Annual Report 2003

Central and Eastern Clinical School Annual Report 2003

Contents

Department of Epidemiology and Preventive Medicine 5

Department of Forensic Medicine 17

Department of Medicine at The Alfred Hospital 23

Department of Medicine at Box Hill Hospital 36

Department of Pathology and Immunology 48

Department of Surgery at The Alfred 57

Clinical School at The Alfred 63

Central and Eastern Clinical School

Head of School Departments of the Faculty of Napier M Thomson MBBS MD FRACP The Central and Eastern Medicine, Nursing and Health Sciences Head of Medicine at The Alfred Clinical School was which comprise the school are: Personal Assistant formally established in • Department of Epidemiology and Marilyn L Bushell January 2001 as a result Preventive Medicine School Manager of restructuring in Monash • Department of Forensic Medicine Gillian A Holley BBus GDipAcc AFAIM AHRI University’s Faculty of • Department of Medicine at The Alfred Hospital Technical Services Manager Medicine Nursing and Paul L Dover BSc Melb MIT RMIT Health Sciences. The • Department of Medicine at Box Hill Hospital IT Manager School operates in • Department of Pathology and Ian Sloan PhD conjunction with all other Immunology Schools of the Faculty in Finance Officers • Department of Surgery at The Alfred Diana Mejia Bravo the provision of its Helen Dinh Assoc Dip (Acct) • Clinical School at The Alfred Katerina Petropoulos academic programs. It is responsible for the The School is principally centred at HR Officer provision of teaching in all Effie Adraktas The Alfred and Box Hill Hospitals but undergraduate courses of has academic presence in other Technical Officer the Faculty, particularly the teaching hospitals in Melbourne, namely Mark A Malin Caulfield General Medical Centre, last three years of the Sandringham and District Memorial Technical Assistant medical curriculum. The Hospital, Maroondah Hospital, William Renae Walsh School also provides Angliss Hospital and St Francis Xavier Security/Reception Officers teaching in a variety of Cabrini Private Hospital. The Graham Levey Department of Forensic Medicine is Geoff Greenhalgh postgraduate diploma and located within the Victorian Institute of degree programs by Forensic Medicine in South Melbourne. coursework and honours The hospitals provide resources in the programs for the degrees form of patients and teachers for the School’s undergraduate medical of Bachelor of Science teaching programs. Members of the and Bachelor of academic staff of the School contribute Biomedical Science. In to the clinical services and administrative addition there are over 120 processes of the affiliated hospitals, often in leadership positions. The postgraduate research undergraduate MBBS program could students (mostly PhD not be provided were it not for the students) working in the honorary teaching contributions from the staff of the affiliated hospitals. This many research programs interaction facilitates the provision of of the School and affiliated high quality clinical care and institutes. Postgraduate postgraduate clinical training within the Diploma and Masters by hospitals and also provides clinical experience and teaching for the coursework is taught students and research programs of to over 250 students the School. largely through the The School also has a close affiliation Department of with the Baker Medical Research Epidemiology and Institute and the MacFarlane Burnet Preventive Medicine. Institute for Medical Research and Public Health. Since moving the research laboratories from the old Medical School building at The Alfred into the new purpose built AMREP (Alfred Medical Research and Education

Central and Eastern Clinical School

Precinct) centre, communication with Teaching Research The Baker and Burnet Institutes, and • Current six-year • The School’s Research Committee, The Alfred Hospital MBBS curriculum in association with the Faculty’s has strengthened. Research Committee, will examine • To continue to engage in the Together each year we organize a very ways for the School to improve evolution of the last three years of successful ‘Open Day’ for prospective research ‘outputs’, grant success, the current curriculum especially in research students, attracting over 100 research collaboration (within and the integration of medical and interested potential PhD students. Each without the School), and efficiency surgical teaching and clinical of the AMREP partners hold seminars of utilisation of research resources. experience in 5th year, selectives weekly to enhance collaborations in in final year, provision of teaching in • In association with the research and provide further education pathology in 4th year, and in the commercialisation ‘unit’ of the to post graduate students and staff. processes of assessment of the Faculty, Monash Commercial, Specialist equipment can be shared students’ competence and Biocomm and other commercial between the partners, thus providing performance. partners, facilitate the commercial greater opportunities for research as well development, when appropriate, of as saving valuable resources. • New five-year discoveries of research groups of MBBS curriculum the School.

• To increasingly contribute to the • Attract the best postgraduate curriculum development especially research students to the School by of the third year of the program advertising, providing excellence in (Pathology, Medicine, Surgery). supervision, interesting and achievable programs of research, • To encourage teachers in the School good student infrastructure, and to provide, where possible, teaching postdoctoral opportunities. (lectures, seminars, tutorials) in semesters one to four of the five- • Establish annual awards for year curriculum appreciating that Excellence in Research and in their engagement in teaching will be postgraduate student supervision especially needed in the final six within the School. semesters of the five year curriculum. • Establish a School-based (in association with the affiliated • In association with the Rural Clinical research institutes) program of School, maximise opportunities for research presentations by students learning in a rural setting. and researchers of the School. • In association with the Centre for Medical and Health Sciences Engagement with teaching Education, develop tools for hospitals, research institutes assessment of teaching performance • Consolidate School relationships AMREP Open Day generates plenty of interest of teachers of the School. from potential higher degree by research student with all teaching hospitals affiliated • In association with the Associate with the School. This process Dean (Postgraduate Coursework includes: allocation of funds (quantity Degrees) examine the performance depending on School income) to all The Central and Eastern Clinical (educational and financial) and hospitals to support teaching and School’s Goals and Objectives for 2003 relevance of current courses and, in student infrastructure, regular – 2005 are to strengthen the academic particular, the redevelopment of the meetings with local teachers and programs (teaching and research) with Master of Clinical Medicine. The hospital administrators, and specific attention to quality of teaching, School’s Postgraduate Coursework provision of honorary Monash research productivity and grant success, Committee will develop this process. appointments to hospital staff interaction with teaching hospitals/ engaging substantively with the research institutes and efficiency • Establish an Annual Award for School’s academic programs. of School administration/ Excellence in teaching within Department structure. the School.

Central and Eastern Clinical School

• Continuing discussions with • Budget: to establish a system of School Executive Committee The Baker and Burnet Institutes expenditure which best supports the Professor Napier M Thomson about increasing research academic programs of the School MBBS MD FRACP collaboration, resources sharing and also reflects special needs, new Head of Medicine at and conjoint management developments, fiscal imperatives, The Alfred (Head of School) processes in AMREP. and need for administrative efficiencies. This Professor Stephen M Cordner School structure will be developed in association with MA MBBS BMedSc FRCPath FRCPA the School Executive and DMJ (Path) DipCrim and management will reflect Faculty requisites. Head of Forensic Medicine • Continue the development of a School structure which maximises • Quality cycle: it is expected that Professor Gabor Kovacs the quality and efficiency of teaching, the School will be reviewed as MBBS MRCOG FRACOG research outputs and efficiency of part of the University and Faculty Head of Obstetrics and Gynaecology School administration. Quality Cycle within the next Box Hill Hospital two years. • Maintain a strong student support Professor John J McNeil process, especially through the office Faculty-wide issues which MBBS MSc PhD FRACP FAFPHM of the Director of Academic Head of Epidemiology and Preventive Programs. will need to be considered Medicine Given that the Schools of the Faculty • Develop a School administrative/ have been in operation for three years Professor Paul E O’Brien secretarial support structure which is and that the activities of the Faculty MBBS MD FRACS effective and efficient. have been expanding and changing over Head of Surgery at The Alfred that period, it is to be expected that the • Complete furbishment of Levels Professor Hatem H Salem functions of the School will need to 4 and 7 of the Burnet Tower of MB ChB MD MRCP MRCS evolve over the next two to three years. AMREP for the relocation of the FRACP FRCPA Some of the issues which will need to Department of Epidemiology and Head of Medicine at Box Hill be considered by the CECS in Preventive Medicine and the blood association with the other Schools diseases research group from the Associate Professor Morry Silberstein and Faculty include: Department of Medicine at Box Hill. MBBS (Hons) MD DRACR FRANZCR • Provision of some teaching • Develop a plan for the changing Assistant Dean Clinical School programs (e.g. pathology). function of the sections of the Professor Ban-Hock Toh School departments located at Box • Collocations (e.g. academic Hill Hospital once the blood diseases MBBS PhD DSc FRACP FRCPA Psychiatry at Alfred, O & G and Head of Pathology and Immunology research group moves to AMREP. Paediatrics at Box Hill are not part This may include expansion of of CECS nor funded by respective Ms Gillian A Holley academic appointments (largely Schools). BBus GDipAcc AFAIM AHRI honorary or conjoint (School Manager) Hospital/Monash), and expansion of • Academic and professional links clinical research programs. This will with the Rural Clinical School. need to be done in association with the Southern Clinical School • School-based BSc Honours and (Obstetrics and Gynaecology, BBiomedSc Honours programs. Paediatrics and Community • Appropriate resourcing of support Medicine). systems for MBBS students in clinical years including that of pastoral care.

Department of Epidemiology and Preventive Medicine

Head Senior Lecturers Honorary Senior Lecturers Professor John J McNeil MBBS MSc PhD Andrew E Ajani Zahid Ansari MS MPH MBBS FRACP FAFPHM Neville J Betts BA GDipOccHazMan Kathryn Antioch BA (Hons) MSc (UBC) MIHM Esther M Briganti MBBS GDipClinEpi FRACP AFCHSE CHE Finance Manager MClinEpi CertHealthEcon David G Barton MBBS MSc FACOM MFOM Vanessa R Fernandes David S Elder MBChB DGM MRCGP Robert Baker BSc (Hon) PhD GDipOccHlth MPH FAFOM Stephen Bernard MBBS FACEM FJFICM IT Manager David G Fish MBBS FAFOM FAFPHM Ronald Borland BSc (Hons) MSc PhD Colin J Fee FACOM Robin Burns BA (Hons) MSc MPH David G Goddard BMedSc MBBS DOH DipEd PhD Data Manager FAFOM MFOM GradCertHigherEd John Crofts MBBS MPH FAFPHM Steven J White BComm DipIT BA BSc CertPestControl RACP Peter Deutschmann MBBS FRACS R Bruce Hocking MBBS FRACGP FAFOM MPrimCare Administration Officers Karin S Leder MBBS (Hons) FRACP MPH Sherene Devaneson MBBS DipObs FRACMA Carolyn M Barrie BA Beatrice Loff MA Lond BA LLB FACHSE Rhonda Blaich BEd Kelly Makarounas-Kirchmann Timothy R Driscoll BSc MBBS MOHS PhD Emma M Conyers Adam D Meehan Leigh Hammond MBBS FRCPA Anthony Del Monaco David Newman MBBS DipAvMed PhD Wendy Holmes MBBS MSc Natalie D Holsinger Deborah Roberts BA MPH PhD Joseph Ibrahim MBBS GradCertHigherEd Leonie Martino Vijaya Sundararajan BA MD MPH PhD MRACMA FAFPHM FRACP Shaarn E Montgomery David McD Taylor MD DRCOG MPH FACEM Don Kay BHA MHA MSc Maida O’Keefe Owen D Williamson MBBS GDipClinEpi Helen Kemp BA Gen Nursing MBA Doris Toh BComm MIntBusAdmin FRACS EW Knight MBBS FAFOM Kelli L Tracey Rory StJ Wolfe BSc PhD Vivian Lin BA MPH PH Sevim Zongur Trish Livingston BA (Hons) PhD Lecturers Kevin MacDonald BMedSc MBBS FAFOM Casual general staff Rochelle M Eime BAppSc (Hons) Jeremy Millar BMedSc MBChB FRANZCR Nadine E Andrew Danny YH Liew BMedSc MBBS FRACP FAChPM GradCertHealthEco Jane Ball Dean P McKenzie BA (Hons) MComp Anne-Marie Pellizzer MBBS FRACP PhD Travis Bloom Josef Reum MA PhD Hayley A Bunker Honorary Professor Tilman Ruff MBBS (Hons) FRACP Moira R Goddard Kit Fairley MBBS PhD FRACP FAFPHM Richard Stark MBBS (Hons) FRACP MACCM Rachel A Joyce FACSHP Paul Talman BSc MBBS FRACP PhD Kate A Leatham Caroline Finch MSc PhD FASMF ASTAT Sandra Thompson MBBS MPH Kirstine Magtengaard Steve Hrudey MSc PhD PhD FAFPHM Laura A McCormick Damien Jolley MSc Mc DipEd CStat Amanda Thrift PhD Susan A McLellan J Zalcberg MBBS PhD FRACP Michael Toole BMedSc MBBS Phallika Neung DipTropMedHyg Julien D Schulberg Honorary Associate Professors Sara Watson MBChB BSc MHA FRACMA Robin Bell MBBS MPH PhD Heather Wellington MBBS BMedSc BHA Academic staff Chris Gray PhD FRACMA Professors William Hart MBBS MAPsS FAFPHM Joanne Williams BSc (Hons) MAppEpi PhD Peter Cameron MBBS MD FACEM Paul Myles MBBS DipRACOG MPH PhD Alan Wolff MBBS DipRACOG FRACP Henry Krum MBBS PhD FRACP MD FFARCS FFARACS AFCHSE MBA MRACMA Johannes U Stoelwinder MD MBBS FRACMA Frank Rosenfeldt MBBS MD FRCS FRACS FACHE FAFPHM Philip Stokoe MBBS DPH MSc MPH Honorary Lecturers Andrew M Tonkin MBBS MD MRACP FRACP Michael Toole BMedSc MBBS Tamara Aboagye-Kwarteng MSc PHD DipTropMedHyg GDipEpi Visiting Professor Campbell K Aitken Henrik Schirmer MD PhD Honorary Associates Stephen Begg BA (Hons) MPH of the Department Malcolm G Brown Associate Professors Michael Ackland MBBS MPH FAFPHM Shin Choo BPharm GradDipHosPharm Michael J Abramson MBBS (Hons) BMedSc Todd Baumgartner MD MPH CertHlthEco PhD FRACP FAFPHM Stephen Bolsin BSc MBBS FRCAL Noel Cranswick MBBS BMedSc FRACP Rachelle Buchbinder MBBS (Hons) MSc RACMA ANZCA (Paeds) (Clin Epi) FRACP Suzanne Garland MBBS FRCPA MASM Margaret Curran MBChB MPH FRCPath Flavia M Cicuttini MBBS (Hons) MSc PhD Kim Hill MBBS MHP FRACMA FFPM DHTM FRACP FAFPHM Graeme Johnstone LLB BJur MA Fabien Dalais BSc (Hons) PhD Andrew B Forbes BSc (Hons) MSc PhD Harry Mond MBBS MD FRACP FACC DDU Maximilian de Courten Chris Reid BA DipEd MSc PhD Alex Proudfoot BSc (Hons) MEngSc BMBch David Dunstan BAppSc (Hons) PhD Malcolm R Sim BMedSc MBBS MSc Graham Rouch MBBS DPH Robyn Horsley MBBS FAFOM GDipOccHyg PhD FAFOM FFOM FAFPHM Colin Russell MBChB FRACS MS Marion Kainer MBBS FRACP Grad Dip Bus Peter Kamen MBBS Denis Spelman Sheila Killalea MBBCh BAO MD MRCPI Howard Smith MBChB MD MRACP Martyn Kirk BAppSc MAppEpi FRACP FFPM David Kong MPharm PhD Theo Vos MSc Dip IDHC Dip Trop Med David Kotzman MBBS Daniel McCarty BA MS PhD Damien Morgan RN BEd PhD

Department of Epidemiology and Preventive Medicine

Peter New MBBS FAFRM GDipClinEpi Research Officers Emma K Link Rajitha S Perera MBBS MSc MD Dianna J Magliano BAppSc (Hons) PhD Beatrice Loff MA Lond BA LLB Priscilla Robinson RN BNurs MPH PhD Karen L Stephan Ewan M MacFarlane BSc CertPathColl MPH Anthony P Stewart MBBS MAE Caroline L Marshall MBBS GDipClinEpi Helen Sutcliffe MBBS FAFOM Research Assistants FRACP Loretta Vaughan BAppSc MPH Elsa B Barton Melanie C Matheson MAppSc BSc Elmer V Villanueva MD ScM Rebecca A Braham BSc (Hons) Alexander A Padiglione MBBS FRACP Nicole Watson BSc (Hons) GDipManSci Bianca Gar Yee Chan M Rwth Stuckey BAppSc GradDipErg MPH Sarah Whorlow Adam S Dowrick Robyn J Tapp Mary Wyatt MBBS DipObstetrics FRACGP Rochelle M Eime BAppSc (Hons) Ogilvie N Thom GradDipOccHlth FAFOM Andrea J Fradkin MAppSc BAppSc Anita E Wluka MBBS DipIntMed FRACP Steven J Haas BPharm BPharmSc (Hons) Tsharni R Zazryn Sessional Lecturers Catherine M Joyce MPsych BA (Hons) Boheng Zhang MBBS MMed Kelly M Allen Pamela K Lightbody BSc Christopher A Barton BSc MMedSc Ewan MacFarlane BSc CertPathColl MPH Occupational Trainee James FP Black MBBS (Hons) MCommH Melanie C Matheson BSc MAppSc Stephanie D Hildebrandt BNutrSc DTM&H Sophie L Rogers Andrea J Fradkin MAppSc BAppSc Marina A Skiba BEd Jane R Fyfield Karen L Smith BSc (Hons) PhD Steven J Haas BPharm BPharmSc (Hons) GDipEpi&Biostat Derrick Harrison Yuan Yuan Wang Elizabeth J Kennedy Joanne M Youd PhD BSc (Hons) Susanna J King Naomi Komadina Casual Research Assistants Rwth Stuckey BAppSc GradDipErg MPH Fiona J Clay Lien Hue Tam Reuben C Fernandes Juliana L Wakely Rosana Hage-Ali Bin Xue Pamela M Simpson Tsharni R Zazryn Research Nurses Research staff Robyn Funston RN Professorial Fellow Judith A Hankin BAPsych RN Brian Priestly BPharm MPharm PhD Linton R Harriss RN DipAppScNursing Alison M Hayes RN Senior Research Fellows Christine U Muske BSc (Nurs) Pauline Branley MBBS FRACP PhD GradDipCommHlth Lisa Demos BPharm GDipHospPharm PhD Andrew Teichtahl RN Russell K Garnsworthy Margaret E Hellard MBBS PhD FRACP Post Graduate students FAFPHM Zahid Ansari MBBS FAFPHM MSc MPH Jan L Hoving PhD Kathryn Antioch BA (Hons) MSc (UBC) MIHM Helen Kelsall MBBS MPH MHealthSc AFCHSE CHE FAFPHM Christopher A Barton BSc MMedSc Mark R Nelson MBBS MFamMed PhD Rebecca A Braham BSc (Hons) Anna Peeters PhD BSc Esther Briganti MBBS GDipClinEpi FRACP Martha I Sinclair BSc (Hons) PhD MClinEpi CertHealthEcon Julie J Yallop NZRN Jessica M Chellappah Jennifer A Coghlan Research Fellows Helen L Cuddihy MD CCFP FRACGP Emma L Ashton BAppSc PhD Glen Doolan Michael J Bailey BSc (Hons) MSc (Stats) Adam S Dowrick Geza P Benke BSc MAppSc GDipQuanMeth Rochelle M Eime BAppSc (Hons) FAIOH David Fish MBBS FAFOM FAFPHM FACOM Lisa J Collins BAppSc PhD Andrea J Fradkin MAppSc BAppSc Helen Cuddihy MD CCFP FRACGP Michael Glisson MAppSc DAppSc (Med Rad) Andrea J Curtis PhD BSc Steven J Haas BPharm BPharmSc (Hons) Belinda J Gabbe MAppSc BPhysio (Hons) Guy SA Haller Deborah C Glass BA (Hons) CertEd MSc PhD Fahad Hanna Jillian F Ikin BA (Psych) GDipBHlth Andrew M Haydon MBBS FRACP Andrew R Kompa PhD BSc (Hons) Jillian F Ikin BA (Psych) GDipBHlth Dean P McKenzie BA (Hons) MComp Catherine M Joyce MPsych BA (Hons) Teresa Z Mitakakis PhD BSc (Hons) Kyriakos Karipidis Kevin F Morris MEng Helen L Kelsall MBBS MPH MHealthSc Stephanie J Poustie MPH RN FAFPHM GradCertCritCare BAppSc DipPracMgt (Med) Narges Khanjani MD Samantha N Rizak BA MSc Danny Liew BMedSc MBBS FRACP Margaret S Stebbing RN DipAppSci MPH Stephen S-P Lim BSc (Hons) Donna M Urquhart BPhysio PhD MAPA

Department of Epidemiology and Preventive Medicine

• Diagnostics Unit continues to be the most popular choice The Department of (Head, A/Prof Flavia Cicuttini) for Victorian Master of Public Health Epidemiology and • Health Services Management and students. Preventive Medicine Research Unit Short courses and seminars (DEPM) employs almost (Head, Prof Just Stoelwinder) The Good Clinical Research Practice one hundred staff and • Infectious Disease Unit (Head, Dr Karin Leder) short courses were run again in 2003 plays a prominent role in and attended by research staff from public health medicine in • Occupational and Environmental Health hospitals and university departments Unit (Head, A/Prof Malcolm Sim) Australia. The core skills of throughout Melbourne. • Preventive Medicine Unit the Department relate to (Head, Prof John McNeil) The Australian Certificate of Civil Aviation epidemiology (the study of Medicine was run in June and • Trauma and Sports Injury Prevention November, also another series of the distribution, risk Research Unit courses on impairment assessment for factors and causes of (Head, Professor Peter Cameron) medical and surgical specialists for the disease) and its application Victorian WorkCover Authority and the to problems in clinical Teaching Transport Accident Commission. medicine and public The Department continued its extensive teaching program including Research health. Research carried undergraduate medical and biomedical Brian Priestly joined the Department out in the Department science degrees, postgraduate courses, in 2003 as a Professorial Fellow and includes clinical trials, a range of Diplomas and Certificates, Director of the newly established economic evaluations of and several short courses. Australian Centre for Human Health Risk Assessment (ACHHRA). Brian was health services, quality of The Department was awarded a grant from the Fogarth International Center, US previously Director of the Laboratories at care assessments, National Institutes of Health, to develop a the Therapeutic Goods Administration and before that, Scientific Director of the environmental health Master of International Research Office of Chemical Safety. He was Bioethics to begin in 2004, and to studies and many others. responsible for various chemical safety sponsor five students from developing programs relating to pesticides and other countries in the Asia-Pacific region. The hazardous chemicals and aims to use Program Director is Bebe Loff, a lawyer The Department continued to grow this experience to develop ACHHRA into and PhD student in this Department. through 2003 and at the end of the year, the leading Australian authority on risk Associate Directors are Mike Toole, Head was preparing to move into new assessment methodology and risk of the Burnet Institute’s Centre for premises in the Alfred Medical Research communication. Brian will be looking to International Health and Jim Black, Head and Education Precinct (AMREP), on the consolidate existing relationships and to of Epidemiology at the Victorian 3rdrd floor of the Burnet Building. establish new linkages with Commonwealth Infectious Diseases Service, Royal and State public and environmental health Research units within the Department Melbourne Hospital. The course will be authorities, risk assessment practitioners collaborate with each other, with other open to fee paying students from 2006. in the private sector and academic, and departments at Monash and The Alfred The Master of Public Health is taught in with international agencies and groups Hospital, and with other universities, collaboration with Deakin University, La involved in risk assessment. Other resulting in research based on the most Trobe University and The University of partners in ACHHRA are Flinders up to date knowledge and methods. Melbourne, partners in the Victorian University, EnTox and the University of Research Units in the Department Consortium for Public Health. Monash Queensland and Griffith University. in 2003 were: • Aviation Medicine Unit (Head, Dr David Newman) • Biostatistics Unit (Head, A/Prof Andrew Forbes) • Cardiovascular Research Unit (Head, Prof Andrew Tonkin) • Clinical Epidemiology Unit (Head, A/Prof Michael Abramson) • Clinical Measurement Unit (Head, A/Prof Rachelle Buchbinder) • Clinical Pharmacology Unit (Head, A/Prof Henry Krum) Australian Certificate of Civil Aviation Medicine students at Mangalore airport.

Department of Epidemiology and Preventive Medicine

Professor Peter Cameron joined the University, Swinburne University of Department in 2003 to head the Trauma Technology, Telstra Research and Sports Injury Epidemiology Unit, Laboratories and the Institute of Medical and the Victorian Trauma Registry based and Veterinary Sciences in Adelaide. in this department. He recently returned from Hong Kong where he was Head of The Health Services Management and the Emergency Department at the Research Unit coordinated a health Prince of Wales Hospital and Professor service management intern program for of Emergency Medicine at the Chinese six recently graduated masters students University of Hong Kong. Prior to this, from the University of Economics in Peter was Professor/Director of Cracow, Department of Public Economy Prof Just Stoelwinder with students from Cracow. Emergency Medicine at The Royal and Administration. The interns spent Melbourne Hospital. He is an immediate two months working on projects at past president of the Australasian either Bayside Health, Southern Health College for Emergency Medicine, co- or Women’s and Children’s Health. The competencies. At the national level, editor of the textbook of Adult program is run in collaboration with the Malcolm has served on a number of Emergency Medicine and the Paediatric Australian Institute of Actuaries and the committees including the NHMRC Textbook of Emergency Medicine. He Australian College of Health Service Regional Grant Interview Committee has significant interests in trauma Executives. Financial support for the and has been a member of the Human epidemiology, prehospital care and interns was provided by the Commercial Research Ethics Committee of the evidence based emergency care. Union Insurance Company of Poland. Cancer Council of Victoria since 2000. Internationally he is a member of the The Occupational and Environmental Scientific Committee on Epidemiology in Health Unit began a study of the general Occupational Health of the International health of Australia’s surviving, male Commission on Occupational Health, a Korean War veterans. A pilot study was member of the Steering Committee of a completed during 2002/03 and the WHO/UNICEF project to reduce arsenic General Health Survey was announced exposure in Bangladesh, and member of by the Hon Danna Vale, Minister for the Editorial Board and Associate Editor Veterans’ Affairs on 2nd December in Epidemiology for the Journal of 2003. Associate Professor Malcolm Sim Occupational and Environmental is the Principal Investigator. Medicine. Malcolm is Head of the Unit of Occupational and Environmental Health Special achievements in this Department. Rochelle Eime, a PhD student looking at the prevention of eye injuries in Funding in 2003 squash, was awarded the 2003 Safety National Health and Medical Initiative Award at the Sports and Research Council of Australia Professor Peter Cameron Recreation Industry Awards. Programs grants totalling $690,000 Malcolm Sim was awarded were awarded to Professor Henry Krum The College Medal from The Royal and Associate Professor The Department was part of a Australasian College of Physicians. The Chris Reid. consortium which was successful in College Medal is awarded for obtaining $2.5m in NHMRC funding to Fellowships were awarded to outstanding service to Fellows of the establish a Centre for Research Dr Margaret Hellard and College, its Faculties or Chapters who in Excellence in Radiofrequency Dr Mark Nelson totalling $127,000. the opinion of the Council have Electromagnetic Energy. The Centre, particularly contributed to the welfare of known as the Australian Centre for Scholarships were awarded to Anita the College but who have not obtained Radiofrequency Bioeffects Research, Wluka, Caroline Marshall, Danny Liew, the office of President of the College. will address the most urgent research Fiona Chi Pei See, Andrea Fradkin, Chris Malcolm was Chair of the Australasian questions in possible health effects of Barton, Catherine Joyce, Melanie Faculty of Occupational Medicine’s radio fields, such as those from mobile Matheson, Rochelle Eime, Fiona Clay, Board of Censors for five years, and phones. It will also train new scientists Helen Kelsall, Rebecca Braham, Steven prior to that for three years was the first and use new knowledge to inform the Haas, and Tsharni Zazryn totalling Chair of the Board’s Assessment public and help the development of $256,000. government policies in an area of Subcommittee. Malcolm also served on Project grants were awarded to Caroline considerable public concern. Professor the Faculty Council, was a regional Finch, Henry Krum, Andrew Tonkin, Michael Abramson from this Department Censor and contributed to the B McGrath, Rachelle Buchbinder, is one of the Chief Investigators. Other development of the AFOM Flavia Cicuttini, Michael Abramson, members of the consortium are RMIT

Department of Epidemiology and Preventive Medicine

Stephen Bernard, S Myles, Emma Australian Health Management - Health fields of clinical medicine, medical Ashton and Belinda Gabbe totalling Inequities - John McNeil $40,000 administration, biological sciences, $1.1 million. environmental health, occupational Colonial Foundation - Flavia Cicuttini health, physiotherapy and law. An Equipment grant of $33,000 was $6,331 awarded to Andrew Tonkin. R L Cooper Medical Research Graduations in 2003 Foundation - Michael Abramson National Heart Foundation Doctor of Philosophy $14,436 Dianna Magliano, Stephen Bernard, and Paul Martin MB BCh BA BAO MRCPI FRACP John McNeil were awarded $123,000 Royal Australasian College Physicians - from the National Heart Foundation. Esther Briganti $65,000 Mark R Nelson MBBS MFamMed National Institutes of Health Shepherd Foundation - Flavia Cicuttini National Institutes of Health in the USA $16,750 Master of Clinical Epidemiology award $493,127 for Bioethics Education HAT-Seattle Institute of Cardiac Susan Margaret Reid and Career Development Research - Andrew Tonkin $53,289 Philip Leviston Russo

State and Federal Support for research and clinical trials Master of Public Health Government Departments was also granted from various Kelly Marie Allen The Department of Health and commercial organisations including Bhasker Amatya Ageing supported the research of Rwth Alcoa Australia, AstraZeneca, Bristol- Toni Michelle Bloodworth Stuckey, Caroline Finch, Malcolm Sim Myers, Pharmacia Australia, Crypto , Caroline Anne Brand and Andrew Tonkin with grants totalling Healthway (WA), Lawson Trust, Sandra Lorraine Brown $162,000. Metropolitan Fire Brigade and Novartis Patricia Frances Cotter totalling $1,325,000. The Department of Human Services Samara Jane Cox award grants to Caroline Finch, Tony Leanne Margaret Crough La Montagne, John McNeil, and Peter Humoon Chol Deng Cameron of $422,000. Concetta Di Iorio Kirsty Addette Douglas The Department of Veterans Affairs Mark Anthony Peter Duncan awarded Malcolm Sim $266,400. Daniel Russell Henderson Physio Qld. Susan Elizabeth Hopkins Vic Health supported Anna Peeters Frances Catherine Hoy research and provided scholarships Carlie Maree Hyett to Fiona Clay, Rebecca Braham and John Keith Jackson Tsharni Zazryn with $209,000 Rebecca Leigh Jessup Researchers and water industry representatives Vanessa Johnston Alfred Research Trust at a CRC for Water Quality and Treatment Sally Bronwyn Kay research meeting. The Alfred Hospital provided research Catherine Ellen Lavars funding to the Department and Makafane Cyril Mabathoana scholarships to Caroline Marshall and Sindhuja Boopathy Maheswaran Anita Wluka to the value of $98,000. Everton Kaurai Maisiri PhD opportunities Margaret Ellen McLeod Monash Research Grants In 2003 the number of PhD students Timothy John Moore Monash Small Grants totalling $46,500 enrolled in the Department reached 30. Mohamed Said Mohamud were awarded to Andrew Tonkin, DEPM provides very high quality PhD Carmel Gerardine Morton Michael Abramson and Mark Nelson research training to graduates from a Saleem Mussabeh Muhammed broad spectrum of medical and non- Genevieve Napper medical backgrounds. Epidemiology Emmanuel Kofi Osei Other Research Grants (together with Biostatistics) is the key Naomi Catherine Paine The CRC on Water Quality provided scientific discipline underlying some of the Elizabeth Helen Plousi $200,000. most important and rapidly developing Tamara Pollard Victorian Trauma Foundation awarded areas in medicine, and our PhD Nora Elizabeth Straznicky Caroline Finch $199,880. graduates are equipped with core skills Rowan David Thomas which form the basis for a successful Gareth Charles Weston Australian Council on Health Standards future career in a range of fields. Recent Bin Xue $22,727 PhD students have been drawn from

Department of Epidemiology and Preventive Medicine

PhD students enrolled Michael Glisson Ewan Macfarlane in 2003 MAppSci, DAppSci (Med Rad) BSc CertPathColl MPH Quantifying the influence of osteoarthritis Occupational exposures and health Zahid Ansari by measuring changes in cartilage in the outcomes in the Australian primary MBBS, FAFPHM, MSc, MPH hip and knee. aluminium industry. Proposal to develop a system to monitor aspects of the quality and performance Steven Haas Caroline Marshall of the Victorian healthcare system using BPharm, BPharmSc (Hons) MBBS, GDipClinEpi, FRACP routine data sources. Epidemiology of chronic heart failure. The development of a method for subtyping methicillin-resistant Chris Barton Guy Haller staphylococcus aureaus (MRSA) and BSc, MMedSc Safety and quality of the peri operative its use in the understanding of the Aspects of care associated with optimal process; a new tool of assessment. epidemiology and transmission and sub-optimal asthma management in dynamics of MRSA and their Fahad Hanna children. implications for hospital infection. Magnetic resonance imaging of Rebecca Braham osteoarthritis. Alex Padiglione BSc (Hons) MBBS, FRACP Andrew Haydon The effectiveness of headgear and Epidemiology of Vancomycin resistant MBBS, FRACP mouthguards for preventing football bacteria in Melbourne. injuries. Adjuvent chemotherapy for Dukes C colon cancer; rates of treatment and the Rwth Stuckey Jennifer Coghlan effectiveness of adjuvent SFU outside of BAppSc, GDipErgonomics, MPH The efficacy and safety of different controlled trials. Evaluation of occupational health and peri-operative modalities of pain control safety models for corporate fleet safety. in subcromial decompression and/or Jill Ikin rotator cuff repair surgery for rotator War exposure and its health outcomes Robyn Tapp cuff disease. in service personnel. Epidemiology of diabetic complications in Australia. Helen Cuddihy Catherine Joyce MD, CCFP, FRACGP BA (Hons), MPsych Anita Wluka Assessing the validity of new An integrated analysis of the health MBBS, Dip Int Med, FRACP approaches to measure clinical workforce in rural Australia. The determinants of knee cartilage competence in junior medical staff. volume in health and disease. Ken Karipidis Glen Doolan Electromagnetic fields and the possibility Tsharni Zazryn Occupational exposure using self of adverse health effects. A prospective study of cumulative brain reports and a job exposure matrix in injury in boxers. Helen Kelsall relation to prostate cancer from an MBBS, MPH, MHealthSc, FAFPHM Australian case-control study. A study of the health of Australian Gulf Publications Adam Dowrick War veterans. Abramson M, Bailey M, Forbes A and Development of an orthopaedic trauma Walters EH (2003). “How well do Narges Khanjani MD registry to evaluate and monitor doctors know their patients with severe Organochlorines and breast cancer. treatment effectiveness. asthma?” Internal Medicine Journal Danny Liew 43(2): 196-203. Rochelle Eime BMedSc, MBBS, FRACP BAppSc (Hons) Abramson M, Dharmage S, Thien F and Epidemiological modelling of ischaemic Protective eyewear use in squash Walters EH (2003). “Sensitisation to heart disease in Australia. - the role of regulation. airborne moulds and severity of asthma Stephen Lim (letter).” BMJ. David Fish BSc (Hons) MBBS FAFOM FAFPHM FACOM Abramson M, Puy RM and Weiner JM Cost effectiveness of interventions for The contribution of worksite assessment (2003). “Allergen specific cardiovascular disease in Australia. to return to work rates. immunotherapy for asthma: Update.” Bebe Loff The Cochrane Library 4. Andrea Fradkin MA (Lond), BA, LLB MAppSc BAppSc. Abramson MJ, Walters J and Walters Health and human rights. Sports injury epidemiology. EH (2003). “Adverse effects of beta agonists: are they clinically relevant?” American Journal of Respiratory Medicine 2(4): 287-297.

