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A NewYork-Presbyterian/Columbia patient was the first in the New York City area to receive incision-free surgery for obesity. The surgery took place during August, 2008 as part of the ongoing multicenter TOGA Pivotal Trial at NYP/Columbia. Drs. Marc Bessler and Daniel Davis performed the TOGA Procedure (for "transoral gastroplasty"), which, like other obesity procedures, is designed to alter the patient's stomach anatomy to give them a feeling of fullness after a small meal. The difference is that TOGA was performed under direct endoscopic visualization with specialized instruments passed into the stomach through the mouth without any incisions. Studies Identify New Options for Breast CancerAt NewYork-Presbyterian Hospital/Columbia University Medical Center, the treatment of breast cancer involves a comprehensive approach that includes reducing toxicities as well as improving outcomes. Initiatives designed to improve outcomes for patients with breast cancer are focused on an ambitious drug development program that often allows patients access to therapies not available outside of clinical trials, as well as an active prevention program that focuses on both drugs and nutrients with the potential to inhibit the mechanisms of malignant transformation. Drug-Eluting Stent for Blockages in the Leg Arteries
FDA Approval to Add Transapical Delivery System to PARTNER Transcatheter Heart Valve TrialThe PARTNER (Placement of AoRTic traNscathetER valves) trial, initiated in the second quarter of 2007, is evaluating the Edwards SAPIEN valve in patients who are considered high risk or inoperable for conventional open-heart valve surgery. In January, 2008, the study, which is being conducted by Edwards Lifesciences in collaboration with medical centers throughout the world including NYPH/Columbia, received conditional approval from the U.S. Food and Drug Administration (FDA) to add transapical delivery method (delivery through a small chest incision and through the left ventricle), and also to increase trial sample size from 600 patients to 1,040 patients. Dr. Craig Smith is co-principal investigator for the trial. Surgeons from the Department of Surgery performing the procedure are Drs. Mathew R. Williams and Allen S. Stewart. The valve is placed using minimally invasive methods: either by advancing a catheter to the aortic valve through the femoral artery or transapically (directly through the heart) in patients that do not have femoral arteries that are large enough. Once the catheter is in place, a tissue valve with metal stent scaffolding is positioned and deployed. X-ray guidance provides indirect visualization. The force of the expanding stent anchors the new valve in place, completely avoiding the need for sutures, cardiopulmonary bypass, open surgery—and their associated effects. Weight-Based Dosing Is Key to Optimal TreatmentWIN-R, a multicenter study of over 5,000 patients with hepatitis C virus, published during 2007 in the journal Hepatology, determined that weight-based dosing with REBETOL (ribavirin, USP) (RBV) in combination with pegylated interferon (PEG-IFN) alfa-2b is key to optimal treatments, particularly in African-Americans with most difficult-to-treat form of disease.
Robert S. Brown Jr., MD, was co-principal investigator of the study;
Ira M. Jacobson, MD, Chief of the Division of Gastroenterology and Hepatology at NewYork-Presbyterian Hospital/Weill Cornell Medical Center was principal investigator.
The study was the largest U.S. hepatitis trial to date. Accelerated Partial Breast IrradiationInvestigational procedure may make radiation therapy accessible to more women.
Tumor Vaccines: First Study of Trovax for Breast Cancer to BeginSince 1997, the Tumor Immunotherapy Program has been at the forefront of efforts to beat cancer through the development of new vaccines. Led by Howard L. Kaufman, MD, Chief, Division of Surgical Oncology, the program conducts laboratory research and offers vaccines to patients with melanoma, colon cancer, kidney cancer, and other types of cancer including breast cancer. Study Confirms Safety and Effectiveness of Treatment for Lower Extremity
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The Division of Vascular Surgery is participating in the first trial of a drug eluting stent to treat peripheral arterial disease (PAD), or blocked arteries in the legs.
Once implanted, the stent releases a medication within the artery to prevent restenosis, or re-blockage, of the vessel.
After undergoing a lumpectomy to remove the part of the breast affected by breast cancer, most women must undergo radiation therapy treatments.
The standard course consists of six to seven weeks of therapy, five days a week.
