these mice hepatocytes transdifferentiated into mature cholangiocytes and formed bile ducts that reverse liver damage. These findings change the paradigm in the field, where thus far hepatocytes had only been found to convert into biliary duct cells incompletely and transiently in the context of injury in an adult animal.  

In addition to making more of themselves, liver cells can switch their identity to produce a liver cell type that is lost or, in the case of severe ALGS, never formed," said Willenbring who was a senior author of the study and leads the Willenbring Lab at UCSF. 

Although the experiments were carried out in mice, they hold great promise for the development of novel therapies for ALGS and other liver disorders.  

Our study shows that the form and function of hepatocytes -- the cell type that provides most of the liver's functions -- are remarkably flexible. This flexibility provides an opportunity for therapy for a large group of liver diseases," says Willenbring. More specifically, he continued, "using transcription factors to make bile ducts from hepatocytes has potential as a safe and effective therapy. With our finding that an entire biliary system can be 'retrofitted' in the mouse liver, I am encouraged that this eventually will work in patients.

 OOZM H05

Co-lead authors were Johanna R. Schaub, PhD, and Simone Kurial, of UCSF, as well as Kari A. Huppert, of Cincinnati Children's Hospital Medical Center. The study was co-led by Willenbring and Stacey Huppert, PhD at Cincinnati Children's Hospital Medical Center.

Read Related Article at UCSF News

Willenbring Lab

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- by Leonardo M.R. Ferreira, Ph.D. https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=78691
Tue, 12 Jun 2018 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=79445 <![CDATA[Pediatric Surgeon Benjamin Padilla, MD Honored with Exceptional Physician Award]]> Benjamin Padilla M.D., a UCSF pediatric and fetal surgeon, and assistant professor in the Division of Pediatric Surgery, has been honored with the Exceptional Physician Award by UCSF Health. He was one of only eight recipients out of more than 100 nominations from a pool of several thousand UCSF physicians.

The awards were announced by Josh Adler, MD, Executive Vice President, Physician Services, UCSF Health in an email to the entire UCSF community:

These eight physicians were nominated and selected based on their demonstration of our core values of PRIDE -- Professionalism, Respect, Integrity, Diversity and Excellence.  Their hard work, dedication and contribution is a testament to the exemplary relationships they have with faculty, staff and patients, and their steadfast commitment to providing outstanding care for our patients.   Please join me in congratulating them on their exceptional service.

Hanmin Lee, M.D., Professor and Surgeon in Chief of UCSF Benioff Children's Hospital San Francisco and Chief of the Division of Pediatric Surgery, was effusive in his praise of Dr. Padilla:

Ben is a very deserving recipient leading our hyperinsulinism, endocrine, chest wall, oncology and pediatric ECLS programs. Just as importantly, Ben is incredibly devoted to his patients and his families spending countless hours counseling and comforting them. His patients constantly rave about what a compassionate doctor he is. He was nominated for this award by his colleagues which speaks to how highly he is regarded by his peers. I couldn't be prouder to call him my partner!

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=79445
Wed, 6 Jun 2018 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=79341 <![CDATA[Turning Surgeons Into Innovators Without Taking Them Out of the OR]]> Academic hospitals have all the makings for rich medical device development. They have physicians to identify surgical needs, researchers to test theories, bioengineers to design and create devices and patients to participate in clinical trials.

However, the disconnect between engineering and surgical departments makes innovation a challenge. So does surgeons' all-consuming job Number One—treating patients.

Providing the Infrastructure for Surgeons to Innovate

Surgical Innovations, part of the University of California, San Francisco's Department of Surgery and Bioengineering & Therapeutic Sciences, aims to open communication between clinical academic surgeons and bioengineering colleagues. It also gives surgeons a platform to develop life-enhancing and lifesaving medical devices.

Shuvo RoyLaunched in 2015, Surgical Innovations draws on the expertise of one of the country's top medical schools for research and primary care. UCSF providers conduct more than 1,300 clinical trials per year. Its research department boasts more than 1,800 active inventions.

"Clinical trainees and grad students work closely together," said Surgical Innovations engineering lead Shuvo Roy, PhD. "We also have post-doc engineers who move technology from bench to clinical studies."



