Notable News from the Department of Surgery

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Notable News from the Department of SurgeryJanuary 28, 2016

William Jordan Begins Tenure as Vascular Surgery Chief

Several months before arriving in Atlanta to serve as chief of the Emory division of vascular surgery and endovascular therapy, William D. Jordan, Jr, MD, had already begun communicating with Emory vascular surgery faculty and was integral to several major discussions involving future directions of the division. Now that he is credentialed and official, he can begin moving those directions forward.

"Emory vascular surgery's imprint is instantly recognizable," says Dr. Jordan. "As the largest vascular surgery group in Georgia, it has had an international role in advancing the treatment of arterial and venous disease. I plan on taking our existing academic, clinical, and research resources and leveraging them further to offer the best vascular care for our patients. In the process, we will expand our services to offer better accessibility for future patients who want to be treated at Emory, and for clinicians who seek to partner with our vascular specialists for advanced care. New clinical trials in the division will bring even more advanced technology to the region, and we will continue to widen our partnerships with medical professionals throughout Georgia."

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Lily Yang Nano-Research Group Receives R01 to Develop Precision Infiltration of Peritoneal Tumors

For the past ten years, Emory translational cancer researcher Lily Yang, MD, PhD (pictured above), Emory radiology and imaging scientist Hui Mao, PhD, and Y. Andrew Wang, PhD, president and principal scientist of Ocean Nanotech, LLC, one of the leading manufacturers and suppliers of dispersible nanomaterials in the U.S., have collaborated on developing multifunctional magnetic iron oxide nanoparticles with targeted drug delivery and tumor imaging abilities for effective treatment of several aggressive and drug resistant cancer types, including pancreatic, ovarian, and triple negative breast cancers. In December 2015, the three investigators received an Academic-Industrial Partnerships for Translation of Technologies for Cancer Diagnosis and Treatment (R01) NIH award to devise a clinically feasible, novel treatment for metastatic peritoneal tumors or peritoneal carcinomatosis using molecularly targeted, precision nanomedicine. The grant totals more than two million dollars over the course of five years.

Peritoneal carcinomatosis (PC) is an often untreatable end-stage disease associated with gastrointestinal and gynecological cancers that occurs in the peritoneum, the thin layer of tissue that covers abdominal organs and surrounds the abdominal cavity. Systemic chemotherapy has been largely unsuccessful in eradicating PC, and complete surgical removal of PC tumors has proven virtually impossible. While the newer treatment regimens of cytoreductive surgery (reducing the tumor without removing it entirely) and hyperthermic intraperitoneal chemotherapy (HIPEC, the delivery of highly concentrated, heated chemotherapy directly to the abdomen) have shown some survival benefit, they are currently not available to the majority of PC patients due to the severity of their metastases.

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Study Examines Prevalence and Effects of Undiagnosed Diabetes in the ICU

Findings published in Critical Care Medicine by first author David Carpenter, MPAS, senior author Craig Coopersmith, MD (pictured above), and other Emory researchers concluded that patients who are unaware that they have diabetes when hospitalized in an intensive care unit have greater complications and poorer outcomes than patients without diabetes. Complications include higher blood glucose levels often requiring an insulin drip, more deaths, and discharge to hospice or rehabilitation instead of home.

"The main purpose of this study was to identify patients in the ICU with diabetes that neither the care team nor the patient knows about," says Dr. Coopersmith, vice chair of research of the Emory Department of Surgery and associate director of the Emory Critical Care Center. "Because we are seeing an epidemic of diabetes in the U.S., finding out early if a critically ill patient in the ICU has diabetes may change the course of treatment for that patient. The diagnosis also has important implications for a patient's long-term health."

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Screening for Prostate Cancer in Kidney Transplant Candidates may be Detrimental

Concerned about how prostate cancer screening could affect the time to transplantation and transplant outcomes for renal transplant candidates, Nicole Turgeon, MD (pictured off-center, above), associate professor of surgery, Emory Division of Transplantation, and a team of Emory kidney transplant and urology researchers retrospectively analyzed information on 3782 male patients undergoing kidney transplant evaluations at Emory between January 1, 2000 and January 1, 2011. The data was primarily sourced from Emory's Organ Transplant Tracking Record.

The findings were published in the Journal of the American Society of Nephrology in December 2015, and determined that PSA (prostate-specific antigen) screening for prostate cancer in male kidney transplant candidates may be more harmful than protective because it does not appear to prolong their survival and may actually interfere with the transplant process.

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Stage Increase in Lung Cancer More Frequent After Open vs Closed Thoracic Surgery

A study published in the Journal of Thoracic Oncology, the official journal of the International Association for the Study of Lung Cancer, has found that accurate identification of the stage of non-small cell lung cancer (NSCLC) due to cancer positive lymph node (LN) discovery was more common following open chest surgery for lung lobe removal of early stage lung cancer than with the closed chest procedure known as video assisted thoracic surgery (VATS).

Emory Department of Surgery chief resident Rachel Medbery, MD (pictured above), was first author of the study, and Emory cardiothoracic surgeon Felix Fernandez, MD (pictured above), was senior author. Additional authors were Theresa Gillespie, PhD, Yuan Li, PhD, Dana Nickleach, MA, Joseph Lipscomb, PhD, Manu Sancheti, MD, Allan Pickens, MD, and Seth Force, MD.

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Monica Rizzo and Others Offer One-Time Radiation During Breast Surgery at EUHM

Emory University Hospital Midtown (EUHM) is one of only three centers in Georgia to provide the new breast cancer procedure known as targeted Intraoperative Radiation Therapy (IORT). Emory surgical oncologist and Winship Cancer Institute member Monica Rizzo, MD (pictured in the OR, above), is among the community and faculty doctors that perform the procedure at the hospital.

Targeted IORT is an individualized radiation treatment that delivers low-energy X-rays directly into the breast tumor cavity immediately following such breast-conserving surgeries as partial mastectomy. Dr. Rizzo enthusiastically supported the establishment of the procedure at EUHM by Rogsbert Phillips, MD, a community-based breast surgeon and Emory Healthcare Network physician, and Emory radiation oncologist Karen Godette, MD.

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John Lyons Awarded NIH F32 Fellowship
John Lyons, MD, a general surgery resident on research sabbatical, has received an NIH F32 Fellowship. The award will fund his third year of research training with sepsis and shock investigator Craig Coopersmith, MD. Dr. Lyons was mentored in the preparation of his successful application by Dr. Coopersmith and Edward Mocarski, PhD, of the Department of Microbiology and Immunology, Emory Vaccine Center. Dr. Lyons is conducting studies of intestinal cell death during sepsis, and he and Dr. Coopersmith have contributed their expertise to Dr. Mocarski's studies of the contribution of regulated cell death pathways to host defense.
Make a Difference: Support our Trainees
Those who would like to nurture the quality of the surgical education the Department of Surgery provides should consider making a gift to our residency program. Our cadaveric dissection workshops, 24-hour simulation lab, and global health program are just a few components of the residency that rely upon philanthropic donations. Monthly, sustained giving via credit card or payroll deduction can do much to assist our academic mission. All gifts to Emory are tax-deductible. For more information, please contact James Owen, director of development, Department of Surgery, at 404-778-5429 or james.p.owen@emory.edu.

February Surgical Grand Rounds Schedule

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