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In 2000, Columbia University Medical Center created a Surgical Science division to provide special support to clinicians engaged in innovative research. Under the guidance of Division Chief Ann Marie Schmidt, MD, this division has received a $7 million grant (from the National Institutes of Aging) to study the progression of Alzheimer's disease. This is the second-largest grant in the country for the study of Alzheimer's disease (the largest was received by Columbia University Medical Center's Department of Neurology). The recipient of a $3 million grant from the Juvenile Diabetes Research Foundation, the Division is now recognized as a Juvenile Diabetes Research Foundation Center of Complications. The Division also runs a vascular biology program funded in large part by the National Heart Lung Blood Institute (NHLBI), of the NIH. The rapid pace of scientific advance in surgery requires a new breed of surgical scientists who understand how translational research should be done; what is safe, what will work, what it will cost, how to fund it, how long it will take. These skills are personified, by more than a dozen members of our faculty, who refined research skills in our surgical laboratories during their residency training. As part of our translational research strategy, a new division of Surgical Science has been established with the cooperation of the Dean's office. This division allows non-surgeons to hold faculty appointments within the Department of Surgery. The Surgical Science Division carries out a broad range of research projects in collaboration with the Department of Surgery faculty, other investigators at Columbia and affiliated institutions. Current projects are related to ischemia/reperfusion injury and organ preservation, modulation of immune/inflammatory disorders, neurodegenerative diseases, mitochondrial function, and blood coagulation. The future depends on our ability to continue to train innovative investigators. The urgency of our dedication to research training is reflected in our newly secured, NIH sponsored three-year training grant, which supported the work of Dr. Talia Spanier and others. Residents and medical students are enthusiastic, vigorous and prolific members of our research teams. Our residents have petitioned the Department for a dedicated laboratory year for everyone in our five-year program. The suggestion by residents, that their training should be prolonged to allow acquisition of research skills, is unique. Departmental research is conducted in new laboratories on P&S 17 that include facilities for molecular biology, genetic engineering, histology, immunology, infection suppression, ventricular mechanics, extracorporeal membrane oxygenation (ECMO), laser surgery, and vascular surgery. Facilities have been established for acute experiments in large and small animals. Survival surgery is conducted within the Institute of Comparative Medicine of the College of Physicians and Surgeons. A new program for prototyping designs for surgical devices has been initiated by Dr. Mehmet C. Oz and Dr. Michael Treat. An educational program for residents, describing research techniques available within the Department, has been organized by Dr. Nowygrod. Clinical research projects include NIH sponsored clinical trials, the REMATCH left ventricular assist devices (LVAD) trial, the CABG Patch (implantable defibrillator) Trial, and the lung reduction surgery trial. Our research efforts are also focused on induction of tolerance, RAGE research in liver regeneration, wound healing, prevention of metastases and diabetes, the use of anti-angiogenic factors in cancer control, cardiac arrhythmias, ventricular remodeling etc. The newly recruited, Dr. Howard Kaufman spearhead tumor vaccines trials. Additional clinical trials involve grafts for aortic aneurysms that can be inserted percutaneously. Limited access cardiac surgery is being aggressively developed. Laser myocardial revascularization is also under study in patients. Additional clinical research involves ECMO and liquid ventilation for lung failure. Minimal access procedures are also under development by our faculty. The role of perioperative endo-scopy in gallbladder/common duct surgery is also under study. LVAD (Left Ventricular Assist Device) patients are the focus of studies of effects of inhaled nitric oxide on pulmonary vascular resistance and studies of aspirin suppression of autoimmune responses originating from endothelial LVAD lining. In patients undergoing cardiopulmonary bypass, current studies involve benefits of pitrossin in vasodilatory shock, the role of antithrombin III in heparin resistance to anticoagulation, and ventricular mechanics in surgery for acquired and congenital heart disease. Basic research in the Department has been promoted by activities of the Surgical Science and department faculty. They are working with Dr. Eric A. Rose to develop a new anticoagulation technique based on a factor IX antagonist. This is potentially applicable to human cardiac and vascular surgery as well as thrombotic diseases. This work has been the central focus of a three-year NIH Training Grant. Other projects involving molecular biology include studies of factors delaying and promoting wound healing in diabetics (AGE/RAGE), studies of Alzheimer's disease and prevention of tumor growth. Studies are also directed at improving transplantation techniques, including xenografting and development of transgenic mammals. An ongoing program in the Department is intended to develop infection resistant materials for catheters, drivelines, and implanted LVADs, ICDs, and pacemakers. The immunologic advantages of limited access surgery are under study. See InCHOIR for a description of clinical evaluative research. Overall, our research programs are intended to improve the surgical care of patients by minimizing mortality, morbidity and discomfort while improving the quality and duration of life. This requires enlightened direction, superior facilities, internal and external funding, and dedicated efforts by our faculty, students, technicians, Ph.D.s, and residents. Expansion of these programs, traditionally supported by government grants, is increasingly dependent on funding support from industry, philanthropic and private sources.
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| ©1999-2007. Columbia University Medical Center, Department of Surgery, New York, NY. |
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