For women who live far from their radiation facilities, the burden associated with daily trips for almost two months can be too much to bear.
As a result, some women have curtailed therapy, or even foregone radiation therapy altogether, despite the increased risk of their cancers recurring.
A new kind of radiation therapy, Accelerated partial breast irradiation, or APBI, may now alleviate this travel burden and allow more women to complete this highly important therapy.
 K. Craig Kent, MD, Chief, Division of Vascular Surgery |
Minimally invasive catheter-based interventions have been increasingly used to treat patients with severe blood-vessel blockages in their legs, a painful condition known as lower extremity vascular disease (also known as claudification). An estimated eight million Americans suffer from the condition. A study led by faculty from the Division of Vascular Surgery including K. Craig Kent, MD (lead author), James F. McKinsey, MD, John Karwowski, MD, Nicholas J. Morrissey, MD, Harry L. Bush, MD, Roman Nowygrod, MD, and has shown the approach is safe and effective and may now be considered a first-line intervention for all patients-even those with the severe form of the disease associated with risk for amputation. The study's Principal Investigator is former Vascular Division fellow Dr. Brian G. De Rubertis, who is currently on the faculty of the UCLA Department of Surgery. The study was published in the September 2007 Annals of Surgery. An article summarizing the findings and their significance ran on medicexchange.com on October 25, 2007.
Incisionless Surgery with Natural Orifice Techniques
Natural Orifice Translumenal Endoscopic Surgery, or NOTES, is a new method of performing minimally invasive surgery through the mouth, anus, or vagina.
Drs. Marc Bessler, Peter Stevens and Dennis Fowler have successfully performed the first U.S. transvaginal gall bladder removal operation (cholecystectomy) with limited laparoscopic assistance as part of a larger IRB approved study.
In addition to transvaginal removal of the gallbladder, the Columbia team is conducting minimally invasive procedures for appendectomy, gastroesophageal reflux, and weight loss surgery.
Read more.
Lap-Band Trial for Teens
Columbia University Medical Center is one of only three U.S. centers presently approved to offer weight loss surgery to teens as part of a tightly regulated FDA study evaluating the outcomes of "Lap-Banding," in adolescents. Patients in the study must first complete a six-month program of rigorous weight loss education and therapy. "The goal of this phase is to determine whether patients can lose 20% of their excess weight," says Jeffrey L. Zitsman, MD, FACS, Director, Center for Adolescent Bariatric Surgery at Morgan Stanley Children's Hospital of NewYork-Presbyterian. "If patients achieve this goal, they can continue with nonsurgical methods and avoid having surgery."
Click here to go to the Center for Adolescent Bariatric Surgery Website.
Advances in Adult Weight Loss Surgery
After surgery for weight loss, 10-15% of patients may regain weight that they lost.
To help such patients, the Center for Obesity Surgery at NewYork-Presbyterian Hospital/Columbia now performs several types of revisional, or secondary procedures.
Colorectal Cancer: Reducing Recurrence, Making Surgery Safer
 Richard L. Whelan, MD |
Ninety percent of colorectal surgeries are performed laparoscopically at the Colorectal Care Program at NewYork-Presbyterian Hospital/Columbia University Medical Center.
Yet even minimally invasive surgery inflicts trauma on the body, according to Richard L. Whelan, MD, Chief, Section of Colon and Rectal Surgery and Associate Director, Division of Surgical Oncology.
Dr. Whelan and colleagues are aggressively working to reduce this downside of surgery through a host of cutting-edge studies.
Pfizer Contracts to Test and Market RAGE-Antagonist Drugs
 Ann Marie Schmidt, MD |
The cell-surface molecule RAGE (Receptor for Advanced Glycation Endproducts) contributes significantly to many ills, including cancer, heart disease, Alzheimer's disease, diabetes complications such as nephropathy, and a host of immune-related disorders. For Ann Marie Schmidt, MD, Chief of the Department of Surgery's Division of Surgical Science, who has been studying RAGE for over a decade, this molecule's ability to trigger such a wide variety of disorders has revealed an unexpectedly unified picture of chronic disease and how it might be medically reversed. After more than 15 years leading basic research on the molecule, Dr. Schmidt is now seeing her efforts pay off in development of therapies for people.
