Research in the Department of Surgery encompasses a broad spectrum of activities that are directed toward improving the quality of our patient care and toward developing novel, innovative therapies. Through investigator-initiated trials, as well as national cooperative group, and industry-funded trials, department faculty are able to offer our patients access to cutting-edge treatments not otherwise available. The increasingly coordinated clinical research effort within the Department will ensure that the discovery continues. Finally, through fundamental basic research into the underlying mechanisms of disease, department faculty
are identifying novel avenues of future treatment.
Age-related macular degeneration (AMD) is a leading cause of vision loss in people aged 60 or older. Until about 5 years ago, few treatment options were available and AMD was considered a blinding disease. With new treatments, specifically the VegF inhibitors, up to 90% of patients can maintain their vision, and up to 30% can actually improve with treatment. For the past 5 years, Brian Kim, MD, and clinical trials coordinator Theresa Goddard, have been able to enroll their patients in a clinical trial of Eylea (VegF-Trap). Recently FDA-approved, Eylea is just as effective as other VegF inhibitors, but is less expensive and requires less frequent treatment, saving the medical system hundreds of millions of dollars per year. “It [Eylea] has recently been FDA-approved just this year. Our patients, however, have had access to this drug since we have been in the study (5 years). Studies like these allow early access for our patients to cutting edge treatments, not available otherwise.” (Brian Kim, MD, Green and Gold Professor of Ophthalmology)
Approximately one third of patients with severe aortic stenosis are not referred for treatment because they are thought to be too high risk for conventional surgical aortic valve replacement. Led by Joseph Schmoker, MD and Harold Dauerman, MD (Cardiology), the Divisions of Cardiothoracic Surgery and Cardiology are collaborating in an effort to enroll patients in a randomized prospective study of transcatheter aortic valve implantation (TAVI). This new technique will offer many of these high-risk patients a treatment option.
Overactive bladder (OAB) is a prevalent medical condition that it is associated with substantial economic and social costs. In the United States alone it affects more than 17 million men and women of all ages and costs an estimated $12.6 billion annually. Despite a growing body of clinical and basic research, the mechanisms underlying detrusor overactivity, the most common cause of clinical symptoms, are still poorly understood and tools available to control it are relatively ineffective.
Katarina Zvarova, MD PhD is investigating the role of voltage-gated calcium channels in detrusor muscle activity in the overactive bladder. Work in the Zvarova laboratory suggests that modulation of R-type Ca2+ channel function leads to enhanced bladder capacity and reduced bladder hyperactivity, as well as decreased urinary bladder smooth muscle contractility. The net effect of inhibition of R-type Ca2+ channel is a greater decrease in the sensitivity of urinary bladder smooth muscle to nerve stimulation in animals with a partial bladder outflow obstruction. This suggests a role for these channels in mediating the contractile state of the diseased smooth muscle, perhaps by contributing to UBSM excitability and contractility by depolarizing the membrane and increasing [Ca2+]I. Results from these studies may yield valuable insight into the maturation of the micturition reflex and the cellular mechanisms underlying its regulation.
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Last modified December 04 2013 11:22 AM