Surgery Commons^™

Resident Update: Where Are They Now?

Jefferson Surgical Solutions

No abstract provided.

Acute Care Surgery Division Continues To Expand

Jefferson Surgical Solutions

No abstract provided.

Overview: Nsqip Update

Jefferson Surgical Solutions

No abstract provided.

Pancreatic Cancer: When The Stakes Are High . . .

Jefferson Surgical Solutions

No abstract provided.

Download The Pdf Of The Full Issue

Jefferson Surgical Solutions

No abstract provided.

Jss Editorial Board & Credits

Jefferson Surgical Solutions

No abstract provided.

News In Brief

Jefferson Surgical Solutions

No abstract provided.

A Legacy Of Leadership: Dr. Francis E. Rosato, Sr.

Jefferson Surgical Solutions

No abstract provided.

On The Job

Jefferson Surgical Solutions

No abstract provided.

Visualizing New Possibilities In Vascular Surgery

Jefferson Surgical Solutions

No abstract provided.

Meet Our Surgical Interns

Jefferson Surgical Solutions

No abstract provided.

Trends In Plastic And Reconstructive Surgery

Jefferson Surgical Solutions

No abstract provided.

Overview From The Chairman

Jefferson Surgical Solutions

No abstract provided.

Col. Darnell Waun's Second Chance At Life

Jefferson Surgical Solutions

No abstract provided.

Download The Pdf Of The Full Issue

Jefferson Surgical Solutions

No abstract provided.

Sentinel Node Staging For Breast Cancer: Intraoperative Molecular Pathology Overcomes Conventional Histologic Sampling Errors, Peter Blumencranz, Pat W. Whitworth, Kenneth Deck, Anne Rosenberg, Douglas Reintgen, Peter Beitsch, Anees Chagpar, Thomas Julian, Sukamal Saha, Eleftherios Mamounas, Armando Giuliano, Rache Simmons

Department of Surgery Faculty Papers

BACKGROUND:
When sentinel node dissection reveals breast cancer metastasis, completion axillary lymph node dissection is ideally performed during the same operation. Intraoperative histologic techniques have low and variable sensitivity. A new intraoperative molecular assay (GeneSearch BLN Assay; Veridex, LLC, Warren, NJ) was evaluated to determine its efficiency in identifying significant sentinel lymph node metastases (>.2 mm).

METHODS:
Positive or negative BLN Assay results generated from fresh 2-mm node slabs were compared with results from conventional histologic evaluation of adjacent fixed tissue slabs.

RESULTS:
In a prospective study of 416 patients at 11 clinical sites, the assay …

Jss Editorial Board & Credits

Jefferson Surgical Solutions

Jefferson Surgical Solutions is published by Thomas Jefferson University and Thomas Jefferson University Hospital. Jefferson Department of Surgery Curtis Building, Suite 620 1015 Walnut Street Philadelphia, PA 19107 www.JeffersonHospital.org/surgery Barry Gutman, Editor/Writer JeffGraphics, Design Editorial Board: Volume 1, Issue 1 Hwyda Arafat, MD, PhD Adam Berger, MD Cataldo Doria, MD Adam Frank, MD Gerald Isenberg, MD Robert Larson, MD John Moore, MD Scott Silvestry, MD Robert Solit, MD Thomas Tulenko, PhD Charles Yeo, MD Jennifer Brumbaugh Diane Calder Patricia McMorrow Flo Williams Information in Jefferson Surgical Solutions is not intended to provide advice on personal medical matters or to substitute …

Honoring Dr. Herbert Cohn

Jefferson Surgical Solutions

On March 28, Mae Gelb of Scranton, Pennsylvania, celebrated her 100th birthday with close friends and family, including her nephew, Herbert E. Cohn, MD, Anthony Narducci Professor and Vice Chair of Surgery, Jefferson. Mrs. Gelb's life has been nearly as healthy as it is long. Aside from giving birth, her only experience as an inpatient was when, in October 1993, at Thomas Jefferson University Hospital, she underwent a major operation performed by then-Samuel D. Gross Professor and Chair of Surgery Francis E. Rosato, MD, with moral support from Dr. Cohn. "So many physicians I know have been taught by Herb." …

News In Brief

Jefferson Surgical Solutions

Jefferson's Department of Surgery has been accepted to participate in the American College of Surgeons' National Surgical Quality Improvement Program (NSQIP). The lead surgeon for this initiative is Herbert E. Cohn, MD. Developed by the United States Department of Veteran Affairs, NSQIP is one of the first outcomes-based, risk-adjusted, peer-controlled programs designed to measure and enhance the quality of surgical care. The program collects data on 133 variables, including preoperative risk factors, intraoperative variables and 30-day mortality and morbidity outcomes data – the latter entered by Kathleen Hartman, RN, BSN, the department's new Surgical Clinical Nurse Reviewer. It will enable …