GER and Lung Transplant
Highly effective treatments can successfully protect patients against the threat of the acute form of rejection that occurs immediately after transplant surgery. Yet even the best medical therapies are powerless against the tide of chronic rejection, which slowly and steadily undermines the health of over half of lung transplant patients during the first three- to five years after transplantation. Frank D'Ovidio, MD, PhD, has shed light on the role of gastro-esophageal reflux (GER) as one of the causes of chronic lung transplant dysfunction, and/or chronic rejection.
Refining Techniques to Make Breast Reconstruction Safer
 Jeffrey A. Ascherman, MD, FACS |
In a recent clinical study of breast reconstruction techniques, Dr. Jeffrey A. Ascherman, Associate Professor of Clinical Surgery at Columbia and Site Chief, Division of Plastic Surgery at NewYork-Presbyterian Hospital/Columbia University Medical Center, performed a careful examination of the pedicled method. Through his study of the technique, which avoids some of the complications that can be associated with free flaps, Dr. Ascherman confirmed its safety and effectiveness.
Biological Markers in Breast Cancer
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This study will determine whether there is a difference in estrogen receptor status between African American and white women with ductal carcinoma in situ (DCIS), and if so, whether that difference impacts recurrence and survival rates.
Blocking Tumor Growth
Scientists now know that the process governing the growth of blood vessels (angiogenesis) plays an important role in the growth of cancerous tumors. Researchers have sought ways to inhibit the process by targeting specific growth factors. Such work has proven a highly promising strategy so far, and is the focus of continued research by Jessica Kandel, MD, Associate Professor of Surgery in the Institute for Cancer Genetics and Director, Charles Edison Laboratory for Pediatric Research.
STEPping Forward
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With every advance in medicine, the thrill of discovery also brings a new set of challenges to meet and questions to resolve. For doctors treating short bowel syndrome, the advent of an important surgical treatment, the STEP procedure, is no exception.
Advancing Treatment of Vascular Diseases
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Surgical techniques for treating major vascular diseases are rapidly evolving, becoming safer, and becoming available to more patients. What makes such advances possible is rigorous research to define which situations demand open or minimally invasive techniques; to examine public health issues such as cost, length of stay, and screening; and to monitor surgical techniques for complication rate, safety, and efficacy. As a leading institution in the quest to refine and advance open and minimally invasive procedures for major vascular disorders, NewYork-Presbyterian Hospital is currently conducting 16 clinical trials.
Biventricular Pacing for Heart Failure
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Therapeutic options for patients with heart failure just broadened—again. The recent introduction of biventricular pacing has meant a valuable addition to the cardiologist's toolbox, good news for the five million Americans who have congestive heart failure. Henry M. Spotnitz, MD, George M. Humphreys II Professor of Surgery at Columbia University College of Physicians and Surgeons and Vice Chairman for Research and Information Systems at the Department of Surgery, is working to gain the fullest potential of this extraordinary technology. He and his team are now researching ways to bring its benefit to other kinds of patients and to optimize its function for those who benefit from it already.
Thymosin Beta-4 and Chronic Wound Healing
NewYork-Presbyterian Hospital/Columbia University Medical Center is conducting a study on thymosin beta-4, a naturally occurring protein that can reduce inflammation and help wounds to heal. "Thymosin beta-4 is a major activator of actin, which improves the process of wound healing," says Mark A. Hardy, MD. Dr. Hardy is Auchincloss Professor of Surgery at Columbia University College of Physicians and Surgeons, and Director of Islet Transplantation at NewYork-Presbyterian Hospital/ Columbia University Medical Center.
Heart surgery without the surgeon: Columbia University researchers test new cardiovascular repair system for mitral valve regurgitation
Evalve adopts catheterization techniques for non-invasive mitral valve repair
Researchers at Columbia University College of Physicians & Surgeons are conducting a Phase II clinical trial of the Evalve Cardiovascular Repair System for the treatment of mitral valve regurgitation, a serious heart condition that —left untreated— can lead to arrhythmias or congestive heart failure. Initial results with the system have demonstrated that successful repair of the mitral valve is feasible using this approach, which uses non-invasive techniques and effectively takes the procedure out of the operating room.
