Bariatric Surgery Program Continues Success - Surgery - University ...

May 2003
Bariatric Surgery Program Continues Success
The UC Surgeons Center for Surgical Weight
Loss has now treated over 500 patients for morbid
obesity, using both open and minimally invasive
(laparoscopic) bariatric surgery techniques.
The incidence of obesity and its associated
health-related problems have reached epidemic
proportions in the United States. Six percent of
health care expenditures go to obesity-related diseases,
and obesity leads to 300,000 deaths annually.
Severe obesity is frequently associated with
significant comorbid medical conditions, including
coronary artery disease, hypertension, type II
diabetes mellitus, gallstones, nonalcoholic steatohepatitis,
pulmonary hypertension, and sleep
apnea. Long-term reduction of significant excess
weight may improve or resolve many of these
obesity-related health problems, although convincing
evidence of long-term benefit is lacking.
Nonsurgical modalities, although less invasive,
achieve only relatively short-term and limited
weight loss in most patients. Currently, surgical
therapy is the most effective modality in terms of
extent and duration of weight reduction in selected
patients with acceptable operative risks. The
most widely performed surgical procedure, Rouxen-Y
gastric bypass (see figure), achieves permanent
(followed up for more than 14 years) and significant
weight loss (more than 50% of excess
body weight) in more than 90% of patients.
Roux-en-Y
gastric bypass
Surgical treatment for
morbid obesity is
endorsed by the National
Institutes of Health as
the only effective solution
to achieve and
maintain weight loss,
and it is the only
approach proven to alleviate
chronic conditions
related to severe obesity.
Approximately 60,000 such procedures were performed
in the U.S. in 2002. These procedures
limit intestinal absorption and/or restrict the
quantity of food that can be consumed. In Rouxen-Y
gastric bypass (RGB), several rows of surgi-
cal staples are placed across the stomach to partition
or divide the stomach and to create a 1-2
ounce pouch. A limb of intestine is connected to
this pouch to bypass enough of the remaining
intestine so that malabsorption occurs.
J. Wesley Alexander, M.D. Keith Gersin, M.D.
The immediate risks are staple line disruption,
blockage, and infection. Nutritional and vitamin
deficiencies can lead to anemia, hair loss, osteoporosis,
or other problems, but these can be prevented
by proper diet and vitamins. Because RGB
drastically decreases the size of the stomach, individuals
must eat small amounts, must eat slowly,
and chew well. Other types of surgery for obesity
are becoming available, including laparoscopic
gastric banding and balloons, but the results have
so far been disappointing compared to RGB.
UC Surgeons Center for Surgical Weight Loss
offers patients an interdisciplinary approach to
bariatric surgery. A patient considering bariatric
surgery first must undergo psychological evaluation
and attend nutrition-counseling classes.
Following surgery, our specialists will monitor
the patient’s progress and lifestyle adjustments.
Support group counseling is also available, and a
schedule of regular checkups is established to
track the patient's progress and overall health.
UC Surgeons Center for Surgical Weight Loss is
located at 222 Piedmont Avenue, Suite 7000,
Cincinnati, Ohio 45219, and now offers surgical
services at The University Pointe, 7700
University Court, Suite 2300, West Chester, Ohio
45069. For more information, contact Jessica
Toliver, Bariatric Coordinator, at (513) 475-7770
or email bariatric@ucsurgeons.com. Also see our
website at www.ucsurgeons.com/bariatric.

Department of Surgery at SNMA
Representatives from the Department of Surgery attended
the Student National Medical Association (SNMA)'s 38th
Annual Medical Education Conference April 17 - 20, 2003,
in Washington, DC. This conference serves as a forum to
examine the current status of health care, health disparities,
mental health stigmas, social inequalities in relation to
health, and obstacles and opportunities in medical education
in our diverse nation and underserved populations. Students
have an opportunity to visit an exhibitor's booth to discuss
issues of diversity and gather information regarding the
many opportunities offered by the Department of Surgery at
the University of Cincinnati.
Drs. Kenneth Davis and Donn Spight share UC surgery residency
program information with a medical student at the SNMA meeting
Residency Match Results
The Department of Surgery had another excellent
match and looks forward to welcoming the new surgical
residents on July 1.