Turning Surgeons Into Innovators - MD + DI



Michael R. Harrison - 144xSurgical Innovations evolved out of UCSF's 
Pediatric Device Consortium (PDC), which creates and develops devices to improve children's health. Michael Harrison, MD, who founded and leads PDC, pioneered fetal surgery procedures at UCSF in the early 1980s. 

"There were no devices or tools back then," Harrison said. "We were inventing, designing, developing, and using devices without regulatory control. And we were very successful."

Harrison also recognized an ongoing need for pediatric-specific devices. FDA agreed. In 2007, Congress passed the Pediatric Medical Device Safety and Improvement Act to stimulate pediatric device development. UCSF became one of the few institutions to develop pediatric devices. 

Surgical Innovations expands on PDC's infrastructure by enabling more surgeons to succeed in medical device innovation. For example, Roy leads the development of a bioartificial pancreas to help people with unstable Type I diabetes. 

Also called Brittle diabetes, unstable diabetes is a severe form of the disease that causes unpredictable, severe blood glucose level swings. Although insulin pumps and continuous glucose monitoring systems(CGM, aka Artificial Pancreas) help, Roy said often CGMs pose a 10-minute to 15-minute delay between levels measured in tissue and blood glucose levels. The bioartificial pancreas works in real-time.

The bioartificial pancreas uses silicon nanopore membranes developed by UCSF's Biodesign Laboratory. Insulin-producing cells are put into a pouch of silicon nanopore membranes, which protects cells from the body's immune system. Surgeons insert the bioartificial pancreas between a small artery and a vein, which allows for an immediate insulin response. 

Roy said the bioartificial pancreas doesn't require sensors. "The cells are the sensor," he said. There's also no need for lifelong immunosuppression medication, which is necessary for a pancreas transplant.

"The silicon nanopore membranes allow us to achieve a high level of immune protection and allow small molecules to pass through," he said. "And it's biocompatible. The device can be used inside the body for months, or possibly years, at a time."

Roy's team of vascular surgeons, immunologists, and other specialists have tested the concept in pigs. Clinical trials are the next step.

Smart Pressure Ulcer Detection

Chumfong, IsabelleHanmin Lee - 144Isabelle Chumfong, MD (pictured left), spent her research years working with Surgical Innovations clinical lead Hanmin Lee, MD (pictured right), biomedical engineers Sachin Rangarajan, Michael Hemati, and medical device engineer Sharvari Deshpande, to develop SmartDerm, a wearable sensor that measures pressure levels on the skin to help prevent pressure ulcers. Pressure ulcers affect 2.5 million patients a year at roughly $9.1 billion to $11.6 billion annually.

The current standard of care to determine pressure ulcer risk is the Braden Scale, developed in 1987. The Braden Scale examines six criteria, of which, Lee said don't always give an accurate picture. SmartDerm uses Big Data to more clearly determine risk, while the sensors measure pressure.

"We use large data sets to determine who's at highest risk through a proprietary machine learning algorithm," Lee said. "Our scoring system is more accurate and cost-effective than the Braden Scale. The low-profile sensor gives us real-time data on pressure ulcers—where they are on the body and for what period of time."

Rangarajan and Hemati, both UCSF Masters of Translational Medicine graduates, created a startup for SmartDerm. Deshpande joined later to focus on analyzing large data and creating the risk algorithm.

Lee said preliminary data shows the devices don't harm patients. The next step is a clinical trial to determine if SmartDerm trumps the Braden Scale.

Magnets for Sleep Apnea

Harrison leads the development of Magnap, a device used to treat moderate obstructive sleep apnea (OSA). OSA affects about 18 million adults, causing health problems and an eroded quality of life. The most common treatment is a continuous positive airway pressure device (CPAP), which is effective, but not popular with patients. It's uncomfortable, noisy, and may slip off in the middle of the night (or the patient pulls it off in frustration).

Magnap uses magnets instead of a mask to provide a more comfortable solution. Surgeons insert a small magnet on the hyoid bone in the neck, secured by sutures. During sleep, the patient wears a fitted collar that contains a second magnet. The collar magnet attracts the internal magnet, keeping the airway open. "It uses very little force, only a couple pounds of pressure," Harrison said.

Surgical Innovations is in the midst of a 10-person clinical trial for Magnap. Harrison said the first patient reported the device "saved my life." Three additional patients are currently undergoing treatment.

