Surgery Commons^™

Robert Milton Zollinger, M.D., Teacher, Surgeon, Soldier, And Farmer., Fiona M. Chory, B.S., Charles J. Yeo, Md, Pinckney J. Maxwell, Iv, Md

Department of Surgery Gibbon Society Historical Profiles

From Humble roots, Dr. Robert Milton Zollinger worked his way to a position in history among the giants of American surgery. He was born on September 4, 1903, in the central Ohio town of Millersport, the son of Elmira and William Zollinger. Neither of his parents had a high school education, but they supported education and always expressed a confidence that young Robert would be successful at anything he attempted.1 He had aspirations of attending West Point, a dream that was never fulfilled when he decided to be a surgeon. On being informed of his son’s intentions, Zollinger’s father bestowed …

Anaesthesia As A Career Choice In A Developing Country; Effect Of Clinical Clerkship, Fauzia Khan, Fauzia Nasim Minai, Shahla Siddiqui

Department of Anaesthesia

OBJECTIVE: To explore the fourth year medical student's knowledge regarding anaesthesia as a specialty, their attitude towards anaesthesia as a career choice and the effect of clinical clerkship on these.

METHODS: This survey was conducted in the Department of Anaesthesia of a university medical centre in a developing country. One hundred and fifty year four medical students rotating in anaesthesia were enrolled. They were asked to fill a structured questionnaire before (pre) and after (post) their anaesthesia rotation. The questionnaire sought information on their perception of anaesthesia as a specialty, role of anaesthetists clerkship duration, and reasons for considering or …

An Organ Culture System To Model Early Degenerative Changes Of The Intervertebral Disc., Ravi K Ponnappan, Dessislava Z Markova, Paul Jd Antonio, Hallie B Murray, Alexander R Vaccaro, Irving M Shapiro, D Greg Anderson, Todd J Albert, Makarand V Risbud

Department of Orthopaedic Surgery Faculty Papers

ABSTRACT: INTRODUCTION: Back pain, a significant source of morbidity in our society, is related to the degenerative changes of the intervertebral disc. At present, the treatment of disc disease consists of therapies that are aimed at symptomatic relief. This shortcoming stems in large part from our lack of understanding of the biochemical and molecular events that drive the disease process. The goal of this study is to develop a model of early disc degeneration using an organ culture. This approach is based on our previous studies that indicate that organ culture closely models molecular events that occur in vivo in …

Download The Full Pdf Of Jefferson Surgical Solutions Fall 2011, Volume 6, Number 2

Jefferson Surgical Solutions

Download the full PDF of Jefferson Surgical Solutions Fall 2011, Volume 6, Number 2.

Koniaris Heads Expanding Multi-Disciplinary Surgical Program At Methodist Hospital

Jefferson Surgical Solutions

Leonidas Koniaris, MD, FACS, is the newly appointed Chief of Surgery at Methodist Hospital in South Philadelphia, an affiliate of Jefferson that now has the strongest presence of full-time Jefferson faculty surgeons to date. One of the oldest hospitals in the Philadelphia region, Methodist has been treating patients continuously since 1892. Professor of Surgery and Vice Chair of the Department of Surgery at Jefferson Medical College, Dr. Koniaris is leading the effort to help what he describes as “an already great local hospital become an even more essential and integral partof this vibrant community.” Dr. Koniaris replaces Melvin Moses, MD, …

The Surgeon Speaks: Leonidas Koniaris, Md, Facs

Jefferson Surgical Solutions

Leonidas Koniaris, MD, FACS Chief of Surgery, Methodist Hospital Vice Chair of Surgery, Jefferson Medical College

The professionalism and work ethic of the Methodist hospital staff are second-to none, and the dedication to superb patient care is a top priority. Over the next three to five years, our focus is to take this existing gem in the Jefferson brand and continue to develop it into a strong top-tier facility.

We have been fortunate to have the support of hospital leadership in meeting our goals and embracing change. Several initiatives – a new endovascular suite and multidisciplinary breast care clinic, coupled …

Overview

Jefferson Surgical Solutions

The academic year 2011/2012 is now four months old, and we are off to a splendid start! We (a) have welcomed several new faculty members and a bolus of categorical interns (see below), (b) had a leadership transition at our Methodist Hospital, (c) are in growth mode at Methodist with initiatives in General Surgery, Vascular Surgery, Wound Care and Surgical Oncology (see the cover story), and (d) with the leadership of Dr. Nicholas Cavarocchi have seen remarkable growth in our adult ECMO program with outstanding clinical results and several research projects brought to fruition. Exciting times again this year at …

Surgeon-Led Ecmo Treatment Improves Survival Rates In Surgical Cardiac Care Unit

Jefferson Surgical Solutions

The Jefferson Surgical Cardiac Care Unit (SCCU), reorganized in July 2010, delivers the best survival rates in Pennsylvania for patients plagued by serious lung and/or heart dysfunction. Nicholas Cavarocchi, MD, FACS, FCCP, the SCCU Director and Associate Professor of Surgery, leads a highly trained team that uses extracorporeal membrane oxygenation (an ECMO machine) to provide respiratory and cardiac support to patients whose lungs and/or hearts cannot function on their own. Because of the excellent outcomes – 70 to 80 percent survival rates for patients with life-threatening situations, up from a previous zero-based survival rate – Dr. Cavarocchi believes the Jefferson …

Meet Our Surgical Interns

Jefferson Surgical Solutions

We have welcomed an amazing new group of categorical interns, selected from over one thousand applicants to our program. These doctors, who recently matched with Jefferson Medical College (JMC), started on June 20, 2011. Just a few months into their Jefferson surgical residency, we have all noticed their dedication to patient care, their energy and their excitement in joining the Jefferson community.

