Introducing Our New Chiefs

FALL/WINTER 2002-2003 Number 15

PNews UpdateO from the STDepartment of SurgeryOp UNIVERSITY . HOSPITAL . AND . HEALTH . SCIENCES . CENTER . AT. STONY . BROOK

Introducing Our i Stony Brook Surgical New Chiefs Speakers Bureau We are very pleased to introduce Enrique Criado, MD, FACS, In keeping with Stony Brook’s commitment who has joined our faculty as chief of vascular surgery, and to community service, the faculty members Martin S. Karpeh, Jr., MD, FACS, who has joined our faculty of the Department of Surgery are available to as chief of surgical oncology. present lectures to health professionals on a range of topics related to those surgical areas in which they have special expertise. For more information, please call (631) 444-7875.

Burn Care • Cultured autologous skin grafting Cardiothoracic Surgery • Automatic implantable cardioverter-defibrillators

VASCULAR SURGERY VASCULAR • Lung volume reduction surgery SURGICAL ONCOLOGY • Maze operation for arrhythmias • Minimally invasive heart surgery • Transmyocardial revascularization General Surgery • Advanced laparoscopic surgery • Bariatric surgery • Minimally invasive approaches to GERD • Laparoscopic colon surgery Otolaryngology-Head and Neck Surgery Dr. Enrique Criado Dr. Martin S. Karpeh, Jr. • Acoustic neuroma • Cochlear implant surgery oard-certified in general vascular oard-certified in surgery and with • Facial reanimation surgery surgery and with special expertise special expertise in surgical oncol- • Facial reconstruction inB endovascular surgery, Dr. Criado ogy,B Dr. Karpeh will contribute to our • Hearing loss will add new strength to our vascular commitment to excellence in providing • Minimally invasive parathyroidectomy surgery services, and his clinical abili- the most sophisticated, compassionate, • Otitis media and cholesteatoma ties will further enhance the University and timely surgical oncology services. Pediatric Surgery Vascular Center at Stony Brook. Dr. Karpeh comes to Stony Brook • Minimally invasive surgery Dr. Criado comes to Stony Brook from Memorial Sloan-Kettering Cancer Plastic and Reconstructive Surgery • Breast reconstruction from the University of Maryland, where Center in New York, where he prac- • Cosmetic surgery he was an associate professor practicing ticed with distinction on the gastric and Surgical Oncology at the Vascular Center of Mercy Medi- mixed tumor service in the Department • Breast surgery of Surgery since 1991. He is known na- cal Center in Baltimore, MD. Prior to • Gastrointestinal cancers his appointment there, Dr. Criado was a tionally and internationally for his ex- • Melanoma tenured associate professor at the Uni- pertise in the treatment of cancers of the • Minimally invasive resection versity of North Carolina at Chapel Hill. stomach and esophagogastric junction. • Soft tissue sarcomas (Continued on Page 2) (Continued on Page 2) (Continued on Page 13) INTRODUCING OUR NEW Traumatologist and General Surgeon n July, James A. Vosswinkel, MD, joined our Division of General Surgery as an assistant professor of surgery. A distinguished graduate of our residency program in general surgery,I Dr. Vosswinkel returns to Stony Brook from a year of fellowship training in trauma/ surgical critical care at Yale University. At Stony Brook, Dr. Vosswinkel’s practice in general surgery includes management of diseases of the gastrointestinal and endocrine systems; treatment of soft tissue disease, including hernias; and surgical treatment of cancers. He is skilled at both conventional and minimally invasive laparoscopic surgery. As a member of our trauma/surgical critical care team, Dr. Vosswinkel is responsible for the surgical management of injured patients—all aspects of traumatology; and pre- and post-operative critical care of adult surgical patients. Dr. Vosswinkel received his MD in 1995 from SUNY-Syracuse, and graduated from our residency program in 2001. Dr. James A. Vosswinkel During his residency training at Stony Brook, Dr. Vosswinkel received the first David J. Kreis, Jr., Award for Excellence in Dr. Enrique Criado Dr. Martin S. Karpeh, Jr. Trauma Surgery, an annual award (Continued from Page 1) (Continued from Page 1) given to a senior surgical resident by Internationally recognized for A prominent academic surgical the trauma/surgical critical care sec- his pioneering work in the design and oncologist, Dr. Karpeh held a faculty tion of our Division of General Surgery testing of endovascular grafts, Dr. appointment at the Weill Medical (see page 10). Criado was one of the first surgeons College of Cornell University since For consultations/appointments with in the United States involved in the the year he joined the staff at Sloan- Dr. Vosswinkel, please call (631) 444-4545. development and testing of endografts Kettering. He became an associate for abdominal aortic aneurysms. He professor of surgery in 2000. was also one of the principal investi- At Stony Brook, Dr. Karpeh gators for one of the early FDA trials will serve as chief of our Division of on a prototype of endograft for the Surgical Oncology, and will practice treatment of such aneurysms. the full range of general surgical At Stony Brook, Dr. Criado will oncology. He specializes in the man- POST-OP is published by the Department of Surgery serve as chief of our Division of Vas- agement of cancers of the gastroin- University Hospital and Health Sciences Center cular Surgery, and will practice the testinal tract, soft tissue (melanoma, Stony Brook University full range of general vascular surgery, sarcoma, and other cancers), and Stony Brook, New York adding further experience to our en- breast. Editor-in-Chief dovascular program. Dr. Karpeh received his medi- John J. Ricotta, MD In addition to his clinical duties cal doctorate from the Pennsylvania Writer/Editor Jonathan Cohen, PhD and responsibilities, Dr. Criado will State University College of Medicine serve as program director of our resi- in 1983 and subsequently completed Contributing Editor Andrew E. Toga, FACHE dency (fellowship) training program his general surgical residency train- Advisory Board in vascular surgery. ing at the Hospital of the University Collin E.M. Brathwaite, MD Dr. Criado completed his resi- of Pennsylvania (1989). Enrique Criado, MD Alexander B. Dagum, MD dency training in both general surgery Dr. Karpeh went on to receive Peter J. Garlick, PhD Martin S. Karpeh, Jr., MD (1990) and general vascular surgery fellowship training in surgical on- Arnold E. Katz, MD (1991) at the University of North cology at Memorial Sloan-Kettering Irvin B. Krukenkamp, MD Cedric J. Priebe, Jr., MD Carolina at Chapel Hill, where he sub- (1991) before being asked to join Harry S. Soroff, MD sequently joined the surgical faculty the staff there and the surgical All correspondence should be sent to: and established himself as a promi- faculty of Weill Cornell Medical Dr. Jonathan Cohen College. Writer/Editor, POST-OP nent academic surgeon. Department of Surgery Health Sciences Center T19 For consultations/appointments with For consultations/appointments with Stony Brook, NY 11794-8191, USA Dr. Criado, please call (631) 444-2565. Dr. Karpeh, please call (631) 444-2565.