Depending on the outcome of the current trial, Harrison said he plans to seek FDA clearance.

Harrison said Surgical Innovations will continue to serve as a resource to its clinicians, graduate students and to the medtech community at large. "When someone from industry says 'we have a problem,' we'll see if we can figure out a solution."

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- by Heather R. Johnson https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=79341
Tue, 22 May 2018 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=78866 <![CDATA[Surgical Innovations Hosts Symposium Uniting Partners Around Children's Health]]> On May 17, the Second Annual UCSF Engineering for Children's Health Symposium was held at Mission Bay Conference Center. Over one hundred clinicians, engineers, scientists, administrators, industry professionals, and government partners gathered to discuss groundbreaking research and developing technologies in pediatric medicine.

UCSF 20180517 Childrens Health Symposium 075

The event commenced with opening remarks by Hanmin Lee, MD, Surgeon-in-Chief of the UCSF Benioff Children's Hospitals and Professor and Chief of the UCSF Division of Pediatric Surgery, along with Bertram Lubin, MD, Associate Dean of Children's Health at UCSF, which highlighted the large unmet need for pediatric medical devices, due to the lack of economic incentives for new technology development for small markets. Research talks by faculty from UCSF and UC Berkeley along with industry partners covered three main themes: fetal therapy and diagnostic technologies, device solutions for kids, and AR/VR and emerging technologies.

UCSF 20180517 Childrens Health Symposium 011

Pediatric surgeon Tippi MacKenzie, MD, kicked off the research presentations with her work on maternal-fetal precision medicine, specifically the effect of fetal T cell tolerance of maternal antigens on preterm labor. Dr. MacKenzie, who is currently leading the world's first clinical trial of in utero stem cell transplantation, also discussed advancements in the field of fetal therapy, which began with the first open fetal surgery performed by Dr. Michael Harrison at UCSF and evolved towards innovative molecular therapies being studied in her lab. Aaron Kornblith, MD, Assistant Clinical Professor of Emergency Medicine and Pediatrics at UCSF, and Adam Rao, MD/PhD candidate in the Medical Scientist Training Program at UCSF, presented Rao's Tabla device – a digital tool for detecting pediatric asthma, one of the most common chronic pediatric diseases in the United States. The handheld device detects acoustic sound waves which are then analyzed by a machine-learning algorithm to assess disease severity.

Additional highlights included talks by Tejal Desai, PhD, Professor and Chair of Bioengineering and Therapeutic Sciences at UCSF, on nanoscale materials for therapeutic drug delivery, and Homayoon Kazerooni, PhD, Professor of Mechanical Engineering at UC Berkeley, on exoskeletons for pediatric mobility disorders. The presenters' wide range of disciplines, from clinical to engineering specialties, exemplified the pressing need for collaboration in the field of pediatric medicine.

UCSF 20180517 Childrens Health Symposium 025

Throughout the day, attendees interacted with demos of novel pediatric devices under development, including a tracheostomy alarm (Asphyxi-Alert), enteral feeding system (Gravitas Medical), breastfeeding appliance for infants with cleft palate, and ionic-dilution technology for vascular catheter navigation (Piccolo Medical). Adam Rao's Tabla, Dr. Kazerooni's SuitX, virtual reality software KindVR, and the UCSF Pediatric Device Consortium returned for the second year with updates on their devices and ongoing clinical trials. The program also included a human-centered design workshop facilitated by Amanda Sammann, MD, Assistant Professor of Surgery and Executive Director of The Better Lab. The hands-on session allowed participants to reimagine the pediatric patient experience through group brainstorming activities.

In the afternoon, Dr. Lee moderated a panel discussion on incentivizing pediatric device development between leading industry, government, and academic experts. Panelists shared their challenges and lessons learned as pediatric device developers and discussed the need for cross-sector collaboraiton and incentive strategies to get more pediatric devices to the market faster. The symposium concluded with a keynote presentation by Vasum Peiris, MD, MPH, Chief Medical Officer for Pediatrics and Special Populations at FDA's Center for Devices and Radiological Health, who shared the FDA's priorities and initiatives for improving pediatric public health and resources available to device innovators. 