General Surgery:
Jocelyn Logan-Collins - Northwestern University
Colin Martin - Wayne State University
Benjamin McIntyre - University of South Carolina
Thomas Shin - University of MIchigan
Janice Taylor - Ohio State University
Ryan Thomas - Loyola University
Oral Surgery:
Rodney C. Stigall, D.M.D. - University of Louisville
Sinul P. Sinha, D.D.S. - New York University
Plastic Surgery:
Rian Maercks - Duke University
Urology:
Gwen Roesel - University of Cincinnati
Rebecca Roedersheimer - University of Cincinnati
UC Researchers to Lead and
Present at Digestive Disease Week
Jeffrey B. Matthews, M.D.,
Christian R. Holmes Professor
and Chairman of the Department
of Surgery, will chair a symposium
(“New Advances in Short
Gut Syndrome and Gut Failure”)
at Digestive Diseases Week in
Orlando in May as well as a
Meet-the-Investigators luncheon
(“Mechanisms and Treatment of
Intestinal Ischemia”).
Members of the Department of
Surgery research laboratories
will make numerous presentations
at Digestive Disease Week:
Ahmad S (poster): “Comparison
Of The Harmonic Scalpel With
Clamp Crushing Technique For
Hepatic Resection.”
Kim J, Ahmad S, Lowy A,
Matthews J, Buell J, Pennington
L, James L, Hanto D (poster):
“Biliary Fistulas Following
Hepatic Resection: Risk Factors
and Treatment Strategies.”
Del Castillo I, Song C, Starlinger
V, Yoo J, Matlin K, Matthews J
(research forum): “Dynamic
Regulation of NKCC1 Surface
Expression by Protein Kinase C
epsilon in Chloride Secretory
Epithelia.”
Mammen J, Song C, Kim P,
Davis H, Matlin K, Matthews J
(poster): “Ischemic Stress
Induces Distinct Membrane and
Cytoskeletal Targeting of PKCε
in Intestinal Epithelia Resulting
in the Differential Activation of
Substrates.”
Mayol J, Song C, Worrel R,
Matthews J (poster): “Propranolol
Enhances cAMP and Ca 2+ -
activated Chloride Secretion in
T84 Cells. Is PLD Involved in
the Regulation of Chloride
Secretion?”
Rilo H, Ahmad S, D'Alessio D,
Matthews J, Kim J, Iwanaga Y,
Martin S, Somogyi L, Liu H,
Lowy A (plenary session):
“Initial Results of Islet Auto-
Transplantation in 16 Patients
Suffering from Severe Chronic
Pancreatitis.”
Song C, Matthews J (poster):
“PKCε Regulation of Endocytosis
in a Model of Enterocyte
Differentiation.”
Worrell R, Oghene J, Cuppoletti
J, Matthews J (poster):
“Interaction of NH4 + with
epithelial Cl - transport machinery:
Role of K + and HCO3 - .”
Other Presentations
Susan Pike, M.D., Chief Resident in Plastic Surgery, presented
"Successful Removal of Gunpowder Tattoos with the Q-Switched
Alexandrite Laser" at the Senior Residents Conference held on March
26-30, 2003 in Los Angeles, CA.
Faculty in the Division of Transplant Surgery will once again have
an enormous presence at the American Transplant Congress. At the
upcoming meeting of the American Society of Transplant Surgeons
on May 30 - June 4, 2003, in Washington, DC, members of the
Division will make 24 oral presentations and 28 poster presentations.
Clinician Resident Award Winners
David Fischer, M.D., and Tim Pritts, M.D., Chief Residents in
Surgery, were the top two vote-getters of six UC residents for the
Clinician Resident Awards. The awards will be presented at the
Clinicians Dinner at the Kingsgate Conference Center on July 2.

Dr. Susan Waltz To Join Department
Susan E. Waltz, Ph.D., currently Assistant
Professor of Pediatrics in the Division of
Developmental Biology of the Cincinnati
Children's Hospital Research Foundation,
will join the Department of Surgery on July
1, 2003. Dr. Waltz will be working in the
Inflammation, Sepsis and Trauma research
group. Her research will focus on defining
Susan E. Waltz, Ph.D. the role of growth factors and receptor tyrosine
kinases in inflammation and disease.
Dr. Waltz received her Ph.D. in Biomedical Science from
Wright State University. She won a Career Development Award
from the Department of Defense in October 2002. Dr. Waltz is
a member of the American Association for the Advancement of
Science, the Federation of American Societies for Experimental
Biology, and the National American Cancer Society, Cell Cycle
and Growth Control Study Section.
*******************
Recent Publications
Aull MJ, Buell JF; Peddi VR, Trofe J, Beebe TM, Hanaway MJ,
Roy-Chaudhury P, Alloway RR, First MR, Woodle ES.