Department of Epidemiology and Preventive Medicine

Ansari Z, Haby M, Barbetti T, Cicuttini F Bernard S, Buist M, Montiero O and Cassell EP, Finch C and Stathakis VZ and Ackland MJ (2003). “Trends and Smith KL (2003). “Induced hypothermia (2003). “Epidemiology of medically geographic variations in hospital using large volume, ice-cold intravenous treated sport and active recreation admissions for asthma in Victoria: fluid in comatose survivors of out-of- injuries in Latrobe Valley, Victoria, opportunities for targeted interventions.” hospital cardiac arrest: a preliminary Australia.” British Journal of Sports Australian Family Physician 32(4): report.” Resuscitation 56: 9-13. Medicine 37(5): 405-409. 286-288. Black J and Fairley CK (2003). “Early Chadban SJ, Briganti EM, Kerr PG, Ansari Z, Henderson T, Carson NJ, detection of water-related disease Dunstan DW, Welborn TA, Zimmet PZ Ackland MJ and Cicuttini F (2003). outbreaks. Drinking water and infectious and Atkins RC (2003). “Prevalence of “The Victorian ambulatory care sensitive diseases: establishing the links.” P kidney damage in Australian adults - conditions study: rural and urban Hunter, M Waile and E Ranchi. Boca The AusDiab Kidney Study.” Journal of perspectives.” Social and Preventive Raton, London, New York, Washington the American Society of Nephrology Medicine 48(1): 33-43. DC, CRC Press/IWA Publishing. 1: 14(7 (Supplement 2)): 131-138. 67-77. Aroni R, Sawyer S, Abramson M, Chow FY, Briganti EM, Kerr PG, Stewart K, Thien F, Goeman D and Braham RA, Finch C and McCrory P Chadban SJ, Zimmet PZ and Atkins RC Douglass J (2003). “Asthma self (2003). “Sports trainers have accurate (2003). “Health-related quality of life in management: what do we really mean?” but incomplete recall of injury details.” Australian adults with renal insufficiency: Australian Journal of Primary Health British Journal of Sports Medicine a population-based study.” American 9: 10-17. 37(6): 561. Journal of Kidney Diseases 41(3): 596-604. Ashton E, Liew D and Krum H (2003). Briganti EM, Atkins RC and Chadban “Should patients with chronic heart SJ (2003). “Albuminuria and renal Cicuttini F, Ansari Z, Henderson T, failure be treated with ‘statins’?” Heart insufficiency prevalence guides Ackland MJ and Sundararajan V (2003). Failure Monitor 3(3): 82-86. population screening (letter).” Kidney “Congestive cardiac failure: urban and International 64: 760-761. rural perspectives in Victoria.” Australian Assendorft WJJ, Green S, Buchbinder Journal of Rural Health 11: 266-270. R, Struijs PA and Smidt N (2003). Briganti EM, Shaw JE, Chadban SJ, “Tennis Elbow (lateral epicondylitis).” Zimmet PZ, Welborn TA, McNeil JJ and Cicuttini F, Ding C, Scott F, Glisson M Clinical Evidence 8: 1290-1300. R Atkins (2003). “Untreated hypertension and Jones G (2003). “Sex difference in among Australian adults: Results from knee cartilage volume in adults: role of Atkins RC, Briganti EM, Zimmet PZ the AusDiab study.” Medical Journal of body and bone size, age and physical and Chadban SJ (2003). “Association Australia 179(3): 135-139. activity.” Rheumatology 42: 1317-1323. between albuminuria and proteinuria in the general population: the AusDiab Buchbinder R and Green S (2003). Cicuttini F, Jones G and Bennell K study.” Nephrol. Dial. Transplant “Shoulder and elbow pain. Evidence- (2003). “Effect of physical activity on 18: 2170-2174. Based Rheumatology.” Tugwell P and cartilage development in healthy kids.” Shea B, BMJ Books. British Journal of Sports Medicine 37: Barton C, Abramson M, Aroni R, 382-383. Stewart K, Thien F and Sawyer S Buchbinder R, Forbes A and Ptasznik R (2003). “What determines knowledge of (2003). “Shock wave therapy for Cicuttini F, Jones G, Ding C, Glisson M, asthma among young people and their treatment of plantar fasciitis.” JAMA Hynes K and Ma D (2003). “Knee families?” Journal of Asthma 39(8): 289: 172-173. Articular Cartilage Development in 701-709. Children: A Longitudinal Study of the Buchbinder R, Green S and Youd J Effects of Sex, Growth, Body Barton C, Sulaiman N, Clarke D and (2003). “Corticosteroid injections for Composition and Physical Activity.” Abramson M (2003). “Coping as a shoulder pain.” The Cochrane Library (1). Pediatric Research 54(2): 230-236. mediator of psychosocial impediments to optimal management and control of Buchbinder R, Jolley D and Wyatt M Cicuttini F, Manek NJ and Spector TD asthma.” Respiratory Medicine 97(7): (2003). “Role of the media in disability (2003). “The Genetics of Osteoarthritis.” 747-862. management. Preventing and Managing Rheumatology. M Hochberg. New York, Disability at Work.” Sullivan T and Frank Mosby: 1817-1821. Bennell K, Hinman RS, Metcalf BR, J, Taylor and Francis Ltd. Crossley KM, Buchbinder R, Smith M Cicuttini FM, Wang YY, Forbes A, Wluka and McColl G (2003). “Relationship of Calabro J, Wolfe R and Shoemark H AE and Glisson M (2003). “Comparison knee joint proprioception to pain and (2003). “The effects of recorded sedative between patella cartilage volume and disability in individuals with knee music on the physiology and behaviour of radiological assessment of the osteoarthritis.” Journal of Orthopaedic premature infants with a respiratory patellofemoral joint.” Clinical and Research 21: 792-7. disorder.” Aust J Music Therapy 14: 3-19. Experimental Rheumatology 21(3): 321-326.

Department of Epidemiology and Preventive Medicine

Cicuttini FM, Wluka A, Bailey M, Eime R, Zazryn T and Finch C (2003). Fritschi L, Sim MR, Forbes A, Abramson O’Sullivan R, Poon C, Yeung S and “Epidemiology of squash injuries MJ, Benke G, Musk AW and de Klerk NH Ebeling PR (2003). “Factors affecting requiring hospital treatment.” Injury (2003). “Respiratory symptoms and lung- knee cartilage volume in healthy men.” control and safety prevention 10: function changes with exposure to five Rheumatology 42(2): 258-262. 243-245. substances in aluminium smelters.” International Archives of Occupational Cicuttini FM, Wluka AE, Forbes A and Eldridge B, Galea M, McCoy A, Wolfe R and Environmental Health 76(2): 103-110. Wolfe R (2003). “Comparison of tibial and Graham HK (2003). “Uptime cartilage volume and radiologic grade of normative values in children aged 8 to Gabbe B, Bennell K, Finch C, the tibiofemoral joint.” Arthritis and 15 years.” Developmental Medicine and Wajswelner H and Orchard J (2003). Rheumatism 48(3): 682-688. Child Neurology 45: 189-193. “Predictors of hamstring injuries in elite Australian football.” Journal of Science Cicuttini FM, Wluka AE, Wang Y, Eldridge B, Kimber C, Wolfe R, Galea M and Medicine in Sport 6(4): S85. Stuckey SL and Davis SR (2003). “Effect and Hutson J (2003). “Uptime as a of estrogen replacement therapy on measure of recovery in children post Gabbe B, Cameron P and Finch C patella cartilage in healthy women.” appendectomy.” Journal of Pediatric (2003). “Is the Revised Trauma Score Clinical and Experimental Rheumatology Surgery 38(12): 1822-1825. still useful?” Australian and New Zealand 21(1): 79-82. Journal of Surgery 73: 944-948. Eldridge B, McCoy A, Galea M, Wolfe R Clarke DM and McKenzie DP (2003). and Graham HK (2003). “Variability in Gabbe B, Cameron P and Wolfe R “An examination of the efficiency of the the measurement of uptime in children: (2003). “TRISS: Does it get better than 12-item SPHERE questionnaire as a a preliminary study.” Clinical this?” Academic Emergency Medicine screening instrument for common Rehabilitation 17(5): 499-503. 11(2): 181-86. mental disorders in primary care.” Australian and New Zealand Journal Finch C (2003). “How useful are Gabbe B, Finch C, Bennell K and of Psychiatry 37: 236-239. insurance claim data for sports injury Wajswelner H (2003). “How valid is a prevention purposes.” Injury control and self-reported 12-month sports injury Coffey C, Veit F, Wolfe R, Cini E and safety prevention 10(3): 181-183. history?” British Journal of Sports Patton GC (2003). “Mortality in young Medicine 37(6): 545-547. offenders: retrospective cohort study.” Finch C, Donaldson A, Hill T and Forero British Medical Journal 326(17 May): R (2003). “The development of a tool to Gabbe B, Finch CF, Wajswelner H and 1064-1068. audit the safety policies and practices of Bennell K (2003). “Does community-level community sports clubs.” Journal of Australian football support injury Cohen M, Wolfe R, Mai T and Lewis D Science and Medicine in Sport 6: prevention research?” Journal of (2003). “A randomised, double blind, 489-494. Science and Medicine in Sport 6(2): placebo controlled trial of a topical 231-236. cream containing glucosamine sulfate, Finch C, Mahoney M, Townsend M and condroitin sulfate, and camphor for Zazryn T (2003). “Rural sports and Gabbe B, Wajswelner H, Bennell K and osteoarthritis of the knee.” Journal of recreational injuries in Australia: what do Finch C (2003). “Predictors of hamstring Rheumatology 30(3): 523-528. we know?” Australian Journal of Rural muscle strains at the community-level Health 11(3): 151-158. of Australian football.” Medicine and Dewey HM, Sturm J, Donnan GA, Science in Sports and Exercise 35(5): Macdonell RA, McNeil JJ and Thrift AG Finch C, McIntosh A, McCrory P and S203. (2003). “Incidence and outcome of Zazryn TR (2003). “A pilot study of the subtypes of ischaemic stroke: initial attitudes of Australian Rules footballers Gabbe BJ, Cameron PA and Finch CF results from the North-East Melbourne towards protective headgear.” Journal (2003). “The status of the Glasgow stroke incidence study (NEMESIS).” of Science and Medicine in Sport 6(4): Coma Scale.” Emergency Medicine Cerebrovascular Disease 15(1-2): 505-511. Journal 15: 353-360. 133-139. Fradkin AJ, Finch CF and Sherman CA Gibson PG, Powell H, Coughlan J, Donaldson A, Hill T, Finch CF and Forero (2003). “Warm-up attitudes and Wilson AJ, Abramson MJ, Haywood M, R (2003). “The development of a tool to behaviours of amateur golfers.” Journal Bauman A, Hensley MJ and Walters EH audit the safety policies and practices of of Science and Medicine in Sport 6(2): (2003). “Self-management education community sports clubs.” Journal of 210-215. and regular practitioner review for adults Science and Medicine in Sport 6(2): with asthma.” Cochrane Database of Fritschi L, Nadon L, Benke G, Lakhani 226-230. Systematic Reviews. R, Latrielle B, Parent ME and Eime R (2003). “How hot is too hot?” Siemiatycki J (2003). “Validation of Australian Tennis. expert assessment of occupational exposures.” American Journal of Industrial Medicine 43: 519-522.

Department of Epidemiology and Preventive Medicine

Gilbert RE, Krum H, Wilkinson-Berka J Haas S, Vos T, Gilbert R and Krum H Hoving JL, O’Leary E, Niere K, Green S and Kelly DJ (2003). “The renin- (2003). “Are beta-blockers as efficacious and Buchbinder R (2003). “Validity of the angiotensin system and the long-term in diabetic as non-diabetic patients with Neck Disability Index, Northwick Park complications of diabetes: chronic heart failure? A meta-analysis of Neck Pain Questionnaire and Problem pathophysiological and therapeutic >13000 patients in large-scale clinical Elicitation Technique for measuring considerations.” Diabetic Medicine trials (abstract).” European Heart Journal disability associated with whiplash 20(8): 607-621. (Aug/Sept (abstract supplement)): 2824. associated disorders.” Pain 102(3): 273-281. Glass D, McKenzie D, Forbes A, Kelsall Haas S, Vos T, Gilbert R and Krum H H, Ikin J, Ittak P and Sim MR (2003). (2003). “Are beta-blockers as efficacious Ioannides-Demos LL, Ibrahim JE and “What was different about exposures in diabetic as non-diabetic patients with McNeil JJ (2003). “Reference-based during the 1991 Gulf War compared to chronic heart failure? A meta-analysis of pricing schemes: effect on other deployments?” Australasian large-scale clinical trials.” American pharmaceutical expenditure, resource Epidemiologist 10(3): 54. Heart Journal 146(5): 848-853. utilisation and health outcomes.” Pharmacoeconomics 20(9): 577-591. Glass DC, Gray CN, Jolley DJ, Gibbons Haas S, Vos T, Gilbert R and Krum H C, Sim MR and Fritschi L (2003). “Effect (2003). “Meta-analysis of effect of beta- Joyce CM, Wimalaratne SRU and of exposure groups on odds ratios in a blocker therapy on all-cause mortality in McNeil JJ (2003). “Future demand for case-control study in the Australian diabetic patients with chronic heart general practice services: Effects of Petroleum Industry.” Abstract failure (abstract).” Clinical and population change and trends in service Epidemiology September Supplement Experimental Pharmacology and use.” Australian Health Review 26: 5: S127. Physiology 30(7): A61-A62. 26-33.

Glass DC, Gray CN, Jolley DJ, Gibbons Haller G and Stoelwinder J (2003). Kainer MA, Cherry CL and Ruff TA C, Sim MR and Fritschi L (2003). “The “Improving compliance with (2003). “Biological weapons Healthwatch case-control study. In requirements on junior doctors’ hours: preparedness: the role of physicians.” Leukaemia risks in relation to benzene dealing with complexity.” British Medical Internal Medicine Journal 33: 242-253. exposure.” Institute of Petroleum: 29-36. Journal 327(7409): 270-273. Kissane DW, McKenzie M, McKenzie Glass DC, Gray CN, Jolley DJ, Gibbons Haydon A (2003). “Adjuvant DP, Forbes A, O’Neill I and Bloch S C, Sim MR, Fritschi L, Adams GG, Bisby chemotherapy in colon cancer: what is (2003). “Psychosocial morbidity JA and Manuell R (2003). “Leukemia risk the evidence?” Internal Medicine Journal associated with patterns of family associated with low level benzene 33: 119-124. functioning in palliative care: baseline exposure.” Epidemiology 14(5): data from the Family Focused Grief 569-577. Hellard ME, Sinclair MI, Harris AH, Kirk therapy controlled trial.” Palliative M and Fairley CK (2003). “Cost of Medicine 17: 526-537. Goeman D, Sawyer S, Aroni R, community gastroenteritis.” Journal of Abramson M, Thien F, Stewart K and Gastroenterology and Hepatology 18(3): Krum H (2003). “Beta-blockers in Douglass J (2003). “Inhaled steroids - 322-328. chronic heart failure: what have we too much of a good thing? (Letter).” learned? What do we still need to Medical Journal of Australia 178(5): 247. Hinwood AL, de Klerk N, Sim MR, know?” Current Opinion in Hankin J and Gerostamoulos J (2003). Pharmacology 3(2): 168-174. Goldstat R, Briganti E, Tran J, Wolfe R “An intervention trial on short term and Davis SR (2003). “Transdermal exposure to inorganic arsenic in drinking Krum H (2003). “Using bisoprolol and testosterone therapy improves well- water.” Environmental Health 3(4). carvedilol in chronic heart failure.” being, mood and sexual function in Medicine Today 4(3): 79-80. pre-menopausal women.” Menopause Hinwood AL, Sim MR, Jolley D, de Klerk 10: 390-398. N, Bastone EB, Gerostamoulos J and Krum H and Gilbert RE (2003). Drummer OH (2003). “Hair and toenail “Demographics and concomitant Grayson ML (2003). “The difference arsenic concentrations of residents living disorders in heart failure.” Lancet between biological warfare and in areas with high environmental arsenic 362(9378): 147-158. bioterrorism: Australia finally makes a concentrations.” Environmental Health start towards real preparedness for Perspectives 111(2): 187-194. Krum H and Gilbert RE (2003). bioterrorism.” Int Med Journal 33: “Urotensin ii: a new player in vascular 213-213. Hinwood AL, Sim MR, Jolley D, de Klerk and myocardial disease?” Clinical N, Bastone EB, Gerostamoulos J and Science 104(1): 65-67. Green S, Buchbinder R and Hetrick S Drummer OH (2003). “Risk factors for (2003). “Physiotherapy for shoulder increased urinary inorganic Krum H and Liew D (2003). “Current pain.” The Cochrane Library (2). concentrations from low arsenic status of endothelin blockade for the concentrations in drinking water.” treatment of cardiovascular and International Journal of Environmental pulmonary vascular disease.” Current Health 13: 271-284. Opinion in Investigational Drugs 4(3): 298-302.

Department of Epidemiology and Preventive Medicine

Krum H and Liew D (2003). “New and Leder K, Sinclair MI and McNeil JJ Mallows RJ and Newman DG (2003). emerging drug therapies for the (2003). “Correction: water and the “The use of impedance cardiography management of acute heart failure.” environment: a natural resource or a with dynamic motion environments.” Internal Medicine Journal 33: 515-520. limited luxury?” Medical Journal of Aviation, Space and Environmental Australia 178(3): 142. Medicine 74: 1014. Krum H and Liew D (2003). “New developments in the pharmacological Leder K, Sundararajan V, Weld L, Manek NJ, Cicuttini FM and Spector TD treatment of chronic heart failure.” Pandey P, Brown G and Torresi J (2003). (2003). “The genetics of osteoarthritis.” Expert Opinion in Investigational Drugs “Respiratory tract infections in travelers: Rheumatology. M Hochberg, A Silman, 12(5): 751-757. a review of the GeoSentinel Surveillance J. Smolen, M Weinblatt and M Network.” Clinical Infectious Diseases Weisman. Sydney, Mosby. 2. Krum H and Liew D (2003). “Recent 36(4): 399-406. advances in the management of chronic Manser RL, Irving LB, Byrnes G, heart failure.” Australian Family Physician Liew D and Krum H (2003). Abramson MJ, Stone C and Campbell 32(1/2): 39-43. “Aldosterone receptor antagonists in DA (2003). “Screening for lung cancer: a hypertension: what do they offer?” systematic review and meta-analysis of Krum H and Tonkin AM (2003). “Why do Drugs 63(751-757). controlled trials.” Thorax 58(9): 784-789. phase III trials of promising heart failure drugs often fail? The contribution of Liew D, Liew D and Kennedy M (2003). Marshall C, Harrington G, Wolfe R, “regression to the truth”.” Journal of “Emergency department length of stay Fairley CK, Wesselingh S and Spelman Cardiac Failure 9(5): 364-367. independently predicts excess inpatient D (2003). “Acquisition of methicillin- length of stay.” Medical Journal of resistant Staphylococcus aureus in a Krum H, Martin J, Haas S and Gilbert R Australia 179: 524-526. large intensive care unit.” Infection (2003). “Metabolic co-morbid conditions Control Hospital Epidemiology 24(5): in chronic heart failure: Diabetes and Liew D, Martin J and Krum H (2003). 322-326. Hypercholesterolemia.” Heart Failure “Eplerenone Pharmacia.” Current Updates: 35-57. Opinion in Investigational Drugs 4(3): Marshall JA, Hellard ME, Sinclair MI, 316-322. Fairley CK, Cox BJ, Catton MG, Kelly H Krum H, Roecker EB, Mohacsi P, and Wright PJ (2003). “Incidence and Rouleau JL, Tendera M, Coats AJS, Liew D, McNeil JJ, Peeters A, Lim SS characteristics of endemic Norwalk-like Katus HA, Fowler MB and Packer M and Vos T (2003). “Epidemiological virus-associated gastroenteritis.” Journal (2003). “Effects of initiating carvedilol in modelling (including economic of Medical Virology 69(4): 568-578. patients with severe chronic heart failure: modelling) and its role in preventive drug results from the COPERNICUS study.” therapy (In Reply).” Medical Journal of Martin J and Krum H (2003). JAMA 289(6): 712-718. Australia 178: 188-189. “Cytochrome P450 drug interactions within the HMG-CoA Reducase Inhibitor Krum H, Skiba M and Gilbert RE (2003). Lord L, May S, Bailey M and Smith L Class: are they clinically relevant?” Drug “Comparative metabolic effects of (2003). “Is one head and neck Safety 26(1): 13-21. hydrochlorothiazide and indapamide in immobilisation system as good as hypertensive diabetic patients receiving another? One centre’s experience.” Matheson MC, Dharmage S, Forbes A, ACE inhibitor therapy.” Diabetic Medical Dosimetry 28(1): 39-43. Raven J, Woods RK, Thien F, Guest D, Medicine 20(9): 708-712. Rolland J, Walters EH and Abramson Magliano DJ, Liew D, Ashton EL, MJ (2003). “Residential characteristics La Montagne A, Youngstorm R, Lewiton Sundararajan V and McNeil JJ (2003). predict changes in Der p 1, Fel d 1 and M, Stoddard A, Klar J, Christiani D and “Novel biomedical risk markers for ergosterol but not fungi over time.” Sorensen G (2003). “An exposure cardiovascular disease.” Journal of Clinical and Experimental Allergy 33(9): prevention rating method for intervention Cardiovascular Risk 10(1): 41-55. 1281-1288. needs assessment and effectiveness evaluation.” Journal of Occ and Env Magliano DJ, Liew D, Pater H, Kirby A, McIntosh A, McCrory P, Finch C, Hygiene 18: 523-534. Hunt D, Simes J, Sundararajan V and Chalmers DJ and Best J (2003). “Rugby Tonkin A (2003). “Accuracy of the headgear study.” Journal of Science and Leder K and Weller PF (2003). Australian National Death Index: Medicine in Sport 6(3): 355-358. “Antiparasitic agents.” Manual of Clinical Comparison with adjudicated fatal Microbiology. Washington DC, USA, outcomes among Australian participants McKenzie D, Clarke D, Smith GC and ASM Press. in the long-term intervention with Dowe DL (2003). “An empirically derived Pravastatin in Ischaemic Disease (LIPID) taxonomy of common distress Leder K, Sinclair M, Mitakakis TZ, Study.” ANZ Journal of Public Health syndromes in the medically ill.” Journal Hellard M, Forbes A and Fairley C 27(2): 649-653. of Psychosomatic Research 54: (2003). “A Community-Based Study of 323-330. Respiratory Events in Melbourne.” Australian and New Zealand Journal of Public Health 27(4): 399-404.

Department of Epidemiology and Preventive Medicine

McKenzie DK, Frith PA, Burdon JGW, Nelson MR, Reid CM, Krum H, Ryan P, Robertson B, Fairley CK, Black J and Town GI, Abramson M, Berend N, Wing LMH and McNeil JJ (2003). Sinclair MI (2003). “Case-control studies. Bergin J, Cala S, Crockett AJ, Gibson P, “Short-term predictors of maintenance Drinking water and infectious diseases: Jenkins C, Jenkins S, Lisle R, McDonald of normotension after withdrawal of establishing the links.” P Hunter, M Waile CF, Parikh J, Rea HH, Robinson M, antihypertensive drugs in the second and E Ranchi, CRC Press/IWA Smith JA, Snell G, Taylor RD and Australian National Blood Pressure Publishing. 1: 175-182. Weidinger M (2003). “The COPDX plan: Study (ANBP2).” American Journal of Australian and New Zealand Guidelines Hypertension 16(1): 39-45. Robertson BR, Fairley CK, Sinclair MI, for the management of Chronic Forbes AB, Veitch MGK, Kirk MD, Willis Obstructive Pulmonary Disease.” Nelson MR, Reid MR, Krum H, Muir T, J and Cunliffe D (2003). “Case-Control Medical Journal of Australia Ryan P and McNeil JJ (2003). Studies of Sporadic Cryptosporidiosis in 178(Supplement): S1-S40. “Predictors of normotension on Melbourne and Adelaide”. withdrawal of antihypertensive drugs in Cryptosporidium: From Molecules to McNeil JJ, Nelson MR and Tonkin AM elderly patients: prospective study in Disease. Thompson RCA, Armson A (2003). “Public funding of large-scale second Australian national blood and Ryan UM, Elsevier BV; 303-306. clinical trials in Australia.” Medical pressure study cohort.” British Medical Journal of Australia 179: 519-520. Journal 325: 815-817. Schwartz MD, Kaufman E, Peshkin BN, Isaacs C, Hughes C, DeMarco T, Finch McNeil JJ, Vale MJ, Jelinek MV, Best J, Osborne R and Buchbinder R (2003). C and Lerman C (2003). “Bilateral Dart AM, Grigg LE, Mark D, Ho BP and “Correlations between two measurement prophylactic oophorectomy and ovarian Newman DG (2003). “Coaching patients scales of hemiplegic shoulder pain.” cancer screening following On Achieving Cardiovascular Health IJTR 10: 334. BRCA1/BRCA2 mutation testing.” (COACH.” Archives of Internal Medicine Journal of Clinical Oncology 21(21): 163: 2775-2783. Padiglione A, Wolfe R, Grabsch E, 4034-4041. Olden D, Pearson S, Franklin C, Meaklim J, Yang J, Drummer OH, Spelman D, Mayall B, Johnson PDR and Serpell JW, Carne PW and Bailey M Killalea S, Staikos V, Horomidis S, Grayson ML (2003). “Risk Factors for (2003). “Radical lymph node dissection Rutherford D, Ioannides-Demos LL, Lim New Detection of Vancomy-Resistant for melanoma.” ANZ Journal of Surgery SS, McLean AL and McNeil JJ (2003). Enterococci in Acute-Care Hospitals that 73(5): 294-9. “Fenitrothion: toxicokinetics and Employ Strict Infection Control toxicologic evaluation in human Procedures.” Antimicrobial Agents and Sim MR (2003). “The continuing volunteers.” Environmental Health Chemotherapy 47(8): 2492-2498. challenge to reduce the burden of Perspectives 111(3): 305-308. occupational asthma - What is the best Peshkin BN, Isaacs C, Finch C, Kent S approach?” Occupational and Nelson M, Reid C, Beilin LJ, Donnan and Schwartz MD (2003). “Tamoxifen as Environmental Medicine 60(10): GA, Johnston CI, Krum H, Storey E, chemoprevention in BRCA1 and BRCA2 713-714. Tonkin A and McNeil JJ (2003). mutation carriers with breast cancer: a “Rationale for a trial of low-dose aspirin pilot study of physicians.” Journal of Sim MR and Benke G (2003). “Hazards for the primary prevention of major Clinical Oncology 21(23): 4322-4328. and controls in aluminium potrooms.” adverse cardiovascular events and Occupational and Environmental vascular dementia in the elderly: Aspirin Polkinghorne KR, Zoungas S, Branley P, Medicine 60(12): 989-992. in Reducing Events in the Elderly Villaneuva E, McNeil JJ, Atkins RC, Sim MR and Benke G (2003). “World at (ASPREE).” Drugs Aging 20(12): McGrath BP and Kerr PG (2003). work: Hazards and controls in aluminium 897-903. “Randomised, placebo-controlled trial of intramuscular vitamin B12 for the potrooms.” Occupational and Nelson MR (2003). “The JNC 7 treatment of hyperhomocysteinaemia in Environmental Medicine 60: 989-992. Hypertension Guidelines (letter).” dialysis patients.” Internal Medicine Sinclair M and Rizak S (2003). “Drinking JAMA 290: 1312. Journal 33(11): 489-494. water quality management: The Nelson MR, Reid CM, Krum H and Rickards CA and Newman DG (2003). Australian Framework. Drinking Water McNeil JJ (2003). “Factors influencing “A comparative assessment of two Safety: A total quality management family physician adherence to techniques for investigating initial approach.” H S, Institute for Risk hypertension treatment guideline cardiovascular reflexes under acute Research: 15-28. recommendations on the initiation of orthostatic stress.” European Journal of Smidt N, Assendorft WJJ, Arola H, pharmacotherapy.” American Journal of Applied Physiology 90: 499-457. Malmivaara A, Green S, Buchbinder R, Cardiovascular Drugs 3(6): 437-441. Rizak S, Cunliffe D, Sinclair M, Vulcano van der Dawm W and Boulter LM R, Howard J, Hrudey S and Callan P (2003). “Effectiveness of physiotherapy (2003). “Drinking water quality for lateral epicondylitis: a systematic management: a holistic approach.” review.” Annals of Medicine 35: 51-62. Water Science and Technology 47(9): 31-36.

Department of Epidemiology and Preventive Medicine

Smith KL, Cameron PA, Meyer AD and Thrift AG, Siritho S, McNeil JJ, You RX, Xiang S, Denver R, Bailey M and Krum McNeil JJ (2003). “Is the public Davis SM and Donnan GA (2003). “Risk H (2003). “Physiologic determinants of equipped to act in out of hospital of ischemic stroke among users of the endothelin concentrations in human cardiac emergencies?” Emergency oral contraceptive pill.” Stroke 34(7): saliva.” Clinical Chemistry 49(12): Medicine Journal 20: 85-87. 1575-1580. 2012-2019.

Solomon A, Cameron PU, Bailey M, Tonkin AM, Lim SS and Schirmer H Zazryn T, Finch C and Garnham A Dunne AL, Crowe SM, Hoy JF and (2003). “Cardiovascular risk factors: (2003). “Is safety a priority for football Lewin SR (2003). “Immunological and when should we treat?” Medical Journal clubs?” Sport Health 21(4): 19-24, 27. virological failure after antiretroviral of Australia 178: 101-102. therapy is associated with enhanced Zazryn TR, Finch C and McCrory P peripheral and thymic pathogenicity.” Tzanidis A, Hannan RD, Thomas WG, (2003). “A 16 year study of injuries to Journal of Infectious Diseases 187(12): Onan D, Autelitano DJ, See F, Kelly DJ, professional boxers in the state of 1915-23. Gilbert RE and Krum H (2003). “Direct Victoria, Australia.” British Journal of actions of urotensin II on the heart: Sports Medicine 37(4): 321-324. Stevenson M, Finch C, Hamer P and implications for cardiac fibrosis and Elliot B (2003). “The Western Australian hypertrophy.” Circulation Research 93(3): Zazryn TR, Finch CF and McCrory P sports injury study.” British Journal of 246-253. (2003). “A 16-year study of injuries to Sports Medicine 37(5): 380-1. professional kickboxers in the state of Vale MJ, Jelinek MV, Best JD, Dart AM, Victoria, Australia.” British Journal of Tapp R, Shaw JE and Zimmet PZ Grigg LE, Hare DL, Ho BP, Newman RW Sports Medicine 37(5): 448-451. (2003). “Complications of Diabetes.” and McNeil JJ (2003). “Coaching Diabetes Atlas. Gan D, International patients on achieving cardiovascular Diabetes Federation: 72-78. health (COACH): a multicenter randomised trial in patients with Tapp R, Shaw JE, De Courten M, coronary heart disease.” Archives of Dunstan DW, Welborn TA and Zimmet Internal Medicine 163(22): 2775-2783. PZ (2003). “Foot complications in Type 2 Diabetes: An Australian population Waters A, Beach J and Abramson MJ based study.” Diabetic Medicine 20: (2003). “Symptoms and lung function in 105-113. health care personnel exposed to glutaraldehyde.” American Journal of Tapp R, Shaw JE, Harper A, De Courten Industrial Medicine 43(2): 196-203. M, Balkau B, McCarty D, Taylor H, Welborn TA and Zimmet PZ (2003). “The Wing LMH, Reid CM, Ryan P, Beilin LJ, prevalence of and factors associated Brown MA, Jennings GLR, Johnston CI, with diabetic retinopathy in the Australian McNeil JJ, Macdonald GJ, Marley JE, population.” Diabetics Care 26. Morgan TO and West MJ (2003). “A comparison of outcomes with Teichtahl A, Wluka A and Cicuttini FM angiotensin-converting-enzyme inhibitors (2003). “Abnormal biomechanics: a and diuretics for hypertension in the precursor or result of knee elderly.” The New England Journal of osteoarthritis?” British Journal of Sports Medicine 348(7): 583-592. Medicine 37(4): 289-290. Wolfe R, Carlin JB and Patton GC Teichtahl AJ, Morris ME, Wluka AE, (2003). “Transitions in an imperfectly Bach TM and Cicuttini FM (2003). “A observed binary variable: depressive comparison of gait patterns between the symptomatology in adolescents.” offspring of people with medical Statistics in Medicine 22: 427-440. tibiofemoral osteoarthritis and normal controls.” Clinical and Experimental Woods RK, Walters EH, Raven JM, Rheumatology 21(9-11): 489-494. Wolfe R, Ireland PD, Thien FC and Abramson MJ (2003). “Food and Thrift AG, Dewey HM, Mihalopoulos C, nutrient intakes and asthma risk in Carter R, Macdonell RA, McNeil JJ and young adults.” American Journal of Donnan GA (2003). “Lifetime cost of the Clinical Nutrition 78(3): 414-421. stroke subtypes in Australia. Findings from the North East Melbourne Stroke Incidence Study (NEMESIS).” Stroke 34(10): 2502-2507.