Meet Our Surgical Interns

Please welcome (from left to right):

• Christine Feldmeier, MD, JMC
• James Crawford, MD, New York University
• Kate Holoyda, MD, University of Wisconsin
• Vishen Sooppan, MD, SUNY Upstate - Syracuse
• Caitlyn Johnson, MD, JMC
• Jonathan …

National Transplantation Pregnancy Registry Celebrates 20th Anniversary

Jefferson Surgical Solutions

This year marks the 20th anniversary of the National Transplantation Pregnancy Registry (NTPR). Established at Jefferson, this unique registry is a voluntary study, in which transplant recipients (both men and women) report their experiences with conception, pregnancy, childbirth, and the health of the recipient. The NTPR was founded by Principal Investigator Vincent Armenti, MD, PhD, a Jefferson alumnus and former transplant fellow with a dual faculty appointment as Professor in the Department of Surgery (Transplantation Division) and the Department of Pathology, Anatomy, and Cell Biology.

Dr. Armenti’s interest was sparked two decades ago when a transplant recipient told him she …

On The Job: Dr. Karen Chojnacki, Residency Program Director

Jefferson Surgical Solutions

Karen Chojnacki, MD, FACS, who has directed the General Surgery Residency Program for the past three years, was a resident at Jefferson from 1995 to 2000 – and loved it. Following a fellowship in minimally invasive surgery at the University of Southern California and a brief stint in private practice, she returned to Jefferson in early 2002, jumping at the chance to capture her “dream job” and buoyed by memories of the institution’s camaraderie and professionalism. “Whoever said ‘You can’t go home again’ didn’t have a home like Jefferson,” she says. “I lead the program that helped make me the …

Alumni Support Jefferson Through Service And Giving

Jefferson Surgical Solutions

On Wednesday, June 29th, the Department of Surgery hosted a reception to recognize Melvin Moses, MD, FACS, for his contributions and many years of service. Dr. Moses graduated from Jefferson Medical College (JMC) in 1962 and remained at Jefferson for his residency training and three separate clinical and research fellowships. He joined the hospital surgical staff in 1970 and became a JMC faculty member in 1982.

In 1990, Dr. Moses was named the Vice Chairman of the Department of Surgery, Methodist Hospital Division of Thomas Jefferson University Hospital (TJUH), where he remained for the duration of his career- a career …

News In Brief

Jefferson Surgical Solutions

Gurjyot Bajwa, MD, has joined the Division of Cardiothoracic Surgery. She is fellowship-trained in Adult Cardiac Surgery, Congenital Cardiac Surgery and General Thoracic Surgery. She also trained in complex adult cardiac surgery and minimally invasive and robotic surgery at the Cleveland Clinic.

Patrick Greaney, MD, has joined the Division of Plastic Surgery. He completed his General Surgery residency at Jefferson in 2007, followed by a fellowship in burn reconstruction at the William Randolph Hearst Burn Center of the Weill Cornell / New York-Presbyterian Hospital, a plastic surgery residency and a fellowship in microsurgery. He will provide services at …

Burden Of Traumatic Spine Fractures In Tehran, Iran., Maziar Moradi-Lakeh, Mohammad R Rasouli, Alexander Vaccaro, Soheil Saadat, Mohammad R Zarei, Vafa Rahimi-Movaghar

Rothman Institute Papers

UNLABELLED: ABSTRACT:

BACKGROUND: The Disability-Adjusted Life Year (DALY) was designed by the World Health Organization (WHO) to measure, compare, and analyze the burden of various diseases. To the best of our knowledge, this is the first study on the assessment of burden of traumatic spinal fracture (TSF) in an Iranian community. We estimated burden of TSF includes both isolated (iTSF) and associated injuries related to traumatic spinal fractures (aTSF) in Tehran, the capital of Iran, for the year 2006-2007 using DALYs.