— 2 — DEPARTMENT OF SURGERY • UNIVERSITY HOSPITAL AND HEALTH SCIENCES CENTER • STONY BROOK UNIVERSITY DEPARTMENT OF SURGERY • UNIVERSITY HOSPITAL AND HEALTH SCIENCES CENTER • STONY BROOK UNIVERSITY — 3 — Thereafter, it became the standard Performing Minimally Invasive of care in most institutions to perform bilateral neck explorations for hyperpara- Parathyroid Surgery thyroidism. The results in large series demonstrate cure rates that exceed 95%, The New Approach to Treating with complication rates in the range of Hyperparathyroidism 1% to 2%.

yperparathyroidism is a condition caus- WHAT IT IS Hing high blood-calcium levels that afflicts Surgery to remove abnormal para- about 100,000 Americans each year. It is caused thyroid glands is indicated for moderate by the overproduction of parathyroid hormone to severe symptoms of hyperparathy- (PTH) by one or more of the four parathyroid roidism. In cases where the problem is glands located in the neck. This chronic condi- an adenoma (benign tumor), just the one tion may result in kidney stones, osteoporosis, gland will be removed. If all four glands abdominal problems, fatigue, and depression, are enlarged (hyperplasia), the surgeon among other illnesses. It can successfully be will likely remove most (three and a treated by removing the abnormal parathyroid half) or all of them. gland(s). Traditionally, parathyroid surgery At Stony Brook, Maisie L. Shindo, MD, has involved a long incision, exploration associate professor of surgery (otolaryngol- on both sides of the neck, and general ogy-head and neck surgery) and director of anesthesia. The new technique—known Dr. Maisie L. Shindo head and neck oncology, is now performing in the medical literature as minimally minimally invasive parathyroid surgery, and invasive radioguided parathyroidectomy her surgical expertise in this new procedure further demonstrates our faculty’s (MIRP)—offers a safer and less invasive commitment to providing state-of-the-art care. approach. In this procedure, a radioiso- Minimally invasive parathyroid surgery—that is, parathyroidectomy tope “sestamibi” scan is used to help (parathyroid gland removal)—can be performed in the ambulatory surgery locate a tumor or abnormal parathyroid setting, under local anesthesia, with minimal risk to the patient. gland prior to surgery. This newly developed approach to parathyroid surgery is well tolerated by patients, and is associated with cure rates that are at least as good as those Since 85% to 90% of patients attained through traditional bilateral neck exploration. Moreover, the complica- with hyperparathyroidism have tion rate is exceedingly low. a single parathyroid adenoma The first successful parathyroidectomy for hyperparathyroidism was per- and its removal generally re- formed in 1925. The four parathyroid glands were identified through a bilateral neck exploration, and an enlarged parathyroid gland was excised. The patient sults in cure, our new ability to experienced cure with marked resolution of his symptoms and signs of hyper- determine—before surgery—the parathyroidism. location of the abnormal gland makes a directed operation the ABOUT DR. SHINDO most logical approach to treat- Dr. Shindo received her MD from the University of Southern California in 1984. She completed her ment. residency training in otolaryngology-head and neck surgery at the University of Southern Califor- nia-Los Angeles County Medical Center, and earned her board certification in 1989. Subsequently, For the scan, the patient is given a she pursued fellowship training in head and neck oncology and in head and neck microvascular very small dose of a radioactive material reconstructive surgery at Northwestern University Hospital and Ohio State University, respectively. that is absorbed only by the overactive In 1991, Dr. Shindo joined the faculty of the Department of Otolaryngology-Head and Neck Sur- parathyroid gland(s)—not healthy ones. gery at the University of Southern California, where she gained national recognition for her work During the operation, the surgeon uses in microvascular head and neck reconstruction. From there, she joined our faculty in 1997. Her the sestamibi scan results as a map to lo- special clinical/research interests in oncology include the management of thyroid cancer and the cate the abnormal gland. In some cases, reconstruction of head and neck defects following cancer resection. Included in the Best Doctors a miniature hand-held probe that detects database (1996-2002; formerly Woodward/White’s Best Doctors in America), Dr. Shindo also has expertise in other specialized areas of otolaryngology-head and neck surgery, including surgery for radioactivity, much as a Geiger counter paralyzed vocal cord and facial paralysis. does, is used to confirm the location. (Continued on Page 14) For consultations/appointments with Dr. Shindo, please call (631) 444-4121.