Department of Forensic Medicine

Head Lecturers Stephen M Cordner MA Lond MBBS Melb Jodie Leditschke PhD The Department of BMedSc Melb FRCPath FRCPA DMJ (Path) Helen Parker MBBS Melb FACEM DipCrim Melb Forensic Medicine was Tutors established 16 years ago Personal Assistant Fiona JS Connor Melinda Franks Nicole Mollard at the same time as the Arthur Rallis Victorian Institute of Resources Manager Forensic Medicine was Russell J Evans BA (SocSc) Research Staff Jim Gerostamoulos established by the IT Manager Joe Ibrahim Coroners Act (1985). Vicky C Winship Matthew Lynch Adam O’Brien Together they provide a Administration Officers Anne Tremayne range of forensic medical Carole Bickle Patricia A O’Brien GDipCrim Melb MBA BA Post Graduate Students services in Victoria as well RN RM Arthur Smardencas as undergraduate and Gavin Reichel Angela Y-C Tan postgraduate education Academic staff and research in forensic Adjunct Professor medical and forensic Olaf H Drummer PhD (Med) Melb BAppSc (Chem) RMIT MRACI ARCPA scientific disciplines.

Associate Professors John Clement BDS PhD Lond LDS RCS Eng DipFOd LHMC Ian Freckleton PhD LLB Syd David Ranson BMedSc MBBS Nottm LLB Research Units in the Department are: West of Eng FRCPath FRCPA MDJ • Forensic Pathology DipCrim Melb • Clinical Forensic Medicine Senior Lecturers • Forensic Scientific /Road Safety Bentley Atchison BAgSc (Hons) PhD Adel Michael Burke BSc MBBS FRCPA • Forensic Entomology DipForensPath Leanna W Darvall LLB Melb PhD • Adverse Medical Treatment Events Malcolm Dodd MBBS Melb DipMLT AAIMLT FACBS FRCPA MACLM Research in 2003 Lynette Ireland BAppSc RMIT MSc GDip MGTMASM The Department has had an active Matthew Lynch MBBS Melb LLB FRCPA research program in 2003. DipForensPath FACLM Ian McVey FRCS Eng FRACS Professor Drummer completed a major Morris Odell BE MBBS Melb FRACGP collaborative 10-year study into the DMJ (Clin) involvement of drugs in fatal road Shelley D Robertson MBBS Melb LLB Melb crashes. This study, which involved most FRCPA DMJ (Path) FACLM DAvMed (Otago) Alexandra Welborn MBBS WA FRACGP of the States in Australia, showed that DMJ (Clin) recent use of cannabis significantly David Wells MA (Crim) Melb MBBS FRACGP increased the risk of a fatal crash. In Dip DRACOG DMJ (Clin) addition many other impairing drugs also increased crash risk. Co-consumption of alcohol further increased crash risk. The significance of this study was further enhanced by the realisation that drugs were becoming an increasingly prevalent factor, while alcohol induced road trauma steadily decreased in this period. These studies have been accepted for publication in two International Journals - Accident Analysis and Prevention and Forensic Science International. The projects were funded by VicRoads and conducted in collaboration with the Divisions of Scientific Services and

Department of Forensic Medicine

Clinical Forensic Medicine and the legislative and operational arrangements The Monash University National Centre Alfred Hospital Accident and within Coroners and Health Departments for Coronial Information (MUNCCI) is a Emergency Centre. throughout all States and Territories in research centre of the University, located Australia. Investigators are Clinical at the Victorian Institute of Forensic A number of studies supervised by Associate Professor David Ranson, Medicine (VIFM). MUNCCI is a Professor Drummer have also focused Ms Leonie Baker and Dr Joe Ibrahim. consortium of three Monash University on the analysis of drugs in hair and oral bodies, namely VIFM, the Monash fluid (saliva). Hair offers the advantage of Information for families regarding health University Accident Research Centre determining a longer time frame of drug risks identified incidentally during an (MUARC) and the Department of use than conventional tissues, and autopsy on a relative has been Epidemiology and Preventive Medicine. through segmental analysis can often recognised by the Department as a MUNCCI’s role is to develop and provide information spanning three to six potential public health activity worthy of manage the National Coroners months. This technique is being used in ongoing research. Current investigations Information System (NCIS). The NCIS is research projects including the use of are aimed at determining the scope of a world first national database of hair to determine abstinence from drug this information and what is required to coronial information that will contribute use in persons in drug treatment address the disease prevention and to a reduction in the incidence of programs. The analysis of drugs in oral mitigation potential of its use. unnatural death and injury in Australia. fluid allows a non-invasive way to rapidly test drug use in a workplace or at a Investigators are Dr Matthew Lynch, The vision of MUNCCI is for the NCIS roadside, and has therefore wide Associate Professor David Ranson and to be recognised nationally and applicability in the community. Studies Professor Stephen Cordner. internationally as being at the forefront are being conducted to establish the of the timely provision of national Coronial investigation of adverse medical reliability of such analyses. coronial data, which is comprehensive, treatment events is currently under reliable and up to date. This coronial intense scrutiny and investigation Adverse medical treatment events are data will facilitate the role of coroners procedures have been found to be subject to close scrutiny in forensic around Australia in preventing death and deficient in a number of studies. This pathology practice. Funded by the injury, whilst at the same time providing project involves a two year review and Department of Human Services, this a valuable resource to policy makers reorganisation of such investigations and project reviews cases and provides data and researchers. to the Department and to the Coroner. analysis of major issues in health care A number of subsidiary specialist provision that can lead to death. A range of Commonwealth, State and projects are being undertaken including Investigators are Clinical Associate Territory public sector agencies has post surgical deaths associated with Professor David Ranson, Ms Leonie contributed to NCIS funding since 2000. pulmonary thromboembolus and deaths Baker and Dr Adam O’Brien. Additional funding was received to associated with undiagnosed cardiac extend the NCIS until June 2003. Law relating to coronial jurisdiction on disease. The investigators were Clinical infants and stillbirths has caused Associate Professor David Ranson, Ms MUNCCI continued working closely considerable difficulties in recent years. Leonie Baker and Dr Dennis Gyomber. with the Commonwealth Department Changes in technology have resulted in of Health and Ageing (DHA) on the The interaction and communication these issues arising more frequently but implementation of strategies to improve between Coroners and Health without substantial legislative review. the quantity and quality of data on water Departments has the capacity to Legislation and operational procedures and drug related deaths. In particular, influence death investigation and public are being reviewed with a view to MUNCCI worked with police in each policy regarding the prevention of suggestions for legislative amendment. jurisdiction to obtain endorsement of the adverse medical treatment events. The Investigators are Dr Matthew Lynch, proposed national standard police form Australian Council for Safety and Quality and Clinical Associate Professor for reporting of coronial deaths. in Health Care is supporting a review of David Ranson. The Consultative Committee on Road Industrial Disease is an area that has Traffic Fatalities was established in not previously received much focus 1992 by the Victorian Road Trauma within forensic pathology and coroners Committee of the Royal Australasian practice in Australia. This is in contrast College of Surgeons and the Victorian to practice in many other jurisdictions Institute of Forensic Medicine. The such as the United Kingdom. Current objectives are to identify errors and/or projects involve a review of the role of inadequacies in the emergency and the coroner and forensic pathologists in clinical management of road trauma this area. Investigators are Professor fatalities who were alive at the time of Stephen Cordner, Clinical Associate the arrival of ambulance services. The Professor David Ranson, Dr Matthew committee has similarly examined a Lynch, and staff of the State group of non-road trauma fatalities and Checking slide quality in the Histology Laboratory Coroners Office. has evaluated the management of crash

Department of Forensic Medicine

survivors with neurological disability following head injury. This committee has had several funding sources. It is currently funded by the Victorian Trauma Foundation and managed by Professor McDermot and Professor Cordner.

The work of this project team played a major part in the review and reform of Victorian trauma care services and the group is now evaluating the impact of these changes.

Other research projects conducted during 2003 included:

• Summer Succession and the Decomposition Rates in the Victorian Bushland. Dr Melanie Archer

• Genetic Analysis of Coronial Cases with the Cause of Death Unascertained. Dr Bentley Atchison; Professor Olaf Drummer

• An@tomedia - A New Approach to Medical Education Developments in Anatomy. This project incorporates post-mortem images of selected viscera obtained at autopsy. PhD student Mark Chu prepares extraction tubes for the analysis of Tetra hydro-Cannabinol (THC) in blood. Associate Professor Christopher Briggs

• Studies on the Toxicology of • Gender Differences in Child Sexual • Plain X-ray radiography of the normal Cannabis. Mr Mark Chu Abuse Characteristics and Long- human skeleton. Associate Professor Term Outcomes of Mental Illness, Jeffrey Kerr, Department of Anatomy • Correlation of Human Femoral Bone, Suicide and Fatal Overdose: A and Cell Biology, Monash University. Quality, Quantity and Structure. Prospective Investigation. Professor John Clement Ms Josie Spataro • Anatomical study into the retaining ligaments and supporting tissues of • Toxicity Associated with Serotonin • Development of a More Efficient the human face. Mr Bryan Uptake Inhibitors. Professor Olaf Method of Mitochondrial DNA Mendelson, Associate Professor Kerr Drummer; Ms Jessica Halstead Analysis. Ms Angela Tan and Richard Huggins (Honours student), Department of Anatomy • The Toxicology of Monoamine Active • Quantitative analysis of kidney and Cell Biology, Monash University. Drugs. Ms Kabrena Goeringer structure in the Australian population. Professor John Bertram • Growth of human cartilage cells in • Effects of Antibiotic Incubation on and Dr Terry Samuel, Monash tissue culture: preliminary studies. Heart Valve Pathology. Ms Kellie Department of Anatomy and Associate Professor Barry Oakes, Hamilton; Ms Lyn Ireland Cell Biology. Department of Anatomy and Cell • Dental Assessment of Victorian Biology, Monash University. • Genetic and Proteomic Studies of Children from Birth to Five Years Human Motor Neurone Disease. • The Concentrations and Correlations of Age using Photographic and Associate Professor Surindar of Organochlorines in different Radiographic Techniques. Cheema, Head, Neurodegeneration autopsy samples. Associate Dr Tony Hill Laboratory, Monash University. Professor Malcolm Sim and • Endothelial Cell Seeding of Cold- Dr Narges Khanjani, Department • Risk factors for serious farm-work Stored Blood Vessels. of Epidemiology and Preventive related injuries among males. Mr Arthur Smardencas Medicine, Monash University. Dr Lesley Day, Accident Research Centre, Monash University.

Department of Forensic Medicine

• Novel Sites of leptin production and Teaching action. Professor Murray Esler and The Institute has had a significant input Ms Nina Eikelis (PhD Candidate), in the provision of teaching and training Baker Research Institute Limited. on a range of forensic topics during the • Anthropology of ancient skeletal year. Institute staff has acted as remains from Sos Hoyük Turkey. examiners and supervisors for a range Dr Bentley Atchison. of undergraduate and postgraduate programs as well as for professional • Segmental testing of the lumbar bodies such as the Royal College of spine: effect of applying tension to Pathologists of Australasia. Programs the lumbar fasciae. Associate have been provided to: Teaching preparation in the Padua Theatre Professor Christopher Briggs and • Medical, science, nursing and law Professor John Clement. undergraduates

• An autopsy video to support those • Medical post-graduates and various approaching relatives, to discuss specialty groups Postgraduate Program in autopsy in hospitals. Forensic Medicine • Medical laboratory science students This program is offered through distance • The anatomical and pathological and undergraduates factors associated with the minimally education mode, it is believed to be invasive direct cardiac (MID-CM) • Police and Department of Human unique as the only university post device. Associate Professor David Services graduate program in clinical forensic Ranson and Ms Sarsha Collet, medicine. (Honours student). • Legal profession The program is open to medical • Community groups, service practitioners who are (or may be During 2003 organisations and schools contemplating) providing forensic • VIFM staff also worked on research medical services. To date, students from Current developments in medical law projects in collaboration with Baker every Australian state and territory have and ethics are a major focus of program Medical Research Institute; Mental enrolled. More recently, enrolments have development for undergraduates. Dr Health Research Institute; National also been received from Africa, South Leanna Darvall Senior Lecturer in Tissue Resource Centre; Royal East Asia and the Pacific. The course is Medical Law is responsible for Melbourne Hospital; St. Vincent’s available at Certificate, Diploma and development of the medical law Hospital; The Royal Victorian Eye Masters levels. program within the medical faculty, and Ear Hospital; Austin and assisted by a team of twelve Repatriation Medical Centre; Royal The Institute in conjunction with the Indo experienced medical law lawyers. Her Women’s Hospital; Royal Children’s Pacific Association of Law, Medicine and position is funded by a consortium from Hospital; Sir Charles Gairdner Science is offering an annual scholarship Victoria’s medical defence community: Hospital Perth; The University of to medical graduates from developing Medical Defence Association of Victoria, Melbourne; University of Sydney; countries. The scholarship covers the Medical Indemnity Protection Society Victoria Police; and Victorian Law cost of all tuition fees and and Professional Management Australia. Reform Commission. accommodation during attendance at the Institute. The first recipient is Final year medical students attend the • The Clinical Liaison Service Group Dr Nadine Agnew, a State Medical Institute on rotation for two days. completed a major project reviewing Officer and pathologist from Namibia. Lectures given over this time cover Coronial Legislation throughout aspects of law relevant to future Australia and investigating the way in practising medical practitioners, clinical PhD Opportunities which health departments use forensic medicine, forensic toxicology, coronial findings. This project was The Department of Forensic Medicine writing of medico-legal reports and an funded by the Australian Council for offers PhD research training introduction to forensic odontology. The Safety in Quality and Healthcare. opportunities in a range of disciplines sessions end with students participating including forensic and analytical • A review of Adverse Medical in a moot court, where they are required toxicology, molecular biology, clinical Treatment Events in Victoria was to give evidence and are subjected to forensic medicine, applications of also undertaken. cross examination by Coroner’s forensic and anatomical pathology and Assistants. This is in addition to elective tissue banking techniques. Past programs for medical students from graduates have been equipped with Monash, the University of Melbourne highly sought after skills to establish a and overseas. successful career in one of the branches of forensic science or medicine.

Department of Forensic Medicine

Our current PhD students are: Atchison B. DNA statistics may be Emmett S, Ibrahim JE, Ranson DL, Angela Tan has been researching the misleading. Law Society Journal 41(1): Johnstone GD. The coronial system: in development of rapid DNA profiling 68-70 2003. need of reform. eBritish Medical Journal. techniques based on a mini-chip See: http://bmj.com/cgi/eletters/ concept. The aim of the project will be Beard J, McKelvie H, O’Brien P. 326/7402/1284-a#34814 2003. to combine this technique with Managing a changing ethical amplification in a microchip format using environment - ethics approval for the Fraser NL, Yoshino M, Imaizumi K, rolling circle amplification. This will speed use of human tissue at the Victorian Blackwell SA, Thomas CDL, Clement up conventional DNA analysis. Institute of Forensic Medicine. in AHEC JG. A Japanese computer-assisted Ethics in Human Research. 2003. facial identification system successfully Arthur Smardencas has been based at Canberra. identifies non-Japanese faces. Forensic BioNova, a biotechnology firm Science International 135: 122-128 specialising in artificial vascular grafts. Cordner S. Suicide, accident, murder or 2003. Arthur’s project has been evaluating natural death, in Forensic Medicine - a number of aspects of the Clinical and Pathological Aspects AB J Goeringer KE, McIntyre IM and re-endothelialisation of these grafts Payne-James, W Smock, Editor. 2003 Drummer OH. LC-MS Analysis of using a sheep model. Greenwich Medical Media Ltd London. Serotonergic drugs. Journal of Analytical p. 133-147. Toxicology 2003. 27(1): p. 30-35.

Higher Degree students who Cordner SM. Outcomes for society: Goldman HM, Bromage TG, Thomas graduated in 2003 forensic pathology. The Australian CDL, Clement JG. Preferred collagen Journal of Forensic Sciences 35(1): fiber orientation at the human mid-shaft Congratulations to the following 133-140 2003. femur. The Anatomical Record Part A students who were awarded Doctor of 272A:434-445 2003. Philosophy during 2003: Cordner SM People missing as a result Kabrena E Goeringer of armed conflict BMJ 2003 326, 943-4 Goldman HM, Bromage TG, Boyde A, Mark H-C Chu Thomas CDL, Clement JG. Cordner SM Missing people and mass Intrapopulation variability in Publications graves in Iraq, Lancet 2003 362, 1325-6 mineralization density at the human femoral mid-shaft. Journal of Anatomy Archer MS, Elgar MA. Yearly activity Drummer OH. Pharmacology and 203:243-255 2003. patterns in southern Victoria (Australia) Toxicology, in Medical-Legal Aspects of of seasonally active carrion insects. Drugs B M Editor. 2003 Lawyers and Hinwood AL, Sim MR, Jolley D, de Klerk Forensic Science International. 2003. Judges Publishing Co Inc. USA: Tuscon, N, Bastone EB, Gerostamoulos J, 132. p 173-176. Arizona. p. 23-40. Drummer OH. Hair and toenail arsenic concentrations of residents living in Archer MS, Elgar MA. Female breeding Drummer OH. Emerging trends in areas with high environmental arsenic site preferences and larval feeding forensic toxicology. The Australian concentrations. Environmental Health strategies of carrion-breeding Journal of Forensic Sciences 35(1): Perspectives. 2003. v111 i2 p. 187(7). Calliphoridae and Sarcophagidae 141-148 2003. (Diptera): a quantitative analysis. Hinwood A L, de Klerk N, Sim MR, Australian Journal of Zoology. 2003. Drummer O H, Gerostamoulos J, Batziris Hankin J and Gerostamoulos J. An 51. p 165-174. HP, Chu M, Caplehorn JR, Robertson intervention trial on short term exposure MD and Swann P. The incidence of to inorganic arsenic in drinking water. Archer MS. Annual variation in carcass drugs in drivers killed in Australian road Environmental Health, The Journal of the arrival and departure times of carrion traffic crashes. Forensic Science Australian Institute of Environmental insects: implications for forensic International 134: 154-162, 2003. entomology succession studies. Health 3(4): 65-72 2003. Australian Journal of Zoology 51: Emmett S and Ibrahim JE. The Coronial Ireland L and McKelvie H. Tissue 569-576, 2003. process in investigating fall-related banking in Australia. Cell and Tissue deaths: A practical approach towards Banking 4: 151-156 2003. Archer MS. (Book review): Spiders and achieving optimal health care. Journal of scorpions commonly found in Victoria. the Australasian Association for Quality Loff B and McKelvie H. Australia shaken (by KL Walker, AL Yen, and GA in Health Care 13(2): 6-7 2003. by complementary medicines recall. The Milledge). The Victorian Naturalist Lancet 2003. 361: p. 1710. 120 (Dec): 267-268, 2003. Emmett S and Ibrahim JE. An open day at the coronial services centre: bridging Archer MS and Elgar MA. Effects of the gap between health care providers decomposition on carcass attendance in and death investigators. Journal of the a guild of carrion-breeding flies. Medical Australasian Association for Quality in and Veterinary Entomology 2003 17, 1-9 Health Care 13(3): 15-16 2003.

Department of Forensic Medicine

Meaklim J, Yang J, Drummer OH, Reports Abstracts 2003 Killalea S, Staikos V, Rutherford D, Briggs CA, Gruspier KL. Forensic Archer MS and Lynch MJ. (Poster) The Horomidis S, Ioannides-Demos L, Lim Anthropology and the ‘Missing’. How occurrence of toxicological substances S, McLean AJ, McNeil JJ. Fenitrothion: can a population based science be known to affect maggot growth rates in toxicokinetics and toxicological applied properly to individual forensic entomology cases at the evaluation in human volunteers. identification? Proceedings of Workshop Victorian Institute of Forensic Medicine. Environmental Health Perspectives of International Red Cross: Human 41st International Meeting of The 111(3): 305-308 2003. Remains and Forensic Sciences; International Association of Forensic Geneva 23-25 July 2003. Toxicologists (TIAFT), Melbourne, 16-20 Odell M. Case 2 - fitness for interview. November, 2003. Journal of Clinical Forensic Medicine Wells D. (Lead author) Guidelines for 10(2): 106-108 2003. Medico-Legal Care of Victims of Sexual Beard J. Lessons Learnt (Abstract). in Violence. World Health Organisation, AHEC Ethics in Human Research. 2003. Ranson DL. Death investigation, in Geneva, 144 pages 2003. Canberra. Forensic Medicine - Clinical and Pathological Aspects AB J Payne- O’Brien A, Ibrahim JE, Emmett S. Drummer OH and Gerostamoulos J. James, W Smock, Editor. 2003 Coronial Communique. Clinical Liaison Psychotropic Drugs and Road Trauma. Greenwich Medical Media Ltd London. Service - Connecting Clinicians with 3rd European Academy of Forensic p. 13-25. Coroners. Melbourne, SCO/VIFM Vol. Science Meeting. September 22-27, 1(1): 1-4, 2003. Istanbul, Turkey, Forensic Science Ranson DL. Medical Issues: Norwalk or International. Vol. 136/Suppl.1, pp 325, Noroviruses. Journal of Law and Ibrahim JE, McMillan N, Grech C, 2003. Medicine 10(3): 267 2003. Bugeja L, Ranson DL. The role of the Coronial process in initiatives for Emmett S L and D L Ranson. Cardiac Ranson DL. Medical Issues: epilepsy improving patient safety and quality of deaths following discharge from and trauma. Journal of Law and health care: Final report of a consultancy Emergency Departments. Evidence to Medicine 10(3): 265-266 2003. into the Coronial Death Investigation Excellence in Emergency Care Process in Australia: its role in reviewing Conference, Sydney, 2003. Ranson DL. Medical Issues: transfusion- the safety and quality of health care related acute lung injury. Journal of Law provision. 2003 Report submitted to the Kotsos A, Gerostamoulos J, Boorman and Medicine 10(3): 266-267 2003. Australian Council for Safety and Quality MC, Drummer OH. Prevalence of drugs in impaired Victorian drivers. 41st Ranson D and Bugeja L. Medical Issues: in Health Care, Commonwealth Dept of International Meeting of The International coroners’ recommendations: do they Health and Ageing, Canberra. Association of Forensic Toxicologists lead to positive public health outcomes? (Confidential Report). (TIAFT), Melbourne, 16-20 November, Journal of Law and Medicine 10(4): 399 2003. 2003. Books Cordner SM. Suicide, accident, murder McKelvie H, Morgan N. (Keynote Ranson DL and Emmett S. Medical or natural death, Forensic Medicine: Address) Research use of autopsy Issues: falls and fall-related injuries: far- Clinical and Pathological Aspects, 2003, tissue at the Victorian Institute of reaching implications. Journal of Law Published by Greenwich Medical Media Forensic Medicine: Legal, Ethical and and Medicine 11(1): 16-17 2003. 133-148 Personal Boundaries. Australian Bio-Specimen Network, Inaugural Ranson DL and Emmett S. Medical Welborn A, Sexual Assault, Chapter in meeting, Melbourne, July, 2003. Issues: medication errors: inadvertent Obstetrics, Gynaecology and Women’s administration of potassium chloride. Health, O’Connor V and Kovacs G (eds) Rosenfeld JV, Rowan D, McDermott F, Journal of Law and Medicine 11: 146- Cambridge University Press, New York, Tremayne A, Maroulis H. The 147 2003. 2003 pp104-114 preventability of “talk and die” head injury. ANZ. J. Surgery 2003. 73 Ryan M. Central cord syndrome Welborn A. “Sexual Assault - Part 1. (Suppl.) Abstract. following assault and subsequent Women’s Health. Obstetrics resuscitation. Emergency Medicine - Gynaecology and Women’s Health: A Swann P, Boorman MC, Drummer OH, Medicolegal Matters 15: 89-91 2003. Woman’s Perspective.” Editor: Vivienne Gerostamoulos J, Ogden E, Papafotiou O’Connor, Gabor Kovacs. Cambridge Ryan M, Young S and Wells DL. Do K, Silber B, Stough C. Investigation of University Press: 704 2003. resuscitation attempts in children who oral fluid screening devices for random die, cause injury? Emergency Medicine roadside illicit drug testing. 41st 20: 10-12. 2003. International Meeting of The International Association of Forensic Toxicologists (TIAFT), Melbourne, 16-20 November, 2003.

Department of Medicine at The Alfred

Head Kenneth Thomson MBChB Otago MD Melb Senior Lecturers Napier M Thomson MBBS MD Adel FRACP FRACR FRCR Rodney Abud MBBS Melb FRACP Steven Wesselingh BMBS Flinders PhD Subhash Arora MBBS Delhi MD Delhi Personal Assistant/ Flinders FRACP MRCP FRACP Administration Officer Peter Bergin MBBS FRACP DDU Marilyn L Bushell Adjunct Professor Caroline Brand MBBS FRACP BA Melb E Haydn Walters BA (PhysiolSci) BMBCh MA Jaye Chin-Dusting BSc (Hons) PhD Business Manager DM Oxford FRCP FRACP FCCP Mark Cook MBBS Melb FRACP PhD Melb Gillian Holley BBus (Mgt) GDipAcc Kathleen Curnow BSc PhD Melb AFAIM MAHRI Associate Professors Christina M Drummond MBBS DObstRCOG Jennifer Hoy MBBS FRACP GDipEpidemiol DTM&H FRACP MPH MAE FAFPHM Technical Services Manager and Biostats Stephen J Duffy MBBS DipRACDG MRCP Paul L Dover BSc GDip Internet and Web Paul A Komesaroff BSc MA MBBS Melb PhD FRACP PhD Comp MIT La Trobe and NY State Stony Brook FRACP Mark Faragher BMedSc Melb MBBS Melb Anne Mijch MBBS Syd FRACP FRACP IT Manager GDipEpidemiol and Biostats Jacob Federman MBBS Melb FRACP DDU Ian G Sloan BSc (Hons) PhD Aubrey Pitt MBBS Melb MD Melb FACC FRACP FACC Judith Frayne MBBS (Hons) FRACP Finance Officer Paul Rene Gorry BAppSc PhD Diana Mejia-Bravo Clinical Associate Professors Peter Habersberger MBBS Melb FRACP D Jamie Cooper BMBS Flinders MD Adel Ian E Haines MBBS Melb FRACP HR Officer FRACP FFARACS FANZCA FFICANZCA Paula Jablonski BSc MSc PhD Melb Effie Adraktas Jo A Douglass BMedSc (Hons) MBBS Philip James BMedSc MBBS WA FRACP MD FRACP DM Southampton Administration Officers Mark Fitzgerald MBBS Melb FACEM Karin Jandeleit-Dahm MD Aachen PhD Virginia N Cable MRACMA Aachen FRACP Mandy M Coats David Fonda BMedSc MBBS Melb Anthony Jaworowski BSc PhD ANU Cheryl J Grant FRACP FAFRM Tom Kotsimbos MBBS Melb MD Melb Liljana Petrovska Victor Kalff BMedSc MBBS Melb FRACP Barbara Welton FRACP FACC Gavin W Lambert BSc PhD Melissa H White John Kelly MBBS Melb MD Melb FACD Michele Levinson MBBS Melb MD Melb Michael Kelly MBBS Melb FRACP FRACP Academic Staff Douglas Lording BMedSc (Hons) MBBS Lara Lipton MBBS Melb FRACP Professors FRACP Peter J Little BPharm MSc PhD Syd Alexander Bobik PhC MPS BPharm MSc Matthew Naughton MBBS Melb MD Melb Geoffrey Metz MBBS MD FRACP MRCP PhD Syd FRACP M Cristina Morganti-Kossmann PhD Rome Nicholas Christophidis MBBS Melb FRACP John Olver MBBS Melb MD Melb Andrew Nunn MBBS FACRM FAFRM PhD Melb FACRM FAFRM Michael J Oldmeadow MBBS FRACP Mark E Cooper MBBS Melb PhD Melb Peter FJ Ryan MBBS FRACP FAFRM Frank Panetta MBBS FRACP DDU FRACP Carlos Scheinkestel MBBS Melb FRACP Stephen Pianko MBBS FRACP Suzanne M Crowe MBBS MD FRACP DipDiving and Hyperbaric Med Indi Rasaratnam MBBS FRACP Anthony M Dart BA (Physiol) DPhil (Physiol) Hans G Schneider MD Heidelberg FRCPA Stuart Roberts MBBS Melb FRACP BMBCh Oxford FRCP FRACP Denis Robertson MBBS Melb FRACP Frank Dudley BSc (Med) MBBS Syd MD Anthony Schwarer MBBS Qld MD Qld Andrew Rosengarten BSc (Hons) MBBS Melb FRACP FRACP FRCPA FACEM Murray D Esler MBBS Melb BMedSc PhD Max A Schwarz MBBS (Hons) FRACP FACP Philipa Rothfield BA (Hons) PhD ANU FRACP FAChPM John Scarlett MBBS Melb MD Melb FRACP John Funder BA MBBS Melb MD Melb PhD Rodney D Sinclair MBBS Melb FACD FRCPA Melb FRACP Gregory I Snell MBBS Melb FRACP Jeremy Shapiro MBBS FRACP Garry Jennings MBBS MD FRACP FRCP Andrew Spencer MBBS Qld DM Lond Simon Stafrace MBBS Melb DipClinHypnosis Colin I Johnston MBBS Syd FRACP FRACP FRCPA GDipMental Health Sci MPM FRANZCP David M Kaye MBBS PhD FRACP FACC Alison Street MBBS FRACP FRCPA Hugo Standish MBBS Melb FRACP Henry Krum MBBS Melb FRACP PhD Melb Frank Thien MBBS MD FRACP Richard Stark MBBS (Hons) FRACP MACCM Sharon R Lewin MBBS (Hons) PhD FRACP Duncan Topliss MBBS MD FRACP FACE Stephen Stuckey MBBS Melb MMed John Mills BS Chicago MD Harvard David Tuxen MBBS Melb MD Melb FRACP FRANZCR FACP FRACP DipHyperbaricMed Cenk Suphioglu BSc (Hons) PhD Melb Robyn O’Hehir BSc MBBS Lond PhD Lond Anthony Weeks MBBS FFARACS FANZCA Michael F Sutherland MBBS FRACP FRACP FRCP MRACMA Niall Tebbutt BMBCh Oxford PhD Melb Neil Paget BA NZ DipEd Vic MA (Educ) Vic Trevor Williams MBBS Melb FRACP FRACP MBA MACE John Wilson BSc (Hons) MBBS Melb PhD James Tulloch MBBS Melb MMed Melb Hatem Salem MBChB Mosul MD MRCP Melb FRACP FCCP FRACP MRCS FRACP FRCPA Charles Varley MBBS FRACP Jan R Stockigt MBBS Melb MD Melb Associates of the Department John A Waterston MBBS MD FRACP FRACP FRCPA Robert McClellan MBBS Melb MRCP FRACP Michael Westmore MBBS Melb FACEM Elsdon Storey MBBS Melb PhD Oxford Allen Yuen MBBS Syd FRACGP FACEM Isla Williams MBBS Melb MD FRCF/PE FRACP FRACP DipOphthalmol Ian J Woolley MBBS Melb FRACP