METHODS: Burden of TSF was estimated based on information provided by the national data on Iranian trauma, data from …

Delayed Surgical Therapy Reduces Mortality In Patients With Acute Necrotizing Pancreatitis, Abdul Rehman Alvi, Ghulam Murtaza Shaikh, Syed Faraz Kazim

Section of General Surgery

Objective: To review the trends in management and analyze the factors influencing outcomes of acute necrotizing pancreatitis.
Methods: It wa a retrospective analytical study. All adult patients with computed tomography with proven necrotizing pancreatitis managed at the department of surgery, Aga Khan University Hospital, Karachi were included in this study extending from January 1998 to January 2008. Outcome variables were hospital stay, complication rate and in-hospital mortality. Data analysis was carried out using SPSS version 16. For comparison, Pearson chi-square test, Fisher's exact test, t-test and ANOVA were used, where applicable. A p-value less than 0.05 was considered statistically significant. …

Audit On Preoperative Midazolam And Level Of Sedation, Sanam Muhammad, Shahla Siddiqui

Department of Anaesthesia

We wished to observe by carrying out a prospective clinical audit, the level of sedation and time interval of all adult elective surgery patients. We enrolled adult ASA I-III patients who came for elective surgery to the Aga Khan University Hospital preoperative surgery suite for 3 months. Hundred patients were enrolled. The majority of patients got 7.5 mg of PO Midazolam. Our median Ramsay sedation score was 2 and the Median drug to door time was 52.35 minutes. 11 patients were reportedly 'drowsy' in the recovery room one hour after surgery was completed. These were mostly the same patients who …

Endovascular Approach As Primary Treatment For Traumatic Carotid Cavernous Fistula: Local Experience From Pakistan, Rana Shoaib Hamid, Tanveer Ul Haq, Muhammad Shahzad Shamim, Syed Faraz Kazim, Basit Salam

Department of Radiology

Objective: To evaluate the technical success, complications and outcome of endovascular management of post traumatic carotid cavernous fistula (CCF) in patients presenting at a tertiary care hospital in Karahci.
Methods: Descriptive case series of 26 patients of post traumatic CCF treated by endovascular techniques was carried out at Radiology and Neurosurgery departments of Aga Khan University hospital between January 2010 to March 2010. Medical records and radiology reports were retrospectively reviewed from November 2000 to December 2009. The diagnosis was primarily clinical and was confirmed in all cases by CT or MRI. Endovascular procedures were performed under general anaesthesia through …

Executive Summary: The Management Of Community-Acquired Pneumonia In Infants And Children Older Than 3 Months Of Age: Clinical Practice Guidelines By The Pediatric Infectious Diseases Society And The Infectious Diseases Society Of America., John S. Bradley, Carrie L. Byington, Samir S. Shah, Brian Alverson, Edward R. Carter, Christopher Harrison, Sheldon L. Kaplan, Sharon E. Mace, George H. Mccracken, Matthew R. Moore, Shawn D. St Peter, Jana A. Stockwell, Jack T. Swanson, Pediatric Infectious Diseases Society And The Infectious Diseases Society Of America

Manuscripts, Articles, Book Chapters and Other Papers

Evidenced-based guidelines for management of infants and children with community-acquired pneumonia (CAP) were prepared by an expert panel comprising clinicians and investigators representing community pediatrics, public health, and the pediatric specialties of critical care, emergency medicine, hospital medicine, infectious diseases, pulmonology, and surgery. These guidelines are intended for use by primary care and subspecialty providers responsible for the management of otherwise healthy infants and children with CAP in both outpatient and inpatient settings. Site-of-care management, diagnosis, antimicrobial and adjunctive surgical therapy, and prevention are discussed. Areas that warrant future investigations are also highlighted.

Cranioplasty After Decompressive Craniectomy: An Institutional Audit And Analysis Of Factors Related To Complications, Zain A. Sobani, Muhammad Shahzad Shamim, Syed Nabeel Zafar, Mohsin Qadeer, Najiha Bilal, Syed Ghulam Murtaza, Ather Enam, Muhammad Ehsan Bari

Section of Neurosurgery

Background:Although a relatively simple procedure, cranioplasties have been associated with high complication rates. Keeping this in perspective, we aimed to determine the factors associated with immediate and long-term complications of cranioplasties at our institution.
Methods: A retrospective review of Patient records was carried out for Patients having undergone reconstructive cranioplasties at our institution during the last 10 years (2001-2010). All case notes, records, and investigations were reviewed and the data were recorded in a predesigned questionnaire. Complications were recorded along with existing comorbids and measures taken for their prevention and management. Univariate and multivariate logistic regression analysis was performed …

Isolated Adult Hypoganglionosis Presenting As Sigmoid Volvulus: A Case Report., Irfan Qadir, Muhammad Musa Salick, Abrar Barakzai, Hasnain Zafar

Department of Surgery Docs

Introduction:Isolated hypoganglionosis is a rare cause of intestinal innervation defects. It is characterized by sparse and small myenteric ganglia, absent or low acetylcholinesterase activity in the lamina propria and hypertrophy of the muscularis mucosae, principally in the region of the colon and rectum. It accounts for 5% of all intestinal neuronal malformations. To the best of our knowledge, only 92 cases of isolated hypoganglionosis were reported from 1978 to 2009. Isolated hypoganglionosis usually manifests as enterocolitis or poor bowel function, and is diagnosed in infancy or childhood. We report the first case of isolated hypoganglionosis presenting with sigmoid volvulus …