— 2 — DEPARTMENT OF SURGERY • UNIVERSITY HOSPITAL AND HEALTH SCIENCES CENTER • STONY BROOK UNIVERSITY DEPARTMENT OF SURGERY • UNIVERSITY HOSPITAL AND HEALTH SCIENCES CENTER • STONY BROOK UNIVERSITY — 3 — Performing Skull Base Surgery urgery in the skull base area has in recent decades established itself as a major new addition to surgical care. It involves a multidisciplinary effortS out of necessity. No one surgeon can obtain, much less sustain, all BIO NOTES the skills required to deal with the complex nature of tumors and other Dr. Smouha is the director of otology-neurotol- disorders located in the skull base area. ogy at University Hospital. He received his certi- Teaming up to perform skull base surgery at Stony Brook, Eric E. fication as Diplomate of the American Board of Otolaryngology in 1986, and has been a fellow Smouha, MD, associate professor of surgery (otolaryngology-head and of the American College of Surgeons (FACS) neck surgery) and neurosurgery, and Raphael P. Davis, MD, associate pro- since 1993. He received his MD from McGill fessor and acting chair of neurosurgery, are working closely together to University, and then trained at St. Vincent’s provide treatment for diseases that previously were debilitating or fatal. Hospital and Manhattan Eye, Ear, and Throat Hospital in New York, and the Ear Research As skull base surgeons, Dr. Smouha and Dr. Davis enjoy Foundation of Florida. a reputation for excellence, an enviably low complication Dr. Smouha received the Honor Award from the American Academy of Otolaryngology-Head rate, and a loyal patient following. and Neck Surgery in 1998. In 1999, he was included in the Best Doctors on-line database Skull base surgery encompasses a (formerly Woodward/White’s Best Doctors in wide variety of operations performed America) and Castle Connolly’s How to Find at the interface of the brain and neck the Best Doctors: New York Metro Area. He is a fellow of the American Neurotology Society where an intricate complex of major and the North American Skull Base Society. nerves, glands, and blood vessels is found. It includes surgery for acoustic Dr. Davis received his MD from Mount Sinai neuromas, meningiomas, pituitary tu- School of Medicine in New York, graduating summa cum laude. He trained at Mount Sinai mors, and other benign and malignant Medical Center under Dr. Leonard Malis, who tumors at the base of the skull. is considered one of the fathers of modern In the past, surgeons were unable microneurosurgery. He obtained his certifica- to perform surgery in the skull base tion as Diplomate of the American Board of area because of its complex anatomy Neurological Surgery in 1990. He was featured in Castle Connolly’s How to Find the Best and the risk to delicate and vital Doctors: New York Metro Area in 1997. He structures. However, advances in di- was promoted to the position of acting chair of agnostic, therapeutic, and reconstruc- neurosurgery and University Hospital’s neuro- tive techniques now allow successful surgeon-in-chief in 1999. treatment of lesions deep in the skull base to be successfully treated through For consultations/appointments, please call team surgery, usually through a col- (631) 444-1213, option 4, and then option 2. laboration of a neurosurgeon and oto- laryngologist-head and neck surgeon. Dr. Smouha and Dr. Davis have years of experience as a team performing skull base surgery. Their philoso- phy of treatment is a combination of conservative case management with state-of-the-art procedures and technology. Treatment plans are individu- alized to each patient’s needs. (Continued on Page 15)

THE COMPREHENSIVE SKULL BASE PROGRAM AT STONY BROOK PROVIDES: 1 Patient access to both 2 Joint conference of 3 Enhanced patient care 4 Close monitoring surgeons at the same the two specialists through a thoroughly of patient progress patient visit, optimizing immediately, further coordinated process through coordinated patient time and efforts saving time to provide records and physician a swift course of action conferences

— 4 — DEPARTMENT OF SURGERY • UNIVERSITY HOSPITAL AND HEALTH SCIENCES CENTER • STONY BROOK UNIVERSITY DEPARTMENT OF SURGERY • UNIVERSITY HOSPITAL AND HEALTH SCIENCES CENTER • STONY BROOK UNIVERSITY — 5 — BOTOX THERAPY . . . • Reduces or eliminates wrinkles Providing Botox Therapy without surgery Wrinkle Reduction Without Surgery • Requires no sedation or anesthetic • Corrects underlying muscles (as ur program in cosmetic surgery now provides Botox therapy for facial and opposed to the skin’s surface or neck wrinkles. This nonsurgical method of reducing such wrinkles recently sub-layer the way peels do) gainedO Food and Drug Administration (FDA) approval for the treatment of • Provides dramatic effects as a cosmetic procedure for: “frown lines” and, according to the American Society for Aesthetic Plastic Sur- gery, has already become the fastest-growing cosmetic procedure. — Vertical lines between the eyebrows Botox is a natural, purified protein that relaxes muscles by blocking nerve — Horizontal forehead lines impulses. A few drops of it are injected with a tiny needle into the muscle that — Crow’s feet creates a wrinkle. When Botox is injected into a muscle, it blocks the nerve im- — Horizontal lines in the neck pulse from reaching that area, and as a result, the muscle weakens. As the muscle weakens, the skin overlying the muscle relaxes, and the wrinkles in the skin gradually soften and often disappear. Normal facial expres- sions are not affected by the treatments.

Dr. Balvant Arora Our Botox specialist, as recommended, is fellowship trained ABOUT DR. ARORA in cosmetic Board certified in plastic surgery, Dr. Arora re- surgery and ceived his medical doctorate (MBBS: Bachelor board certified in of Medicine and Bachelor of Surgery) in 1984 plastic surgery. from the University of Baroda, in Vadodara, India. BEFORE From the same institution, he then received his MS (Master of Surgery, 1988) in general Patients usu- surgery and his MCh (Magister Chirurgie, 1991) ally see dramatic in plastic surgery. results within a few In 1992, after practicing plastic surgery in days. Existing frown India, Dr. Arora moved to the United States. lines, in most cases, He subsequently joined our residency program disappear in about here at Stony Brook in 1995. He left in 1998 to pursue further training in plastic surgery at the a week. Because the Oregon Health Sciences University in Portland, results are tempo- which he completed in 2000. This training was rary, the therapy followed by his fellowship in cosmetic surgery needs to be repeated AFTER at Lenox Hill Hospital in New York. after 3 to 6 months. Dr. Arora’s practice at Stony Brook includes When Botox is first injected, a minor sting is initially felt for a few seconds. general plastic and reconstructive surgery, with an emphasis on cosmetic surgery in which he Once the injection is complete, there is usually no discomfort. Nearly all patients has special expertise. He is skilled at providing continue their routine daily activity immediately after the treatment. care for both adults and children. Our Botox specialist is Dr. Balvant Arora, who joined our Division of Plastic and Reconstructive Surgery in 2001, and has contributed to the establishment of In addition to Botox injections, other cosmetic surgery procedures that Dr. Arora performs are our growing program in cosmetic surgery. face-lift, blepharoplasty (eyelid lift), liposuction, breast augmentation and reduction, total body FDA APPROVAL contouring, laser resurfacing, chemical peel, Botox was first approved by the FDA in 1989 to treat two eye-muscle dis- collagen injection, and hair transplantation. He orders—uncontrollable blinking (blepharospasm) and misaligned eyes (strabis- also performs minimally-invasive endoscopic plastic surgery, including breast augmentation mus). In 2000, it was approved to treat a neurological movement disorder that and brow-lift. causes severe neck and shoulder contractions, known as cervical dystonia. As an unusual side effect of the eye disorder treatment, Botox softened the For consultations/appointments with vertical frown (glabellar) lines between the eyebrows that tend to make people Dr. Arora, please call (631) 444-4545. (Continued on Page 15)