MALToma: a Helicobacter pylori-associated malignancy in
transplant patients: a report from the Israel Penn International
Transplant Tumor Registry with a review of published literature.
Transplantation 2003;75:225-228.
Buell JF; Hanaway MJ, Woodle ES. Maximizing renal artery
length in right laparoscopic donor nephrectomy by retrocaval
exposure of the aortorenal junction. Transplantation 2003;
75:83-85.
Kashem A, Hassan S, Crabbe DL, Melvin DB, Santamore WP.
Left ventricular reshaping: effects on the pressure-volume relationship.
J Thorac Cardiovasc Surg 2003;125:391-399.
Mayol JM, Alarma-Estrany P, O'Brien TC, Song JC, Prasad M,
Adame-Navarrete Y, Fernandez-Represa JA, Mun EC, Matthews
JB Electrogenic ion transport in mammalian colon involves an
ammonia-sensitive apical membrane K + conductance. Dig Dis
Sci. 2003;48:116-25.
Scott WJ, Howington J, Movsas B. Treatment of Stage II nonsmall
cell lung cancer. Chest 2003;123(1 Suppl):188S-201S.
Tiao G, Warner BW. Transcription factors and cholangiocyte
development. Gastroenterology 2003;124:263-264.
Yoo J, Nichols A, Mammen J, Calvo I, Song J, Worrell R, Matlin
K, Matthews JB. Bryostatin-1 enhances barrier function in T84
epithelia through PKC-dependent regulation of tight junction
proteins. Am J Physiol (Cell Physiol) 2003;in press.
Jeffrey B. Matthews, M.D.
Walter H. Merrill, M.D.
Michael Nussbaum, M.D.
Amy B. Reed, M.D.
Honors and Kudos
Jeffrey B. Matthews, M.D., Christian R.
Holmes Professor and Chairman of the
Department of Surgery, was appointed to
the Membership Advisory Committee of
the Central Surgical Association. Dr.
Matthews was also Visiting Professor at
Baylor College of Medicine (April 1-2), at
Wright State University (April 22-23), and
at the Medical College of Ohio (May 2-3).
Walter H. Merrill, M.D., Chief of the
Section of Cardiothoracic Surgery, has
been invited to serve on the new Medical
Advisory Board for LifeCenter, as well as
Christ Hospital Heart Tower Task Force. In
addition, Dr. Merrill is now the Chair,
Work Force on Graduate Medical
Education, of the Society of Thoracic
Surgeons.
Michael S. Nussbaum, M.D., Associate
Professor of Surgery, Chief of the Section
of General Surgery, and Chief of Staff at
The University Hospital, was elected to the
Board of Governors of the Society of
American Gastrointestinal Endoscopic
Surgeons (SAGES) at the Annual Meeting
of SAGES in Los Angeles in March.
Amy B. Reed, M.D., Assistant Professor
of Surgery, Division of Vascular Surgery,
was recently named Program Director of
the Vascular Surgery Fellowship at the
University of Cincinnati. Dr. Reed's
expertise lies in endovascular and minimally
invasive surgery, as well as complex
peripheral vascular reconstruction.
Upcoming Visiting Professors
May 14, 2003 -- Gerald Buckberg, M.D., Professor of Surgery,
UCLA Medical Center, Cardiac Visiting Professor in Honor of
the John B. Flege, Jr. Chair: “The Helix and the Heart”
May 21, 2003 -- Rao R. Ivatury, M.D., Professor of Surgery,
Medical College of Virginia, Frame Lectureship in Trauma and
Critical Care: “Towards Optimal Resuscitation After Trauma”
June 4, 2003 -- Douglas Evans, M.D., Professor of Surgical
Oncology, MD Anderson Cancer Center, Barrows Visiting
Professor: Topic to be announced.
Area physicians are invited to attend these lectures. Please contact
Gilda Young at 513-558-4206 or Gilda.Young@uc.edu for further
information.

UC Medical Student Honored at National Meeting
Jason H. Bell, Ph.D., one of our top UC medical students, currently
a Research Associate working with his mentor, Jeffrey Pearl, M.D.,
in Cardiothoracic Surgery at Children's Hospital Medical Center, was
one of six finalists chosen (out of 97 manuscripts submitted to the
Surgery Session) to give an oral presentation entitled "Calpain
Inhibition Reduces Ischemia-Reperfusion Induced Pulmonary
Hypertension and Cardiopulmonary Dysfunction by Decreasing
Endothelin-1 in Neonates” at the 44th Annual National Student
Research Forum held in Galveston, Texas, on April 3-5, 2003. Of the
six finalists, two were medical students, the rest general surgery residents.