SCCOR Grant Supports Extensive LVAD Research
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In March 2005, the NIH awarded Columbia University College of Physicians & Surgeons a $17 million SCCOR grant to investigate improving outcomes for end-stage heart failure patients with implanted mechanical devices. Eric A. Rose, MD, Chairman, Department of Surgery, is the principal investigator for the grant. Alan J. Moskowitz, MD, Co-Director of InCHOIR, and Mario Deng, MD, Director, Cardiac Transplantation Research, serve as co-principal investigators.
Trial of New Vaccine for Stage IV Kidney Cancer
Since the first vaccine for smallpox was documented in 1796, scientists have developed effective vaccines to prevent numerous deadly diseases, including cholera, anthrax, typhoid fever, and the plague in the 1800's, and polio, measles, and mumps in the 1900's. With these and other scourges behind them, researchers have since turned their focus to the most challenging killers today, including cancer. Once considered a pipe dream, the possibility of preventing or curing cancer with vaccines is now within our reach — and an important new trial at NewYork-Presbyterian Hospital/Columbia now promises to advance the field even closer to that goal.
STICH Trial: Optimizing Management of Complex Heart Disease Patients
The Departments of Surgery and Medicine are collaborating on a multi-national, randomized National Institutes of Health (NIH) funded project to test treatment alternatives for patients with left ventricular dysfunction and coronary artery disease that is amenable to surgical revascularization (bypass surgery). Deborah V. Davis Ascheim, MD is the principal investigator of the trial, which is known as STICH (Surgical Treatment of Ischemic Heart Failure).
Adult Stem Cells and the Quest to Repair the Human Heart
The promise of stem cells lies in their ability to develop into specialized cells required for organ or tissue functioning. While adult stem cells lack the enormous versatility of embryonic stem cells, they may be easier to use clinically, since they are already partially differentiated in the body. In addition, the use of adult stem cells does not confront the many ethical and legal questions associated with embryonic stem cell research. Physician-scientists at NewYork-Presbyterian Hospital/Columbia University Medical Center are currently testing the therapeutic potential of adult stem cells for select diseases.
Silviu Itescu, MD, Director of Transplantation Immunology for the Departments of Surgery and Medicine, is launching two clinical trials to test different types of adult stem cell in treating patients with heart disease. The initial trial–the first of its kind to receive FDA approval in the United States–evaluates the use of angioblasts in patients with ongoing symptoms of chest pain. The second trial will focus on patients with end-stage heart failure who have a left ventricular assist device (LVAD).
Viramidine for Hepatitis C: A New Therapy Enters the Mix
An estimated four million Americans are currently infected with Hepatitis C, a viral disease that swells the liver and prevents it from functioning properly. Hepatitis C-related liver disease is the most common reason for liver transplantation in adults. A multifunctional organ, the liver fights infections and stops bleeding, it removes drugs and other poisons from the bloodstream, and it stores energy for when you need it. Robert S. Brown Jr., MD, MPH, Associate Professor of Clinical Medicine and Pediatrics at Columbia University College of Physicians & Surgeons and Medical Director of the Division of Abdominal Organ Transplantation at NewYork-Presbyterian Hospital, is fighting to give more Hepatitis C patients a complete recovery through a new clinical trial called Viser 1.
Thoracic Aortic Stent-graft Takes on a Silent Killer
Each year, more than 20,000 Americans are diagnosed with thoracic aortic aneurysms, which occur when a section of the aorta running through the chest weakens and bulges outward like a balloon. The aorta is the body's main circulatory vessel. If an aortic aneurysm expands to the point where it ruptures, the resulting internal bleeding is life threatening. Thoracic aortic aneurysms are known as a silent killer since patients typically have no symptoms until the aneurysm begins to leak or expand. Cardiac and vascular surgeons in the Columbia University Department of Surgery specialize in aortic thoracic aneurysm repairs. The Thoracic Aortic Stent-graft trial offers a less invasive treatment for patients with thoracic aortic aneurysms. James F. McKinsey, MD, is principal investigator of the trial.