— 4 — DEPARTMENT OF SURGERY • UNIVERSITY HOSPITAL AND HEALTH SCIENCES CENTER • STONY BROOK UNIVERSITY DEPARTMENT OF SURGERY • UNIVERSITY HOSPITAL AND HEALTH SCIENCES CENTER • STONY BROOK UNIVERSITY — 5 — adequacy in the United States. The new Addressing Complex dietary reference intakes (DRIs) are established using an expanded concept Nutritional Issues that includes indicators of good health Guiding Policy-Makers And and the prevention of chronic disease, Health Professionals as well as possible adverse effects of overconsumption. eter J. Garlick, PhD, professor intake of protein during pregnancy is Collectively, Dr. Garlick and his of surgery and director of our increased. fellow panel members assessed thou- surgicalP research division, played a Because data on the potential for sands of scientific studies linking ex- major role in the landmark nutrition high-protein diets to produce chronic cessive or inadequate consumption of report, Dietary Reference Intakes for or other diseases are often conflicting fats, carbohydrates, and protein with Energy, Car- or inadequate, tolerable upper intake increased risk for dietary deficiency bohydrate, levels for consumption could not be diseases, obesity, heart disease, diabetes, Fiber, Fat, determined for protein or for the indi- and other chronic illnesses. The DRIs Fatty Acids, vidual amino acids. However, given include not only recommended intakes, Cholesterol, the lack of data on overconsumption intended to help individuals meet their Protein, and for some of these amino acids and pro- daily nutritional requirements, but also Amino Acids tein, caution is warranted in consum- tolerable upper intake levels (ULs) that (Macro- ing levels significantly above those help them avoid harm from consuming nutrients), normally found in foods. too much of a nutrient. released This study was sponsored by the in Septem- “Most people are not at risk U.S. Department of Health and Human ber by the of either under- or over- Services Office of Disease Prevention National Dr. Peter J. Garlick consumption of protein,” and Health Promotion; Health Canada; Academies’ says Dr. Garlick. “However, U.S. Food and Drug Administration; Institute of Medicine. A specialist there is a possibility that National Institutes of Health; Centers in protein metabolism, Dr. Garlick some young men might take for Disease Control and Prevention; U.S. chaired the Protein and Amino Acid Department of Agriculture; U.S. Depart- Section of the Panel on Dietary Ref- excessive protein supplements ment of Defense; Institute of Medicine; erence Intakes for Macronutrients; in the belief that additional the Dietary Reference Intakes Private the 21-member panel included dis- protein will aid in muscle Foundation Fund, including the Dan- tinguished scientists from both the building. On the other hand, non Institute and the International Life United States and Canada. there may be a risk for older Sciences Institute-North America; and This report, the sixth in a series, persons, whose appetites are the Dietary Reference Intakes Corporate develops new guidelines for the U.S. diminished, to suffer muscle Donors’ Fund, contributors to which in- and Canada for the consumption of wasting through consuming clude Roche Vitamins Inc., Mead John- energy, carbohydrates, fiber, fat, fatty too little protein.” son Nutrition Group, and M&M Mars. acids, cholesterol, protein, and amino The Institute of Medicine’s Food acids, collectively known as macro- “The new guidelines should and Nutrition Board has been respon- nutrients. help individuals to design sible for developing recommended In addition to the other nutri- the most appropriate diet dietary allowances or RDAs for the tional requirements, the report estab- United States for the last 60 years. The lishes age-based requirements for the for health, but their main Institute is a private, nonprofit organiza- first time for all nine of the essential function is to give advice tion that provides health policy advice amino acids found in dietary protein. to the government, and to under a congressional charter granted to Values are included for pregnant organizations, such as those the National Academies (formerly Na- women, infants, and children based who provide meal services to tional Academy of Sciences). on their special needs. Using new schools and residences for the An active researcher, Dr. Garlick’s data, the report reaffirms the previ- elderly.” work at Stony Brook has included nu- ously established recommended level merous studies of surgery’s effect on the of protein intake, which is 0.8 grams In the past, recommended di- body’s protein metabolism. per kilogram of body weight for etary allowances (RDAs) have served adults. However, the recommended as the benchmarks of nutritional