Department of Medicine at The Alfred

Lecturers Research Assistants Paul Biegler MBBS MBioethics DipAnaes Estelle M Abbas The Department of (UK) FACEM Efstathia Apostolou Marco Bonollo MBBS (Hons) FRACP Mark T Coulson BSc (Hons) PhD Medicine at The Alfred has Amy Brodtmann MBBS FRACP Aozhi Dai a major undergraduate Graham Burns BSc MBBS Newcastle Upon Joanne M Ferguson Tyne MRCP PhD Newcastle Upon Tyne Chris Fotinopoulos teaching commitment Brenda Button DipPhthy Pretoria PhD Melb Giuliana F Fuscaldo throughout the whole John Coleridge MBBS Lond DA DCH FACEM Ivana J Glogowski MSc DipEd medical course and also Bruce Day MBBS NSW FRACP Lucas Man Chung Law BSc Hons Melb Stephen De Graaff MBBS FACRM FAFRM Shanhong Ling MBBS Guangxi MS MD contributes to teaching Xiao-Jun Du MBBS Chongqing MMed Xian Guangzhou PhD programs in the Bachelor PhD Edin Julie A Maguire BAppSc Sam El-Osta BSc (Hons) LaTrobe PhD Melb Bernadetta Orsida PGDip Immunol of Biomedical Science. It David Ernest MBBS Melb FRACP Ajantha Solomon BSc (Hons) Melb has an Honours program Christopher Fong MBBS Melb FRACP Daniela Stefani BSc (Hons) Amanda K Gilligan BSc MBBS FRACP Fiona Wightman BSc (Hons) Melb for science and biomedical Michelle L Gold MBBS FRACP science students and P Shane Hamblin MBBS (Hons) FRACP Peter J Hand MBBS MD Edin FRACP there were 63 Robyn G Langham MBBS (Hons) PhD postgraduate research FRACP students enrolled through Robert Lefkovits MBBS Melb FRACP Carolyn Lethborg BA (SocWork) Tas MA the department in 2003. (Soc Work) Melb Andrew Maclean MBBS Melb FACEM Jennifer H Martin BMBS Otago MA Oxon FRACP Gregory J Perry MBBS Syd MD FRACP Jennifer Philip MBBS Melb GDipPallCare Current research programs of the Stephen Pianko MBBS FRACP Department include: John M Power BVSc (Hons) Qld PhD David Reid BSc St Andrews MBChB • Clinical pharmacology: drug Manchester MRCP FRACP evaluation (clinical and experimental) Laila Rotstein MBBS Melb FRACP Linda Schachter MBBS Melb FRACP • Bioethics: Centre for Ethics in Simon Scharf MBBS Melb MD Melb FRACP Medicine and Society Gim Aik Tan MBBS Melb DRANZCOG • Infectious Diseases: HI virology and FACEM Olga Vujovic MBBS FRACP immunopathogenesis, HIV brain Edwina Wright MBBS Syd FRACP disease, immunization, Hepatitis B Deborah Zion BA (Hons) Melb MA Melb PhD virus immunopathogenesis, HIV- hepatitis co-infection, molecular Research Staff diagnostics Research Fellows Louise Kelly BSc (Hons) PhD Leeds • Oncology: national and international Alicia N Stein Licenciada en Ciencias therapeutic trials Biologicas Buenos Aires PhD • Neurosciences: biological Cenk Suphioglu BSc (Hons) PhD Melb mechanisms of adult neurogenetic Victor J Turnbull BSc (Hons) PhD Christopher Ward BSc Newcastle upon Tyne diseases; neuropsychology of MPhil Newcastle upon Tyne PhD Alzheimer’s disease, cerebellar Ling Zheng MB MD Tongji PhD Tongji MD degeneration and cardiac failure; Essen PhD quantification of ataxia: Van Cleef Roet Centre for Nervous Diseases • Renal disease: immunobiology of progressive renal damage, diabetic nephropathy and allograft rejection • Rheumatology: immunobiology of inflammatory arthritis • Immunobiology of asthma, progressive chronic lung damage, lung transplantation and sleep apnoea

Department of Medicine at The Alfred

• Cardiovascular (in collaboration with • CHABLIS: study of addition of ARB It is part of the mission of the Centre to the Baker Research Institute): heart versus increasing the dose of ACE emphasise that debate must be based failure (human and experimental) inhibitor in patients with systolic on reliable factual information and that immunobiology of heart heart failure research should be undertaken to transplantation ensure that such information is available. • COLA II: prospective open-label • Haematology: clotting abnormalities, Further, the Centre is committed to study of tolerability of administration making a difference within both the haematological malignancy and of the beta-blocker, carvedilol, to bone marrow transplantation medical and the wider communities. elderly patients with heart failure This means that it sees its role as not • Gastroenterology: vascular merely a reflective or reactive one, but to The unit also conducts a number of pathophysiology in chronic liver assist in the development of a deeper, basic research programs. Current disease richer and more critical culture. To programs include: achieve this, it emphasises that in Teaching • Role of urotensin II in cardiac addition to the need for high quality disease (NHMRC supported) research it is important to ensure that The Department is very grateful for its wherever possible programs are linked network of consultant physicians and • Role of p38 MAP kinase system in to enduring products such as written PhD candidates who contributed heart failure disease progression materials, educational programs or significantly to both undergraduate and specific outcomes designed to affect the post-graduate medical education. The • Anti-fibrotic effects of statin therapies lives of the individuals to whom the Case-Based Learning (CBL) program in cardiac cells specific projects are directed. was central to the innovative 4th year The Clinical Pharmacology Unit is part of undergraduate curriculum, with tutorials the newly established Alfred/Monash The research interests represented at based around actual patient Centre of Research Excellence in the Centre include both qualitative and consultations performed by participating Therapeutics awarded $2 million over quantitative research and research of a students in the areas of heart failure, five years by NHMRC. theoretical kind, embracing the ethical stroke, renal failure and anaemia. and cultural context of clinical practice “Bedside” clinical skill teaching and research. Topics covered include: The Monash Centre for the Study of commenced in 4th year was reinforced in Experiences of women with physical Ethics in Medicine and Society the 5th year program and supplemented disabilities; Social and ethical aspects of - Associate Professor Paul Komesaroff by a lecture program. Final year students cosmetic surgery; Ethical aspects of The Monash Centre for the Study of participated in a lecture program and research and ethics committees; Ethical Ethics in Medicine and Society has four joined both the Professorial General and philosophical aspects of palliative key aims: (1) to stimulate a culture of Medical Unit and other specialty units for care; Conflicts of interests in science reflection, debate, dialogue and electives and the popular “student intern” and medicine; The ethics of the clinical awareness of ethical issues in the program. HMO education sessions and encounter; Assessment and medical community and the Faculty; the FRACP tutorial program were also management of pain in ambulance care; (2) to deliver high quality teaching strongly supported by the Department. Ethics Education in Medicine; Ethical products; (3) to conduct research; and The Neurosciences Unit gives lectures and philosophical aspects of Chinese (4) to contribute to the development and runs several practical classes for medicine; Ethical aspects of end of life and enrichment of clinical and Years 2 and 3 of the Bachelor of decision making; Health care, research practice. Behavioural Neuroscience course. globalisation and ethics; and Rational The activities of the Centre encompass use of medicines: social and ethical Research undergraduate and postgraduate issues. Several other projects are either in progress or planned. Clinical Pharmacology Unit teaching, theoretical reflection, - Professor Henry Krum empirically based research, the delivery The Clinical Pharmacology Unit of a clinical ethics service, and policy, Infectious Diseases conducts mechanistic trials of new and public education and other intervention - Professor Sharon Lewin existing drug therapies. It also serves as programs. Their scope includes clinical Research in infectious diseases is a coordinating centre for multi-centre practice, policies affecting national focused on HIV, viral hepatitis, clinical trials. Such trials ongoing at health care and the conduct of the neurovirology and molecular diagnostics. present include: medical profession, and the large scale In May 2003, appointment of the new social determinants of health. Two major director of the IDU, Professor Sharon • UNIVERSE: study of statin therapy in ongoing projects focus on the nature Lewin brought further strength in basic the treatment of heart failure and use of complementary medicines and applied research expertise • CHAT: NHMRC-sponsored study and practical strategies for global specifically in the field of immunovirology looking at the utility of telephone reconciliation. of HIV and hepatitis. In 2003, the IDU support in rural and remote areas for received a substantial amount of peer- the patient with heart failure to reviewed funding including research prevent rehospitalisation support from NHMRC, the National

Department of Medicine at The Alfred

Institutes of Health, State Government, • Immunopathogenesis of HBV Medical Oncology Clinical Associate Federal Government and private and HIV-HBV co-infection Professor Max Schwarz sources. The IDU actively collaborates The Medical Oncology Unit provides a with The Alfred Microbiology • Role of dendritic cells in HIV comprehensive multi-disciplinary cancer Department, The Macfarlane Burnet dementia service and major primary care facility Institute for Medical Research and for patients with malignancy, as part of • Pathogenesis of mitochondrial Public Health, Monash University The Alfred Blood Diseases and Cancer toxicity and HIV-related peripheral Department of Epidemiology and Clinic. Patient care is coordinated with neuropathy Preventive Medicine, the Victorian the Palliative Care Service. Infectious Diseases Reference • Early detection of invasive The Unit’s major ongoing research Laboratory and the Victorian Infectious aspergillosis using PCR based relates to active participation in National Diseases Service based at the Royal diagnostics Melbourne Hospital, Department of and International clinical trials. Microbiology and Immunology, The Clinical Research Program The Palliative Care Service provides a University of Melbourne and the National • Natural history of HIV-HBV consultation service to inpatients from Centre for HIV Epidemiology and Clinical co-infection (NHMRC project grant, all Hospital Units living with progressive, Research at the University of New South co-investigator Mijch and NIH, RO1, incurable disease. In addition to Wales. International collaborators include co-investigator Lewin, in inpatient consultations, an outpatient Queen Mary Hospital, Hong Kong collaboration with Johns Hopkins service is provided, which is unique University (Dr George Lau); Los Alamos University, University of New South among the major metropolitan hospitals. National Laboratories, New Mexico Wales and Victorian Infectious (Dr Alan Perelson); Department of Diseases Reference Laboratory) The Palliative Care Service continues Gastroenterology, Singapore General to focus on clinical issues, including • Epidemiology of nosocomial Hospital, Singapore (Dr Seng Lim); symptom management. Current MRSA infection Department of Infectious Diseases, research projects are: Tan Tock Seng Hospital, Singapore • Management of HIV treatment • Randomised, double-blind, cross- (Dr Nick Paton); Department of toxicities over trial of the effect of oxygen on Infectious Diseases, Johns Hopkins dyspnoea in patients with advanced University, Baltimore, MD (Drs Thio • HIV and depression cancer. and Thomas) • HIV therapeutic vaccination with • Pilot study investigating a Screening Basic Research Program vectors co-expressing HIV genes Instrument for Spiritual Distress. • HIV T cell turnover and immune and interferon (in collaboration with restoration following antiviral therapy the University of New South Wales) (NHMRC Project Grant, CIA Lewin; in collaboration with the Burnet Institute)

• The role of the thymus in HIV and SIV infection (NIH RO1, co-investigator Lewin, in collaboration with the Aaron Diamond AIDS Research Centre, The Rockefeller University, New York, NY)

• The origin and persistence of HIV viral reservoirs, specifically resting memory and naïve T cells (in collaboration with the National Centre for HIV Epidemiology and Clinical Research, University of NSW)

• Hepatitis B viral dynamics (in collaboration with Victorian Infectious Diseases Reference Laboratory, Hong Kong University and Los Alamos National Laboratories)

Ajantha Solomon and Fiona Wightman in the Infectious Diseases Laboratory

Department of Medicine at The Alfred

Other collaborators are: The Centre continues to be active in four iv) Development of quantitative • Department of Respiratory Medicine, principal areas of research: movement analysis tools for The Alfred i) Basic neurological studies in the ataxias inherited disorders of coordination These endeavours are progressing • Palliative Care Service, (ataxias) well, with support to two of our Peter MacCallum Cancer Institute This area is the most difficult, as this neurophysiology scientists via Alfred small project grants to develop and • Palliative Medicine Clinical Trials laboratory-based project refine the equipment, a BMedSci. Working Group, Cancer Council necessitated that we make our own student Mr Jason Wong collecting of Victoria reagents (monoclonal antibodies, recombinant proteins, etc.) before normative data, and a provisional • Palliative Care Unit, Flinders the planned experiments could be patent application filed on one of University performed. This work forms part of the tests. an NH and MRC program grant on Van Cleef Roet Centre for Nervous neurodegeneration headed by Renal Research - Professor Diseases - Professor Elsdon Storey Professor Colin Masters of the Napier Thomson The Van Cleef Roet Centre for Nervous University of Melbourne, and is also Clinical research projects are Diseases was created in September supported by NSV. Steady progress predominantly in the area of 1996, with the appointment of the first has been made, and initial results glomerulonephritis, vasculitis, Director, Professor Elsdon Storey. Base are supportive of our hypothesis of progression of renal disease, chronic recurrent funding for the Centre was differential regional proteolysis of the allograft rejection, evaluation of renal derived from income generated from the mutant proteins as the underlying disease in patients with end stage heart Van Cleef Foundation capital, which was explanation for the different and lung pathology facing heart or lung handed over to Monash University by neuropathological distributions of this replacement, and renal disease following the Van Cleef Trustees at that time. The group of diseases. If these findings successful heart and lung transplantation. Van Cleef Foundation itself had been are confirmed, the next step is Other projects concern evaluation of created over 30 years earlier, as the protease identification. This is hoped vascular access in patients on result of a bequest from Mr. Louis Roet to result in viable therapeutic targets. haemodialysis / haemofiltration for the establishment of a Centre of techniques in the management of Neuroscience at the Alfred Hospital, ii) Neuropsychological studies in acute renal failure. where Mr Roet’s own brain tumour had degenerative nervous diseases The broad theme of the laboratory been successfully treated. (particularly inherited ataxias) research program is the mechanisms of In this area, our NH and MRC progression of primary renal disease and The Van Cleef Roet Centre has a wide funded project on correlation of chronic renal allograft rejection. Both remit, including neurological research, neuropsychological changes in the human and experimental models of renal teaching and training in clinical inherited ataxias with genotype, disease and allograft rejection are neurosciences, and education of the quantitative MRI volumetry and studied, with particular focus on the role public in neurological diseases. quantitative movement analysis is of the fibrogenic growth factors and now in its second year, and The Centre is a part of Neurosciences apoptosis in progression of injury. proceeding well. Our Monash- Victoria (NSV), through its membership funded project on cognition in of Monash University Centre for Brain The unit has established a study group cardiac failure with Professor Henry and Behaviour. The Monash Node of on Type II Diabetic Nephropathy Krum should be completed this year. NSV is one of three nodes of Genetics, a database and DNA repository, and research will focus on Neurosciences Victoria, a state-wide iii) Delineation of previously genetic influences on progression of consortium of neuroscience researchers. undescribed neurogenetic diseases Van Cleef Roet Centre members are nephropathy. eligible to apply for NSV funds. So far Our description of the third novel A program of research in the area of Ms Renae Walsh has successfully form of cerebellar ataxia described renal ischaemia / reperfusion injury and applied for a PhD scholarship (2002- by our group has recently been evaluation of drugs to relieve this injury 2004 inclusive), and Professor Storey published, and we have also is being undertaken. The techniques of has received an $80,000 one year submitted data on a pedigree with a immunohistochemistry and molecular project grant for a potentially novel mutation causing a known biology - real time RT-PCR - are widely commercial project. ataxia (SCA 14). Our collaborators in this work have been from the applied to these studies and the At a collaborative level, our links with Murdoch Institute, Royal Children’s techniques have been highly refined. the Psychology Department at La Trobe Hospital. University continue, through shared research project applications and PhD students.

Department of Medicine at The Alfred

Funding in 2003 Postgraduate scholarship Westall, Australian Centre for HIV and G. Virological and immuno-logical Hepatitis Virology Research National Health and Medical dynamics of cytomegalovirus associated Development of in vitro models for Research Council of Australia chronic rejection in lung trans-plantation investigating the cellular toxicities of Project Grant. (now rolled into NHMRC $28,432 2003-2005 nucleoside analogues and the utility of Program Grant on HIV vaccines). Kent micronutrients in preventing these SJ, Purcell DFJ, Lewin SR. Determinants Postgraduate Medical and Dental toxicities. Cherry K. 2003-2004 of the clearance of HIV infected cells by Scholarship Morrissey, O. Invasive successful AIDS vaccines. $450,000. Aspergillosis in patients post CASS Foundation 2003-2006 haematopoietic stem cell transplantation Research Grant Stein-Oakley, A. Effect and in patients with acute leukaemia: Centre for Clinical Research Excellence of genetic variation in the TGF_1 gene Current epidemiology and methods of in Infectious Diseases, Victorian on the onset and progression of diabetic improving survival 2003-2006. Total Infectious Diseases Service, Royal nephropathy $26,728 2003 $120,000 Melbourne Hospital. Brown GV, Lewin SR, Sasadeusz J, Slavin M, Torresi J, Diabetes Australia National Institutes of Health Biggs BA, Campbell D, Rogerson SJ. Research grant Stein-Oakley, A. Effect of Pathogenesis of Macrophage Tropic Total grant support $2 million. genetic variation in the TGF_1 gene on HIV-1. P Gorry, SM Crowe, SR Lewin, 2003-2007 the onset and progression of diabetic D Purcell. The Burnet Institute and The nephropathy $30,000 2003 Practitioner Fellowship. Lewin SR. The Alfred Hospital. Total funding $300,000 Alfred Hospital and Monash University. USD. 2003-2005 $100,000 per year. Total funding Sci Com Biotech $500,000. 2003-2008 RO1 grant. McArthur J and Wesselingh Contract research Krum, H. Chronic S. HIV-sensory neuropathies: risk factors Heart Failure $89,808 2003 Research grant Wesselingh, and immunopathology. Total $2 million S. Development of improved vaccine USD. 2003-2007 Wellcome Trust Equipment grant strategies for measles using plant- Thomson, N. ABI Prism Sequence The Natural History and Virology of HIV- derived edible vaccines $330,375 $180,991 2001-2003 2002-2004 HBV co-infection. C Thio, SA Locarnini, D Thomas, SR Lewin, J Sasadeusz, Postgraduate scholarship Gahan, G Dore, D Cooper, E Seeger, Johnson & Johnson Pharma (USA) M. Development of vaccine strategies Z Goodman. Total funding 2.5 million Contract research Krum, H. Effects for measles and malaria using oral dollars. 2004-2009 of p38 MAPK inhibition following bacterial vectors and edible plant myocardial infarction in rats $46,820 2003 vaccines $19,659 2002-2004 National Heart Foundation Scholarship Calkin, A. Effects of Postgraduate scholarship Morrissey, cardiovascular disease in diabetes The Cancer Council Victoria O. Invasive aspergillosis: development $29,481 2003-2005 Data Management for Non-Commercially of a decision analysis strategy for early Sponsored Clinical Trials A/Professor M diagnosis and improved survival in Schwarz, Dr S Davis, A/Professor A Alfred Research Trust immuno-compromised patients $28,432 Schwarer Clinical Trials Management Scholarship Koutrouvelis, 2002-2004 Scheme $62,814 2003 K. Mechanisms of TRAIL action and Postgraduate scholarship Cherry, resistance in multiple myeloma C. Sensory neuropathy in HIV/AIDS $18,009 2003 Monash Research Grants $14,099 2000-2003 Zion, D. Finding ethical means of Research grant Thomson, compensation and conciliation. Postgraduate scholarship McWilliams, N. Mechanisms of progressive renal Interviewing participants involved in T. The effects of RAD on development of damage $20,000 2003 medical negligence claims and in bronchiolitis obliterans syndrome, airway mediation. $5,000 2003 inflammation and remodelling post lung Research Assistance for Cancer transplant $6,180 2002-2003 Research A/Professor M Schwarz Alfred O’Hehir, R. Immunoglobulin epsil. Research Trusts Funding (Peter Grant $25,916 2003 Postgraduate scholarship Martin, J. The Hay Trust) $35,000 2003 pathophysiology of heart failure in type II diabetes $33,850 2002-2004 Research grant Lewin, S. $40,000 2003

Postgraduate scholarship Thompson, Cora Brennan Trust Equipment Grant K. The role of astrocyte dysfunction in Equipment for PC2 and PC3 research the pathogenesis of HIV-associated laboratories. Lewin SR. $25,000. 2003 dementia $19,659 2002-2004

Department of Medicine at The Alfred

Funding for Clinical Trials Dr J Shapiro was awarded $800 by PhD opportunities Associate Professor M Schwarz was Eli-Lilly for his study - Phase II study of The Department of Medicine at The awarded $4,000 by ANZ BCTG for his gemcitabine integrated with concomitant Alfred Hospital is a centre for clinical and study - An intergroup phase III trial to 5-FU and 3-D conformal radiotherapy biomedical research and education, evaluate the activity of Docetaxel given for the treatment of localised pancreatic offering postgraduate study in either sequentially or in combination with cancer. Doxorubicin followed by CMF in • allergy, asthma and clinical comparison to Doxorubicin alone or in Dr J Shapiro was awarded $200 by immunology Aventis Pharma for his study - A combination with Cyclophosphamide • clinical pharmacology followed by CMF in the adjuvant multicentre phase III randomised trial • cardiovascular disease treatment of node positive breast comparing docetaxel administered either cancer patients. weekly or every three weeks in • ethics in medicine and society combination with prednisone versus • infectious diseases Associate Professor M Schwarz was mitoxantrone in combination with awarded $19,882 by BCIRG for his prednisone for metastatic hormone • neuroscience study - Randomised trial comparing refractory prostate cancer. • organ transplantation Docetaxel in combination with Doxorubicin and Cyclophosphamide vs Dr J Shapiro was awarded $800 by • renal disease Doxorubicin and Cyclophosphamide Orion Clinical Services for his study - • respiratory medicine Prospective randomized controlled followed by Docetaxel as adjuvant • rheumatology treatment of operable breast cancer double-blind multicentre study of G17DT HER2Neu negative patients with positive immunogen in combination with The Department also offers axillary lymph nodes (005). Gemcitabine vs placebo in combination postgraduate research programs for with Gemcitabine in previously untreated Masters of Biomedical Science, as well Associate Professor M Schwarz was subjects with locally advanced as honours programs for Bachelor of awarded $2,000 by Roche Products Pty (nonresectable stage II and III) recurrent Science, Bachelor of Biomedical Ltd for his study - An open-label disease following primary resection or Science and Bachelor of Medical randomized phase III study comparing metastatic (stage IV) adenocarcinoma of Science. Students perform the Xeloda (Capecitabine) with IV bolus the pancreas. coursework that is most relevant to their 5-Fluorouracil in combination with low- background and their field of research. dose leucovorin as adjuvant chemotherapy in patients who underwent surgery for Dukes C PhDs completed and colon cancer. passed in 2003 Associate Professor M Schwarz was Melissa Byrne awarded $1,550 by AstraZeneca for his Mark Timothy Coulson study - A double blind, placebo Felicity Meredith Dunlop controlled, parallel group, multi-centre, Bryce Nathan Feltis randomised, phase III survival study Shanhong Ling comparing Iressa (250mg tablet) plus Tanya Louise Medley best supportive care versus placebo Brindhesha Rasaratnam plus best supportive care in patients Andrew John Taylor with advanced NSCLC who have Glen Wiesner received one or two prior chemotherapy Maro Ramiz-Ibrahim Williams regimens and are refractory or intolerant Ling Zheng to their most recent regimen. Sharon Lewin joined the Department in 2003 as Professor-Director of Infectious Diseases, Dr J Shapiro was awarded $110.92 by replacing Professor Steve Wesselingh who now CancerVaxTM Corporation for his study - heads the Macfarlane Burnet Institute A phase III randomised double-blind pivotal trial of immunotherapy with BCG plus a polyvalent melanoma vaccine, CancerVax vaccine, versus BCG plus a placebo as a post-surgical treatment for stage III melanoma.

Department of Medicine at The Alfred

Tiffany Bamford Philip Ellery IL-13 and airway wall remodelling in Role of cells in the macrophage lineage asthma as a reservoir for human immunodeficiency virus type-1 (HIV-1) David Barton The neurobiology of depressive illness; Bryce Feltis monoaminergic function and Inflammatory cytokines in human mechanisms of cardiac risk asthma

Karen Berry Michelle Gahan The structural basis of arterial Development of vaccine strategies for compliance and its relationship to measles and malaria using oral bacterial cardiovascular outcome vectors and edible plant vaccines

Marco Bonollo David Godler Cytokine gene polymorphisms in IgA Rheumatism and arthritis glomerulonephritis Mark Coulson at his graduation with supervisor, Paul Gould Dr Alicia Stein Melissa Byrne Influence of electrophysiological Relationship between atrial arrhythmia disturbance on cardiovascular and renal and ventricular activity and function performance in heart failure

PhD Graduations in 2003 Anna Calkin Julie Gregg Anuradha Aggarwal Effects of cardiovascular disease in Plantar plate of the foot: dynamic Karen Louise Berry diabetes ultrasound imaging with x-ray and MRI Mark Timothy Coulson correlation, pre- and post-operatively. Catherine Cherry Felicity Meredith Dunlop Sensory neuropathy in HIV/AIDS Deanne Greenwood Bryce Nathan Feltis Autoimmune disease models Paul Thomas Martin Mark Coulson Tanya Louise Medley The effect of ischaemia on chronic renal Karen Holzer Brindhesha Rasaratnam damage in isografts and allografts Exercise-induced asthma in elite athletes Andrew John Taylor Glen Wiesner Tye Dawood Isabelle Hoong Maro Ramiz-Ibrahim Williams Affective disorders and their association Functional analysis of the enzyme HSD2 Ling Zheng with the cardiovascular system Zhongjun Huang Stephanie De Dios Plant derived vaccines: analysis of novel PhD students in the Effect of peroxisome proliferator delivery vehicles Department of Medicine activating receptor (PPAR)-gamma Ngan Huynh at The Alfred during 2003 ligands on vascular proteoglycan biosynthesis The role of endothelin and nitric oxide in Anna Ahimastos hypercholesterolaemia Effects of ACE-inhibition on walking Rachel Denver distance and endothelial function during Endothelin and inflammatory cytokines Susannah King exercise in patients with peripheral in patients with chronic heart failure and Metabolic and gastrointestinal influences arterial disease other cardiovascular diseases on nutritional status in cystic fibrosis

Belinda Ahlers Felicity Dunlop Karly Koutrouvelis L-arginine transport in humans Structural and functional studies of Mechanisms of TRAIL action and human aldosterone synthase (CYP11B2) resistance in multiple myeloma Rula Azzam Mechanisms underlying HIV-mediated Katrina Dunster Frank Lai inhibition of macrophage effector Characterisation of autoantigens Studies of function of EEA1 in functions implicated in protein trafficking genetically manipulated model systems

Mandy Ballinger Nina Eikelis Robert Lew Role of tyrosine kinases in controlling Investigation of the biology of Potential role of oestrogens in male glycosaminoglycan length of vascular adipocytes, brain and cardiac leptin and vasculature proteoglycans of the impact of leptin on the Mandy Lindsay sympathetic nervous system Pathophysiological role of nerve growth factor in arthritis

Department of Medicine at The Alfred

Shanhong Ling Fiona See Publications in 2003 Effects of oestrogen on the vasculature Role of transforming growth factor B1 Aksoy H, Dean G, Elian M, Deng HX, in cardiac remodelling Darren Mansfield Deng G, Juneja T, Storey E, Gardner Implications of sleep disordered Volga Tarlac RJM, Jacob RL, Laing NG, Siddique T. breathing in congestive heart failure Triplet repeat expansion disorders A4T mutation in the SOD1 gene causing familial amyotrophic lateral sclerosis. Caroline Marshall Andrew Taylor Neuroepidemiology 2003. 22: 235-238. Development of method for subtyping Platelet involvement in microvascular methicillin-resistant staphylococcus injury in acute coronary syndromes Aroni R, Sawyer SM, Abramson MJ, aureus and its use in the understanding Stewart K, Thien FCK, Goeman DP, of epidemiology and transmission Simon Teteris Douglass JA. Asthma self-management: dynamics of MRSA Apoptotic mechanisms of cultured what do we really mean? Australian renal cells Journal of Primary Health 2003. 9: Jennifer Martin 10-16. The pathophysiology of heart failure in Katherine Thompson type II diabetes The role of astrocyte dysfunction in Baker HW, Mijch A, Garland S, Crowe the pathogenesis of HIV-associated S, Dunne M, Edgar D, Clarke G, Foster Tanya McWilliams dementia P, Blood J. Use of assisted reproductive The effects of RAD on development of technology to reduce the risk of bronchiolitis obliterans syndrome, airway Renae Walsh transmission of HIV in discordant inflammation and remodelling post lung Does differing proteolytic susceptibility couples wishing to have their own transplant determine neuronal selectivity in children where the male partner is expanded polyglutamine tract diseases? seropositive with an undetectable viral Tanya Medley load. J Med Ethics. 2003 Dec; Glen Westall The genetic basis of large artery stiffness 29(6):315-20. Virological and immunological dynamics Solomon Menahem of cytomegalovirus associated chronic Birch C, Middleton T, Hales G, Cooper Apoptosis and its regulators in the rejection in lung transplantation D, Law M, Crowe S, Hoy J, Emery S. progression of IgA nephropathy Limited evolution of HIV Antiretroviral Anthony (Tony) White Drug Resistance-Associated Mutations Anne Mijch Large artery stiffness as a risk marker during the Performance of Drug Predicting and preventing virological and therapeutic target; structural and Resistance Testing. JAIDS - Journal of failure in HIV genetic aspects Acquired Immune Deficiency Syndromes C Orla Morrissey Glen Wiesner 2003. 32: 57-61. Invasive aspergillosis: development of The sympathetic nervous system and its Birch C, Middleton T, Hales G, Emery S, a decision analysis strategy for early role in regulating obesity and Law M, Crowe SM, Hoy J, Workman C, diagnosis and improved survival in thrombosis; and their CNS control Kelleher T, Cooper D. Evolution of HIV immunocompromised patients Dharshini Wignarajah antiretroviral drug resistance - Julie Nigro Remodelling of vasculature and matrix associated mutations during the Effect of lipid lowering agents on proteins in inflammatory airway performance of drug resistance testing atherogenic properties of human conditions J AIDS 2003;32:57-61. vascular smooth muscle cells Maro Williams Castiglione-Gertsch M, O’Neill A, Price Kylie O’Brien Pre-eclampsia - clinical and molecular KN, Goldhirsch A, Coates AS, Collins J, Chinese medicine: philosophical and studies of vascular function in changing Schwarz MA, et al : The International empirical intersections between Western hormonal state Breast Cancer Study Group For The and Chinese medicine paradigms Cancer Council of Victoria. Adjuvant Edwina Wright Chemotherapy followed by Goserelin Jennifer Philip The neuropathogenesis of HIV dementia versus Either Modality Alone for Examination of the cultural and ethical Premenopausal Lymph Node Negative core components of palliative care Alan Young Breast Cancer: A Randomized Trial, J Randomised controlled trial of non- Natl Cancer Inst., 2003, 95: 1833 - 1846. Brindi Rasaratnam invasive ventilation in cystic fibrosis Nitric oxide in the hyperdynamic patients with nocturnal desaturation Cherry CL, Kainer MA, Ruff TA. circulation of cirrhosis Biological weapons preparedness - Dong Cheng Zhang the role of physicians. (Invited review). Stephania (Leone) Roberts Apoptotic signalling and regulatory Internal Medicine Journal 2003; 33 (5-6) Evaluation of the safety and efficacy of mechanisms in glomerulonephritis p 242 - 253 foamed ultrasound guided sclerotherapy Ling Zheng Airway remodelling post-lung transplant

Department of Medicine at The Alfred

Cherry CL, McArthur JC, Hoy JF, de Dios ST, Bruemmer D, Dilley RJ, Ivey Gelber RD, Bonetti M, Castiglione- Wesselingh SL. Nucleoside analogues ME, Jennings GLR, Law RE, Little PJ. Gertsch M, Coates AS, Goldhirsch A, and neuropathy in the era of HAART. Inhibitory activity of clinical Schwarz MA, et al : The International J Clin Virol, 2003, 26(2): 195-207. thiazolidinedione peroxisome proliferator Breast Cancer Study Group For The activating receptor-_ ligands toward Cancer Council of Victoria. Tailoring Cherry CL, Wesselingh SL. Nucleoside internal mammary artery, radial artery, Adjuvant Treatments for the Individual analogues and HIV - the combined cost and saphenous vein smooth muscle cell Breast Cancer Patient. The Breast to mitochondria. (Invited leader) Journal proliferation. Circulation 2003. 107: 12:558 - 568, 2003. of Antimicrobial Chemotherapy 2003; 2548-2550. 51 (5), p 1091-1093 Hammond EL, Sayer D, Nolan D, Walker Douglass JA, O’Hehir RE. Emergency UA, de Ronde A, Montaner JSG, Cote Collman RG, Perno C-F, Crowe SM, treatment of asthma: how are we doing? HCF, Gahan ME, Cherry CL, Wesselingh Stevenson M, Montaner LJ. HIV and Internal Medicine Journal 2003. 33: SL, Reiss P, Mallal S. Assessment of cells of macrophage/dendritic lineage 401-403. precision and concordance of and other non-T cell reservoirs: new quantitative mitochondrial DNA assays: answers yield new questions. J Leuk Dunne AL, Mitchell F, Allen KM, Baker a collaborative, international quality Biol 2003; 74: 631-634 HW, Garland S, Clarke GN, Mijch A, assurance study. Journal of Clinical Crowe SM. Analysis of HIV-1 viral load in Virology 2003; 27 (1) p 97 - 110 Cooley L and Lewin SR. 2003. HIV viral seminal plasma samples. J Clin Virol. entry inhibitors. J Clin Virol 2003 Feb; 2003 Feb; 26(2):239-45. Haydon AM. Adjuvant chemotherapy in 26(2):121-32 colon cancer: what is the evidence? Elliott JH, Mijch AM, Street AC, Crofts Intern Med J., 2003 Mar; 33 (3): 119-24. Cooley L, Ayers A, Bartholomeusz A, N. HIV, ethnicity and travel: HIV infection Review. Lewin S, Crowe SM, Mijch A, Locarnini in Vietnamese Australians associated S, Sasadeusz J. Prevalence and with injecting drug use. J Clin Virol. Hill MK, Shehu-Xhilaga M, Campbell characterisation of LMV-resistant HBV 2003 Feb;26(2):133-42. SM, Poumbourios P, Crowe SM, Mak J. mutations in HIV and HBV co-infected The dimer initiation sequence stem-loop individuals. AIDS 2003; 17:1649-1657. Fairley CK, Levy R, Rayner CR, Allardice of human immunodeficiency virus type 1 K, Costello K, Thomas C, McArthur C, is dispensable for viral replication in Crivellari D, Price K, Gelber RD, Coates Kong D, Mijch A. Melbourne Adherence peripheral blood mononuclear cells. AS, Collins J, Goldhirsch A, Schwarz Group. Randomized trial of an Journal of Virology 2003. 77: MA, et al: The International Breast adherence program for clients 8329-8335. Cancer Study Group for The Cancer with HIV. Int J STD AIDS. 2003 Council of Victoria. Adjuvant Endocrine Dec;14(12):805-9. Holzer K, Anderson SD, Chan H-K, Therapy Compared With No Systemic Douglass J. Mannitol as a challenge Therapy For Elderly Women With Early Friis-Moller N, Sabin CA, Weber R, test to identify exercise-induced Breast Cancer: 21 year Results of d’Arminio Monforte A, El-Sadr WM, bronchoconstriction in elite athletes. International Breast Cancer Study Group Reiss P, Thiebaut R, Morfeldt L, De Wit American Journal of Respiratory and Trial IV, J.Clin.Oncol, 2003, 21: S, Pradier C, Calvo G, Law MG, Kirk O, Critical Care Medicine 2003. 167: 4517 - 4523. Phillips AN, Lundgren JD. Data 534-537. Collection on Adverse Events of Anti-HIV Crowe SM, Turnbull S, Oelrichs R, Drugs (DAD) Study Group. Combination Howden BP, Slavin MA, Schwarer AP, Dunne A. Monitoring of human antiretroviral therapy and the risk of Mijch AM. Successful control of immunodeficiency virus infection in myocardial infarction. N Engl J Med. disseminated Scedosporium prolificans resource-constrained countries. Clinical 2003 Nov 20;349(21):1993-2003. infection with a combination of Infectious Diseases (Supp. 2) 2003 37: voriconazole and terbinafine. Eur J Clin S25-S35. Friis-Moller N, Weber R, Reiss P, Microbiol Infect Dis. 2003 Thiebaut R, Kirk O, d’Arminio Monforte Feb;22(2):111-3. Crowe SM, Turnbull S, Oelrichs R, A, Pradier C, Morfeldt L, Mateu S, Law Dunne A. Monitoring of HIV infection in M, El-Sadr W, De Wit S, Sabin CA, Howden BP, Michaelides A, Spelman resource constrained countries. Clin Phillips AN, Lundgren JD. DAD study DW, Spencer A, Schwarer AP, Infect Dis (Supp 1):2003 37. S25-S35. group. Cardiovascular disease risk Wesselingh S, Kotsimbos TC. factors in HIV patients—association with Cytomegalovirus viral load monitoring Crowe SM, Zhu T, Muller W. The antiretroviral therapy. Results from the after allogeneic bone marrow contribution of monocytes to DAD study. AIDS. 2003 May transplantation in patients receiving persistence and trafficking in HIV 23;17(8):1179-93. antiviral prophylaxis. Bone Marrow infection. J Leuk Biol 2003; 74:635-641 Transplant. 2003 32(8):795-800.