Heart Surgery without the Heart Surgeon: Evalve for Non-Invasive Mitral Valve Repair
Researchers at Columbia University College of Physicians & Surgeons are conducting a Phase I clinical trial of the Evalve Cardiovascular Repair System (CVRS) for the treatment of mitral valve regurgitation, a potentially serious and common heart condition that may lead to arrhythmias or congestive heart failure. Initial results with the system have demonstrated that successful repair of the mitral valve is feasible using this less invasive approach, which takes the procedure out of the operating room and into the cardiac catheterization room. The clinical trial is called EVEREST I, or Endovascular Valve Edge-to-Edge Repair Study.
Vent for Emphysema: A Minimally Invasive Approach to Breathing Easy
For patients with emphysema, a lung disease typically caused by cigarette smoking, the fundamental act of breathing becomes a battle. Approximately two million Americans are affected by emphysema, the vast majority of whom are over age 50. Emphysema occurs when damage to the air sacs affects the elasticity of the lungs, trapping air in the lungs and enlarging the chest wall. In lung volume reduction surgery (LVRS), those parts of the lung most affected by emphysema are surgically removed in order to improve the function of the rest of the lung. After LVRS, patients typically experience less shortness of breath and improved quality of life.
In the Endobronchial Valve for Emphysema Palliation Trial (VENT), physician-scientists at Columbia are investigating the potential benefits of a less invasive approach to lung reduction. Mark E. Ginsburg, MD, Assistant Clinical Professor of Surgery at Columbia University College of Physicians & Surgeons and Surgical Director of The LeBuhn Center for Chest Disease and Respiratory Failure at NewYork-Presbyterian Hospital/Columbia University Medical Center, is the principal investigator of the trial, along with Roger A. Maxfield, MD, Associate Clinical Professor of Medicine at Columbia University College of Physicians & Surgeons.
PET/CT: Fusing Views for More Targeted Medicine
From the invention of the X-ray in 1895 to the plethora of medical imaging technologies available today, many of the advances of modern medicine stem from our ability to see inside the human body. A dual-purpose imaging device, PET/CT is literally the combination of PET (positron emission tomography) and CT (computed tomography) imaging techniques within a single scanner. The individual scans, which are taken virtually simultaneously, can be presented separately or as a single, overlapping, or "fused" image. The two techniques present different types of information about the human body.
Richard M. Gewanter, MD, Clinical Instructor of Radiation Oncology at Columbia University College of Physicians & Surgeons, is conducting a clinical trial to investigate the benefits of PET/CT for targeted, dose-escalated radiation therapy in individuals with unresectable (inoperable), non-small cell lung cancer that has not spread beyond the lungs.
LAP BAND®: Bringing Hope to More Overweight Americans
Obesity is the second largest cause of preventable death in the United States after smoking. Based on current trends, researchers predict obesity will become the number one cause by 2005, with the toll surpassing 500,000 deaths a year, rivaling the annual deaths from all forms of cancer combined. Despite efforts to reduce obesity, the incidence of this disease has been increasing over the past 20 years. While effective, obesity surgery has been reserved to date for patients at the highest risk—the most overweight. However, in a new clinical trial, physicians at Columbia are now taking a closer look at a different patient pool who they believe could significantly benefit from weight loss surgery.
"Our clinical trial is looking at patients who aren't heavy enough for weight loss surgery based on standard criteria, but they are suffering from medical problems and quality of life issues," says Marc Bessler, MD, Assistant Professor of Surgery at Columbia University College of Physicians & Surgeons and Surgical Director of the Center for Obesity Surgery at Columbia University Medical Center. Dr. Bessler is the principal investigator of the trial, along with Daniel G. Davis, DO, Assistant Professor of Surgery at Columbia University College of Physicians & Surgeons and Surgical Director of the Center for Obesity Surgery at Lawrence Hospital.