e are very pleased to introduce Valerie A. The Stony Brook Leg and Foot Ulcer Treatment Group provides multidisciplinary care for Brunetti, DPM, a board-certified podiatrist W patients with nonhealing ulcers on the leg, who provides evaluation and treatment of the ankle, or foot. foot and ankle, both in the hospital and on an outpatient basis. Located at our Surgical Care Center in East Setauket, the Leg and Foot Ulcer Treatment A Diplomate of the American Board of Group is directed by Paul S. van Bemmelen, Podiatric Surgery and Fellow of the American MD, PhD, assistant professor of surgery College of Foot and Ankle Surgeons, Dr. Brunetti (vascular surgery), and Richard A. Clark, MD, is a member of the faculty of the Department professor and chairman of dermatology. of Surgery (clinical assistant professor) and the Our goal is to promote faster wound healing medical staff of Stony Brook University Hospital. and decrease recurrences, with a minimum Dr. Brunetti has operating room privileges of patient visits and cost. At the initial visit, Dr. Valerie A. Brunetti at University Hospital and at the Stony Brook patients are evaluated by our team of Ambulatory Surgery Center. Additionally, she specialists in vascular surgery, dermatology, podiatry, and orthotics. If indicated, plastic or is an active member of the multidisciplinary wound care team of the Stony orthopedic surgery consultation is obtained. Brook Leg and Foot Ulcer Treatment Group, at the Surgical Care Center in East Setauket, where she provides foot/ankle consultations and treatment. We provide a complete spectrum of treatment, ranging from Unnaboots to recombinant DNA Dr. Brunetti’s foot care services include palliative and/or surgical treatment of: growth factor and cultured skin substitute. We have a special interest in the nonsurgical • Infections (soft tissue or bone) or ulcerations of the foot treatment of patients with poor circulation, using impulse compression technology. • Diabetic foot Clinical research into the effectiveness • Biomechanical imbalances including bunions and hammertoes of various topical treatment modalities is • Hypertrophied mycotic nails and pedal hyperkeratoses conducted on an ongoing basis. This allows our patients access to state-of-the-art • Heel pain, gouty arthritis, and Charcot foot deformities treatment for chronic wounds. All members of our wound care team are Dr. Brunetti received her DPM from the New York College of Podiatric Stony Brook faculty, and the Group operates Medicine in 1984, and completed her surgical residency at Manhattan independent of commercial suppliers. hospitals affiliated with NYCPM. She then spent the academic year of 1986-87 as dean of podiatric medicine at Barry University in Miami Shores, For consultations/appointments, FL. Returning to New York, she entered private practice, and subsequently please call (631) 444-4545. joined the faculty of NYCPM. In 1992, Dr. Brunetti joined the staff of the Northport Veterans Affairs e Medical Center, as chief of podiatry and director of the podiatric residency The Stony Brook Leg and Foot Ulcer Treatment Group is dedicated to: program. She became a member of our faculty and clinical practice in 2002. Dr. Brunetti can be reached on Fridays at the Surgical Care Center, • Comprehensive patient care at (631) 444-4545, or from Monday through Thursday at the Northport VA • Early intervention Medical Center, at (631) 261-4400, ext. 2061. • Improved healing rates • Reduced hospitalization • Reduced amputations • Reduced disability • Community outreach

— 6 — DEPARTMENT OF SURGERY • UNIVERSITY HOSPITAL AND HEALTH SCIENCES CENTER • STONY BROOK UNIVERSITY DEPARTMENT OF SURGERY • UNIVERSITY HOSPITAL AND HEALTH SCIENCES CENTER • STONY BROOK UNIVERSITY — 7 — Residency Update Since the class of 1975 entered the profession of surgery, 154 physicians have completed their residency training in general surgery at Stony Brook. The alumni of our residency program now practice surgery throughout the United States, as well as in numerous other countries around the world—and we’re proud of their diverse achievements and contributions to healthcare.

Our fully accredited five-year nonpyramidal residency program fulfills the standards for professional excellence adopted by the American Board of Surgery, and leads to eligibility for board certification. Five surgical residents are selected each year through the National Resident Matching Program.

2002 Graduating Residents Name Career Direction General Surgery Nasrin Ansari, MD TBA Cheng Lo, MD Vascular surgery fellowship at U of Massachusetts-Worcester Zhanna Logman, MD Private practice in Mineola, NY John Platz, MD Surgical critical care fellowship at SUNY-Stony Brook Colleen Willett, MD Plastic surgery fellowship at Cleveland Clinic Vascular Surgery Daniel Char, MD Private practice in Woodcliff Lake, NJ Our accredited general vascular surgery residency (fellowship) was Otolaryngology established in 1980 by our Division of Eric Gross, MD General plastic surgery residency at U of Kentucky Vascular Surgery, and since then, 22 Critical Care vascular surgeons have been trained at Stony Brook. Aleksander Komar, MD Staff position at Holmes Regional Trauma Center, Melbourne, FL Our accredited residency in otolaryn- New Chief Residents gology was established in 1993 by our Division of Otolaryngology-Head and Name Career Direction Neck Surgery, and since then, six oto- Salvador Cuadra, MD Vascular surgery fellowship at UMDNJ-Newark laryngology-head and neck surgeons Tomasz Kozlowski, MD Transplantation fellowship at Johns Hopkins U have been trained at Stony Brook.

Paul Mancuso, MD Colorectal surgery fellowship at Thomas Jefferson U Our accredited residency (fellowship) Steve Martinez, MD Surgical oncology fellowship at John Wayne Cancer Institute, in surgical critical care was established Santa Monica, CA in 2000 by our Section of Trauma/ Surgical Critical Care, and since then, two surgeons have been trained in Incoming Residents/All Categorical PGY-1* surgical critical care at Stony Brook. Name Medical School (Grad. Year)

Joseph Ametrano, MD SUNY-Syracuse (’02) Wei Fan Chen, MD SUNY Downstate (’02) Paul Impellizzeri, MD SUNY Downstate (’02) Fady Kaldas, MD U of California-Irvine (’02) Kristen Rezak, MD Ross U (’01) * As of July 1, 2002.

1) Dr. Eugene Mohan (left) and Dr. John Ricotta (right) with our 2002 graduating chief residents (from left to right), Drs. Nasrin Ansari, Cheng Lo, Zhanna Logman, John Platz, and Colleen Willett, at the graduation banquet held on June 16 at Flowerfield, St. James, NY.

2 3

4 2) Our graduating otolaryngology resident (center), Dr. Eric Gross, with Dr. Arnold Katz (left) and Dr. Ricotta.