Department of Medicine at The Alfred

Jenney A, Liolios L, Spelman D, Wilson Kotasek D, Steger G, Faught W, Mansfield DR, Solin P, Roebuck T, Bergin J, Wesselingh S, Kotsimbos T. Use of Underhill C, Shapiro J, et al. Aranesp P, Kaye DM, Naughton MT. The effect of pulsed field gel electrophoresis in Study Group. Darbepoetin alfa successful heart transplant treatment of infection control issues concerning administered every 3 weeks alleviates heart failure on central sleep apnoea. Burkolderia cepacia. Infection Control anaemia in patients with solid tumours American College of Chest Physicians and Hospital Epidemiology 2003; 24 (8) receiving chemotherapy; results of a 2003. 124: 1675-1681. 624-626 double-blind, placebo-controlled, randomised study. Europ J Cancer, Marshall C, Harrington G, Wolfe R, Kedzierska K, Azzam R, Ellery P, Mak J, 2003, (39): 2026-34. Fairley C, Wesselingh SL, Spelman D. Jaworowski A, Crowe SM. Defective Acquisition of methicillin resistant phagocytosis by human monocyte/ Krum H, Kompa A, Hannan R, Thomas staphylococcus aureus in a large macrophages following HIV-1 infection: W. Emerging role of the urotensin II intensive care unit. Infection Control underlying mechanisms and modulation system in cardiovascular disease. Heart and Hospital Epidemiology. 2003: 24, by adjunctive cytokine therapy. J Clin Drug 2003. 3: 153-158. 322-326 Virol 2003;26:249-245. Krum H, Liew D. Current status of McKenna MJ, Fraser SF, Li JL, Wang Kedzierska K, Churchill M, Maslin CLV, endothelin blockade for the treatment of XN, Carey MF, Side EA, Morton J, Snell Azzam R, Ellery P, Chan H-T, Wilson J, cardiovascular and pulmonary vascular GI, Kjeldsen K, Williams TJ. Impaired Deacon NJ, Jaworowski, A, Crowe SM. disease. Current Opinion in muscle Ca2+ and K+ regulation contribute Phagocytic efficiency of monocytes and Investigational Drugs 2003. 4: 298-302. to poor exercise performance post-lung macrophages obtained from Sydney transplantation. Journal of Applied Blood Bank cohort members infected Langham RG, Kelly DJ, Maguire J, Physiology 2003. 95: 1606-1616. with an attenuated strain of HIV-1. JAIDS Dowling JP, Gilbert RE, Thomson NM. - Journal of Acquired Immune Deficiency Over-expression of platelet-derived McWilliams TJ, Levvey BJ, Russell PA, Syndromes 2003. 34: 445-453. growth factor in human diabetic Milne DG, Snell GI. Interstitial nephropathy. Nephrology Dialysis pneumonitis associated with sirolimus: Kedzierska K, Crowe SM, Turville S, Transplantation 2003. 18: 1392-1396. a dilemma for lung transplantation. Cunningham AL. The influence of The Journal of Heart and Lung cytokines, chemokines and their Law M, Friis-Moller N, Weber R, Reiss P, Transplantation 2003. 22: 210-213. receptors on HIV-1 replication in Thiebaut R, Kirk O, d’Arminio Monforte monocytes and macrophages. A, Pradier C, Morfeldt L, Calvo G, El- Michaelides A, Facey D, Spelman D, Rev Med Virol 2003;13:39-56 Sadr W, De Wit S, Sabin CA, Lundgren Wesselingh S. Kotsimbos TC. HCMV JD; DAD Study Group. Modelling the DNA detection and quantitation in the Knight MA, Kennerson ML, Anney RJ, 3-year risk of myocardial infarction plasma and PBL of lung transplant Matsuura T, Nicholson GA, Salimi-Tari P, among participants in the Data recipients: COBAS Amplicor HCMV Gardner RJM, Storey E, Forrest SM. Collection on Adverse Events of Anti-HIV monitor test versus in-house quantitative Spinocerebellar ataxia type 15 (SCA15) Drugs (DAD) study. HIV Med. 2003 HCMV PCR. J Clin Virol. 2003 maps to 3p24.2-3pter: exclusion of the Jan;4(1):1-10 28(2):111-20. ITPRI gene, the human orthologue of an ataxic mouse mutant. Neurobiology of Lewin SR, Walters T and Locarnini. Munro PE, Bailey MJ, Smith JA, Snell Disease 2003. 13: 147-157. 2003. Hepatitis B viral dynamics. GI. Lung volume reduction surgery in Antiviral Research Sep;55(3):381-96 Australia and New Zealand. Chest 2003. Komiti A, Judd F, Grech P, Mijch A, Hoy 124: 1443-1450. J, Williams B, Street A, Lloyd JH. Liew D, Martin J, Krum H. Eplerenone Depression in people living with Pharmacia. Current Opinion in Murray JM, Kaufmann GR, Hodgkin PD, HIV/AIDS attending primary care and Investigational Drugs 2003. 4: 316-322. Lewin SR, Kelleher AD, Davenport MP, outpatient clinics. Aust N Z J Psychiatry. Zaunders JJ. Naive T cells are Mackay DA, Fingert JH, Luzhansky JZ, 2003 Feb;37(1):70-7. maintained by thymic output in early McCluskey PJ, Howell N, Hall AJ, Pierce ages but by proliferation without Kossmann T, Morganti-Kossmann MC, AB, Hoy JF. Leber’s Hereditary Optic phenotypic change after twenty. Orenstein JM, Britt WJ, Wahl SM, Smith Neuropathy triggered by antiretroviral Immunol Cell Biol. 2003 Dec;81(6): PD. Cytomegalovirus production by therapy for Human Immunodeficiency 487-495. infected astrocytes correlates with Virus (HIV). Eye, 2003, 17 (3): 312-317. transforming growth factor-_ release. Naughton MT. Cycling sleep apnoea - Mansfield D, Kaye DM, La Rocca HB, Journal of Infectious Diseases 2003. the balance of compensated and Solin P, Esler MD, Naughton MT. Raised 187: 534-541. decompensated breathing. American sympathetic nerve activity in heart failure Journal of Respiratory and Critical Care and central sleep apnoea is due to heart Medicine 2003. 168: 624-625. failure severity. Circulation 2003. 107: 1396-1400.

Department of Medicine at The Alfred

Naughton MT. Sleep disorders in Scheithauer W, McKendrick J, Begbie Thompson KA, Kent SJ, Gahan ME, patients with congestive heart failure. M, Burns WI, Burris HA, Cassidy J, Purcell DFJ, McLean CA, Preiss S, Dale Current Opinion in Pulmonary Medicine Jodrell D, Korelewski P, Levine EL, CJ, Wesselingh SL. Decreased 2003. 9: 453-458. Marschner N, Maroun J, Garcia-Alfonso neurotropism of nef long terminal repeat P, Tujakowski J, Van Hazel G, Wong A, (nef/LTR)-deleted simian Nelson MR, Reid CM, Beilin LJ, Donnan Zaluski J, Twelves C, Schwarz MA et al. immunodeficiency virus. Journal of GA, Johnston CI, Krum H, Storey E, X-ACT Study Group. Oral Capecitabine NeuroVirology 2003. 9: 442-451. Tonkin A, McNeil JJ. Rationale for a trial as an Alternative to iv 5-Fluorouracil- of low-dose aspirin for the primary based Adjuvant Therapy for Colon Trihia H, Murray S, Price K, Gelber RD, prevention of major adverse Cancer : Safety Results of a Coates AS, Collins J, Schwarz MA, et al: cardiovascular events and vascular Randomized Phase III Trial. Annals of The International Breast Cancer Study dementia in the elderly. Drugs and Aging Oncology, 2003, 14:1735 - 1743. Group For the Cancer Council of 2003. 20: 897-903. Victoria. Ki-67 Expression in Breast Sexton D, Spelman D. Current best Carcinoma : Its Association with Grading Oelrichs RB, Crowe SM. The molecular practices and guidelines. Assessment Systems, Clinical Parameters, and other epidemiology of HIV-1 in South and East and management of complications in Prognostic Factors - A Surrogate Asia. Current HIV Res 2003;1:239-248. infective endocarditis. Cardiology Clinics Marker? Cancer, 2003, 97 (5): 2003, 21 273-282 1321 -1331. Padiglione A, Wolfe R, Grabsch E, Olden D, Pearson S, Franklin C, Snell GI, Holsworth L, Borrill ZL, Tzanidis A, Hannan RD, Thomas WG, Spelman D, Mayall B, Johnson P, Thomson KR, Kalff V, Smith JA, Williams Onan D, Autelitano DJ, See F, Kelly DJ, Grayson ML. Risk factors for new TJ. The potential for bronchoscopic lung Gilbert RE, Krum H. Direct actions of detection of Vancomycin resistant volume reduction using bronchial urotensin II on the heart. Circulation enterococci in Acute Care hospitals prostheses. Chest 2003. 124: Research 2003. 93: 246-253. that employ strict infection control 1073-1080. procedures. Antimicrobial Agents and Warby T, Crowe SM, Jaworowski A. Chemotherapy 2003, 2492-2498 Solin P, Kaye DM, Little PJ, Bergin P, HIV-1 infection inhibits GM-CSF induced Richardson M, Naughton M. Impact of activation of STAT5A in human Read T, Mijch A, Fairley CK. Adherence sleep apnoea on sympathetic nervous monocyte-derived macrophages (MDM). to antiretroviral therapy: are we doing system activity in heart failure. American J Viro 2003;77:12630-38 enough? Intern Med J. 2003 May- College of Chest Physicians 2003. 123: Jun;33(5-6):254-6. 1119-1126. Wallgre A, Bonetti M, Gelber RD, Coates AS, Collins J, Schwarz MA, et al : The Reed C, Gorrie G, Spelman D. Hospital Solomon A, Cameron PU, Bailey M, International Breast Cancer Study Group Infection Control in Australia. Journal of Dunne A, Crowe SM, Hoy J, Lewin SR. For the Cancer Council of Victoria. Risk Hospital Infection 2003, 54, 267-271 Immunological and virological failure Factors for Locoregional Recurrence following antiretroviral therapy is Among Breast Cancer Patients: Results Reid DW, Street A, Mansfield D, Chin W, associated with enhanced peripheral from international Breast Cancer Study Cole-Sinclair M, Williams TJ, Snell GI. and thymic pathogenicity. J Infect Dis Group Trials I Through VII, J.Clin.Oncol, Microangiopathic haemolytic anaemia 2003; 187:1915-1923 2003 21 (7): 1205-1213. and thrombocytopenia following lung volume reduction surgery in a single Spataro VJ, Litman H, Viale G, Collins J, Westall GP, Michaelides A, Williams TJ, lung transplant recipient on maintenance Coates AS, Schwarz MA, et al: The Snell GI, Kotsimbos TC. Bronchiolitis tacrolimus (FK506) therapy. Respirology International Breast Cancer Study Group obliterans syndrome and early human 2003. 8: 243-245. For the Cancer Council of Victoria. cytomegalovirus DNA aemia dynamics Decreased Immunoreactivity for p27 after lung transplantation. Reid DW, Ward C, Wang N, Zheng L, protein in Patients with Early Stage Transplantation. 2003 75(12):2064-8. Bish R, Orsida B, Walters EH. Possible Breast Carcinoma is Correlated with anti-inflammatory effect of salmeterol HER-2/neu Overexpression and with Williams DR, Stark RJ. Intravenous against interleukin-8 and neutrophil Benefit from One Course of lignocaine (lidocaine) infusion for the activation in asthma in vivo. European Perioperative Chemotherapy in Patients treatment of chronic daily headache Respiratory Journal 2003. 21: 994-999. with Negative Lymph Node Status : with substantial medication overuse. Results from International Breast Cancer Cephalalgia 2003. 23: 963-971. Study Group Trial V. Cancer, 2003 97 Woods RK, Walters EH, Raven JM, (7): 1591-1600. Wolfe R, Ireland PD, Thien FCK, Tarlac V, Storey E. Role of proteolysis in Abramson MJ. Food and nutrient polyglutamine disorders. Journal of intakes and asthma risk in young adults. Neuroscience Research 2003. 74: American Journal of Clinical Nutrition 406-416. 2003. 78: 414-421.

Department of Medicine at The Alfred

Woolley IJ, Mijch AM, Carter VM, Archer Naughton M, Tuxen D. Acute respiratory B, Hoy JF. Anterior neck fat deposition failure in chronic obstructive pulmonary in lipodystrophy syndrome; a new disease. In: Oh’s Intensive Care Manual. variant on a theme? AIDS, 2003; Edited by Bersten AD and Soni, N. Pub. 17: 1857-8 Butterworth Heinemann (Elsevier Limited) 2003: pp297-308. Worth L, Street A, Elliot J, Anderson J, Lewin SR. A cautionary tale: fatal lactic Stellbrink HJ, van Lunzen J, Westby M, acidosis complicating nucleoside O’Sullivan E, Schneider C, Adam A, analogue and metformin therapy. Weitner L, Kuhlmass B, Hoffmann C, Clin Infect Dis. 2003. 37:315-6 Fenske S, Aries PS, Degen O, Eggers C, Petersen H, Haag F, Horst HA, Xiang S, Denver R, Bailey M, Krum H. Dalhoff K, Mocklinghoff C, Cammack N, Physiologic determinants of endothelin Tenner-Racz K, Racz P. Effects of concentrations in human saliva. Clinical interleukin-2 plus highly active Chemistry 2003. 49: 2012-2019. antiretroviral therapy on HIV-1 replication and proviral DNA (COSMIC trial). (S Books/Book chapters Crowe, Ed) 2003. Best of AIDS, Gorry PR, Sonza S, Kedzierska K, Lippincott Williams and Wilkins, London. Crowe S. Isolation of human S107-108. immunodeficiency virua type 1 from peripheral blood monocytes. (Zhu T, Ed) Thomson NM, Haist SA, Robbins JB. 2003. Human Retrovirus Protocols (eds). Internal Medicine on Call 2nd Volume 1: Virology and Molecular Edition (Australian edition). 2003. Biology. Humana Press, USA. McGraw-Hill ISBN 007-47-1035-4.

Krum H, Martin J, Haas S, Gilbert R. Metabolic comorbid conditions in chronic heart failure: Diabetes and hypercholesterolaemia. In: Heart Failure Updates. Edited by McMurray JJV and Pfeffer MA. Pub. Martin Dunitz - Taylor and Francis Group plc, London UK 2003: pp35-57.

Lewin SR and Hoy JF (editors). 2003. HIV Management in Australasia. Australasian Society of HIV Medicine.

Ling B, Veazey RS, Luckay A, Penedo C, Xu K, Lifson JD, Marx PA. SIV (mac) pathogenesis in rhesus macaques of Chinese and Indian origin compared with primary HIV infections in humans. (S Crowe, Ed) 2003. Best of AIDS, Lippincott Williams and Wilkins, London. S105-107.

Martinez MA, Gutierrez A, Armand-Ugon M, Blanco J, Parera M, Gomez J, Clotet B, Este JA. Suppression of chemokine receptor expression by RNA interference allows for inhibition of HIV-1 replication. (S Crowe, Ed) 2003. Best of AIDS. Lippincott Williams and Wilkins, London. S103-104

Department of Medicine at Box Hill

Head Debbie S Leach Research Nurses Hatem H Salem MB ChB MD MRCP MRCS Gabriele Liberatore Jacqueline S Barrett FRACP FRCPA Kim Lim Anne F Buckland Sylvia Su-Wei Lim-Tio Susan M Fawcett RN RM Personal Assistant Paul MacCory FRCPA Prue M Freeman Jennifer Saravanamuttu Andrew V Maclean Cherriyl M Gillzan RN RM NICU Lawrence Moran MBBS MRCP FRACP Shanne J Kast Business Manager Sanjay Nandurkar MBBS FRACP Isobel Marshall Gillian Holley BBusMgt GradDipAcc Mark Patrick Debra V McCall AFAIM AHRI Glennys Powell Thilagvathy Nagalingam BN CCN David J Rose FRCPA Joanne O Phillips RN Administration staff Michael Rowe FRCPA Lesley Poulton RN RM BNursing Margaret K Abbott William F Ryan FRCPA Zofia Ross RN Midwife BNursing Simone Braund Dilek Saylik CertCCU/ICU Janet Calder Malcolm Steel Irina Shinkarsky Bradley P Mander Vincent Strangis BSc (Hons) Miniver Che Wan Siah Nina Petropoulos Patricia Taylor Rosemary R Snell Rhonda J Prince Frank Thien FRCPA Rowena M Stewart Anna M Pugliese Michael Tong Gillian A Syres RN BA Jan Stephens David Williamson PhD GDipAdvNursingPractice Susan A Varley RN BA GDipCCU Technical Officer Research staff Fiona J Page Principal Research Fellow Post Graduate students Shaun Jackson MBBS (Hons) BMedSc Belinda Abbott BSc (Hons) Technical Assistants (Hons) PhD Denison Chang Carolina Chavez Emily Chen BBiomedSci Linda Wang Senior Research Fellows Lovisa Dousha BSc Paul B Coughlin PhD FRCPA Silva Douzmanian Academic staff Robert L Medcalf BSc (Hons) PhD Mark Frazzetto Professors Isaac Goncalves BSc (Hons) Christopher Bladin FRCPA Research Fellows Claire E Hirst Peter Gibson MBBS (Hons) MD FRACP Susan L Cranmer BSc (Hons) PhD Corinne Hitchen Michael Grigg MBBS FRACS Anthony E Dear MBBS (Hons) PhD Melissa L Holdsworth Yean Leng Lin FRCPA Sharon L Forsyth BSc (Hons) PhD Anita J Horvath BSc (Hons) Mariko E Howlett Sally L James Associate Professors Jane G Muir BSc (Hons) PhD GDipDiet Swaroop Manjunath Joseph J McKendrick MBBS MD FRACP Anil Radhakrishnan Mhairi J Maxwell BSc (Hons) Gishel New MBBS PhD FRACP FACC Simone M Schoenwaelder PhD Melinda A Missen BSc (Hons) John Rasa Nicola P Robinson Graham T Schmidt MBBS MRCP FRCP Research Officers Mythily Sachchithananthan FRACP Karen Anderson PhD BScBiomed (Hons) Daniel P Bruce Andre L Samson Senior Lecturers Varuni S Kanagasundaram Susan J Shepherd Timothy J Humphery Suhasini Kulkarni BSc (Hons) PhD Eunice Yang Henry Kranz FRCPA Stephen J McMaugh Michael Leyden MBBS FRACP FRCPA Warwick S Nesbitt BSc (Hons) PhD Kam Narayan MBBS MD MRCP FRACP Stan Stasinopoulos MSc PhD Harvey Newnham MBBS FRACP PhD May-Ling Wong MBBS FRACP Phillip Parente Cindy Yap BA BSc (Hons) PhD Richard W Simpson BMedSc DM Oxon Hong Yu Medical Degree China PhD FRACP FRCP Yu-Ping Yuan BSc PhD

Lecturers Research Assistants Raymond J Buttigieg MBBS FRACP Penelope AF Ball Niall F Cain FRCPA Kate M Fernandez Daniel Castelino Anna Harvey BBiomedSc (Hons) SPFS Jacquie Chirgwin Hilary Hoare Rowan Doig FRCPA Hong Bin Liu David Ernest Melinda A Missen BSc (Hons) Paul Fogarty FRCPA Be’eri Niego Rosemary Genovese Inna Pikovski BSc (Hons) Deborah Hedger Ourania Rosella BSc (Hons) DipEd Terrie-Anne Hinds BSc Shannon Turnbull Philip James FRCPA David John Kenner Geoffrey D Kerr FRCPA

Department of Medicine at Box Hill

chromosome 12F1. The murine locus Centerin: a serpin expressed The Department of contains an orthologous cluster of serpin in lymphoma Medicine at Box Hill and genes in which two members, Another member of the ‘A’ clade serpin corresponding to α1-antitrypsin and α1- cluster is the germinal centre cell- the Australian Centre for antichymotrypsin, have undergone specific protein, centerin. Preliminary Blood Diseases contribute dramatic expansion. We have examined investigations by other investigators to the teaching of the organization of the human and have shown that this is not expressed in undergraduates of the murine ‘A’ clade clusters making use of any other tissues but it is markedly their recently completed genomes upregulated in B-cell lymphomas. We Faculty of Medicine, sequences. One of the most surprising have cloned the gene for this protein Nursing and Health outcomes of this analysis was that and have produced a recombinant Sciences at Box Hill human α1-antichymotrypsin is protein. Ongoing studies are evaluating Hospital, as well as represented by 14 genes in the mouse. the role of centerin in normal B-cell While these genes appear to have development and investigating its conducting an extensive conserved elements indicating they will usefulness in the diagnosis and research program which make functional proteins, they are management of lymphomas. provides opportunities for divergent within the specificity- New members of the serpin ‘A’ postgraduate studies. determining reactive loop. Using gene- specific PCR we have studied the clade cluster expression pattern of the murine α1- In addition to the known members of antichymotrypsin-like proteins. We have the ‘A’ clade cluster we noticed two also cloned several members of this members of the family which had not group and analysed their biochemical previously been studied. One of these Current research programs of the and biophysical properties. Recently, we (SERPINA12) has been described in rat Department include: have crystallized one of the serpins, adipose tissue and is upregulated in diabetes. The other new gene is • Australian Centre for Blood Diseases EB22.4 and obtained a high resolution structure which gives important insights SERPINA11 and is expressed in fetal • The Serpins Biology Group into its inhibitory mechanism. liver. We are currently developing studies • Fibrinolysis and Gene Regulation on these proteins to define their normal Laboratory One of the murine α1-antichymotrypsin- roles and investigate whether they are like group, serpin2A, is primarily involved in human disease. • Platelet/Leukocyte Biology and expressed in primitive haemopoietic Signalling Laboratories stem cells and activated T-cells. We α2-antiplasmin: a key regulator of • Gastroenterology Research Unit have produced a recombinant version of clot dissolution We are currently developing new • Eastern Clinical Research Unit serpin2A and examined its biochemical properties with a view to defining its role research in the area of fibrinolysis (clot of serpins in regulating the growth and dissolution). A major problem in the Research differentiation of haemopoietic management of patients with deep vein Serpin biology group progenitors. We have also investigated thrombosis is long term pain, swelling - Dr Paul Coughlin the expression patterns of other and ulceration in the legs. The standard The evolutionary success of serpins members of the serpin family and their approach to treatment of these marks them as a very special group of cognate proteases in human bone disorders is the use of anticoagulants proteins. Their name is an acronym marrow and peripheral blood cells. The because clot dissolving agents often derived from the best known feature of long-term aim of this work is to give cause an unacceptable risk of serious the family, serine protease inhibitor. new insights into the control of blood bleeding. There is a need for therapeutic Over 800 serpin genes are present in cell development. agents which promote clot dissolution sequence databases from prokaryotes, without significantly increasing the risk of plants, simple multicellular animals and haemorrhage. A member of the serpin mammals. The human genome alone contains 35 serpin genes.

Serpin gene duplication and functional diversity The focus of research in our laboratory has been on the biological role of members of the serpin superfamily of proteins. Much of this research has involved the ‘A’ clade cluster of serpins on human chromosome 14q32.1 and the syntenic region on mouse

Department of Medicine at Box Hill

family, α2-antiplasmin is the major promote neurodegeneration. Therefore, thereby reducing the ability of the host inhibitor of the clot dissolving enzyme, our research impacts directly into the to remove blood clots. One project we plasmin. Although this protein has been areas of neurobiology and neuro- are undertaking addresses the molecular known for a long time remarkably little is pathophysiology. Figure 1 provides a mechanism behind TNF-mediated known about its precise mechanism of schematic overview of the plasminogen suppression of t-PA transcription in action or regulation. We are therefore activating system. endothelial cells. We are examining the investigating recombinant α2- regulatory domains within the t-PA antiplasmin using X-ray crystallography Our laboratory is interested in the promoter to identify the control and domain-specific antibodies to molecular and cellular biology of this sequences that are needed to convey facilitate production of new therapeutic system. Most of our efforts are focused TNF-mediated suppression to the t-PA agents which will allow modulation of on the regulation of expression of its gene promoter. In addition to these the fibrinolytic system. individual components at the levels of approaches, we are exploring post- transcription, mRNA accumulation, and transcriptional regulation of the t-PA Research in the Serpin Biology Group is protein production. We have also gene by TNF and other agents, complemented by active collaborations initiated a study into the role of the including PMA. with members of Monash University plasminogen activating system Department of Biochemistry and (particularly t-PA) in the central nervous t-PA gene regulation in vivo Molecular Biology and the Stem Cell system and we are evaluating novel Transgenic mice provide a means to Group at Peter MacCallum Cancer thrombolytic agents that lack the assess the in vivo expression pattern Institute. neurotoxic features characteristic of directed by defined sequences of gene t-PA. One such agent in the highly fibrin- promoters. Transgenic mice and rats The Fibrinolysis and Gene Regulation specific plasminogen activator is found expressing 9.5 kb of the human t-PA Laboratory - Dr Robert Medcalf in the saliva of the common vampire bat. promoter fused to a reporter gene (9.5 The Plasminogen Activating system tPALacZ) have been used to visualise t- The removal of blood clots from the PA promoter directed expression in vivo. circulation and the turnover of We previously showed that the 9.5 kb extracellular matrix proteins is facilitated human t-PA promoter directs high level by specialised enzymes. One of the reporter gene expression in discrete most important enzymes in this setting areas of the brain including the limbic is plasmin. Plasmin performs many region, hippocampus, the superior functions, but it is generally accepted colliculis and cerebellum. The expression that its primary role is to degrade fibrin, pattern in the brain was reproducible the structural scaffold of a blood clot. and consistent with the expression Regulation of tissue-type plasminogen The generation of plasmin from its pattern of the endogenous mouse (and activator gene expression in vitro: inactive precursor plasminogen is human) t-PA gene. We are now using The activation of plasminogen by t-PA is mediated by serine enzymes known as these mice to look more closely at how the principle means by which plasmin is tissue-type plasminogen activator (t-PA) the t-PA gene is regulated in neuronal generated in the circulation. Many and urokinase (u-PA). The proteolytic cells following treatment with agents that agents influence the transcriptional activity of t-PA and u-PA is in turn promote neurodegeneration. control of the t-PA gene, most notably regulated by specific protease inhibitors: cytokines and growth factors. Indeed, Figure 2 shows the pattern of plasminogen activator inhibitor (PAI)-1 one particular agent (Phorbol ester expression directed by the human t-PA and PAI-2. A specific cell surface [PMA]) has been shown to either induce gene promoter in the mouse brain. receptor for u-PA also exists which not or repress t-PA depending on the cell Panels i and ii show Dorsal ventral only provides a means of generating type. We are interested in determining views, respectively of transgenic mice localised proteolytic activity in the the molecular basis for this opposite expressing the LacZ reporter gene pericellular environment, but with the regulation as this might shed light on controlled by 9.5 kb of the human t-PA help of adjacent transmembrane how the t-PA gene is regulated. We are gene promoter. Blue-green colouration proteins, can transmit signals to the cell also interested in determining how indicates regions of reporter gene nucleus and influence the expression cytokines regulate t-PA gene expression. expression on the brain surface. For pattern of other genes. The plasminogen One particularly important cytokine in comparative purposes, panel iii shows a activating system also actively this setting is the inflammatory mediator, dorsal view of a transgenic line participates in cell movement, wound tumour necrosis factor (TNF). High levels expressing the LacZ reporter gene healing and the metastatic spread of of TNF in the blood are associated with driven by only 1.4 kb of the human t-PA cancer. There is now clear evidence that the development of thrombosis and in promoter that does not show reporter the plasminogen activating system this context, addition of TNF to gene expression. Coronal sections of contributes to the turnover of the endothelial cells results in a marked the brains of transgenic mice expressing extracellular matrix in the central nervous suppression of t-PA production. Hence it 9.5 kb of the t-PA promoter were cut system. For example, t-PA has been follows that the means by which TNF and stained for reporter gene expression shown to play a role in cognitive can promote thrombosis occurs, at least (Figure 2, panel iii). As shown, LacZ memory, visual processing, and can in part, by switching off the t-PA gene, staining is directed to discrete regions of

Department of Medicine at Box Hill

Fig 2 To assess the role of PAI-2 using THP-1 monocytes Not all cells express PAI-2, but those that do exhibit a similar PAI-2 expression profile. There is however, one notable exception: in THP-1 monocytes, the PAI-2 gene is mutated and PAI-2 protein cannot be produced. The availability of the THP-1 cell line has allowed us to explore aspects of PAI-2 biology which were previously difficult to assess. We have recently stably introduced the fully functional PAI-2 into THP-1 cells and we are using these cells to explore the influence of PAI-2 on monocyte biology. Results to date have shown that the presence of PAI-2 in these cells alters the rate of cell proliferation. Microarray data have further shown that the presence of PAI-2 alters the expression pattern of a number of other genes. Therefore, PAI-2 can also modulate cell behaviour by influencing or reprogramming gene expression patterns. We are looking more closely at the PAI-2 responsive target genes to determine how PAI-2 alters their pattern of expression. We are also interested in determining whether PAI-2 alters the gene expression pattern on other cell systems.

The regulation of metastatic disease the brain. Panel iv shows a magnified 2. The PAI-2 gene is one of the most by novel compounds region of the area outlined in panel iv responsive genes known: for The metastatic ability of tumour cells is showing more clearly the areas example, the PAI-2 gene is the most dependent to a large extent on their expressing the reporter gene: H prominently induced gene in ability to generate localised proteolytic (hippocampus); DG (dentate gyrus); MH fibroblasts treated with the activity to facilitate cell migration. Much (medial habenula). Scale bar in panel i = inflammatory mediator, tumour evidence has indicated that u-PA is 5 mm; Scale bar in panel v = 2.5 mm necrosis factor (TNF). critical for this activity. Indeed, many Regulation of the plasminogen Our laboratory recently demonstrated clinical studies have shown that tumours activator inhibitor type 2 gene that the PAI-2 gene is impressively with high levels of u-PA are more – Post transcriptional regulation of PAI- regulated at the level of PAI-2 mRNA aggressive and display a greater degree 2 gene expression stability. We have identified a number of of metastasis than tumour with low levels We have devoted much effort to sequences within the PAI-2 3’-UTR as of u-PA. Furthermore, animal studies elucidate the molecular mechanisms well as in the coding region that provide have demonstrated that alteration in underlying the regulation of the PAI-2 binding sites for cellular factors that u-PA activity either by decreasing gene. We have been particularly appear to influence the decay rate of expression of u-PA itself, or alternatively interested in the biology and regulation PAI-2 mRNA. Two of these mRNA by increasing expression of u-PA of PAI-2 for a number of reasons: binding proteins have been identified inhibitory agents (e.g. PAI-2) can alter the metastatic potential of certain cancers. 1. PAI-2 is an unusual protease inhibitor (“HuR” a known mRNA stabilising protein; and tristetraprolin [TTP] an since it resides intracellularly, yet its We have described a novel compound mRNA destabilizing protein) and work is targets are located extracellularly. that has the ability to suppress u-PA underway to define the role of these This suggests that PAI-2 may have activity by two mechanisms: directly factors in the control of PAI-2 mRNA an intracellular function independent suppressing u-PA expression and metabolism. We are also using a of the inhibition of u-PA. In fact, two simultaneously increasing expression of proteomics approach to identify other laboratories have provided evidence its natural inhibitor, PAI-2. We are now novel mRNA binding proteins. for a role for PAI-2 as an inhibitor of using animal models of metastatic apoptosis. cancer to explore the therapeutic potential of this agent.