UCSF 20180517 Childrens Health Symposium 055The annual event, hosted by UCSF Surgical Innovations, UCSF Benioff Children's Hospitals, UCSF Pediatric Device Consortium, and UCSF-Stanford Center of Excellence in Regulatory Science and Innovation, serves as a foundation for forging partnerships between clinical, academic, and industry stakeholders, learning about innovative research and technologies, and building momentum towards implementing cutting-edge solutions into pediatric clinical care

Event program

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- by Stacy Kim https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=78866
Mon, 21 May 2018 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=78593 <![CDATA[Resident Research Winners Announced for Presentations at 31st Annual J. Engelbert Dunphy Resident Research Symposium]]> The 31st Annual J. Engelbert Dunphy Resident Research Symposium was held Wednesday, April 25, 2018 at UCSF Medical Center at Mission Bay. The program showcased the laboratory research of residents, fellows and medical students in the Department of Surgery, and honors the life and accomplishments of J. Engelbert Dunphy, M.D., a legendary surgeon and a former chair of the UCSF Department of Surgery.

This year's J. Englebert Dunphy Visiting Professor, Carla M. Pugh, MD, PhD, FACS, Professor of Surgery and Director of the Technology Enabled Clinical Improvement (T.E.C.I.) Center at Stanford University, delivered a highly engaging and fascinating keynote presentation entitled, "Hacking Healthcare with Sensors: Unfolding the Metrics of Physician Expertise".

Symposium Winners

Visit the Resident Research Symposium Page

31st Annual Resident Research Symposium Program 

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=78593
Wed, 16 May 2018 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=78739 <![CDATA[Department of Surgery Announces 21st Maurice Galante Lecture Featuring Bill Browder]]> Bill Browder News StoryThe 21st Maurice Galante Lecture will feature Bill Browder, founder and CEO of Hermitage Capital Management. Browder was the largest foreign investor in Russia until 2005, when he was denied entry to the country for exposing corruption in Russian state-owned companies.

In 2009, Browder's Russian lawyer, Sergei Magnitsky, was killed in a Moscow prison after uncovering and exposing high-level corruption committed by Russian government officials. In February 2015, Browder published the New York Times bestseller Red Notice: How I Became Putin's No.1 Enemy, which recounts his experience in Russia and his ongoing fight for justice for Sergei Magnitsky.

Established in celebration of intellectual exchange outside of medicine, the Maurice Galante Lecture Series was created in 1995 in honor of the late Maurice Galante, MD, a UCSF professor emeritus of surgery. Regarded as "one of the last generation of real 'general' surgeons," Galante brought superb technical expertise to a wide variety of surgical procedures.

The lecture, followed by a book signing and reception, will be held on Wednesday, June 13th at 4:00pm at the UCSF Mission Bay campus, Byers Auditorium in Genentech Hall, 600 16th Street.

Please RSVP by June 3rd at www.ucsfgalante.rsvpify.com

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- by Teresa Toy and Sarah Krumholz https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=78739
Wed, 16 May 2018 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=78747 <![CDATA[Iris Liu Awarded Summer Intern Scholarship in Cardiothoracic Surgery by American Association of Thoracic Surgery]]> Iris Liu, BA, a first-year medical student at UCSF and former HHMI scholar at Dartmouth,has been awarded a prestigious Summer Intern Scholarship in Cardiothoracic Surgery by the American Association of Thoracic Surgery for 2018. The program was established to introduce the field of cardiothoracic surgery to first and second year medical students with the goal of broadening their educational experience by working in an AATS member's, cardiothoracic surgery department. The Scholarship is partially funded by Scanlan International Inc. and the AATS Foundation.

Liu's research is focused on studying mechanisms of resistance and recurrence in non-small cell lung cancer, with an emphasis on harnessing large-scale "omics" data to elucidate patterns of molecular alterations in the tumor and tumor microenvironment. She will pursue this research in the Kratz Lab and Bivona Lab at UCSF and will attend the AATS annual meeting in 2019.

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=78747
Tue, 15 May 2018 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=78697 <![CDATA[ April Painting Event Spanning Four Campuses Highlights Department of Surgery Commitment to Staff Engagement]]> Dos Staff Engagment Painting MTZ

ZSFG Els Pic 1The Department of Surgery Staff Engagement Committee hosted a painting event across four campuses on Friday, April 27th. The event allowed staff at Parnassus, Mission Bay, Mt. Zion, and ZSFG to let their creativity flow in a calming, relaxed atmosphere.