3) Our graduating vascular surgery resident (center), Dr. Daniel Char, with Dr. Paul van Bemmelen (left) and Dr. Ricotta.

4) Our graduating critical care fellow (center), Dr. Aleksander Komar, with Dr. Collin Brathwaite (right) and Dr. Ricotta.

— 8 — DEPARTMENT OF SURGERY • UNIVERSITY HOSPITAL AND HEALTH SCIENCES CENTER • STONY BROOK UNIVERSITY DEPARTMENT OF SURGERY • UNIVERSITY HOSPITAL AND HEALTH SCIENCES CENTER • STONY BROOK UNIVERSITY — 9 — Third Annual David J. Kreis, Jr., Award Some Recent Publications* For Excellence in Trauma Surgery Bilfinger TV, Seifert FC, Giron F, McLarty AJ, Krukenkamp IB, Saltman AE, Ricotta JJ. Can the added risk of stroke from combined coronary artery bypass grafting and carotid endarterectomy be predicted? Ann Thorac Surg 2002;73:S377. Bilfinger TV, Stefano GB. The role of protease inhibition with emphasis on the effects of inflammation and vascular immune phenomena. Curr Pharm Des 2002;8:505-9. Bilfinger TV, Vosswinkel JA, Cadet P, Rialas CM, Magazine HI, Stefano GB. Direct assessment and diminished production of morphine stimulated NO by diabetic endothelium from saphenous vein. Acta Pharmacol Sin 2002;23:97-102. Brodsky SV, Malinowski K, Golightly M, Jesty J, Goligorsky MS. Plasminogen activator inhibitor-1 promotes formation of endothelial micropar- Dr. Steve Martinez (left) ticles with procoagulant potential. Circulation receiving award from Dr. 2002;29;106:2372-8. Collin E.M. Brathwaite. Cadet P, Mantione K, Bilfinger TV, Stefano GB. Morphine down regulates human vascular tissue estrogen receptor expression determined by real- he third David J. Kreis, Jr., Award for Excellence in Trauma Surgery time RT-PCR. Neuroendocrinol Lett 2002;23: Twas presented to Steve Martinez, MD, at our resident graduation ban- 95-100. quet on June 16, 2002. Dr. Martinez, who received his MD in 1997 from the Caso G, Ford GC, Nair KS, Garlick PJ, McNurlan MA. Aminoacyl-tRNA enrichment after a flood of University of Washington, is cuurently a chief resident in the Department. labeled phenylalanine: insulin effect on muscle This annual award is given to a senior (fourth-year) surgical resident protein synthesis. Am J Physiol Endocrinol Metab 2002;282:E1029-38. by our Section of Trauma/Surgical Critical Care, in honor of the late Dr. Caso G, Garlick PJ, Gelato MC, McNurlan MA. Kreis, who served with distinction on our faculty from 1986 until his un- Lymphocyte protein synthesis is increased with timely death in 1989. He was the founding chief of our trauma service. the progression of HIV-associated disease to AIDS. Clin Sci (Lond) 2001;101:583-9. Presented at our annual graduation banquet in June, this award Char D, Cuadra S, Ricotta J, Bilfinger T, Giron F, recognizes the unique characteristics that make a trauma surgeon—the McLarty A, Krukenkamp I, Saltman A, Seifert characteristics that Dr. Kreis personified: integrity, educational acumen, F. Combined coronary artery bypass and carotid endarterectomy: long-term results. Cardiovasc leadership, and excellence both in clinical practice and medical research. Surg 2002;10:111-5. In addition to an engraved plaque, the winning resident receives Criado E, Izquierdo L, Lujan S, Puras E, Mar Espino funding towards attendance at a national conference on trauma/surgical M. Abdominal aortic coarctation, renovascular, hypertension, and neurofibromatosis. Ann Vasc critical care. Surg 2002;16:363-7. The David J. Kreis, Jr., Memorial Fund was established in the Depart- Criado E, Lujan S, Izquierdo L, Puras E, Gutierrez M, ment soon after his death. The Fund supports the annual award which Fontcuberta J. Conservative hemodynamic surgery for varicose veins. Semin Vasc Surg 2002;15: was first given in 2000. It is also used to underwrite resident travel to re- 27-33. search conferences, and to support other educational activities related to Cuadra SA, Char DJ, Ricotta JJ, Krukenkamp IB, trauma/surgical critical care in the Department. Seifert FS, Giron F, Bilfinger TV. Is there a gen- der bias after combined carotid endarterectomy/ coronary artery bypass grafting? Ann Thorac Donations to the David J. Kreis, Jr., Memorial Fund are tax-deductible. For information, Surg 2002;73:S371. please call (631) 444-8330. Gao J, Wymore RS, Wang Y, Gaudette GR, Kruken- kamp IB, Cohen IS, Mathias RT. Isoform-specific stimulation of cardiac Na/K pumps by nanomolar concentrations of glycosides. J Gen Physiol 2002;119:297-312. Garlick PJ. Assessment of the safety of glutamine and other amino acids. J Nutr 2001;131(9 Suppl): 2556S-61S. Gaudette GR, Todaro J, Krukenkamp IB, Chiang FP. Computer aided speckle interferometry: a technique for measuring deformation of the surface of the heart. Ann Biomed Eng 2001;29:775-80.

(Continued on Page 14) * The names of faculty authors appear in boldface.