Dr. Bell was sent to represent the University of Cincinnati
College of Medicine after receiving first prize for his work in the
University of Cincinnati College of Medicine Medical Student
Summer Research Program. A second-year medical student, Dr. Bell
was given the University of Texas Medical
Branch “Surgery Award" based on quality
of the manuscript and oral presentation,
and ability to handle discussion and questions
from the judging surgeons. As part of
the award, Dr. Bell received an engraved
plaque and $200. Dr. Bell received his
Ph.D. in Biochemisty from Wesleyan
University, involving work in combating
bacterial resistance to antibiotics. He
Jason H. Bell, Ph.D. plans to become an academic surgeon.
UC Surgeons Win Teaching Awards
Richard Stevenson, M.D., Director of Medical Student Education,
won the “Golden Apple Award” for clinical teaching at the end of the
2002-2003 academic year. The Golden Apple Award is given by the
students of the College of Medicine to the faculty member they
believe has most benefited their clinical education.
Jay Johannigman, M.D., Chief of the Division of Trauma and
Critical Care, won the “Silver Apple Award” for second place.
Richard Stevenson, M.D.
Jay Johannigman, M.D.
First Annual Department of
Surgery Research Retreat
The Department of Surgery will host a Research
Retreat on Saturday, May 31, 2003, from 9:00 a.m. to
3:00 p.m. in the Mill Race Banquet Center at Winton
Woods. This will be an excellent opportunity to meet
new faculty members and observe current research
projects. For further information, contact Michael
Moore at 513-558-6491 or Michael.Moore@uc.edu.
Department Members Attend Society
of Black Academic Surgeons Meeting
Several members of the Department of Surgery attended the
Thirteenth Annual Scientific Session of The Society of Black
Academic Surgeons (SBAS), April 3-5, 2003, hosted by the
University of Alabama at Birmingham, Alabama.
Attendees at the SBAS Meeting:
Front, Ken Davis, Jr., M.D., and Donn Spight, M.D.
Back, Dennis Dove, M.D. (UC ‘72 graduate, currently Professor and Regional
Chairman, Department of Surgery, Texas Tech Medical Center, in Amarillo, Texas),
Gilda B. Young (Administrative Services Coordinator, Division of Education,
UC Department of Surgery), and Anthony Stallion, M.D. (UC ‘94)
The Society of Black Academic Surgeons (SBAS) was founded in
1989. Its goal is to stimulate academic excellence among its members
by providing a forum of scholarship in collaboration with the
leading departments of surgery in the U.S. It encourages and supports
professional development of black surgical residents and
attempts to recruit the best and brightest medical students into a
career in surgery. The annual meetings of SBAS, attended by members
as well as numerous residents and students, provide outstanding
programs in both the science and practice of surgery.
Anthony Stallion, M.D., who completed his surgical residency at UC
in 1994, presented a paper entitled: “Elevated Tissue Cytokine
mRNA Expression Precedes Increased Serum Protein Levels:
Evidence for Organ to Organ Communication in a Murine Model of
Multi-system Organ Failure.” Dr. Stallion is currently on faculty at
the Children's Hospital, Cleveland Clinic Foundation.
Dr. Stallion and Dr. Kenneth Davis, Professor of Surgery, Division of
Trauma/Critical Care, both moderated sessions on Shock and Critical
Care.
Dr. Kenneth Davis was also named Chairperson of the Program
Committee and will coordinate the arrangements for the 2006 SBAS
meeting which will be held in Cincinnati.
Donn Spight, M.D., was the First Place Co-Winner of the Dr. Claude
H. Organ Jr. Resident award for his abstract presentation entitled,
"It's Not the Bugs that Kill You: Proof of Principle."

Kagan is University Hospital’s
Surgical Physician of the Year
Richard J. Kagan, M.D., Associate Professor of Surgery and
Director of the Burn Special Care Unit, was honored by University
Hospital as “Surgical Physician of the Year.” The award was presented
at Grand Rounds on April 23 by James M. Hurst, M.D.,
Professor of Surgery and Executive Director, University Hospital.