Tumor Vaccines: A Promising Weapon in the Fight Against Metastatic Melanoma
To date, physicians have struggled to successfully fight metastatic cancer, the spread of cancer beyond the original tumor site. Surgery, chemotherapy, and radiation therapy have failed to have a substantial impact on most metastatic solid tumors. Recently, the application of immunotherapy, or tumor vaccines, to the treatment of metastatic cancer has garnered much attention. The primary focus of immunotherapy is T-cell immunity. T-cells are white blood cells that fight infection and are involved in the destruction of tumor cells. Researchers believe that T-cells can recognize and possibly destroy tumors if they have been properly activated or stimulated against the tumor cells.
Physician-scientists at Columbia stand at the forefront of immunotherapy research, which could potentially revolutionize the treatment of metastatic melanoma, the most serious type of cancer of the skin. "Several co-investigators and I are currently leading a trial at Columbia to see if two particular tumor vaccines have the ability to create a strong immune response within patients—enabling their T-cells to react to the tumor cells and, hopefully, to fight back against the melanoma," says Howard L. Kaufman, MD, Associate Professor of Clinical Surgery at Columbia University College of Physicians & Surgeons and Director of Tumor Immunotherapy at NewYork-Presbyterian Hospital/Columbia University Medical Center.
Reducing Rejection: Combination Therapy for Kidney Transplant Recipients
 Mark A. Hardy, MD |
In a kidney transplant, a patient with advanced renal (kidney) disease or kidney failure receives a healthy kidney from a living donor or from a recently deceased donor. To ensure a successful transplant, however, kidney transplant recipients require life-long treatment with immunosuppressants—medications that suppress the body's readiness to fight and destroy the "foreign" kidney. "One of the main challenges, as with other transplants, is graft rejection—or tissue/organ rejection," says Mark A. Hardy, MD, Auchincloss Professor of Surgery at Columbia University College of Physicians & Surgeons and Director of Renal & Islet Transplantation at NewYork-Presbyterian Hospital/Columbia University Medical Center.
Dr. Hardy is the co-principal investigator of a clinical trial testing a combination of two immunosuppressant drugs to prevent kidney transplant rejection.
Introducing Penelope, the Robotic Scrub Nurse
 Dr. Treat and his staff presented Penelope to U.S. Army representatives in spring 2003  Penelope handing an instrument to Dr. Treat |
In the Operating Room, the scrub nurse is responsible for dispensing surgical instruments kept on a tray called the Mayo stand. When the surgeon verbally requests an instrument, the technician retrieves it from the Mayo stand. Once finished with that instrument, the surgeon lays the instrument down on the surgical field. The scrub technician then retrieves the instrument and returns it to the Mayo stand, ready to be used again if needed. In this way, the surgeon does not have to look away from the surgical field.
Robotic Surgical Tech, Inc. has developed Penelope™ ,the robotic scrub nurse, with speech recognition, machine vision and robotic arm path planning and targeting. Robotic Surgical Tech, Inc is a Columbia University spin-out enterprise, based on technology developed by Columbia faculty. Robotic Surgical Tech, Inc. receives support from the U.S. Army Telemedicine and Advanced Technology Research Command (TATRC).
Michael Treat, MD was invited by TATRC to present Penelope at the American Telemedicine Association meeting in April. Dr. Treat notes the potential to save thousands of dollars each year and free up valuable OR staff for other tasks.
Study Shows Tumor Shrinkage with Angiogenesis
 Jessica J. Kandel, MD |
For the first time, an experimental angiogenesis blocker has been shown to shrink both large tumors and the tumor's metastases, or spread to other organs. Research by Jessica J. Kandel, MD and Darrell Yamashiro, MD.
Using Anger Management Techniques to Reduce Risk of Heart Disease
Can anger management work to reduce risk for coronary disease in people with no existing heart disease? A new clinical research study sponsored by CUMC's Behavioral Medicine Program seeks to answer that question.
Ultrasound Proves Cost-Effective in Screening for Abdominal Aortic Aneurysm
In a study published in the medical journal Surgery in fall 2002, researchers at NYP have shown that an ultrasound procedure is a cost-effective way to screen for abdominal aortic aneurysm (AAA). In addition, ultrasound has proven to be completely reliable in detecting AAAs. The study was led by K. Craig Kent, MD, Chief of Vascular Surgery at NYP.