— 10 — DEPARTMENT OF SURGERY • UNIVERSITY HOSPITAL AND HEALTH SCIENCES CENTER • STONY BROOK UNIVERSITY DEPARTMENT OF SURGERY • UNIVERSITY HOSPITAL AND HEALTH SCIENCES CENTER • STONY BROOK UNIVERSITY — 11 — in the Heart Center. Dr. Krukenkamp Dr. Robert D. Barraco, assistant Division Briefs is actively engaged in research aimed professor of surgery, was initiated at bringing innovative treatment/ into fellowship in the American Col- Cardiothoracic Surgery technology to patient care. The central lege of Surgeons at the College’s 88th Dr. Thomas V. Bilfinger, profes- focus of his current research is upon Annual Clinical Congress, held in sor of clinical surgery, has become an solutions to congestive heart failure October in San Francisco. By meeting auditor for cancer programs spon- and arrhythmogenesis. Among his the College’s stringent membership sored by the National Cancer Institute clinical research programs to treat requirements, Dr. Barraco has earned (NCI) and American College of Sur- atrial fibrillation is the use of the mi- the distinguished right to use the des- geons Oncology Group (ACoSOG). crowave maze operation that was pio- ignation “FACS” (Fellow, American Established in 1998, ACoSOG was the neered at Stony Brook. College of Surgeons) after his name. first new cooperative study group (ie, Dr. Barraco has been awarded network of medical centers around General/Gastrointestinal a $30,000 research grant from Stony the country) sponsored by the NCI in Surgery Brook’s General Clinical Research 18 years, and the only one to focus on Dr. Arif Ahmad, assistant pro- Center (GCRC) to conduct a year-long surgery. Its primary goal is to evalu- fessor of surgery and director of the clinical study titled “Early Occult ate surgical therapies in the manage- Center for Minimally Invasive Sur- Deep Venous Thrombosis in Trauma ment of patients with malignant gery, did the first Stretta procedures Patients with Isolated Lower Extrem- solid tumors. The participation of our for GERD to be performed on Long ity Fractures Requiring Operative cardiothoracic surgeons, who joined Island. On December 11, two patients Repair” (June 2002-June 2003). The ACoSOG in 1999, provides eligible pa- successfully underwent the newly de- GCRC is committed to supporting re- tients with the only available access in veloped endoscopic procedure. Both search that advances patient care. Suffolk County to promising experi- patients were treated in less than an In addition to his research activ- mental therapies for lung cancer and hour on an outpatient basis. ity, Dr. Barraco has been appointed other cancers. to the clinical advisory group of Uni- Dr. Glenn R. Gaudette, direc- Just five days following the versity Hospital, and named as chair tor of the cardiothoracic research Stretta procedure, Jamna Per- of the subcommittee on teaching/ lab, received his PhD in biomedical saud, 42 of Bay Shore, NY, learning strategies of the medical engineering from SBU in May. He reported relief already. “It was school’s curriculum committee. In has recently been awarded New York hard to breathe from the re- October, he gave a presentation titled State’s James D. Watson Investigator “Trauma Resuscitation and Shock” at Grant, which brings in approximately flux and sometimes I felt like the 4th Annual CME Meeting of the $200,000 over several years. This grant I was dying. For the first time American Association of Surgical Phy- is designed to support outstanding in several years I did not take sician Assistants, held in San Francisco scientists and engineers who early in medicine at night and I had in conjunction with the Congress of their careers show potential for lead- no symptoms,” he said. “I feel the American College of Surgeons. ership and discovery in the field of great. There is no reflux, noth- biotechnology. Dr. Gaudette was cited ing at all.” And he no longer Otolaryngology-Head for his work in developing functional needs medication. and Neck Surgery blood vessels and was one of only two Dr. Arnold E. Katz, professor of researchers from institutions within Stretta involves lowering a cath- clinical surgery and chief of otolaryn- the State University of New York to be eter, through a tube in the mouth and gology-head and neck surgery, chaired a grant award recipient. throat, to the valve between the stom- the faculty senate’s ad hoc committee Dr. Irvin B. Krukenkamp, ach and esophagus. Carefully con- of the executive board to establish the professor of surgery and chief of car- trolled radiofrequency energy is given School of Medicine’s Code of Ethics, diothoracic surgery, served as com- to the sphincter muscle and the up- which was approved in November. mittee chairman of the 8th Annual permost part of the stomach to create With dermatologist Dr. Donald J. Research Classic Golf Tournament, thermal lesions. As the lesions heal, Grande, Dr. Katz gave a presentation which took place in September. It was they strengthen and improve the bar- titled “Reconstruction of Large Facial the most successful tournament ever, rier function of the sphincter muscle. Defects after Mohs Surgery,” at the raising over $251,000. The proceeds This reduces the reflux and heartburn 2002 Annual Meeting of the American will be used to support the develop- because the stomach contents remain Academy of Otolaryngology-Head ment of collaborative clinical research in the stomach where they belong. and Neck Surgery, held in September

— 10 — DEPARTMENT OF SURGERY • UNIVERSITY HOSPITAL AND HEALTH SCIENCES CENTER • STONY BROOK UNIVERSITY DEPARTMENT OF SURGERY • UNIVERSITY HOSPITAL AND HEALTH SCIENCES CENTER • STONY BROOK UNIVERSITY — 11 — ing in this study to better understand the maternal burden of organochloro Dr. Arnold E. Katz (front, compounds, a family of synthetic second from right), professor organic compounds including PCBs of surgery and chief of and DDT, and its relationship with otolaryngology-head and neck surgery, with staff one of the major male genital deformi- and family members at ties, undescended testes—a condition the 5th Annual Revlon treated by our pediatric surgeons. Run/Walk for Women—to raise awareness and critical Drs. Priebe, Lee, and Scriven are funds for breast and ovarian providing more and more patient care cancer research, counseling, at our new Ambulatory Surgery Cen- and outreach programs— ter, where children and their families held on May 4, 2002, in New York. find an especially comfortable, patient-friendly environment.