Department of Medicine at Box Hill

Functional effects of the prothrombin effects of a plasminogen activator response must be tightly regulated to G20210A gene polymorphism derived from the saliva of the common ensure that the formation of a blood clot We have been investigating the vampire bat (Desmodus rotundus). This is of sufficient size to seal off the functional consequences of a G to A substance, known as DSPA (Desmodus damaged area, preventing blood loss, polymorphism at position 20210 in the rotundus Salivary Plasminogen Activator) whilst not disrupting blood flow to vital prothrombin gene. Prothrombin is a is far more fibrin selective than t-PA and organs by causing vessel occlusion. critical enzyme required for the hence more clot specific. We have also Unfortunately, the consequences of generation of fibrin from fibrinogen. shown that DSPA does not display the abnormal platelet regulation are seen all Individuals carrying this polymorphism neurotoxic effects seen with t-PA. DSPA too frequently in the clinical setting, with have increased levels of prothrombin in therefore holds much promise as a new the incidence of cardiovascular related the blood and an increase in the plasminogen activator for stroke patients. diseases such as heart attack and incidence of venous thrombosis. We stroke, remaining some of the major have evidence to suggest that the Platelet/Leukocyte Biology and causes of death in the western world increase in plasma prothrombin levels Signalling Laboratories today. Therefore, it is important to gain a in individuals carrying the A allele - Dr Shaun P Jackson comprehensive understanding of the prothrombin variant promotes a The organs and tissues that make up processes performed by platelets that pro-thrombotic state which precipitates the human body rely on a continual participate in vessel wall maintenance, the increased incidence of venous supply of blood, which is circulated as this knowledge may have important thrombosis. throughout the body via a complex implications for the future development series of arteries, veins, and capillaries. of novel antithrombotic strategies. The mechanism(s) whereby G20210A This blood not only carries vital oxygen polymorphism leads to elevated Leukocytes are nucleated white blood and nutrients to the tissues, as well as prothrombin is unknown but its location cells (WBCs) that are formed from stem removing carbon dioxide and other in the 3’-untranslated region (3’-UTR) cells in the bone marrow, and defend waste products, but it is also a vehicle immediately preceding the poly (A) tail of the body against infecting organisms for various blood cells, including PT mRNA suggested that it may and foreign agents. The interaction of platelets and leukocytes, which play key influence PT mRNA stability, processing these WBCs with platelets at sites of roles in the maintenance of blood vessel or protein translation. Our preliminary in vascular injury has been found to play a integrity. The main focus of the Platelet vitro experiments have indicated that critical role in the inflammatory and Leukocyte Biology Laboratories is cDNA expression vectors containing A responses associated with vascular to identify the mechanisms regulating allele variant of prothrombin produce at diseases such as atherosclerosis. The blood vessel injury and repair, with least three-fold more prothrombin in recruitment of leukocytes, in particular particular emphasis on the role of blood stably transfected cells compared to monocytes, to vessels is a key step in platelets and leukocytes in these cells expressing the G allele counterpart the initiation of atherosclerosis, and processes. and this certainly involves changes in the circulating activated platelets and post-transcriptional expression pattern platelet-monocyte aggregates have also of prothrombin. We are presently using a been shown to promote the formation proteomics approach to identify the of the atherosclerotic lesion. Monocyte- cellular factors that influence platelet interaction have also been prothrombin mRNA expression. associated with vascular lesions that re-develop as a consequence of The Role of t-PA in the central mechanical injury from balloon nervous system angioplasty and stenting, which are In addition to its well known role as a both currently used for the treatment of fibrinolytic agent, t-PA also plays a vascular disease and vessel occlusion. previously unsuspected role within the Therefore, a better understanding of the central nervous system (CNS). In this leukocyte-platelet interaction, and the compartment, t-PA plays a positive role consequence of this interaction to vessel under normal conditions as it participates maintenance, is fundamental in order to in neuronal plasticity and memory better understand the progression of formation and also plays a role in stress- vascular disease. induced anxiety. Under conditions of neuronal injury, the presence of t-PA Our laboratories have established state- intensifies the degree of cell death of-the-art in vitro and in vivo models to indicating a negative effect of t-PA under examine interactions of circulating blood Platelets are small blood cells produced these conditions. We are presently cells with vessel wall components during by megakaryocytes. In the event of attempting to determine the means by hemostasis and inflammation. There are blood vessel injury, these tiny blood cells which t-PA is neurotoxic. This has numerous projects utilising transgenic are rapidly recruited to the area of important implications in patients with mouse models to examine signalling damage, where they spread and form a ischaemic stroke. In this context, we stable thrombus (blood clot). This have been evaluating the neurotoxic

Department of Medicine at Box Hill

pathways regulating platelet and PI 3-kinase Signalling and Ras Family Small GTPases and leukocyte function. Specific areas of Platelet Function Platelet Function - Dr Simone study throughout 2002-2003 have One signalling pathway important in the Schoenwaelder, Mr Shannon Turnbull, included: activation and regulation of many Ms Akiko Ono, Ms Karen Boniface, Ms Signal Transduction and Platelet platelet responses involves the enzyme Megha Mulchandani Function: Calcium Flux and Platelet phosphatidylinositol 3-kinase (PI3- The major platelet integrin αIIbβ3 is Activation - Dr Warwick Nesbitt kinase) and its lipid products. fundamental in the physiological process A major focus of the group is the of haemostasis and is also implicated in i) A Role for PI 3-kinase in Platelet pathological thrombosis. Recent investigation of calcium signalling Function - Dr Cindy Yap mechanisms governing platelet adhesion evidence from our laboratory and others and activation at the surface of The ability of platelets to adhere to has implicated members of the Ras thrombogenic protein matrices. We have inured vessels under conditions of family of small G-proteins, Rap1b and developed a number of blood flow is dependent on two RhoA, as critical enzymes controlling the microscopy/imaging based assays that major platelet surface receptors, promotion of integrin activity. Our studies enable us to quantitatively measure however the mechanisms by which have demonstrated for the first time that changes in platelet calcium they trigger platelet activation remain the activation of RhoA downstream of concentration within flowing blood. This poorly defined. Using state-of-the-art integrin αIIbβ3 is responsible for advance in platelet calcium imaging has technology developed in the maintaining stable adhesion of platelets, enabled us to elucidate distinct laboratory, Dr Cindy Yap has particularly under conditions of blood signalling mechanisms responsible for examined the role of a ubiquitous flow. This effect is achieved through the activation of the major platelet enzyme known as phosphoinositide modulation of integrin stability itself, 3-kinase (PI3K) in regulating platelet rather than regulation of the platelet integrin αIIbβ3, during platelet adhesion. These studies have demonstrated that activation. Dr Yap discovered a novel interaction with vWf, or initial activation the efficiency by which calcium signals role for PI3K in regulating platelet of the integrin. In further studies that are are propagated within platelet activation under flowing conditions, ongoing, we are investigating preliminary aggregates plays an important role in and demonstrated that inhibiting the evidence demonstrating the existence of dictating the rate and extent of action of this enzyme prevents distinct yet cooperative roles for both thrombus growth. Ongoing studies are platelets from becoming activated RhoA, and another Ras family member, aimed at elucidating the molecular normally. This finding has formed the Rap1b, in regulating integrin αIIbβ3 mechanisms governing platelet calcium basis for the development of a new adhesive function. signal transduction. class of anti-clotting drugs which are currently under development in Platelet Morphology Regulation of Platelet-Fibrinogen Victoria. - Ms Mhairi Maxwell Interactions - Mr Isaac Goncalves, Within the normal circulation, platelets Dr Sascha Hugan ii) Identification of Lipid Binding exist in a resting flat, discoid Fibrinogen is an important adhesive Proteins Participating in the PI 3- morphology. However, in the event of protein involved in platelet function. kinase Signalling Pathway - blood vessel injury, platelets undergo a Platelets bind to fibrinogen during blood Dr Karen Anderson, Dr Steve dramatic ‘activation’ process that clot formation, via a glycoprotein (GP) McMaugh, Ms Penelope Ball involves rapid morphological changes, becoming spherical and extending receptor GPIIbIIIa, also known as the The exact mechanism by which membrane projections called filopodia. major platelet integrin αIIbβ3. Delineation PI3-kinase and its products regulate These changes alter the dynamics of of the signalling mechanisms that platelet responses is unclear. We are platelet behaviour, potentially influencing regulate platelet-fibrinogen interactions is investigating platelet PI3-kinase platelet-platelet interactions, as well as one major focus of our ongoing studies. signalling, through the identification platelet-vessel wall interactions. We are In recent work, using mice deficient in and characterisation of novel platelet investigating the signalling mechanisms the enzyme phospholipase C_2 (PLC_2), proteins that bind to PI3-kinase lipid involved in platelet morphological change our studies have identified an important products, to define what role these using various pharmacological inhibitors role for this enzyme in integrin _IIb_3- proteins play in platelet PI3-kinase in combination with physiological in vitro dependent calcium flux, necessary for dependent functions relevant to flow based assays developed in our lab. stable platelet adhesion and spreading hemostasis, thrombosis and other We are also undertaking experiments on fibrinogen. Furthermore, our studies pathological states. establish an important cooperative involving intravital microscopy signalling role for PLC_2 and the techniques, which allow us to image nucleotide ADP in regulating platelet thrombus formation occurring in vivo in adhesion efficiency on fibrinogen. real-time. These studies will help to identify the functional significance of platelet morphological changes during the formation of blood clots.

Department of Medicine at Box Hill

Regulation of Platelet Surface consequences of sP-selectin on advanced atherosclerotic lesions Reactivity - Dr Suhasini Kulkarni neutrophil activation and interaction with contribute significantly to the increased Following their initial adhesion to the platelet monolayers, during flow reactivity of these plaques. Despite the injured vessel, activated platelets provide mediated adhesion. The overall rationale potential importance of collagens in a highly reactive surface for the of the project being to determine the regulating the process of blood clot recruitment of additional platelets, consequences of sP-selectin in vivo and formation, there is still limited insight into leading to platelet aggregation. While ultimately determining whether their role in the body. There are a large much is known regarding the factors modulating sP-selectin in vivo with novel number of potential receptors for promoting platelet surface reactivity, the compounds would be beneficial in collagens on the platelet surface, mechanism(s) by which platelet surface vascular disease. however the GPVI receptor was recently reactivity is downregulated remain poorly shown to play a major role in supporting understood. Using state-of-the-art Structure-function analysis of Platelet blood clot formation on collagen technology, our laboratory has Surface Receptors: surfaces. This receptor is only established a confocal based assay that A Role for the GPIb/V/IX -Filamin expressed in the presence of the FcR allows the visualisation of calcium Interaction - Dr Sue Cranmer, Dr Pierre γ-chain, which forms the signalling dynamics in platelets adhering to vessel Mangin, Ms Teresa Domagala, element of the GPVI/FcR γ complex. wall substrates under physiologically Ms Inna Pikovski Using mice deficient in the expression of relevant perfusion conditions. Using this The platelet glycoprotein (GP)Ib/V/IX the GPVI/FcR γ complex (FcR γ-chain technique Dr Suhasini Kulkarni has receptor complex plays a major role in knockout mice), Dr Cindy Yap has been identified a novel role for calcium and promoting platelet adhesion and studying the importance of the the calcium-dependent clotting factor, thrombosis, and as such, has become a GPVI/FcR γ complex in regulating the FXIII, in regulating the adhesive function major target for the development of formation of occlusive blood clots. Dr of platelets. Specifically she has found a novel anti-clotting drugs. The Yap established two in vivo mouse novel mechanism for limiting the size of importance of GPIb/V/IX in the clotting techniques which allow the examination thrombi at sites of vascular injury. This process is highlighted by the congenital of the importance of platelet-collagen mechanism may be important in the bleeding disorder, Bernard-Soulier interactions in blood clot formation prevention of vaso-occlusive clot syndrome. Over the last several years, a within large arteries. She found that FcR formation upon serious vascular trauma. major focus of our laboratory has been γ-chain knockout mice were able to to investigate the association between form clots to the same rate and extent ‘Soluble P-selectin in cell signalling’ GPIb/V/IX and the platelet membrane as normal mice in both in vivo models. - Dr Kevin Woollard scaffolding (cytoskeleton). Our most This suggests that the collagen receptor, (Roche Research Fellow) recent findings has demonstrated that GPVI, is not absolutely critical for the The level of the soluble form of an the interaction between GPIb/V/IX and formation of occlusive blood clots in the adhesive protein, soluble P-selectin the cytoskeletal-associated protein, large vessels, and may not be the best (sP-selectin), in human plasma is filamin-1, regulates the ability of platelets target for development of anti-clotting suggested to reflect the activation of to maintain adhesion to blood vessels compounds. both platelets and/or endothelial cells. In under high shear conditions. We believe normal human plasma, sP-selectin is this may be an important mechanism Platelet-Leukocyte Biology present at relatively low levels (30-60 that regulates platelet adhesion and Monocyte-platelet interactions ng/ml). However, in patients with normal blood clotting. We are currently - Dr Varuni Kangansundarum, vascular disorders, such as peripheral investigating the role of specific Ms Thanae Georgakopoulos vascular disease, unstable angina, structural domains in the interaction of The recruitment of leukocytes postangioplasty restenosis and diabetes this receptor with intracellular structural (Monocytes) to vessels is a key step in and those with hypertension and and signalling proteins. These studies the initiation of atherosclerosis. The hyperlipidemia, levels of sP-selectin are will help to further define receptor central focus of our investigation is the increased ranging from 120-200 ng/ml interactions that regulate platelet regulation of the primary integrins and with extreme values of 1000 ng/ml. adhesion and activation and contribute adhesion molecules that mediate the While the significance of this increase in to our overall understanding of the firm adhesion of monocytes under flow humans has not been determined, processes that lead to normal conditions. Dr Varuni Kanagasundaram previous work has shown that an (haemostasis) and pathological and Thanae Georgakopolous have increased level of sP-selectin in mice is (thrombosis) blood clot formation. identified a novel role for the alphaX associated with a procoagulant state in beta2 integrin in monocyte interaction these animals. Plasma from mice with The Importance of Collagen and its with platelets under flow. The role for elevated sP-selectin clots faster than Receptors in Supporting Blood Clot this integrin, in co-operation with others, plasma from wildtype mice and more Formation - Dr Cindy Yap to regulate the interaction of monocytes fibrin is deposited on platelet thrombi The sudden rupture of atherosclerotic with activated platelets under flow formed in a perfusion chamber. Whether plaques can precipitate life-threatening conditions may have important the findings in mice can be extrapolated diseases such as heart attack and implications in the regulation of to the human situation requires further stroke. It is thought that the increased inflammatory responses of monocytes in investigation. We are investigating the concentration of fibrillar collagens, in vascular injury. Examination of the particular types I and III, in these

Department of Medicine at Box Hill

signalling mechanisms involved in the studies. Many of the drugs that have • Protease Inhibition in Metastatic regulation of alphaM and alphaX beta2 been studied in ECRU have found their Solid Tumours (Dr Robin Anderson, integrins during monocyte-platelet way to clinical practice. Peter Mac Callum Cancer Institute, interactions under flow conditions is a Dr Anthony Dear) key aspect to understanding the Currently ECRU has 86 active clinical regulation of monocyte interactions trials with 25 new studies added until • Novel Treatments in Acute during inflammatory response. We are June 2003. Monthly more than 150 Leukaemia, Myelodysplastic using various approaches to investigate patients are screened, and 30 new Syndrome and Lymphoma (Dr Ricky the signalling pathways including patients enrolled. In addition Johnstone, Peter Mac Callum calcium flux during monocyte approximately 500 patients visit the unit Cancer Institute, Dr Richard Lock, interactions, inhibitors and knockout monthly. These are very significant Children’s Medical Research mouse models. statistics for a unit that has only been Institute, Sydney and Professor G operational for 9 years. Leone, Gemmelli Hospital, Rome, Italy, Dr Anthony Dear) Gastroenterology Research ECRU has successfully established a - Professor Peter Gibson similar unit at Maroondah Hospital. This • In vitro and in vivo Assessment of Gastroenterology research focuses on unit is currently recruiting in several Novel Treatments for Neointimal three areas: studies with a number of clinicians Hyperplasia in the Setting of Bypass 1. How manipulation of dietary intake actively contributing. Several studies have Graft Failure and Stent Implantation. can alter the intestinal environment included patients from both sites giving (Dr Rob Widdop, Dept and influence clinical outcomes in the Eastern Clinical Research Unit the Pharmacology Monash University, chronic gastrointestinal diseases. best recruiting figures in Australia. Box Hill Professor Michael Grigg, Dept Specific interests involve and Maroondah Hospitals are firmly Surgery Box Hill Hospital, Dr Hong based in the community and the Clinical Bin Liu, Dept Medicine Monash • the effects of long-chain Research Unit has therefore invited a University, Dr Anthony Dear) carbohydrates (resistant starch, number of interested General non-starch polysaccharides) on large Practitioners to participate in Unit • Chemical Synthesis of Novel bowel physiology and its contents in activities. This clearly improves our ability Inhibitors of Protease and Histone ulcerative colitis, asking the to initiate more community based studies. Deacetylase Activity. (Professor important question of whether Patrick Perlmutter, Monash findings in healthy persons is The capacity of ECRU to enrol patients University, Dept of Chemistry, Ms applicable to this disease state is very significant which makes the unit a Penny Mayes, Monash University, (NHMRC funding). port of first call for many pharmaceutical Dept of Chemistry, Dr Anthony Dear) • The effects of short-chain poorly companies that have a study in mind. absorbed carbohydrates on ECRU has consistently enrolled more • Molecular Assessment of Gene symptoms in irritable bowel patients than other centres in Australasia Profiles Responsible For Disease syndrome. and internationally. The quality of record Predisposition and Drug Metabolism keeping continues to impress the (Dr Keith Byron, Gribbles Pathology 2. The value of audit and determination pharmaceutical industry, and is another Group, Dr Anthony Dear) of attitudes in improving clinical reason why the unit is continuously practice of gastroenterology, asked to take part in clinical programs. Funding in 2003 focusing on biopsy practice in National Health and Medical endoscopy and the value of faecal Eastern Clinical Research Unit fat estimations. Research Council of Australia Biotechnology Research Division Dr Jackson’s laboratory received 3. Clinical trials of new drugs in Crohn’s - Dr Anthony Dear NHMRC project grants totalling disease and ulcerative colitis. Projects currently conducted by the $398.376 during the year Biotechnology Division of ECRU are: Dr Medcalf’s laboratory received Eastern Clinical Research Unit Clinical • Effects of Thiozolidinediones on Plasminogen Activator Inhibitor Type NHMRC project grants totalling Trials - Professor Hatem Salem $244,121 during the year Eastern Clinical Research Unit (ECRU) 1 Expression in Endothelial Cells. continues to grow, funding increased by (Dr Richard Simpson, Dr Hong Bin Professor Salem’s laboratory received 72% over last year. By far, ECRU Liu, Dr Anthony Dear, Eli Lilly) NHMRC project grants totalling represents the largest clinical research • Novel Small Molecule Treatment in $288,121 during the year unit in Australia. The unit carries out The Prevention of Abdominal Aortic clinical research in diabetes, blood Dr Schoenwaelder’s laboratory received Aneurism Formation and clotting, cancer, neurological, NHMRC project grants totalling Progression. (Dr Rob Widdop, Dept gastroenterological and respiratory $75,440.00 during the year Pharmacology, Monash University diseases. Most of the studies are either Dr Anthony Dear) advanced phase II or phase III clinical

Department of Medicine at Box Hill

Professor Gibson’s laboratory received Other Grants PhD students in the NHMRC project grants totalling Ian Potter Fdn - Dr S Cranmer Department of Medicine $65,621.27 during the year $2,000.00 at Box Hill during 2003 Dr Jackson was awarded an NHMRC ARC Linkage 2003 - Dr K Belinda Abbott Senior Research Fellowship of $130,816 Anderson/Jackson $4,095.00 Synthesis and structure activity studies of antiplatelet 2-morpholinochromones. Dr Medcalf was awarded an NHMRC Collier - Prof P Gibson $2,500.00 Senior Research Fellowship of $114,250 Mark Frazzetto Gastroenterological Soc Scholarship Selective inhibitors of PI3-kinase Dr Schoenwaelder was awarded an RD was awarded to Sally James of $6,970 isoforms as reagents for identification of Wright Fellowship of $75,643 Eastern Clinical Research Unit platelet signalling mechanisms. Dr Anderson was awarded an NHMRC ECRU received $2.24 million from Isaac Goncalves Career Development grant of $83,500 Australian industry during 2003 to fund Adhesion-specific signalling mechanisms clinical trials. Dr Anderson received an Equipment in platelets. Grant of $66,000 Postgraduate Education Anita Horvath Molecular characterisation of the murine Dr Mangin received an NHMRC The Department of Medicine at Box Hill _1-ACT-like serpins. Fellowship of $16,875 encourages the development of science at both an undergraduate and Mhairi Maxwell Wellcome Trust postgraduate level. The centre hosts Investigation of signalling molecules Wellcome Senior Research Fellowship dynamic postgraduate PhD and honours involved in integrin-mediated adhesion. 2000-2004 The role of haemoatopoietic programs, as well as fostering serpins in cell growth and development undergraduate science talent. Mythily Sachchithananthan P Coughlin $225,693 Post-transcriptional regulation of prothrombin gene expression. Wellcome Trust - Dr S Jackson PhDs completed and $34,228.00 passed in 2003 Andre Samson Dr Simon Guiliano Biology of tissue-type Plasminogen Monash University Dr Sascha Hughan Activator (t-PA) in the central nervous 2002 Logan Fellowship Dr Nayna Mistry system. (S Schoenwaelder) $24,290 Dr Suhasini.Kulkarni (pictured) Eunice Yang Dr Cindy Yap 2003 MURF Travel Grant S Cranmer Effects of novel 3-substituted Aniline $1,500.00 Sulphonamide analogues in acute promyelocytic leukemia. Monash Small Grant - Dr R Medcalf $25,000.00 Firkin PhD Scholarship Students who are interested in pursuing PAION GmbH doctorate studies in cardiovascular 2002 To explore the effects of a serine disciplines, and who have the protease from the Common Vampire appropriate graduate qualifications, are Bat, Desmodus Rotundus in animal encouraged to apply for the Firkin PhD models of excitotoxic injury. Medcalf Award to undertake a PhD program at RL$87,500 the ACBD or affiliated institutes within AMREP, commencing in February. National Heart Foundation Grant-In-Aid Further information on these A Role for RhoA in platelet integrin αIIbβ3 scholarships can be obtained by signalling and thrombus growth SM contacting Dr Robert Medcalf (03 9903 Schoenwaelder $42,655 Masters completed and 0133). Up to four scholarships of three passed in 2003 years duration will be awarded with an Anti-Cancer Council of Victoria Ms Inna Pikovski annual tax-free stipend of $22,500. Molecular regulation of migration in To apply for one of these prestigious normal and neoplastic colonic cells PhD Graduations in 2003 awards, please send a copy of your Prof Peter Gibson $55,000 Megha Mulchandani curriculum vitae including a transcript of Ramona Muttucumaru your academic record to

Department of Medicine at Box Hill

Dr Robert Medcalf Denison Chang - Investigation of diYF Opportunities for Australian Centre for Blood Diseases mouse platelets and the role of tyrosine Undergraduates to gain Monash University phosphorylation in the activation of working experience at 6th Floor Burnet Building integrin αIIbβ3. AMREP, Commercial Road Supervisors: Dr Y Yuan and the ACBD Melbourne, Victoria 3004, Australia Dr S Jackson In addition to offering summer scholarships and opening up our Closing date for applications is research laboratories to host October 31 of each year. ACBD Summer Scholarship Program miniprojects for BMS undergraduates, the ACBD also offers the opportunity Honours Degree program Each year the Department of Medicine for 2nd and 3rd year undergraduates invites currently enrolled Science, Over the last few years, the honours to apply for a part-time position to gain Biomedical Science and Medicine program at the ACBD has been valuable working experience in our undergraduates to apply for a BG Firkin conducted under the umbrella of several research laboratories (see advert on Summer Scholarship. The scholarships Monash University Departments page x). These positions are designed to recognise the enormous contribution of including Anatomy and Cell Biology, allow undergraduates to experience the the late Professor BG Firkin to the fields Biochemistry, Immunology and research lab environment, and gain a of thrombosis and cardiovascular Microbiology. The program is heavily better understanding of what it means disease. The scholarships are designed devoted to the student’s research to be a ‘scientist’ before they delve into to encourage high achieving project, and emphasizes the importance their honours and PhD years. This undergraduates who wish to pursue a of experimental design, data collection program has been on offer for a number career in biomedical research by giving and analysis, literature reviews and of years now, and has proven to be very them the opportunity to participate in a trouble shooting. effective in assisting undergraduates in research project supervised by senior their career decision making, and also The ACBD has supported a large research staff for six to ten weeks during providing them with that all important number of honours students in the past, their university holidays. The ‘hands on’ “first experience” that is required for and 2003 was no exception. We involvement of the students in these many job applications. congratulate the following students who projects provides them with a unique chance to enhance their practical skills successfully completed their honours ACBD prizes and awards year with us. and to challenge them with the intellectual rigors inherent in good 2003 Inaugural Firkin Awards Emily Chen - The post-transcriptional research. In many cases, the summer The Firkin awards were implemented in regulation of Plasminogen Activator scholarships also serve as a springboard 2003 by the ACBD in recognition of Inhibitor Type 2. for students to undertake an Honours Professor Firkin’s many achievements. Supervisors: Dr R Medcalf and year within the Department. These awards were designed to Dr S Stasinopoulos encourage and inspire young Australian Molecular Medicine and scientists and medical practitioners who Lovisa Dousha - Characterization of wish to pursue a career in medical novel inhibitors of Matrix Biotechnology Research research. The Firkin Awards will be open Metalloproteinase expression in vascular Laboratory Miniprojects to medical undergraduates wishing to smooth muscle cells. The ACBD was pleased to continue to pursue a career in medical research Supervisors: Dr R Medcalf and take part in the Bachelor of Biomedical (BMedSci.), Medical graduates wishing Dr A Dear Sciences (BMS) - Molecular Medicine to enrol in an MD or PhD program, and Science graduates (BSc, BBioMedSc) Corinne Hitchen - Zebrafish serpins: and Biotechnology Research Laboratory entering an Honours or PhD program. Identification, characterization and Miniprojects scheme. This teaching initiative involves groups of third year patterns of expression. In 2003, recipients of the Inaugural Firkin students being assigned a miniproject Supervisor: Dr P Coughlin and Awards were Dr A Perkins within the department, to be undertaken as part of their university contact hours. 1. Georgia Soldatas- Baker Swaroop Manjunath - Investigation of Students visiting the laboratories were 2. Melanie Ivey - Baker the relative roles of the p110β and required to participate in laboratory 3. Akiko Ono - ACBD p110γ isoforms of phosphoinositide work, prepare a formal presentation and 3-kinase in platelets. critically review some of the relevant Dr Robert Medcalf was awarded the Supervisors: Dr S Schoenwaelder literature. This scheme took the students Faculty’s Silver Jubilee Research Prize and Dr S Jackson beyond the bounds of the university 2003 environment and into some of the research Institutes affiliated with Monash University.

Department of Medicine at Box Hill

ACBD Scholarships and is well known for her work on small Departures G-proteins and cellular adhesion Fellowships In 2002/2003, the Department said and migration. NH&MRC CJ Martin Overseas Training farewell to a number of staff members, Fellowships NH&MRC BioMedical (Dora Lush) including Mr Ron Morris, the Dr Suhasini Kulkarni was awarded a Postgraduate Scholarship Department’s Resources Manager who Partnership CJ Martin overseas Melinda Missen was awarded an has been with the Department since its postdoctoral Fellowship Award by the NHMRC Dora Lush Postgraduate inception, as well as Dr Sascha Hughan, NH&MRC and NHF. Dr Kulkarni will be Research Scholarships, of which only Dr Simon Guiliano and Dr Nayna Mistry. travelling to one of the premier 150 are awarded nationwide to PhD laboratories in Cambridge, UK, for a applicants. This prestigious scholarship Publications period of two years to investigate the will allow Ms Missen to commence PhD Anderson KE and Jackson SP (2003) role of phosphatidylinositol 3-kinase in studies in the Serpin Biology Laboratory Class I phosphoinositide 3-kinases. Int inflammation. She will then return to the in 2004, under the supervision of Dr J Biochem Cell Biol. 35(7):1028-1033. Australian Centre for Blood Diseases Paul Coughlin. to continue her work in the field of Chrzanowska-Wodnicka M, cardiovascular medicine examining Overseas Visitors to Schoenwaelder SM and White GC the processes of thrombosis and (2003) Rap1b regulates Integrin αIIbβ3 inflammation using transgenic the ACBD activity and platelet function - lessons mouse models. Visiting scientists from a knockout. Blood, 102(11):773a. Ms Anna Tjarnlund The prestigious CJ Martin Overseas PhD student; Goteborg, Sweden Cranmer SL and Jackson SP (2003) postdoctoral fellowships were also GPIb, filamin and platelet activation: a awarded to Dr Cindy Yap and Dr Associate Professor Christina Jern view from within. Blood, 102:1937. Sascha Hughan. Dr Hughan plans to Goteborg, Sweden train as a post-doctoral scientist with Forsyth S, Horvath A and Coughlin P. Dr Steve Watson in Birmingham, UK, Phil Daniels The murine α1-antitrypsin and where she hopes to gain further insight PhD - New Zealand α1-antichymotrypsin multi-gene clusters: into the signal transduction pathways a review and comparison with the Pierre Mangin involved in platelet function and to better human clade A serpins. Genomics PhD, Strasbourg, France understand the processes of 2003; 81(3):336-45. haemostasis and thrombosis. Dr Yap Dr Kevin Woollard Guiliano S, Nesbitt WS, Rooney M and will also join a well regarded laboratory Birmingham, UK in the UK, that of Dr Anne Ridley, who Jackson SP (2003) Bidirectional integrin alpha IIb beta 3 signalling regulating platelet adhesion under flow: contribution of protein kinase C. Biochem J, 372(Pt 1):163-172.

Goncalves I*, Hughan SC*, Schoenwaelder SM, Yap CL, Yuan Y and Jackson SP (2003).Integrin αIIbβ3 dependent calcium signals regulate platelet-fibrinogen interactions under flow: Involvement of PLCγ2. * Denotes equal first author. J. Biol. Chem., 278(37): 34812-34822.

Horvath, A. and Coughlin, P.B. Expression patterns of the murine antichymotrypsin-like genes reflect evolutionary divergence at the serpina3 locus. J Mol Evol (in press).

Jackson SP, Nesbitt WS and Kulkarni S. (2003) Signalling events underlying thrombus formation. J Thromb Haemost. 1(7): 1602-1612.

Rob Medcalf is presented with the Silver Jubilee Research Prize by Acting Dean, Professor Warwick Anderson

Department of Medicine at Box Hill

Jackson SP and Schoenwaelder SM Plambeck CA, Kwan AY, Adams D, Commentaries (2003) Anti-Platelet Therapy - In Search Westman BJ, Weyden, L, Medcalf RL, LeBrasseur N. Calcium for strong of the ‘Magic Bullet’. Nature Reviews Morris B, and Mackay J P (2003). The clotting. J. Cell Biol., 160:980, 2003 Drug Discovery, October, 2(10): zinc finger domain from human splicing 775-789. factor ZNF265 forms a novel fold. J. Schubert C. Platelet attraction. Nature Biol. Chem. 278:22805-22811. Med., News and Views, 9:511, 2003 Liberatore GT, Samson, A, Bladin, C, Schleuning, WD, and Medcalf, RL Quinsey NS, Fitton HL, Coughlin P, (2003). Vampire bat salivary Whisstock JC, Dafforn T, Carrell RW, plasminogen activator (desmoteplase) - Bottomley SP and Pike RN. The a unique fibrinolytic enzyme that does introduction of a mutation in the shutter not promote neurodegeneration. Stroke region of antithrombin (Phe77-Leu) 34:537-543. increases affinity for heparin and decreases thermal stability. Biochemistry Mangin P, Yuan Y, Goncalves I, Eckly A, 2003 Sep 2;42(34):10169-73. Freund M, Cazenave J-P, Gachet C, Jackson SP and Lanza F (2003) Yu H, Stasinopoulos S, Leedman P, and Signalling role for phospholipase C Medcalf RL (2003). Inherent instability of gamma2 in platelet glycoprotein Ib alpha plasminogen activator inhibitor type 2 calcium flux and cytoskeletal mRNA is regulated by tristetraprolin. J. reorganisation. Involvement of a Biol. Chem. 278:13912-13918. pathway distinct from FcR gamma chain and Fc gamma RIIA. J Biol Chem, Patents 278(35):32880-32891. “An Agent For Plasminogen Activator Morris EC, Dafforn TR, Forsyth SL, And Matrix Metalloproteinase Associated Missen MA, Horvath AJ, Hampson L, Conditions And Method Of Use”. Hampson IN, Currie G, Carrell RW, Australian Provisional Patent IRN Coughlin PB. Murine serpin 2A is a 602223 Inventors, Dear AE, and redox sensitive intracellular protein. Medcalf RL. Refiled September 23rd Biochem J 2003; 371(1):165-73. 2003 on behalf of Monash University.

Nesbitt WS, Giuliano S, Kulkarni S, “Compositions And Methods For Dopheide CL, Harper IS, and Jackson Treating Aneurysm”. Australian SP. A Novel Inter-cellular Calcium Provisional Patent # IRN 679911 Signalling Mechanism Driving Platelet Inventor: Dear AE. refiled 24th Aggregation Under Flow. (2003) J. Cell December 2003 on behalf of Biol. 16 0(7): 1151-1161 Monash University.