Attendees were provided a blank canvas, brushes and a variety of paint colors and encouraged to let their artistic abilities loose while calming music played in the background. Flowers, dinosaurs, scenes of nature, and abstract art were all produced by the staff. Comments from staff included:

"It Was A Lot of Fun"
"It Was Nice to See Faces" of Co-Workers."

The Staff Engagement Committee was established with the goal of uniting the staff of the Department of Surgery from all of the various UCSF campuses. While we are spread out around San Francisco, our mission and goals are all the same. The engagement events are conceptualized with the purpose of allowing staff to interact with other staff members in the Department of Surgery. Often, staff only know others through email communication or as voices over the telephone. Face-to-face interactions are severely limited. We encourage personal connections as that will only strengthen us as a cohesive group.

The next event, Department of Surgery Ice Cream Social, will take place on Friday, May 25th at 2:00pm - 3:30pm at the following campuses:

  • Parnassus: N-225
  • Mission Bay: MH-5200-D
  • ZSFG: Surgical Research Lab, Bldg. 1, Rm 210
Parnassus Campus Painting     Parnassus Campus Painting TWO

Mission Bay Painting

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- by Matt Kuhn and Aiten Hassouna https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=78697
Mon, 14 May 2018 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=78690 <![CDATA[Pediatric Surgeon Amar Nijagal Receives Jay Grosfeld MD Scholar Award from APSAF]]> Amar Nijagal, M.D., assistant professor of Surgery in the Division of Pediatric Surgery, received the Jay Grosfeld MD Scholar Award from the American Pediatric Surgical Association Foundation (APSAF) at the 2018 APSA annual meeting. Dr. Nijagal was one of two junior faculty honored with the highly competitive award for his grant proposal, "Investigating the fetal mechanisms of liver and bile duct repair: a link to the prenatal origins of biliary atresia".

The Department of Surgery is also pleased to announce the launch of the Nijagal Lab website. The lab will study how immune cells regulate the development and repair of fetal organs with a research focus on the development of the liver and bile ducts. The fetal liver is ripe with interactions between developing hepatocytes/cholangiocytes and the hematopoietic system. Other members of the lab include postdoctoral fellow Anas Alkhani, M.D. and researcher Katya Polovina, B.S.

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=78690
Thu, 3 May 2018 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=78559 <![CDATA[UCSF Naffziger Society Symposium to be Held May 11th with Harvard Professor Gerard M. Doherty as Featured Guest Lecturer]]> The UCSF Howard C. Naffziger Surgical Society, the alumni society for graduates of the the UCSF General Surgery Residency Program and associate members, will hold its 2nd annual "Naffziger Society Day" symposium on Friday May 11th in San Francisco. 

Naffziger Society Day brings together multiple generations of UCSF surgeons including former chief residents, surgeons in academic medicine, those with community practices, and retired surgeons. The symposium generates substantive discussion of the history and future of surgical training and practice, while celebrating the common lineage of graduates of the UCSF Department of Surgery.

The distinguished list of symposium speakers includes UCSF faculty Julie Ann Sosa, MD, MA, FACS, the new Department of Surgery Chair, and Lygia Stewart, MDEdward Chen, MD of Emory University; Jerry Goldstone, MD, FACS, FRCSE (hon) of Case Western Reserve; and the featured guest lecturer, Gerard M. Doherty, MD of Harvard Medical School who is also Surgeon-in-Chief at Brigham Health and Dana-Farber Cancer Institute.

Sosajulie 2017 ET 144x192 Lygia Stewart - 144x Edward Chen Goldstone Jerry Gerard M Doherty MD story image


There will be a celebration dinner following the symposium honoring the outgoing class of graduating Chief Residents. Naffziger Day will be preceded by a Women in Surgery event on the evening of May 10th.