On The Job

Jefferson Surgical Solutions

Patricia Kal Sauter, RN, MSN, ACNP, NCTMB, Gastrointestinal Surgery, Department of Surgery Since graduating from the University of Maryland School of Nursing, Pat Sauter had worked at the Johns Hopkins Hospital in Baltimore –the last 15 years with Charles J. Yeo, MD, whom she accompanied when he was appointed in 2005 as the Samuel D. Gross Professor and Chair of Surgery at Jefferson Medical College of Thomas Jefferson University and at Thomas Jefferson University Hospital. She works four days a week and spends the others on her farm near York, Pennsylvania, with children Kate, age 14, and Jack, 11. Describe …

Meet Our Surgical Interns

Jefferson Surgical Solutions

The staff of the Department of Surgery at Jefferson is currently assisted by an exceptional group of interns. Pictured left to right, they are: Hamid Abdollahi, MD, Jefferson Medical College (JMC), Class of 2005; Lisa Harris, MD, State University of New York (SUNY) Downstate Medical Center, Brooklyn, Class of 2005; Matthew Rosen, MD, JMC, Class of 2005; Jennifer Sullivan, MD, University of Maryland, College Park, Class of 2005; Nikolai Bildzukewicz, MD, JMC, Class of 2001 (followed by military service as a flight surgeon in the United States Navy); and Daniel Lefebvre, MD, SUNY Upstate Medical University, Syracuse, Class of 2005. …

Initiation Of A Critical Pathway For Pancreaticoduodenectomy At An Academic Institution -- The First Step In Multi-Disciplinary Team Building, Eugene P. Kennedy, Ernest L. Rosato, Patricia K. Sauter, Laura M. Rosenberg, Cataldo Doria, Ignazio R. Marino, Karen A. Chojnacki, Adam C. Berger, Charles Yeo

Department of Surgery Faculty Papers

Objective: This study was designed to identify quantifiable parameters to track performance improvements brought about by the implementation of a critical pathway for complex alimentary tract surgery.

Background: Pancreaticoduodenectomy (PD) is a complex general surgical procedure performed in varying numbers at many academic institutions. Originally associated with significant perioperative morbidity and mortality, multiple studies have now shown that this operation can be performed quite safely at high volume institutions that develop a particular expertise. Critical pathways are one of the key tools used to achieve consistently excellent outcomes as these institutions. It remains to be determined if implementation …

Building A Better Bypass Graft

Jefferson Surgical Solutions

Jefferson vascular surgeon obtains three research grants. Vascular surgeon Paul DiMuzio, MD, FACS,Assistant Professor of Surgery and Radiology,Jefferson Medical College (JMC) of ThomasJefferson University, has been awarded grantsfrom the National Institutes of Health (NIH),American Vascular Association and AmericanHeart Association totaling $975,000. Thesefunds will further his team's research to usetissue engineering and stem cell technologyto develop a novel bypass graft for patientswho lack autogenous tissues for vascularprocedures such as coronary and peripheralartery bypass and hemodialysis access. "Today, the gold standard for creatingthese grafts is using the patient's saphenousvein or another artery," Dr. DiMuzio says."When those are unavailable because theyare diseased, too …

Idiopathic Granulomatous Mastitis Masquerading As Carcinoma Of The Breast: A Case Report And Review Of The Literature., Richard Tuli, Brian J O'Hara, Janet Hines, Anne L Rosenberg

Department of Surgery Faculty Papers

BACKGROUND: Idiopathic granulomatous mastitis is an uncommon, benign entity with a diagnosis of exclusion. The typical clinical presentation of idiopathic granulomatous mastitis often mimics infection or malignancy. As a result, histopathological confirmation of idiopathic granulomatous mastitis combined with exclusion of infection, malignancy and other causes of granulomatous disease is absolutely necessary. CASE PRESENTATION: We present a case of a young woman with idiopathic granulomatous mastitis, initially mistaken for mastitis as well as breast carcinoma, and successfully treated with a course of corticosteroids. CONCLUSION: There is no clear clinical consensus regarding the ideal therapeutic management of idiopathic granulomatous mastitis. Treatment options …

Peritoneal Perfusion With Oxygenated Perfluorocarbon Augments Systemic Oxygenation., Shamus R Carr, Joshua P Cantor, Atul S Rao, Thiru V Lakshman, Joshua E Collins, Joseph S Friedberg

Department of Surgery Faculty Papers

BACKGROUND: Despite maximal ventilatory support, many patients die from hypoxia in the setting of potentially reversible pulmonary failure. There remains a pressing need for additional pulmonary supportive care measures, especially techniques that do not require systemic anticoagulation. The objective of our experiments was to determine whether systemic oxygenation could be increased in a large animal, with induced hypoxia, by perfusing the abdominal cavity with oxygenated perfluorocarbons.