Peart MJ, Dear AE, Tainton KM, Ruefli AA, Sedelies K, Trapani JA, Smyth MJ, Press releases Johnstone RW. “Novel Mechanisms of Monash University Apoptosis Induced by Histone http://www-pso.adm.monash.edu.au/ Deacetylase Inhibitors”. Cancer Res. news/Story.asp?ID=856&SortType=1 Aug 1;63(15):4460-71 (2003). Scientific American Perrault CP, Mangin P, Santer M, Baas http://www.sciam.com/article.cfm? M-J, Moog S, Cranmer SL, Pikovski I, articleID=000293D5-D911-1E1D- Williamson D, Jackson SP, Cazenave J- 8B3B809EC588EEDF P, and Lanza F (2003) Role of the intracellular domains of GPIb in American Heart Association controlling the adhesive properties of the http://www.americanheart.org/presenter. platelet GPIb/V/IX complex. Blood, jhtml?identifier=3007500 101:3477-3484. CNN http://www.cnn.com/2003/HEALTH/con ditions/01/09/stroke.bat.treatment/

Department of Pathology and Immunology

Head Associate Professors Karen Sheppard BSc (Hons) PhD Professor Ban-Hock Toh MBBS PhD DSc Robert Conyers BSc (Hons) MBBS DPhil Shaw Ping Tong MB ChB Glasgow DRCOG FRACP FRCPA (Oxon) FRCPA FACB (USA) MAACB MRACI UK FRCPA MRACMA Deputy Head Dale Godfrey BSc (Hons) PhD Assistant Lecturer Associate Professor Jennifer Rolland BSc PhD Mark Smyth BSc (Hons) PhD Cynthia Jackson BBioMedSci MBBS

Personal Assistant Clinical Associate Professors Clinical Teachers Kristal Smith BAppSci John Andrew BMedSci MBChB Otago Stephen Kay BSc MBBS FRACP FRACPA FASM Alastair Veitch MBBS School Manager Abraham Dorevitch MBBS Melb MD Melb Gillian Holley BBus (Mgt) GDipAcc MRACP FRACP DCP Lond Dip Path UK Research staff AFAIM MAHRI FRCPA Senior Research Fellow Denys Fortune MBChB MRCPE FRCPE Dale Godfrey BSc (Hons) PhD Technical Services Officer MRCPath FRCPath FRCPA MIAC FIAC Paul Dover BSc MTech MCSE John Hayman MBBS FRCPA MD FACTM Senior Research Officers Glenn Hocking BSc (Hons) PhD MBBS Melb Ann Chidgey BSc (Hons) PhD Melb Finance Officer FRCPA MBA He Li MD China MMedSc PhD Helen Dinh Assoc Dip (Acct) Catriona McLean BSc MBBS MD FRCPA Peter Ryan MBBS FRACP FAFRM Post Doctorates HR Officer Hans-Gerhard Schneider MD Germany AMC Shoukat Serle BSc (Hons) MSc PhD Effie Adraktas FRCPA FRACP Bella Blaher BSc (Hons) PhD Anthony Schwarer MD Qld MBBS (Hons) Qld Janet Davies BSc (Hons) PhD Professional Officer FRACP FRCPA James de Jersey BSc (Hons) PhD Mark Malin BSc Alison Street MBBS (Hons) FRACP FRCPA Alexander Drew BSc (Hons) PhD Jason Gill BSc (Hons) PhD IT Manager Senior Lecturers Daniel Gray BSc (Biomed) (Hons) PhD Ian Sloan BSc PhD Kevin Bendall MBBS MD (Melb) FRCPA Kirsten Hammond BSc (Hons) PhD FRACP MAACB FIAC Charles Hardy BSc (Hons) PhD Technical Officer Zemin Cao MD Shuo Li BSc (Hons) PhD Gloria Kiri BSc (Vet) Master (Microbiology) John Catalano MBBS FRACP FRCPA Nunzio Mancuso BSc (Hons) PhD Siew Chin Choong MBBS Sing FRCPA Cenk Suphioglu BSc (Hons) PhD Melb Technical Assistant Sheung-To Chou MB PhD FRCPA FRCPath Jayne Sutherland BSc (Hons) PhD Maree Borland David Clouston MBBS FRCPA Michael Sutherland MBBS FRACP PhD Timothy Cole BSc (Hons) PhD Academic staff Merrole Cole-Sinclair BSc (Hons) MBBS Research Officer Professors FRACP FRCPA Jason Lin BSc (Hons) James Goding MBBS BMedSci PhD FRCPA Judith Constable MBBS FRCPA (Haem) Faith Ho MBBS (Hons) Hong Kong DObst FRCPA (Anat Path) Research Assistants RCOG London MRCPath UK MD Hong Kong David Deam MBBS (Hons) MAACB FRCPA Effie Apostolou BSc (Hons) MSc FRCPA FRCPath FHKCPath FHKAM (Path) James Doery BSc MSc MD FRCPA Jade Barbuto Dip BioSc (Animal Technology) Robyn O’Hehir BSc MBBS London PhD William Downey MBBS (Hons) MRCPath Nirupama Eusebius BSc (Hons) London FRACP FRCP FRCPA Maree Hammett BSc (Hons) MSc Paul Handley MA Cantab MBBCHIR FRACP Samantha Harris BA BSc (Hons) Associate Professors FRCPA MRACMA Linda Kenins BSc (Hons) Richard Boyd BSc (Hons) PhD Santanu Khan BSc MBBS MRCPath Konstantinos Kyparissoudis BSc (Hons) Ruth Salom BMedSc MBBS FRCPA MD Warren McNaughton MB ChB NZ FRCPA Daniel Pellicci BSc (Hons) Christine McTigue MBBS FRCPA Adnan Sali BSc (Hons) Senior Lecturers Nicholas Mulvany MB Bch BAO DCP FRCPA Sarah Snelgrove BSc (Hons) Frank Alderuccio BSc (Hons) PhD Kenneth Opeskin MBBS FRCPA MD Lisa Spyroglou BSc (Hons) Saif-Ud-Din Chopra MBBS DTM&H Lond Robert Puy MBBS BMedSc FRACP FRCPA Yee-Wah (Eva) Wong BSc DCP Lond DPath Lond FRCPA Salvatore Rambaldo BMedSci (Hons) MBBS Jun Yao BBiol Nanjing MSc Nanjing Leo Cussen MBBS FRCPA MAACB MASM MRACMA FRCPA Lauren Young BSc (Hons) Michael Irlicht BSc (Hons) MBBS Norman Sonenberg MBBS FRCPA Jun-Ping Liu MD MSc PhD Cenk Suphioglu BSc (Hons) PhD Melb Postgraduate students Siew-Khin Tang MBBS MD FIAC FRCPA Ilia Banakh BSc (Hons) Lecturer Patrick Van Der Hoeven MD FRCPC FRCPA Adele Barnard BSc John Emmins BSc GDipEd (Asian Studies) Ralph Zito MBBS FRCPA Sharyn Bayne BSc MSc PhD MASM Mark Biondo BSc (Hons) Lecturers Irene Boo BBioMedSci Honorary Academics Dominic Autelitano BSc (Hons) PhD Ann James Braunegg BSc MBMS (Part 1) Professors Chidgey BSc (Hons) PhD Melb Matthew Burton BSc (Hons) Michael C Berndt BSc Qld PhD Qld Leonie Constable MBBS (Hons) FRCPA Elizabeth Chapman BSc (Hons) Stewart Bryant MBBS FRCPA MAACB Janet Davies BSc (Hons) PhD Nadine Crowe BSc (Hons) Mark Cooper MBBS PhD FRACP Michael Hickey BSc (Hons) PhD Maria de Leon BSc (Hons) John PG Dowling MBBS Melb FRCPA Stephen Lade MBBS FRCPA MRCPath Michael Ditiatkovski BBioMedSci MRCPath FRCPath He Li MD China MMedSc PhD Jarrod Dudakov BSc Ian Mackay AM MD FRCP FRCPA FRACP Richard Norris MBBS FRCPA Tamara Etto BSc (Hons) FAAA Prudence Russell MBBS (Hons) FRCPA Nirupama Eusebius BSc (Hons)

Department of Pathology and Immunology

Judith Field BSc (Hons) responses are also responsible for Leanne Gardner BSc (Hons) The Department of allergic reactions such as hay fever, Ian Glaspole MBBS rejection of foreign tissue grafts as well Gabrielle Goldberg BSc (Biomed) (Hons) Pathology and as autoimmune diseases such as Tracy Heng BSc (Biomed) (Hons) Immunology at The Alfred Rachael Keating BSc (Hons) rheumatoid arthritis, diabetes and Douglas Liddicoat BSc (Hons) has a major multiple sclerosis. The understanding of Jessica Markby BSc (Hons) undergraduate teaching immunological processes is critical to Aiden Marshall BSc (Biomed) (Hons) commitment in the developing strategies aimed at solving Morag Milton BSc (Hons) these problems. All these complex Kim Murphy BSc (Hons) Bachelor of Biomedical biological responses involve specific cell Yen Pham BSc Science, to medical recognition phenomena, and advances Alex Pinto BioMedSci Jessica Porter BSc students and also in recombinant DNA technology have Jared Purton BSc (Hons) contributes to teaching opened up the gate for understanding Samy Sakkal BSc (Hons) the structure and nature of the important Natalie Seach BBioMedSci programs of the Faculty of molecules involved in these events. Shayna Street BSc (Hons) Science. It has an Immunology has a real place in today’s Audrey Tan BSc world as we tackle global problems Adam Uldrich BSc (Biomed) (Hons) Honours program for such as HIV/AIDS, the emergence of Katerina Vlahos BBioMedSci science and biomedical Kate Ward BSc (Hons) new viral diseases, new antibiotic David Zammit BSc (Hons) science students and resistant strains of bacterial diseases there were 46 and the need to solve problems such postgraduate research as autoimmunity and transplantation students enrolled through rejection. the department in 2003. Immunology links with other branches of biology offered at Monash such as genetics, biochemistry, cell biology, pathology, physiology and microbiology. The control of immunological mechanisms is by genetic, biochemical Current research programs of the and pharmacological means and the Department include: targets of immunological attention are • Autoimmunity usually micro-biological. In addition, the • Allergy and Immunology outcome of immune reactions can produce pathological changes in the • Lymphostromal and Immune- body’s organs and tissues. Reconstitution Consequently, knowledge of immunology • T cell laboratory can be of considerable advantage to • Molecular Signalling those who seek to enter other fields of medical and biological science. • Immunochemistry Laboratory The study of immunology can lead to Teaching career opportunities such as: Immunology is the study of mechanisms • Secondary school science teacher within the vertebrate body primarily • Technical/Research assistant responsible for the defence against • Research scientist infectious micro-organisms. Immune • University lecturer

Department staff and post graduate students

Department of Pathology and Immunology

• Hospital scientist reviewed in Alderuccio et al, 2004). T cell to increase efficacy of • Veterinary scientist Studies are in progress to clear the immunotherapy. These preparations will stomach of pathology before be selected for lack of IgE binding • Biotechnical developmental scientist transplantation with genetically modified epitopes to ensure safety. In addition, • Forensic laboratory scientist bone marrow. underlying mechanisms by which adverse Th2-polarised cytokine Diagnostic immunoassays responses to allergens can be down- Research Jason Lin has established a sensitive regulated are also being investigated Autoimmunity Laboratory - Professor ELISA using human recombinant using both in vitro cell culture models Ban-Hock Toh, Dr Frank Alderuccio ribosomal P proteins for the detection of and clinical immunotherapy studies. Aims of this laboratory autoantibodies to these proteins, a test Strategies for inducing protective useful for the laboratory diagnosis of 1. To better understand the T regulatory cell responses with IL-10 systemic lupus erythematosus. pathogenesis of autoimmune secretion are being explored. diseases Autoantibodies as molecular probes Through the CRC for Asthma program 2. To explore stem cell strategies We have shown that a trans-Golgi the laboratory is developing directed at reversing autoimmune autoantigen p230 is associated with a hypoallergenic latex preparations for disease microtubule actin cross linking factor treatment of latex allergy, a major cause (MACF) and that this complex is 3. To develop diagnostic of occupational asthma and allergy. A implicated in transport to cell immunoassays mouse model for latex allergy has been membranes (Kakinuma et al, 2004). established for evaluation of these 4. To apply autoantibodies as probes Studies are in progress examining the preparations. Other projects examine for molecular cell biology molecular mechanisms of a cell division the potent food allergens of peanut, the autoantigen CDA1 in cell proliferation in Pathogenesis of autoimmune gastritis widespread aeroallergens of house dust collaboration with Dr Zhonglin Chai, Dr Having established that the gastric H/K mite and grass pollens, IgE antibody Zemin Cao and Professor Mark Cooper ATPase is the initiating autoantigen and characteristics, improved diagnostic of the Baker Institute. CD4 T cells are the pathogenic approaches for drug allergy and the lymphocytes, we have continued our presence of potential food allergens in studies to dissect the pathways that Allergy Research Laboratory - wine. Successful outcomes of these lead to autoimmune mediated tissue Professor Robyn O’Hehir, research projects are documented by injury. More recently we have shown that Associate Professor Jennifer Rolland publications, patents and graduate TNF does not appear to have a role in Allergic diseases affect over 30% of the student prizes and awards. the genesis of the stomach lesion Australian population. Approx. 80% of (Marshall et al, 2004) asthmatics are atopic with specific Lymphostromal and Immune- allergen exposure able to induce asthma Reconstitution Laboratory Autoimmune mechanisms in attacks and clear evidence of the allergic - Associate Professor Richard Boyd atherosclerosis phenotype preceding asthma in the For over 20 years, our laboratory has In collaboration with Professor Alex ‘atopic march’. Allergen specific examined the cellular and molecular Bobik of the Baker Institute we have immunotherapy is a treatment option for basis to thymus development and initiated studies directed towards the some patients and has been confirmed function, including the incorporation examination of the role of macrophage as an efficacious treatment for asthma of newly developed T cells into the active cytokines such as MIF and and rhinitis by meta-analyses. Unlike peripheral T cell pool. In the last five GMCSF in the progression of mainstay drug treatments that counter years our focus has shifted to the atherosclerosis. As well we have allergic inflammatory mediators and their utilisation of such knowledge for clinical embarked on studies examining the role effects, specific immunotherapy offers applications. of pathogenic and regulatory T cells in the advantages of antigen specificity and this process. is currently the only treatment able to The production of T lymphocytes in both alter the natural course of disease. humans and mice undergoes an age- Reversing autoimmunity Nevertheless the available unmodified related decline associated with the These studies are extensions of our crude allergen extracts used in this increase in sex steroid levels at puberty, observation that the transgenic treatment are generally denied to resulting in at least 95% loss of expression of self antigen in the thymus asthmatics due to the risk of acute functional capacity in the elderly when driven by MHC class II promoter renders severe asthma or anaphylaxis. compared with children. This reduction mice tolerant and resistant to disease. in thymic function leads to a gradual These observations led to Research in the Monash University narrowing of T cell repertoire and a transplantation bone marrow from the Allergy Research Laboratories aims to greater susceptibility in the elderly to transgenic mice to achieve the same characterise clinically important allergens infectious diseases and cancers. The outcome. We found that while we with respect to IgE and T cell reactivity inability of an adult thymus to produce succeeded in achieving tolerance, and to develop allergen preparations adequate numbers of new T cells is stomach pathology persisted in the based on this information that most profoundly observed in individuals recipient mice (Murphy et al, 2003 and specifically target the allergen-specific

Department of Pathology and Immunology

who undergo immunoablative therapy consequence the lab has been able to understanding how NKT cell for malignancy or prior to hemopoietic greatly extend its Research and development may be manipulated as a stem cell transplantation. A child who Development programs. means for future clinical therapy. has received chemo- or radiotherapy can usually replace the body’s T cells T cell laboratory - Dr Dale Godfrey Molecular Signalling Laboratory within a few months, whereas an adult NKT cells are a subset of T lymphocytes - Dr Jun-Ping Liu can take several years - directly that are CD1d restricted and recognise We investigate intracellular signalling correlating with thymus function. In the glycolipid antigens rather than peptide pathways that regulate lifespan of any meantime, these individuals remain antigens. NKT cells are present in mice types of human cells. When errors are susceptible to a range of opportunistic and humans and play a key role in generated from these pathways, cells infections which are often fatal. As such, regulating immune responses in a variety can become either early ageing or the ability to regenerate the involuted of disease settings including cancer and immortal as seen in cancer. For nerve aged thymus is of great clinical autoimmunity. Dr Godfrey’s research and cardiac muscle cells, changes in relevance. team has published several studies, in certain key proteins underlie collaboration with Dr Mark Smyth at the degenerative diseases, and engineering One of the major areas of study Peter MacCallum Cancer Institute, these molecules may thus provide currently in our laboratory has been the showing that NKT cells play an mechanisms of prevention and therapy. use of sex steroid ablation by surgical or important role in tumour rejection in chemical castration as a means to mice. More recently, the team has To reveal the fundamental mechanisms regenerate the thymus and thus, shown that the ability of NKT cells to controlling cell lifespan, we focus on increase T cell output in mice. Following mediate tumour rejection is limited to a several key players that are pivotal in the finding that chemical castration specific subpopulation of NKT cells that mediating cell survival and proliferation. could reactivate the thymus in prostate are CD4 negative and reside in the liver. These molecules include the enzyme cancer patients (who routinely undergo They have also shown that NKT cell telomerase that maintains the structure LHRH analogue, a sex steroid inhibitor, numbers are a significant factor in of chromosome ends called telomeres. administration), clinical trials on determining the outcome of some We measure the sizes of telomeres and leukaemia/lymphoma patients diseases such as cancer, and NKT cell the levels of telomerase activity that are undergoing stem cell transplantation numbers are controlled by the altered in degenerative diseases, were initiated in late 2000. These trials production of these cells in the thymus. proliferative diseases and certain involved both the Alfred Hospital and the A major focus of Dr Godfrey’s laboratory pathological conditions including Peter MacCallum Cancer Institute and has been the study of how NKT cells chromosomal abnormalities. continued throughout 2001-2003. develop in the thymus, with the goal of Results from this trial have led to the In addition, two new genes have been understanding this process in enough establishment of a multi-centre cloned. One is a new ATPase that is detail to identify molecular targets that international trial following the acquisition only present in nervous system may ultimately allow us to regulate NKT of prestigious NIH funding. controlling intra-neuron membrane cell numbers in the clinical setting. A key trafficking during neurotransmission. step in this direction has been the Honours, Masters and PhD students in Localized to substantia nigra and other elucidation of a developmental pathway our laboratory worked on a range of particular regions, this new ATPase is for NKT cells, showing that they pass projects in 2003 focussing on the effects implicated in neural degenerative through defined, phenotypically and of sex steroid ablation on molecular and diseases including Parkinson’s disease. functionally distinct stages as they cellular events in the bone marrow and In the heart, a novel protein has been mature, and that they migrate from the thymus, disease progression in identified that is required for survival. In thymus to peripheral tissues prior to autoimmune models, tumour immunity response to ischemia or hypoxia, it reaching full maturity. The research has and vaccine efficacy. Work also disappears within minutes in also shown that NKT cells are continued on the developmental myocardium. relationship between thymic stromal susceptible to intrathymic selection cells and the T cells whose events, akin to those that shape the Molecular signalling is involved in many differentiation they dictate, with repertoire of conventional T cells. While aspects of physiological and particular focus on the characterisation the original research in this project was pathological conditions. With a variety of of recently identified putative thymic carried out in the mouse model, Dr different methods and tools at the levels epithelial cell progenitor cells (MTS24+ Godfrey and Dr Stuart Berzins, a of genes, messages and proteins, we thymic epithelium). postdoc in Dr Godfrey’s laboratory, in work together and collaborate with collaboration with Dr Andrew Cochrane colleagues within and outside the Alfred In 2003 commercial support for our at the Royal Children’s hospital, have Medical Research and Education laboratory was formalised with extended the NKT cell development Precinct. We believe that studies of Melbourne-based medical devices studies to humans, and have molecular signalling events and company Norwood Abbey (ASX listed) determined that the process they had pathways will lead to improved officially licensing the lab’s intellectual previously mapped out in mice also understandings of various disease property from Monash University. As a applies to human NKT cell development. conditions, and improved activities and This is an important step towards lifespan for all cells in our bodies.

Department of Pathology and Immunology

Immunochemistry Laboratory Leptin is a newly discovered hormone because the local lymph nodes are often - Professor James W Goding that controls appetite and body weight. removed during surgery. We are This laboratory is devoted to the We have used genetic engineering to culturing cells from lymph nodes of understanding of metabolic control express human, mouse and sheep leptin patients with breast cancer, and mechanisms at the molecular level, in bacteria, and developed ways to examining whether they secrete particularly the control of bone refold and purify leptin so that it is fully antibodies that are specific for the calcification and body weight. active. Previous work on leptin in animal tumour. This work is technically models has concentrated on mice, demanding, but if successful, could lead Over many years we have studied which differ from humans in many ways. to improved and novel forms of ecto-nucleotide pyrophosphatase/ In collaboration with Professor Iain diagnosis and treatment of cancer. phosphodiesterase, also known as the Clarke of Prince Henry’s Institute, plasma cell membrane glycoprotein Melbourne, we have embarked on a Research funding in 2003 PC-1, which cleaves extracellular ATP series of experiments on the role of to generate AMP and pyrophosphate. leptin in control of body weight in sheep. Department of Pathology and Extracellular AMP can in turn be Sheep have many advantages as an Immunology Research Program. Alfred converted to adenosine by the experimental model for weight control, Research Trusts Grant. 2003: $35,000. ubiquitous 5’ nucleotidase. Each of because they have a closer Department of Pathology and these products is metabolically active. resemblance to humans in the way in Immunology. Funding for collaborative ATP, AMP and adenoside can act on which hormones control body weight. teaching programs in Pathology. purinergic receptors and hence influence We have shown that sensitivity to leptin Gribbles Project Grant. 2002-2004: cellular activity. PC-1 is also the major differs in males and females, and varies $60,000. source of extracellular pyrophosphate, depending on the time of year. which is a potent inhibitor of formation Alderuccio F. Monash University Project of hydroxyapatite, the main component It is widely believed that the immune Grant. 2003: $30,000. of bone. We have shown that this system can fight cancer. If this concept enzyme is a key regulator of calcification could be shown to be true, it would Boyd R. Pre-clinical and clinical trials on of bone and other tissues, and failure to suggest new ways to attack cancer via the effectiveness of LHRH agonists on produce the right amount of PC-1 leads the immune system. However, despite rejuvenating T cell based immune to arthritis and osteoporosis. In intensive study over many years by responses. Norwood Abbey. 2001- collaboration with Pfizer, we are using many laboratories, it has been very 2003: $2,785,162. high throughput screening to seek drugs difficult to identify and isolate such that inhibit the enzyme. Such drugs tumour antigens. In a project funded by Boyd R and Chidgey A. The molecular might be useful in treating some forms CancerProbe, we are approaching this basis to the development and function of arthritis. We are also working towards problem in a novel way, by focussing of the thymic microenvironment. solving its structure at the atomic level our attention on the lymph nodes that NMHRC Project Grant. 2001-2003: by X-ray crystallography. drain the tumour. This is possible $227,036.

Boyd R, Emmins J and Rood J. Pathogenesis of clostridial myonecrosis. NHMRC Program Grant component. 2003: $56,151.

Etto T. Alfred Hospital and Norwood Abbey Scholarship. 2003: $9,004.

Gill J. CJ Martin Overseas Training Fellowship. NHMRC. 2003: $53,941.

Godfrey D. Research Fellowship. NHMRC. 2002-2006: $525,000.

Godfrey D, Cole T and Boyd R. The influence of glucocorticoid hormones in T cell development and function. NHMRC Project Grant. 2002-2003: $220,823.

Professor Jim Goding with Research Assistant Adnan Sali in the Immunochemistry Laboratory

Department of Pathology and Immunology

Goding J, Mancuso N, Meeusen E and Toh BH and Greenwood D. Utilisation of Professor Robyn O’Hehir and Associate Lopata A. Identification of cancer novel experimental autoimmune gastritis Professor Jennifer Rolland, jointly with antigens by antibodies secreted by local models to study the immunopathogenesis the Menzies School of Health Research, draining lymph nodes. Cancer Probe Pty of disease. NHMRC Postgraduate were successful in obtaining a three year Ltd commercial grant. 2002-2004: Research Scholarship. 2002-2003: NHMRC project grant entitled: $300,000. $38,783. “Characterisation of immune responses to Sarcoptes scabiei cysteine proteases, Hammond K. CJ Martin Overseas Patents filed group 1 allergen homologues, in Training Fellowship. NHMRC. 2003: scabies”. Total funding for duration $89, 951. Boyd Richard and Gill Jason. “Thymic of grant, $465,750. epithelial cells with progenitor capacity”. Hibbs M, Anderson G and O’Hehir R. 16 June 2003. Dr Jun-Ping Liu was successful in Is Lyn kinase a predictor of severe obtaining a three year ARC project grant persistent multi-trait allergy and asthma? Liu Jun-Ping, Lu Junjie and Li He. entitled: “Molecular regulation of NHMRC Project Grant: 2003-2005: “A novel brain specific ATPase”. telomeres and telomerase by p53 in cell $360,000. 22 September 2003. ageing”. Total funding for duration of grant: $240,000. Liu JP and Toh BH. Functional studies O’Hehir Robyn and Rolland Jennifer. on a novel, brain-specific, Golgi ATP- “Immunotherapeutic and Ms Anne Fletcher was awarded the binding protein in membrane trafficking. immunoprophylactic reagents”. Faculty of Medicine, Nursing and Health ARC Discovery Project Grant. 2003- 2 April 2003. Sciences Postgraduate Excellence 2005: $315,000. Award, for 2003-2006. Special achievements O’Hehir R. Consumer priorities. CRC Dr Ann Chidgey was awarded the for Asthma Project Grant. 1999-2005: during 2003 Federal Government Centenary Medal - $756,000. Dr Jason Gill was awarded the Victorian “For service to the role of women in Premier’s Commendation for his science” (April 2003). O’Hehir R. Immunomodulation. CRC research into the human thymus, a for Asthma Project Grant. 1999-2005: crucial part of the immune system. Associate Professor Richard Boyd was $3.1 million. Dr Gill’s studies led to the identification awarded the Federal Government Centenary Award - “For service to O’Hehir R. Targeting Treatment. CRC of stem cells that enable growth of a international medical research and for Asthma Project Grant. 1999-2005: fully functioning thymus. His findings undergraduate teaching” (April 2003). $381,144. could lead to a novel therapeutic strategy aimed at restoring this organ Associate Professor Richard Boyd’s O’Hehir R and Stockley C. The in the aged, people undergoing achievements in Australian Research identification and measurement of chemotherapy and those with immune and Biotechnology were profiled in the potential allergens in wine. Grape and diseases. Weekend Australian Financial Review Wine Research Development (October 4-5, 2003). Corporation Project Grant. 2003-2004: Dr Kirsten Hammond and Dr Jason Gill were each awarded NHMRC CJ Martin $206,811. Associate Professor Richard Boyd Training Fellowships. received extensive profiling of his O’Hehir, Suphioglu C and Rolland J. laboratory’s clinical achievements by Couch grass allergy cellular and Ms Nadine Crowe was awarded an Premier Steve Bracks at Bio 2003, molecular studies directed at improved International Congress of Immunology Washington specific immunotherapy. NHMRC Travel Grant. Project Grant. 2002-2004: $405,660. Ms Leanne Gardner was awarded a Mr Adam Uldrich co-won the student investigator presentation award at O’Hehir R, Thien F, Rolland J and scholarship to attend the Keystone ThymOz IV, International Workshop on Douglass J. Allergy to medications. Hygiene, Allergy and Asthma T Lymphocytes, Heron Island, 1st -5th The Harold Mitchell Foundation Project Symposium in April 2003. April 2003. Grant. 2003-2005: $270,000. Dr Frank Alderuccio and Professor Dr Janet Davies was the recipient of the Toh BH. Production of purified antigens Ban-Hock Toh were successful in Paul Clarke poster prize at the Annual for use in ELISA assays used for obtaining a three year NHMRC project Scientific Meeting of the Australian detecting gastric parietal cell grant entitled: Stem cell engineering to Society for Clinical Immunology and autoantibodies. Immunoconcepts establish tolerance and reverse Allergy, in October 2003 for her poster Project Grant. 2001-2003: $210,790. autoimmunity. Total funding for duration of grant; $490,500. and presentation entitled “Bahia grass pollen is an important allergen in Australian patients with seasonal rhinitis and fails to show cross-reactivity with other clinically important grasses.”

Department of Pathology and Immunology

Dr Janet Davies was the recipient of the Ying Cao Emily Lai Monash University Research Fund Telomerase regulation and its roles in Immunology of peanut allergy Fellowship 2002-2003 for her work on cell survival and proliferation IgE antibody characteristics in grass Douglas Liddicoat pollen allergic individuals. Elizabeth Chapman Analysis of the effect of glucocorticoids Molecular mechanisms of thymic on T cell development and peripheral Post graduate student, Katherine regeneration function Kedzierska, was awarded the Mollie Holman medal Nadine Crowe Jinhua Li The role for NKT cells in tumour immunity The mechanisms between TGF-beta The Nairn Medals for 2003 were and TERT awarded to undergraduate students: Maria de Leon Immunological and molecular Jessica Markby • Ms Renu Eapen for Pathology and characterisation of major peanut Characterisation of the immune • Ms Stacey Jamieson for Immunology allergens and their cross-reactive response to B cell lymphomas components in tree nuts Visitors to the Department Aiden Marshall Tamara Etto The role of Fas and TNF _ in in 2003 Generation of antigen-specific T cell experimental autoimmune gastritis Dr. Robyn Slattery BSc (Hons), PhD - lines using polymorphic antigenic On sabbatical leave from the John proteins and dendritic cells Morag Milton Curtin School of Medical Research, Cell surface proteins involved in T-cell The Australian National University, Judith Field development in the thymus Canberra, ACT Experimental autoimmune gastritis: mechanisms of induction and Kim Murphy Mr John Thwaites - Deputy Premier, therapeutic strategies Autoimmunity; tolerance mechanisms Victorian Government and initiation Anne Fletcher Ms Kylie Webster - PhD Student, Thymic stromal cells: tolerance induction Jared Purton The Walter and Eliza Hall Institute and abnormalities in autoimmune The influence of glucocorticoids and disease other factors in T cell development and Professor Georg Hollander - Pediatric selection Immunology, University of Basel Leanne Gardner Modulation of the allergen-specific T cell Shayna Street Mr Adrian Liston - PhD Student, response Effector mechanisms in tumour immune Australian National Institute surveillance Jason Gill Professor Marvin Fritzler - Faculty of Progenitor cells of the thymic epithelium Michael Sutherland Medicine, University of Calgary, Canada and factors influencing thymic The human immune response to the latex allergen Hev b 5 Mr Simon Weigert - Master of Science development Student, University of Heidelberg, Ian Glaspole Adam Uldrich Germany The human cellular response to peanut The effect of antigen encounter on (Arachis hypogoea) and cross-reacting T cell development and recent thymic Dr Ling Li - Visiting Scientist, Peking emigrants University Health Science Center, China tree-nuts Gabrielle Goldberg Catherine Van Vliet Dr Wenzhou Duan - Visiting Scientist, The GRIP domain: a novel Golgi Long Fang Medical College, China Sex steroid ablation enhances immune reconstitution following severe targeting domain of a family of coiled Mr Junjie Lu - Visiting Scientist, Peking immunodepletion coil peripheral membrane proteins University Health Science Center, China Daniel Gray Kate Ward Thymic stromal cells: population Polymorphic minor histocompatibility PhD students in 2003 dynamics and their role in thymopoiesis antigens and dendritic cells: a method Ilia Banakh for generating a potent graft-versus- Biology of ecto-nucleotide Tracy Heng leukaemia effect for use in pyrophosphatase/phosphodiesterase 1 Early kinetics and functional impact of immunotherapy thymic regeneration Mark Biondo David Zammit Autoimmune gastritis in PC-GMCSF Rachael Keating Developmental and immunological transgenic mice and the development of Activation of CD8+ T cells and NKT cells characterization of mice deficient in a curative protocol in normal and HSV-1 infected thymic shared antigen-1

Department of Pathology and Immunology

Masters students in 2003 Publications Crowe NY, Uldrich AP, Kyparissoudis K, Hammons KJ, Hayakawa Y, Sidobre S, James Braunegg Journals Keating R, Kronenberg M, Smyth MJ Expression and characterization of two Alderuccio F, Murphy K and Toh BH. and Godfrey DI. Glycolipid antigen drives hTERT modules in yeast Stem cells engineered to express self- rapid expansion and sustained cytokine Nirupama Eusebius antigen to treat autoimmunity. Trends in production by NK T cells. Journal of The human T cell response to major Immunology. 2003; 24(4): 176-180. Immunology. 2003; 171(8): 4020-4027. Bermuda grass pollen allergen Cyn d1 Chong MM, Cornish AL, Darwiche R, de Leon MP, Glaspole I, Drew A, Rolland Samy Sakkal Stanley EG, Purton JF, Godfrey DI, J, O’Hehir R and Suphioglu C. In vivo models of thymic regeneration Hilton DJ, Starr R, Alexander WS and Immunological analysis of allergenic Kay TW. Suppressor of cytokine cross-reactivity between peanut and tree Charles Xu signalling-1 is a critical regulator of nuts. Clinical and Experimental Allergy. Expression of telomere binding proteins interleukin-7-dependent CD8+ T cell 2003; 33(9): 1273-1280. in vitro differentiation. Immunity. 2003; 18(4): 475-487. Field J, Marshall A, Hertzog P, Wells T, Alderuccio F and Toh BH. Chemokine Higher Degree students who Cornish AL, Davey GM, Metcalf D, receptor CCR5 is not required for graduated in 2003 Purton JF, Corbin JE, Greenhalgh CJ, development of experimental Congratulations to the following Darwiche R, Wu L, Nicola NA, Godfrey autoimmune gastritis. Clinical students who were awarded Doctor of DI, Heath WR, Hilton DJ, Alexander WS, Immunology. 2003; 109(2): 238-247. Philosophy during 2003: Starr R. Suppressor of cytokine signalling-1 has IFN-gamma- Gardner LM, O’Hehir R and Rolland J. T Ying Cao independent actions in T cell cell targeted allergen derivatives for Jason Gill homeostasis. Journal of Immunology. improved efficacy and safety of specific immunotherapy for allergic disease. Daniel Gray 2003; 170(2): 878-886. Current Medicinal Chemistry - Anti- Aiden Marshall Cretney E, Uldrich AP, Berzins SP, Inflammatory and Anti-Allergy Agents. Michael Sutherland Strasser A, Godfrey DI and Smyth MJ. 2003; 2(4): 351-365. Normal thymocyte negative selection in Catherine van Vliet TRAIL-deficient mice. Journal of Gill J, Malin M, Sutherland J, Gray D, Experimental Medicine. 2003; 198(3): Hollander H and Boyd R. Thymic The following students graduated in 491-496. generation and regeneration. 2003 after completing Bachelor of Immunological Reviews. 2003; Science Honours in the Department: Crowe NY, Godfrey DI and Baxter AG. 195: 28-50. Adele Barnard BSc (Hons) Natural killer T cells are targets for human immunodeficiency virus infection. Sharyn Bayne BSc (Hons) Immunology. 2003; 108(1): 1-2. Jarrod Dudakov BSc (Hons) Marty McCaig BSc (Hons) Yen Pham BSc (Hons) Jessica Porter BSc (Hons) Audrey Tan BSc (Hons)

The following students graduated in 2003 after completing Bachelor of Biomedical Science Honours in the Department: Irene Boo BBioMedSci (Hons) Michael Ditiatkovski BBioMedSci (Hons) Alex Pinto BBioMedSci (Hons) Natalie Seach BBioMedSci (Hons) Katerina Vlahos BBioMedSci (Hons)

Dr Robyn Slattery on sabbatical leave from ANU, pursues her research on diabetes in the Department of Pathology and Immunology.