Richard Kagan, M.D., holds the plaque honoring him as University Hospital’s
Surgical Physician of the Year. From left to right are Carolyn Thomas, Vice
President of Patient Care Services and Chief Nursing Officer; Karen Bankston,
Vice President of Operations, The University Hospital; Grace Schmits, Assistant
Clinical Manager of the Burn Center; Richard Kagan, M.D.; James Hurst, M.D.;
and Terri Jacques, Patient Care Services Associate
Department of Surgery Hosts Ohio Valley
Society of Colon and Rectal Surgeons
The Ohio Valley Society of Colon and Rectal Surgeons held their
annual meeting at The Cincinnati Hotel on April 25-26, 2003.
Janice F. Rafferty, M.D., Chief of the Division of Colon and Rectal
Surgery, served as host of the meeting. Local presenters included
Bradford Sklow, M.D., Division of Colon and Rectal Surgery, and
Bruce Robb, M.D., a third-year surgical resident.
The “Consultants Corner” panel at the Ohio Valley Society of Colon and
Rectal Surgeons Meeting. Left to right are James Church, M.D. (Cleveland),
Janice F. Rafferty, M.D. (Cincinnati), and K.S. Khanduja, M.D. (Columbus).
UC Department of Surgery to Host
Ohio Chapter, American College of
Surgeons on May 8-10, 2003
The 48th Annual Meeting of the Ohio Chapter, American
College of Surgeons will be held in Cincinnati on May 8-10,
2003, at the Marriott Kingsgate Conference Center. John
Howington, MD, FACS, Chief of the Division of Thoracic
Surgery, will serve as the Program Chair.
Highlights include Major
General Paul K. Carlton, Jr.,
USAF (Retired) discussing
John Howington, M.D.
“Homeland Security” and the
presentation of three new surgical
therapies for gastroesophageal
reflux disease (GERD) by Keith
Gersin, MD (Cincinnati), Jeffrey
Ponsky, MD (Cleveland) and
Scott Melvin, MD (Columbus).
For further information, please
contact John Howington, M.D.,
at (513) 584-1387 or by email at
ucthoracic@uc.edu.
Gina Greathouse, R.N., Joins Division of Surgical Oncology
The Division of Surgical Oncology is
happy to welcome Gina Greathouse, R.N.,
a nurse practitioner who will be working
with Dr. Elizabeth Shaughnessy in the
Breast Clinic at the Barrett Cancer Center.
Ms. Greathouse most recently worked in
the High-Risk Breast Clinic at The Lahey
Clinic in Boston.
Gina Greathouse, R.N.
Lowy, Soldano are “Unsung Heroes”
Andrew Lowy, MD, Chief, Division of Surgical Oncology, and
Debbie Soldano, RN, BSN, OCN, Nurse Manager for the Division,
were honored by Cancer Family Care as Unsung Heroes of Cancer.
They were nominated by a
patient in the oncology professional
category. Also nominated
was John Howington, M.D.,
Chief of Thoracic Surgery. This
is the first year for the Joslin
Haggart Yeiser Unsung Hero
Awards. The award stressed the
impact Dr. Lowy and Ms.
Soldano's team approach had on
the patient’s health. They will
be honored at a banquet at the
Metropolitan Club on May 7.
Their names will be added to a
plaque at Cancer Family Care's
Debbie Soldano, RN, BSN, OCN,
facilities on Auburn Avenue.
and Andrew Lowy, M.D.

Surgical Grand Rounds Schedule
May 14, 2003 Cardiac Visiting Professor in Honor of the John B. Flege, Jr., Chair (Cardiothoracic Surgery):
Gerald Buckberg, M.D., Professor of Surgery, UCLA Medical Center - “The Helix and the Heart”
May 21, 2003 Frame Lectureship (Trauma/Critical Care): Rao R. Ivatury, M.D., Professor of Surgery, Medical
College of Virginia - “Towards Optimal Resuscitation After Trauma”
May 28, 2003 David R. Fischer, M.D. (General Surgery Chief Resident): “Laparoscopic Inguinal Hernia”
June 4, 2003 Barrows Visiting Professor (Surgical Oncology): Douglas Evans, M.D., Professor of Surgical
Oncology, MD Anderson Cancer Center - TBA
June 11, 2003 Resident Research Competition. Four finalists chosen from abstracts submitted.
June 18, 2003 Walter H. Merrill, M.D. (Chief, Section of Cardiothoracic Surgery): “What’s Past is Prologue”
June 25, 2003 Final Grand Rounds
Department of Surgery Website Updated
The Department of Surgery has completely revised and updated its website. Please
check out http://surgery.uc.edu to see the new and improved website. The website was
reconstructed by SpringDot (www.springdot.com), who also print this newsletter.