METHODS: Fifteen pigs with a mean (+/- SD) weight of 45 +/- 5 kg were intubated and rendered hypoxic by ventilating them with a blend of nitrogen and oxygen to achieve subatmospheric concentrations of …

Fulminant Hepatic Failure Bridged To Liver Transplantation With Molecular Adsorbent Recirculating System: A Single Center Experience, Cataldo Doria Md, Lucio Mandala Md, Victor L. Scott Md, Salvatore Gruttadauria Md, Ignazio R. Marino Md

Department of Surgery Faculty Papers

Purpose: We herein describe the clinical course of a consecutive series of fulminant hepatic failure patients treated with molecular adsorbent recirculating system, a cell-free albumin dialysis technique. From November 2000 to September 2002, 7 adult patients age 22-61 (median 41), one male (14.2%), and 6 females (85.7%), affected by fulminant hepatic failure, underwent 7 courses (1 to 5 session each, six hours in duration) of extracorporeal support using the molecular adsorbent recirculating system technique. Pre and post treatment blood glucose, liver function tests, ammonia, arterial lactate, electrolytes, hemodynamic parameters, arterial blood gases, liver histology, Glasgow Coma Scale, and coagulation studies, …

3,3′-Diindolylmethane And Paclitaxel Act Synergistically To Promote Apoptosis In Her2/Neu Human Breast Cancer Cells, Kandace P. Mcguire, N. Ngoubilly, M. Neavyn, Susan Lanza-Jacoby

Department of Surgery Faculty Papers

Background. HER2/neu positive breast tumors are difficult to treat. About 25 to 30% of invasive breast tumors overexpress the HER2/neu oncogene. These tumors are aggressive and become resistant to chemotherapeutic drugs. 3,3′-diindolylmethane (DIM), the active metabolite of indole-3-carbinol, a naturally occurring compound found in cruciferous vegetables, has been found to have anti-cancer properties in both humans and animals. DIM has been shown to induce cell cycle arrest and apoptosis in animal breast cancer models. Because HER2/neu overexpression confers resistance to paclitaxel, and DIM has anti-tumor effects, we hypothesized that DIM will enhance the cytotoxic effects of paclitaxel, a common …

Analysis Of Epstein-Barr Virus Reservoirs In Paired Blood And Breast Cancer Primary Biopsy Specimens By Real Time Pcr., R Serene Perkins, Katherine Sahm, Cindy Marando, Diana Dickson-Witmer, Gregory R Pahnke, Mark Mitchell, Nicholas J Petrelli, Irving M Berkowitz, Patricia Soteropoulos, Virginie M Aris, Stephen P Dunn, Leslie J Krueger

Department of Surgery Faculty Papers

INTRODUCTION: Epstein-Barr virus (EBV) is present in over 90% of the world's population. This infection is considered benign, even though in limited cases EBV is associated with infectious and neoplastic conditions. Over the past decade, the EBV association with breast cancer has been constantly debated. Adding to this clinical and biological uncertainty, different techniques gave contradictory results for the presence of EBV in breast carcinoma specimens. In this study, minor groove binding (MGB)-TaqMan real time PCR was used to detect the presence of EBV DNA in both peripheral blood and tumor samples of selected patients. METHODS: Peripheral blood and breast …

Recollections Of My Research In Developing The Heart-Lung Machine At Jefferson Medical College, Bernard J. Miller

Jefferson Biographies

A personal memoir written by Dr. Bernard J. Miller about his introduction to and interest in medical research as well as his experiences working on the heart-lung machine. He focuses specifically on his working relationship with John H. Gibbon, Jr., the development of a viable oxygenator and ventilator, and early testing of the machine on animals

Passing The Boards: Can Usmle And Orthopaedic In-Training Examination Scores Predict Passage Of The Abos Part-I Examination?, Gregg R Klein, Matthew S Austin, Susan Randolph, Peter F Sharkey, Alan S Hilibrand

Department of Orthopaedic Surgery Faculty Papers

No abstract provided.