Full Details on this Year's Events

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- by Richard Barg https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=78559
Fri, 27 Apr 2018 00:00:00 PSThttps://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=78581 <![CDATA[Survivor On the Margins: Historic UCSF Transplant Patient and His Pioneering Surgeon]]> Survivor on the Margins

Richard Schielke, long-term transplant survivor

I first noticed Richard on a Wednesday before my 8am lecture, sitting in a corner of the nursing building's food court. Or rather, it was the first time I really noticed him, because I realized I had seen him sitting there before, looking ahead contentedly with his hands folded on the table in front of him. Richard, it turns out, is a historic patient at UCSF; one of the first people worldwide to receive a kidney transplant. Born with renal failure in the early 1960s, Richard received his transplant at UCSF in 1971 at age ten, at a time when such procedures were rare and UCSF served as a pioneer in the field.

Richard's transplant was performed by the renowned surgeon Samuel Lee Kountz, MD, a world leader in transplant surgery. After performing the first successful non-twin kidney transplant while training at Stanford University, Dr. Kountz came to UCSF in 1967 and ultimately built UCSF's program into one of the largest and most respected kidney transplant programs worldwide. One quarter of all kidney transplants in the U.S. were performed at UCSF under his supervision, and before his death in 1981, he had personally led over 500 of these operations.

Reading through UCSF's old press releases, I immediately appreciated the number of technological innovations Dr. Kountz pioneered and his impressive list of scientific accolades. Even more impressive is that he accomplished all this before and during the Civil Rights Movement, at a time when few doctors of color were seen in the field of surgery. In fact, he had been the first African American student admitted to the University of Arkansas for Medical Sciences.

But what struck me most were his quotes that emphasized the 'human aspects' of transplant medicine and the personal transitions a transplant catalyzes. In anticipation of the 1972 International Congress of the Transplantation Society, for which he served as President, Dr. Kountz announced, "What we want to do is document the non-scientific aspects of transplants from the patient's viewpoint. Kidney transplants have been so successful that now they can be documented and patients can tell what it has meant to them, their families, and their lives."

Samuel Kountz performing a Kidney TransplantI thought of Dr. Kountz's words as I spoke with Richard, whose transplant is undoubtedly a medical success. Before his transplant, he explains, "I was crying, peeing the bed, guessing I'm dying. And I could hear them talking, the nephrologist telling my parents, 'The urine's backed up into his kidneys, his kidneys are destroyed, he's gonna die. I'm surprised he's not dead yet.' All of a sudden, my mother's having seven weeks of testing." His mother, Richard soon learned, was being tested to determine whether she could serve as his kidney donor. She could.

Immediately after the transplant, Richard remembers a striking change. "The kidney started working right when they put it in. I woke up with all this energy that I'd never had before. Because all you do when you have renal failure is sleep. You're tired and run down. When I awoke after the transplant, I could hear people in the operating room saying, 'What an amazing transplant'. I woke up and I felt so… not powerful exactly. But felt so alive. Now I'm suddenly a kid at 11, 12 years old. I'm riding my bicycle, I'm going out in the sun, I'm being with my buddies. I'm feeling really alive."

That was one of many transitions Richard experienced when he returned home after the surgery. He explains, "When you leave the hospital world here—cartoons, food, doctors, nurses paying attention to you—you go back to 'the root of awakening,' I call it. Trying to be a ten year-old kid, but you feel like you're going on 30. You grow up really fast."

His parents were only beginning to grapple with post-transplant life. "There's a lot of heartache with parents that have sick kids. I'm getting better. But my mom was the donor, so she was still in pain and recovering." Already poor before Richard's healthcare needs and struggling to pay for follow-up visits after the surgery, his parents began fighting over money. When his father started beating his mother, Richard found himself in the middle, trying to explain to doctors why his mother was black and blue, and ultimately taking beatings himself to protect her. "I held it, I took care of it, somehow some way." By his mid-teens, Richard's parents had divorced, and Richard began living at a children's home in Gilroy.

To manage his pain, he explains, "I found this magical thing called drinking. I drank myself out of a will, lost everything, lost almost everybody that I really wanted to love. I don't know how I kept the organ. Some would say you really don't deserve to be here today. True."

After working briefly for NASA as a machinist at Moffett Field in Mountain View, Richard suffered his first epileptic seizure and stopped working. He moved to Indiana for several years, but returned to San Francisco in 1994 when he learned that a brain surgery might cure him of epilepsy.