Department of Pathology and Immunology

Goding JW, Grobben B and Slegers H. Pellicci DG, Uldrich AP, Kyparissoudis K, Physiological and pathophysiological Crowe NY, Brooks AG, Hammond KJ, functions of the ecto-nucleotide Sidobre S, Kronenberg M, Smyth MJ pyrophosphatase/phosphodiesterase and Godfrey DI. Intrathymic NKT cell family. Biochimica et Biophysica Acta. development is blocked by the presence 2003; 1638(1): 1-19. of alpha-galactosylceramide. European Journal of Immunology. 2003; 33(7): Gruehn S, Suphioglu C, O’Hehir R and 1816-1823. Volkmann D. Molecular cloning and characterization of hazel pollen protein Smart JM, Suphioglu C and Kemp AS. (70 kD) as a luminal binding protein Age-related T cell responses to allergens (BiP): a novel cross-reactive plant in childhood. Clinical and Experimental allergen. International Archives of Allergy Allergy. 2003; 33(3): 317-324. and Immunology. 2003; 131(2): 91-100. Suphioglu C. Analysis of immunoglobulin Hardy C, Kenins L, Drew A, Rolland J E-mediated responses in central Africa. and O’Hehir R. Characterization of a Clinical and Experimental Allergy. 2003; mouse model of allergy to a major 33(1): 1-2. occupational latex glove allergen Hev b5. American Journal of Respiratory and Vaingankar S, Fitzpatrick T, Johnson K, Critical Care Medicine. 2003; 167(10): Goding J, Maurice M and Terkeltaub R. 1393-1399. Subcellular targeting and function of osteoblast nucleotide pyrophosphatase Johnson K, Goding J, Van Etten D, Sali phosphodiesterase 1/NPP1. American A, Hu SI, Farley D, Krug H, Hessle L, Journal of Physiology-Cell Physiology. Millan JL and Terkeltaub R. Linked Dec 2003. deficiencies in extracellular PP (i) and osteopontin mediate pathologic Vollmayer P, Clair T, Goding JW, Sano K, calcification associated with defective Servos J and Zimmermann H. PC-1 and ANK expression. Journal of Hydrolysis of diadenoside Bone and Mineral Research. 2003; polyphosphates by nucleotide 18(6): 994-1004. pyrophosphatases/phosphodieterases. European Journal or Biochemistry. 2003; Malcolm KM, Gill J, Leggatt GR, Boyd 270(14): 2971-2978. RL, Lambert P and Frazer IH. Expression of the HPV16E7 oncoprotein Zhan Y, Purton JF, Godfrey DI, Cole TJ, by thymic epithelium is accompanied by Heath WR and Lew AM. Without disrupted T cell maturation and a failure peripheral interference, thymic deletion is of the thymus to involute with age. mediated in a cohort of double-positive Clinical and Developmental Immunology. cells without classical activation. 2003; 10(2-4): 91-103. Proceedings of the National Academy of Science of the United States of America. Matheson MC, Dharmage SC, Forbes 2003; 100(3): 1197-1202. AB, Raven JM, Woods RK, Thien FC, Guest DI, Rolland JM, Walters EH and Books Abramson MJ. Residential O’Hehir R and Berger WE. 2003. characteristics predict changes in Der Asthma and Allergies for Dummies. p 1, Fel d 1 and ergosterol but not fungi Wiley Publishing Australia Pty Ltd. over time. Clinical and Experimental Allergy. 2003; 33(9): 1273-1280.

Murphy K, Biondo M, Toh BH and Alderuccio F. Tolerance established in autoimmune disease by mating or bone marrow transplantation that target autoantigen to thymus. International Immunology. 2003; 15(2): 269-277.

Department of Surgery at The Alfred

Head Sidney R Davis FRACR MBChB FFRad(T) Adrian Pick MBBS FRACS FRACS Paul E O’Brien MBBS MD FRACS Gillian M Duchesne BSci MBChB FRCR MD (Cardiothoracic) FRANZCR Geoffrey Quail Personal Assistant/ Paul D’Urso MBBS (Hons) PhD FRACS Peter L Royce MBBS FRACS Administration Officer Barry Elliott MBBS FRACS RFD David Westmore MBBS FRCS FRCS Edin Kathryn F Noble Peter M Evans MBBS FRACS FRACS Keith C Farmer MBBS FRACS Mark Whitty MBBS FRACS Business Manager Michael Fogarty MBChB NZ FRCS (Ed) Scott Williams MBBS FRACS Gillian Holley BBus (Mgt) GDipAcc FRACS FAOrthA AFAIM AHRI Xiao-Ming Gao MBBS Box Hill Annette Holian MBBS FRACS John Buntine MBBS FRACS Technical Services Manager Gregory Hoy MBBS DipAnst FRACS FASMF Peter Lawson MBBS FRCS FRACS Paul L Dover BSc GDip Internet and Web FACSP FAOAHa Stan Schofield MBBS FRCS FRACS Comp MIT Anton Iseli BMedSc MBBS FRACS William R Johnson MBBS (Hons) MD FRACS Cabrini IT Manager FRCS FACS Ian Cox MBBS FRACR Ian G Sloan BSc (Hons) PhD John Laidlaw MBBS FRACS Felicity Hawker MBBS FANZCA FFICANZCA Peter S Lawson MBBS FRCS FRACS FRCA Finance Officer Gregory M Malham FRACS EMST MBChB Alain Lavoipierre MBBS FRACR Helen Dinh Assoc Dip (Acct) BSc Paul McMurrick MBBS FRACS Bronwyn Matheson MBBS FRANZCR Ian Rechtman MBBS FFARACS FANZCA HR Officer Jeremy L Millar FRACR MBChB BMedSc Morris Ritz MBBCh FCS SAfrica FRACS Effie Adraktas R Malcolm Millar MBBS FRACS Peter Nottle MBBS FRCS FRACS Clinical Dean Cabrini Administration Officer Gabriel Reisner MBBS FRACS DipUrol Simon DS Woods MBBS FRACS Jo-Ann Giovannoni AssocDip Office Mgt Henry Rundle MBBS FRCS Edin FRACS Jonathan Serpell MBBS FRACS FRCS Honorary Clinical Teacher Academic staff Kevin Siu MBBS FRACS Justin Beng Lin Chee MBBS FRACS Professors Stewart A Skinner MBBS PhD FRACS Robert Burton BA MBBS BMedSc MD PhD Julian Smith MBBS MS FRACS Research staff FRACP FRACS Ross Snow MBBS FRACS FACS Research Fellows Michael J Grigg MBBS FRACS David Stoney MBBS FRACS John B Dixon MBBS DipRACOG FRACGP Thomas Kossmann MD Heidelberg FRACS John Swann MBBS FRCS FRACS PhD Adrian L Polglase MBBS (Hons) MS FRACS Rodney Taft MBBS FRACR FRCR Xiaodi Han PhD FRCS Eng FRCS (Ed) FACS Keen-Hun Tai MBBS FRANZCR Paula Jablonski BSc MSc PhD Melb Alan Rodger BSc MBChB Edin DMRT Karen E Taylor BSc MBChB MRCP MSc FRCSE FRCR FRACR FRCR FRANZCR Research Assistants Jeffrey Rosenfeld MBBS MS Melb FRACS Christopher Thien MBBS (Hons) FRACS Margaret L Anderson BHIM PGDipHA FRCS (Ed) FACS FACTM Val Usatoff MBBS FRACS Nicole Bye Franklin L Rosenfeldt MD BS FRCS Roger Wale MBBS FRACS Susan Colles FRCS Edin John Waugh MBChB Aberd FRACR Maureen E Dixon BSc DipEd Marije Libeton Associate Professors Lecturers Aileen Misajon MSc Francis T McDermott AM MBBS Melb MD Harley Baxter MBBS FRACS FRCS Phuong Nguyen FRCS FRACS FACS Adam A Boyt Research Nurses Michael Bruce MBBS FRACS Cheryl P Laurie RN RM BHSc Clinical Associate Professors Richard Cade MBBS FRACS FRCS Julie Playfair D Jamie Cooper BMBS Flinders MD Adel Elton Edwards MBBS FRACS FRACP FFARACS FANZCA FFICANZCA Max Esser MBBS FRCS (Ed) FRCS (EdOrth) Senior Technical Officer Bruce B Davis MBBS FRACS FACS FRACS (Orth) Joanne E Paddle-Ledinek AM BSc MSc Donald Esmore MBBS FRACS FRCS Gary Grossbard MBBS FRACS John AL Hart MBBS FRACS FAOrthA FASMF Peter Grossberg MBBS FRACS FACS Technical Assistant FACSP Janet Havercroft BSc (Hons) Manc MSc Christine G Egan Vet Tech Ian McInnes MBBS FRCS FRACS PhD Sur Zeyad Nasa BSc Nina Sacharias MBBS FRCR FRACR Doh Ong Hii MBBS FRACS Carlos Scheinkestel MBBS FRACP Boon-Hung Hong MBBS FRACS Post Graduate Students Andrew Jamieson MBBS FRACS FRCS W J Lyon Senior Lecturers James Keck MBBS FRACS Graham D McCrystal Christopher Atkin MBBS FRCS FRACS Evangelos Klonis MBBS FACGM Francis J Miller David Birks MBBS Melb FRCS Edin FRCS(C) Peter Lugg MBBS FRACS Mehrdad Nikfarjam FRACS Kenneth M MacGowan MBBS FRACS FRCS Olivier WV van den Brink Wendy A Brown MBBS PhD FRACS Richard Maxwell MBBS BMedSc Anthony J Buzzard MBBS FRCS FRACS Campbell Miles MBBS FRACS Anthony Cass MBBS FRACS FRCS Gerald Moran MBBS FRACS Vince Cousins BMedSc MBBS FRACS M Cristina Morganti-Kossmann PhD Rome Ian Cunningham MBBS FRACS Vincent Pellegrino Michael Dally FRACR MBChB BSc Salvatore Pepe BSc PhD Robert Piaggio MBBS FRCR

Department of Surgery at The Alfred

Research 3. Optimal treatment for the obese: The Department of Obesity - the Disease and its Medical or surgical treatment - Surgery at The Alfred Treatment - Professor Paul O’Brien ongoing randomised controlled trial Hospital is the This has now become the major The obese adolescent - randomised coordinating centre for the research area of the Department. controlled trial commencing soon Obesity is a common and growing surgical undergraduate problem, it generates more disease than Eating behaviour and outcomes teaching program within any other single pathogen and it can Levels of obesity and outcomes now be treated safely and effectively. the Central and Eastern Predicting outcomes after treatment Clinical School. Other sites Through the extensive clinical use of the Lap-Band procedure, the department is 4. Endoscopic treatments for obesity: include Box Hill Hospital now the world leader in research into Intragastric balloon (Professor Michael Grigg), the health benefits of weight loss. Cabrini Hospital (Professor RF energy - induced gastric The areas of study which we are reduction Adrian Polglase) and the undertaking include: 5. Mechanisms of satiety/appetite: rural surgery program 1. The Problems of Obesity and the supervised by Benefits of Weight Loss on: Clinical/laboratory studies of ghrelin, leptin, insulin and other candidate Mr David Birks at Type 2 diabetes - ongoing hormones Latrobe Valley. randomised control trial The diseases of the metabolic 6. Quality of Life: syndrome - insulin resistance; Changes in validated QOL measures hyperlipidaemia; hypertension; with weight loss steatohepatitis; polycystic ovary The Department currently has 86 clinical syndrome Appearance orientation/evaluation members including paid and honorary Increased risk of cardiovascular academics who are involved in the events teaching of students in the surgery program. The department contributes Obstructive sleep apnoea and sleep to undergraduate teaching of the six disordered breathing year curriculum principally in years 4, Asthma 5 and 6. The new 5 year curriculum Gastro oesophageal reflux disease commenced in 2002, with the first major contact of students with the Alfred Gallstones Hospital to commence in 2004. Urinary incontinence The Department also contributes Osteoarthritis significantly to postgraduate clinical and Low back pain research training, clinical service and audit and quality assurance processes. Depression Obstetric complications It has continued to be a major Research Nurse - Cheryl Laurie from the Obesity Research Unit contributor to surgical research with a In general, we have completed most high level of input - funding and output - of the observational studies in these papers published in refereed journals. areas and are now moving to the use of RCT format as the defining Keratinocyte and Chondrocyte Cell Current research programs of the studies wherever possible. Culture - Ms Joanne Paddle-Ledinek Department include: 2. Optimising the technique of The Monash Tissue Culture Laboratory • Obesity Lap-Band placement and is primarily interested in the optimal • Keratinocyte and Chondrocyte Cell follow-up care: production of autologous cells for tissue repair. Culture Pars flaccida versus perigastric - • Gastrointestinal Function and ongoing randomised controlled trial Keratinocytes: In collaboration with the Disease The eating and exercise rules after Alfred Burns Unit, this laboratory • Trauma Research Lap-Band provides autologous keratinocytes cultured from skin biopsies for treatment • Neurosurgery Research Optimising the adjustment schedule of patients with extensive burns. The • Radiotherapy Research Anaesthesia in the morbidly obese growth of keratinocytes in tissue culture • Cardiovascular Research The assessment of obesity - clinical, and the influence of growth factors and laboratory, special techniques

Department of Surgery at The Alfred

of electrical and magnetic fields have • Development of urothelial cell culture A great number of new dressings to been investigated. The application of and its use in bladder reconstruction promote wound healing have been cultured epithelial allografts as biological - collaborative work with Professor developed since the early 1980s. The dressings is also being examined. PA Dewan at the Royal Childrens’ choice of dressing is usually made on Preliminary findings have been Hospital. the basis of personal experience, promising. A proposal to establish an availability, cost, type, state and site of Allograft Tissue Bank is being In studying the effect of different the wound. Patient preference and considered by the Alfred Burns Unit wound dressings on cell viability and tolerance is also considered. Wound and plastic surgeons at the Monash proliferation, we have also developed healing generally comprises three Medical Centre. a model to study the effects of possible stages: Cleansing, granulation and cytotoxic or growth promoting vascularisation, and epithelialisation. Chondrocytes are being isolated from substances on keratinocytes and The epithelialisation phase requires an the patient’s own healthy cartilage, other cells. optimum microenvironment and the grown in the laboratory and applied to absence of any cytotoxic factors. In this defects in the articular cartilage in the study, we examined the effect of a knee joint. The laboratory techniques number of wound dressings commonly and clinical outcomes in these patients used in the Alfred Hospital Burns Unit on are being evaluated. The cell culture epithelialisation. It was found that silver- laboratory, under the direction of Joanne containing dressings which are Paddle-Ledinek, has been accredited by bactericidal also compromise the Therapeutics Goods Administration keratinocyte viability. Alginate-containing for preparation of chondrocytes as a dressings with beneficial haemostatic commercial service to surgeons across properties due to high calcium Australia. compromise cell proliferation. Greater discrimination in the use of these The laboratory has also developed dressings is recommended. Wound optimal methods of isolation and culture status and healing phase should be conditions for a number of other cells. Control considered when choosing a dressing These cells have been used to evaluate for optimal epithelialisation. the cytotoxicity or growth promoting properties of different dressings used for treatment of burns and ulcers and the Gastrointestinal Function and Disease efficacy of therapeutic agents on growth - Mr Stewart Skinner promotion. Cultured cells have also We are studying the development of been provided to stimulate the immune colon cancer looking for methods of system as part of a novel cancer prevention, particularly using non- therapy. Melanocytes have been steroidal anti-inflammatory drugs. cultured for application in vitiligo. The Areas of study include the quantitation culture of ovine urothelial cells has been of effectiveness of various drugs, developed for a preliminary study of characterisation of their effect on urinary bladder augmentation in sheep. aberrant crypt foci, polyps and cancers, Silver-based dressing mechanisms of action, particularly via The specific research studies include: possible cyclo-oxygenase and non- • Autologous chondrocytes for clinical cyclo-oxygenase pathways. research into the repair of articular Specific studies of mechanisms include cartilage defects. measurements of COX-1 and COX-2 • Cultured epithelial allografts as mRNA in different settings and the role biological dressings for skin donor of (-catenin as a central path for NSAID sites are compared to Algisite M, the effect. The inter-relationship between the dressing currently used in the Burns use of these drugs and growth patterns, Unit. This clinical trial will be and rate of cell death in the cancer completed in 2004. being studied, have been linked with • The effect of different wound the expression of oncogenes in the dressings on viability and Alginate-based dressing tumour cells. proliferation of epithelial cells in culture. Epithelial Cell Cultures with Extracts of Wound Dressings

Department of Surgery at The Alfred

In parallel with these studies we are Current research projects of the We have developed strong links with examining the patterns of injury and unit include: several Alfred Hospital departments, repair in the gastric mucosa, particularly • Victorian Trauma Foundation Grant general practitioners and outside relating to the effect of NSAIDs which, for the study of Severe Brain Injury institutions. One important aim of our while capable of preventing colon at the Alfred Hospital. Part A - research is to improve the outcome from cancer, have a parallel capacity to injure Decompressive Craniectomy Study severe traumatic brain injury. We have the gastric mucosa. (DECRA). developed a strong clinical research program with the Department of Trauma There is an urgent need to identify • Part B - Intensive Monitoring Study. and Intensive Care Unit investigating precursors or markers of malignancy in • Modelling traumatic brain injury (TBI) brain injury and spine injury. We have the colon so that earlier diagnosis and using neuropsychological, also developed a strong link with treatment can be achieved. We have a neurosurgical, neurochemical and Dr Cristina Morganti-Kossmann who particular interest in the Aberrant Crypt neuroradiological measures of brain is developing brain injury research Foci (ACFs) in the human colon as a damage. laboratories on the Alfred campus. marker for cancer. The study of ACFs involves both animal and human study • A case-control study of brain and The first multi-centre randomised and includes the following: other tumours in adults and controlled study with decompressive exposure to radiofrequency craniectomy commenced at the Alfred • Determination of the incidence of electromagnetic energy in use of ACFs in the human colon Hospital in 2003 and is now a mobile phones. Australian Mobile multicentre study. The Principal • Determination of the histological Phone Safety Study (AUSPHONE). Investigators are Associate Professor characteristics of ACFs • Intraoperative Hypothermia J Cooper and Professor J Rosenfeld. • Determination of immunohistological Aneurysm Surgery trial (IHAST2). A similar study was completed in children and this is now the first study in characteristics of ACFs • ‘Talk and Die’ Project. Victorian the world to address the question as to • Development of endoscope for Institute of Forensic Science and whether Decompressive Craniectomy detecting and counting ACFs Consultative Committee in Road (DECRA) improves the outcome following Traffic Fatalities in Victoria (Monash • Trials of drug effects on ACF severe traumatic brain injury in adults. It University). Completed 2003. numbers will take another three years to complete • Use of confocal fluorescence • Familial Intracranial Aneurysm (FIA) the Intensive Brain Injury Monitoring microscopy for rapid identification of Study: a large scale international Study which commenced in 2003. human colorectal status. study to identify the genetic basis for the formation of intracranial Dr Xiaodi Han from Beijing, China has aneurysms. Clinical Trials Research been appointed as a Research Fellow in Neurosurgery Unit - University of Auckland. the Department of Neurosurgery and is - Professor Jeffrey Rosenfeld working in the laboratory of Dr Cristina • Three Dimensional Biomodelling of The Alfred Hospital Neurosurgery Morganti-Kossman on the effects of cranial and spinal pathology as an Department provides comprehensive in- traumatic brain injury on the endogenous aid to patient education, surgical patient and out-patient neurosurgical brain stem cells and inflammatory planning and operative neurosurgery. services treating the full range of markers. Mr Adam Boyt a final year intracranial spinal and peripheral nerve • Trauma Reception and Resuscitation medical student is also working with Dr disorders. The unit treats around 900 - Time for a New Approach. Morganti-Kossman on ‘Inflammatory patients annually with around 50% being • Long term outcome from early response to traumatic brain injury’. The elective and 50% emergency. Trauma childhood brain injury: 10 year Neurosurgery Department has purchased cases account for approximately 35% follow-up. a small animal stereotactic frame and in of the caseload. The Neurosurgery part a fluorescent microscope for the Department has further developed Laboratory Research Brain Injury Laboratory. sub-speciality interest in cerebrovascular • Definition of markers of traumatic surgery, spine surgery, skull base axonal injury with or without hypoxia. The clinical spine research program is surgery and neurotrauma. We are developing under the direction of Mr Greg • Investigation of the inflammatory committed to providing excellence in Malham in association with Professor response following traumatic brain neurosurgical care through quality Thomas Kossmann and the Departments injury with/without hypoxia using the management, education and training of of Trauma and Orthopaedics. The bio- rat diffuse axonal injury. health care professionals in clinical and modelling project is proceeding under the laboratory research. • Characterisation of neurogenesis direction of Mr Paul D’Urso. A multi- following experimental traumatic disciplinary Cerebro-vascular Clinic has brain injury. been set-up with the Departments of Radiology and Radiotherapy particularly to evaluate patients with arterio-venous malformations and will form the basis of ongoing clinical research.

Department of Surgery at The Alfred

Funding in 2003 • Alfred Res Trust - Professor PhD students in the P O’Brien $20,000.00 • Victorian Trauma Foundation Grant Department of Surgery at for the study of Severe Brain Injury at • Collier - Dr C Morganti-Kossmann The Alfred during 2003 the Alfred Hospital. $1.8 million. $2,500.00 Graham D McCrystal Part A - Decompressive Craniectomy Optimal organ preservation strategies for • Estate E F Luke $5,719.20 Study (DECRA) cardiac transplants: protecting the Part B - Best Practice and Intensive coronary vasculature. Monitoring Study Achievements during 2003 Francis J Miller Professor Jeffrey V Rosenfeld received Dysfunction in the senescent • Modelling Traumatic Brain Injury the following awards: (TBI) using neuropsychological, myocardium in cardiac surgery neurosurgical, neurochemical and • The Sally Harrington Goldwater Mehrdad Nikfarjam neuroradiological measures of brain Memorial Visiting Professor Award Treatment of liver tumours damage. The Alfred is a from the Barrow Neurological Foundation Phoenix, Arizona USA collaborating centre in this study. Olivier WV van den Brink in February 2003. NH&MRC Grant No. 207711 Novel role of cardiac opioids in University of Adelaide, SA. Years of • President’s Award, Melbourne High ischemia-reperfusion, heart failure and funding 2002-2004. $143,250 School Old Boys Association for cardiac surgery. (2002); $138,250 (2003); $120,000 ‘Excellence in Career Achievement’ - (2004). March 2003.

• A case-control study of brain and • ‘Defence Long Service Medal’ other tumours in adults and (DLSM) - March 2003. exposure to radiofrequency • Geoffrey Harkness medal. electromagnetic energy in use of Recognising outstanding mobile phones. Australian Mobile contribution to Royal Australian Army Phone Safety Study (AUSPHONE). Medical Corps - (awarded 2001) NH&MRC Grant. $1.2m, years of presented July 2003 funding 2001-2005.

• Familial Intracranial Aneurysm (FIA) Study: a large scale international study to identify the genetics basis for the formation of intracranial aneurysms. Clinical Trials Research Unit - University of Auckland. $90,000 2003-2005. Mehrdad Nikfarjam

• Definition of markers of traumatic axonal injury with or without hypoxia. The Alfred Research Trust - $20,000. Other higher degree students • Characterisation of neurogenesis in the Department following experimental traumatic Freya Louise Sheeran brain injury with/without hypoxia Susan Leigh Colles using the rat diffuse axonal injury model. The Alfred Research Trust - $40,000. Publications Journals • Regulation of chemokine synthesis Dixon JB, Dixon ME, O’Brien PE. Body in cultured mouse astrocytes. The image: Appearance orientation and Alfred Research Trust - $25,000. Professor Jeffrey Rosenfeld evaluation in the severely obese and • Department of Health and Aged - post-obese. Obesity Surgery. 2002; Incontinence Study $30,137.00 12: 65-71

• Inamed - Obesity Study - Professor Dixon JB, O’Brien PE. Health outcomes P O’Brien $236,688.82 of severely obese type 2 diabetic subjects 1 year after laparoscopic • Bioenterics Corp - Professor adjustable gastric banding. Diabetes P E O’Brien $90,701.68 Care. 2002;25:2 356-363

Department of Surgery at The Alfred

Dixon JB, Dixon ME, O’Brien PE. Harvey AS, Freeman JL, Rosenfeld JV, O’Brien PE, Dixon JB. Obesity - the Alcohol consumption in the severely Berkovic SF. Transcallosal resection of extent of the problem. Am. J. Surg. obese: Relationship with the metabolic hypothalamic hamartomas in patients 2002; 184 (suppl): 4-8. syndrome and cardiovascular risk. with intractable epilepsy. Epileptic Obesity Research. 2002; 10(4): 245-252 Disorders 5:257-265, 2003. O’Brien PE, Dixon JB. Weight loss, early and late complications - the international Dixon JB, Dixon ME, O’Brien PE. Lipid Hudson SM, Dixon JB, O’Brien PE. experience. Am. J. Surg. 2002; 184 profile in the severely obese: Changes Sweet eating is not a predictor of (suppl): 42-45. with weight loss following Lap Band outcome after Lap-Band (r) placement. surgery. Obesity Research. 2002; 10: Can we finally bury the myth? Obesity O’Brien PE. Invited Commentary. 903-910 Research. 2002; 12: 789-794. Algorithm for Bariatric Surgery. Obesity Surgery 2002; 12: 747-748 Dixon JB, O’Brien PE. Neck Jackson AC, Tsantefski M, Goodman H, circumference - a good predictor of Johnson B, Rosenfeld JV. The Book Chapters raised insulin and free androgen index in psychosocial impacts on families of Rosenfeld JV, Mark Sheridan, Bhadu obese pre-menopausal women: low - incidence, complex conditions in Kavar, Simon McKechnie. Head Injuries Changes with weight loss. Clinical children : the case of craniopharyngioma. - Chapter 29 in Definitive Surgery Endocrinology. 2002; 57: 769-778. Social Work in Health Care 38 (1): Trauma Course (DSTC) (2003) 81-110, 2003. Dixon JB, O’Brien PE. Selecting the Malham G. ‘Brain and Spinal Tumours’. optimal patient for Lap band placement. Kurrupu D, Christophi C, Maeda H, A guide for people with these tumours, Am. J. Surg. 2002; 184 (suppl): 17-20. O’Brien PE. Changes in the their families and friends. Cancer microvascular architecture of colorectal Council of Victoria 2003. Dixon JB, O’Brien PE. Outcomes after liver metastases following the Lap band placement: Changes in administration of SMANCS/Lipiodol. comorbidities and improvements in Journal of Surgical Research. 2002 Mar; quality of life. Am. J. Surg. 2002; 184 103 (1): 47-54. (suppl): 51-54. Muralidharan V, Malcontenti-Wilson C, Dixon JB, O’Brien PE. Wine consumers Christophi C. Effect of blood flow have reduced cardiovascular risk occlusion on laser hyperthermia for liver through improved insulin sensitivity and metastases. J Surg Res. 2002 Apr; reduced plasma homocysteine. 103 (2): 165-74. Australian Grapegrower and Winemaker October 2002 Muralidharan V, Malcontenti-Wilson C, Christophi C. Interstitial laser Favretti F, O’Brien PE, Dixon JB. Patient hyperthermia for colorectal liver Management after Lap Band placement. metastases: the effect of thermal Am. J. Surg. 2002; 184 (suppl): 38-41 sensitisation and the use of a cylindrical diffuser tip on tumour necrosis. Freeman JL, Harvey A, Rosenfeld JV, J.Clin.Laser Med Surg 2002; 20 (4): Wrennall JA, Bailey CA, Berkovic SF. 189-196 The evolution and postoperative resolution of symptomatic generalised Nikfarjam M, Muralidharan V, Christophi epilepsy in hypothalamic hamartomas. C, Tang H, Clouston D. Autoimmune Neurology 60: 762-7, 2003. Pancreatitis. ANZ Journal of Surgery. 2002 Jun; 72 (6): 450-2. Freeman JL, Zacharin M, Rosenfeld JV, Harvey AS. The endocrinology of Nikfarjam M, McLean C, Muralidharan V, transcallosal hypothalamic hamartoma Christophi C. Neuroendocrine Tumours resection for intractable epilepsy. of the Ampulla of Vater. ANZ Journal of Epileptic Disorders 5:239-247, 2003. Surgery. 2002 Jul; 72 (7): 531-3.

Georgius P, Yu K-F X, Rosenfeld JV, O’Brien PE, Dixon JB, Brown WA, D’Urso P. Healing of a brain abscess by Schachter LM, Chapman L, Burn A, secondary intention: case report. J Dixon M, et al. The laparoscopic Neurosurg 99:1091-1093, 2003. adjustable gastric band (Lap Band): a prospective study of medium term effect on weight, health and quality of life. Obesity Surgery. 2002; 12 (5): 652-660.

Clinical School at The Alfred

Directors of Academic Programs • Renovations were completed on the Laila Rotstein MBBS Melb FRACP The Clinical School Ground Floor of the Medical School Morry Silberstein MBBS (Hons) MD Melb building at The Alfred, and the DRACR FRANZCR comprises divisions located at The Alfred Clinical School’s offices were moved Personal Assistant from their previous location of the Judi Hall Hospital, Box Hill Hospital, Lower Ground Floor. St F.X. Cabrini Private • Morry Silberstein’s research group - Administration Manager Hospital and Maroondah Lawrence Hudson ‘Functional Imaging of Lower Hospital. The Alfred Extremity Diseases’ - previously Clinical Supervisor Clinical School was based at ‘The Avenue’, a private Sanjay Swaminathan MBBS established in the first teaching hospital of the School, expanded to include a wing in decade of the 20th association with the Epworth Private century as a teaching Hospital, and Stefania Roberts joined hospital for the University as a new PhD student. of Melbourne, but with the • Over 45 international elective commencement of students were supervised. They Monash University’s spent between 2 weeks and 3 medical degree in the early months attached to The Alfred and came from as far away as Austria 1960s, and Zaire. The School and the The Alfred became the first Hospital benefit from the diverse teaching hospital for the cultural backgrounds of these new medical school. With international visitors. the restructuring of the Teaching Faculty of Medicine in The Clinical School delivered 2000, the Clinical School undergraduate MB BS teaching to more at The Alfred became a than 500 students across the 4th, 5th formal division of the and 6th years of the Monash curriculum. Central and Eastern In excess of 160 students who had undertaken some or all of their training Clinical School and took at The Alfred graduated at the end of responsibility for 2003, and a considerable proportion of management of the clinical these were subsequently appointed as schools at Box Hill, Cabrini 1st year Medical Officers at The Alfred and Box Hill Hospitals. and Maroondah. Undergraduate Awards 2003 • Alfred Hospital Residents’ and Graduates’ Association Prize - to the sixth year student who, after Highlights of 2003 studying at the Central and Eastern • With the arrival of the new Dean of Clinical School, obtains the highest the Faculty, Professor Ed Byrne, the aggregate of marks in the final positions of Clinical Deans examinations - Nicky Zigouris (Academic Programs) were renamed • Geoff Conron Prize - to the sixth ‘Directors of Academic Programs’ year student who obtains the highest and advertised externally. Dr Laila aggregate of marks, or the most Rotstein and A/Professor Morry deserving student as determined by Silberstein were subsequently the Head of unit in the sixth year appointed to these positions in Psychological Medicine rotation at December 2003. the Central and Eastern Clinical School - Jonathan Clark

Clinical School at The Alfred

• Harriet and Robert Power Research Scholarships in Medicine and The Clinical School conducts research Surgery - to a sixth year student into the provision of clinical teaching, in from the Central and Eastern Clinical association with the Monash Centre for School as determined by a written Medical and Health Sciences Education. examination, followed by a vive voce for selected candidates - Syndia Lazarus PhD opportunities PhD opportunities exist in areas as • Harry Hindlip Green Scholarship in diverse as the evaluation of clinical Medicine for excellence in Medicine - examination methods to the to a sixth year student from Central establishment of the efficacy of and Eastern Clinical School on the web-based teaching modules. basis of results in the final year OSCA - Edmund Wong Publications • RACP Victorian State Committee Silberstein M. A Graduate Program in Prize in Clinical Medicine (MMC and Medical Imaging: Foundations of Alfred) - to the top Final Year Practice II. Sydney University Press, Student in Clinical Medicine at each Sydney, 2003 ISBN 1-8648-504-6 school as determined by the highest mark in the 5th Year Silberstein M, Given CA. CT diagnosis Medicine/Surgery clinical of pseudo-subarachnoid hemorrhage. examinations - Elissa Kennedy AJNR Am J Neuroradiol 24:1492-93; 2003

Grants Baird M, Budd R, Silberstein M. National Competition Policy Review of Radiation Protection Legislation Commonwealth Department of Health and Ageing (ARPANSA), $99,780.

Jonathan Clark, recipient of the Geoff Conron Prize, with Marissa Tubridy at graduation

64 Further information Central and Eastern Clinical School Faculty of Medicine, Nursing and Health Sciences Alfred Medical Research and Education Precinct Commercial Road, Melbourne, Victoria 3004 Australia Telephone +61 3 9903 0681 Facsimile +61 3 9903 0018 Email [email protected] www.monash.edu.au

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