It is estimated that 2.7 million Americans have AAA, but only 50 percent of these individuals have been diagnosed. Known as a 'silent killer,' AAA is a sac-like enlargement of the aorta, the largest artery in the body. Over time the pressure of circulating blood can slowly push out the vessel wall. Like an inflating balloon, the larger the aneurysm gets the greater the chances that it will burst. A ruptured AAA results in internal bleeding so severe that only 20 percent of victims survive. Ultrasound screening could be an effective way of reducing mortality from AAA.
Laparoscopic Surgery May Help Protect Colorectal Cancer Patients Against Recurrence
A tumor suppressor protein remains at higher levels after laporascopic surgery compared with traditional open surgery.
For Elderly Heart Patients, Extra Weight May Be Beneficial
A new study by a group of Columbia researchers led by Mathew S. Maurer, MD, indicates, surprisingly, that elderly patients (75 and over) who had a BMI (body mass index) of 25 and over had a lower risk of complications and death from cardiovascular surgery than did those with a lower BMI.
Unusual RAGE protein worsens rheumatoid arthritis
Ann Marie Schmidt, MDDivision Chief, Surgical Science |
Why does rheumatoid arthritis cripple some while others are only mildly affected? New research from a Columbia University Health Sciences researcher reveals that a certain form of a gene called RAGE is more common in people with rheumatoid arthritis.
RAGE (the receptor for advanced glycation end products) is a protein found on cell surfaces in joints. The binding of RAGE to other proteins called S100/calgranulins leads to inflammation and ultimately joint destruction. In a study, led by Dr. Ann Marie Schmidt, Chief, Division of Surgical Science in the Department of Surgery, the researchers found that the protein product from a certain form of the RAGE gene bound more avidly to S100/calgranulins and increased activity of molecules that led to joint destruction. When RAGE was prevented from binding to the S100/calgranulins arthritic mice had decreased joint inflammation. The findings, published in the May Genes and Immunity, suggest new types of rheumatoid arthritis treatments against RAGE proteins could be developed.
Division of Surgical Science
Division of Surgical Science: Research
Cancer-prevention surgery for women more effective than believed
Women who test positive for BRCA1/2 gene mutations, which are associated with a high risk of breast and ovarian cancer, face difficult cancer prevention choices. They can elect to undergo prophylactic surgeries, take medications, or receive a combination of medication and surgery.
Now researchers from Columbia Health Sciences, led by Dr. Victor R. Grann, associate clinical professor of medicine at Columbia University College of Physicians & Surgeons and in epidemiology and health policy and management at Columbia's Mailman School of Public Health, have found that prophylactic surgery–either mastectomy or ovary removal–offers greater survival benefits compared with findings from studies done in 1997 and 1998. The researchers also report that ovary removal and tamoxifen appears to be the best survival strategy, when quality of life is considered. The findings, which are based on a computer model used to analyze cancer patient data from medical literature, a National Cancer Institute database, and a published survey, were reported in the May 15 Journal of Clinical Oncology.
Division of Breast
Division of Breast: Research
Landmark REMATCH Trial Proves Benefits of Heart Pumps for Heart Failure Patients
- Results reveal a 50 percent increase in life expectancy over medical management of heart failure
- Significant improvement in quality of life also found
 Mechanical Heart Pump |
A three-year landmark multicenter clinical research trial has shown that implanted heart pumps can extend life and improve the quality of life of terminally ill heart failure patients. Eric A. Rose, MD, Surgeon-in-Chief, Columbia University Medical Center, NewYork-Presbyterian Hospital and Chairman of the Department of Surgery of Columbia University College of Physicians & Surgeons, led the study, known as REMATCH (Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure). Investigators at Columbia University's International Center for Health Outcomes and Innovation Research, directed by Annetine C. Gelijns, PhD, supervised data collection and results for REMATCH.
"This trial transforms decades of hopeful research into the development of man-made machines to support the failing heart into a successful long-term treatment," Dr. Rose said.
Findings of the approximately $25 million trial were published in November in the New England Journal of Medicine, and results were presented at the 2001 American Heart Association meetings in Anaheim, CA, on November 12. Media covering REMATCH included the New York Times, Wall Street Journal, NBC Nightly News, USA Today, New York Newsday, and all local New York City network affiliates.
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