He began working at the Fillmore Auditorium and the Warfield Theater. Even with the job, though, it became increasingly challenging to afford housing in the City. "The longest I lived in one place was about six years before being priced out in 2005 when rents more than doubled," says Richard. First moving from the Inner Sunset to the Henry Hotel at 6th and Mission, Richard later found other temporary housing in the Tenderloin and China Town. Now, he uses Social Security checks to stay at Motel 6, and sleeps there until his money for the month runs out. "I'm still on the streets," he says. "And I am trying to understand what's happened, because it feels like another failure in my life. I've always been the one that's persistent and believes I'm gonna make it and I'm gonna get through it. But it's been a long time, way too long. I know it's not my fault but it's becoming painful."

"My personal prayer—in soul and body and heart—is that if you have the time, you gotta make sure that the people who work at the hospital know that you're really grateful to be alive."

Talking to Richard, our conversation cycles through the same themes. In one moment he expresses immense gratitude for the hospital, the doctors, and the staff at UCSF. "My personal prayer—in soul and body and heart—is that if you have the time, you gotta make sure that the people who work at the hospital know that you're really grateful to be alive. You realize wow, the guy that I saw walking around in the blue uniform makes the bed go up and down. Wow, that guy makes my room clean so I don't get an infection or lose my organ. Wow that's the anesthesiologist. That's the nurse, who is running intensive care units where a patient's hooked up to so many machines. The people that are polishing the floors and getting the operating rooms ready for you or me when we're having major surgeries. People that don't get to be recognized but they make a really big impact. I'm really grateful for them."

In the next moment, he talks of lost opportunities, of botched possibility. He repeatedly mentions how he doesn't feel like the model transplant patient, and asks me rhetorically, "How is it that the junkyard dog's still living?"

But I feel stuck on the counterpoints: Richard hasn't used drugs or alcohol since quitting 34 years ago. He traveled to San Francisco alone when he needed surgery for his epilepsy, and recovered with little help from family or friends. I sense that he is still searching for a sense of purpose, and sometimes ponders the meaning behind the transplant. "I know I could make a difference. I know I can make a difference because I've been the poor, uneducated patient. I've been epileptic guy. I've been the drunk. I've been the drug addict. I've been the homeless guy."

Dr. Samuel KountzI see someone, too, who craves to be seen for his role as a patient in UCSF's transplant history, yet equally longs to be seen and heard as someone beyond his health conditions. "I'm not just a patient," he emphasizes. "I have feelings. I like to eat food, I love to walk, I like to take pictures. I love music, I love beautiful, classic cars. I love dressing up nice."

Just as Richard circles around these themes, I circle around the question of how to measure the success of his historic transplant. Dr. Kountz understood the importance of tracking patients' post-operative experiences to see the effects of organ transplantation beyond pure physiology. He may have been ahead of his time for placing such emphasis on the social, financial, and personal effects that transplant surgery could have on a patient. And I can't help but hold two feelings at once: that UCSF has served Richard well, and that the institution, the City of San Francisco, and I as a future physician owe him more.

Background for This Story

Berry Ketura 2018This article is reprinted courtesy of the UCSF School of Medicine (SOM) and the author Kacey Berry, a 1st year medical student. Kacey became intrigued by the presence of Richard Schielke on the Parnassus campus and soon learned he was a kidney transplant patient, an historic one, having received his donor organ nearly 47 years ago in 1971. His doctor turned out to be a renowned African-American transplant surgeon, Samuel Lee Kountz, MD, a pioneer in the field.

Kelsi Evans 667Dr. Kountz' life as a surgeon was previously highlighted and chronicled by Kelsi Evans in a February 2017 post on the "Brought to Light blog". Kelsi, a project archivist at the UCSF Library, penned the story in honor of Black History Month. The blog is part of the Archives & Special Collections, an invaluable resource for aspiring medical student-cum-authors like Kacey Berry. The stories of Richard Schielke and his trailblazing surgeon, Dr. Kountz, leave an indelible imprint, enriching the history of both the Department of Surgery and the Division of Transplant Surgery. Kacey has given readers a window into the past, insight into Richard's endurance despite significant obstacles, and perspective into the work of Dr. Kountz, viewed against the backdrop of the era in which he practiced, making his achievements all the more remarkable.

Related Links

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- by Kacey Berry, UCSF Medical Student https://surgery.ucsf.edu/news--events/ucsf-news.aspx?id=78581