in San Diego. Dr. Katz is now collabo- All of these presentations pro- Plastic and Reconstructive rating with Dr. Alexander B. Dagum, vided demonstrations of the diverse Surgery associate professor of surgery and expertise of our faculty. Dr. Balvant Arora, assistant pro- chief of plastic and reconstructive fessor of surgery, who recently became surgery, in our newly established inte- Pediatric Surgery a Diplomate of the American Board of grated cutaneous oncology program Dr. Thomas K. Lee, assistant Plastic Surgery, is expanding our cos- that provides a multidisciplinary ap- professor of surgery, and Dr. Rich- metic services, and now does Botox proach to the reconstruction of large ard J. Scriven, assistant professor of therapy (see page 5), chemical peel, defects following the removal of ad- surgery, have recently performed two collagen implant, laser hair removal, vanced skin cancer. successful laparoscopic esophageal and laser vein therapy, among other Dr. Maisie L. Shindo, associate myotomy operations (Heller pro- procedures. professor of surgery and director of cedure) for the minimally invasive head and neck oncology, gave three treatment of achalasia (severe swal- Surgical Research presentations at the 2002 Annual lowing disorder). One patient was 11 Dr. Margaret A. McNurlan, as- Meeting of the American Academy years old, and the other 17. sociate professor of surgery, has been of Otolaryngology-Head and Neck In the fall, Drs. Lee and appointed to a study section of the Surgery: “Early Detection of Laryn- Scriven performed three success- National Institute of Diabetes and geal Cancer”; “Surgical Management ful pull-through operations to treat Digestive and Kidney Diseases of the of Hyperthyroidism”; and “Vocal Hirschsprung’s disease in newborn National Institutes of Health. This Cord Paralysis.” That month, she also infants. Also known as congenital group of scientists will evaluate grant gave a presentation at the Annual Fall megacolon, this disease afflicts the proposals for clinical studies in the Meeting of the American Academy large intestine (colon); its treatment in- research program titled “Treatment of of Facial Plastic and Reconstructive volves taking out the part of the intes- HAART-Associated Metabolic Chang- Surgery: “Free Flap in Head and Neck tine that doesn’t work and connecting es in Patients with HIV Infection.” In Reconstruction.” the healthy part that’s left to the anus. recent years, the advent of highly ac- Dr. Eric E. Smouha, associate The result is a working intestine. tive anti-retroviral therapy (HAART) professor of surgery and neurosurgery Dr. Cedric J. Priebe, Jr., profes- has dramatically improved the surviv- and director of otology-neurotology, sor of clinical surgery and chief of al of patients infected with HIV, but also gave three presentations at the pediatric surgery, together with Drs. this therapy has been associated with 2002 Annual Meeting of the American Lee and Scriven, is contributing to a a variety of metabolic complications Academy of Otolaryngology-Head one-year study started in September: that need to be resolved. and Neck Surgery: “Acute Facial Pal- “A Pilot Case-Control Study of the In June, Dr. McNurlan gave a sy: Current Concepts in Diagnosis and Relationship between Maternally De- presentation at the 84th Annual Meet- Management”; “Cholesteatoma: Issues rived Organochloro Burden and Unde- ing of the Endocrine Society, held in and Controversies in Surgical Manage- scended Testes in Male Infants.” San Francisco: “Rosiglitazone-Mediat- ment”; and “Computer Databases: Ap- Collaborating with Stony Brook ed Improvement of Insulin Sensitivity plications for Clinical and Academic colleagues in preventive medicine Is Highly Correlated with Increases in Practice.” and pediatric urology, they are aim- (Continued on Page 15)

— 12 — DEPARTMENT OF SURGERY • UNIVERSITY HOSPITAL AND HEALTH SCIENCES CENTER • STONY BROOK UNIVERSITY DEPARTMENT OF SURGERY • UNIVERSITY HOSPITAL AND HEALTH SCIENCES CENTER • STONY BROOK UNIVERSITY — 13 — Dr. Pierre M. Sfeir (’97), who Alumni News completed fellowship training in cardiothoracic surgery at Mt. Sinai Since the class of 1975 entered the profession of surgery, 154 physicians Medical Center in New York, is now have completed their residency training in general surgery at Stony on staff in the surgery department Brook. The alumni of our residency program now practice surgery of the American University of Beirut throughout the United States, as well as in numerous other countries Medical Center, in Lebanon, where he around the world. specializes in adult cardiac and aortic surgery, cardiac transplantation, beat- Dr. Andreas G. Tzakis (’83) is been featured in a recent article in the ing heart surgery (off pump), and tho- professor of surgery at the University Washington Post, and been named by racoscopy. Dr. Saad A. Shukri of Miami, and director of the liver/ Washingtonian Magazine as “one of the (’99) has gastrointestinal transplant program top plastic surgeons in the Washing- established a solo practice in general at Jackson Memorial Hospital, as well ton area.” surgery in Patchogue. Dr. James A. Vosswinkel as co-director of the transplantation Dr. Biagio Ravo (’84), who is on (’01) division. The University of Miami has staff at the Rome American Hospital, has joined the Department’s faculty; recently honored Dr. Tzakis by estab- in Rome, Italy, recently published the see page 2. Personal note: He and his lishing the Andreas Tzakis Chair in following paper: wife, Regina, are pleased to announce Transplant Surgery “to ensure that his • Ravo B, Amato A, Bianco V, et al. the birth of their daughter, Kaitlyn mission and excellence will continue Complications after stapled hemorrhoidecto- Marie, born in August 2002. to be a permanent hallmark of the my: can they be prevented? Tech Coloproctol 2002;6:83-8. institution.” Dr. Mark E. Mausner (’84), Stapled hemorrhoidectomy is whose practice—Mausner Plastic Sur- a new approach to the treatment of i gery Center—is located in Rockville, hemorrhoids. MD, has been appointed to serve on Dr. Aaron H. Chevinsky (’88) is STONY BROOK SURGICAL currently the acting chairman of the SPEAKERS BUREAU the medical advisory board of the Tu- (Continued from Page 1) berous Sclerosis Alliance, a national Department of Surgery at Morristown voluntary health organization dedi- Memorial Hospital, in Morristown, Trauma/Surgical Critical Care cated to finding a cure for the many NJ. He also serves as co-director of the • ABC’s of trauma management aspects of tuberous sclerosis complex. hospital’s Carol G. Simon Cancer Cen- • Abdominal compartment syndrome • Acute spinal injury In September, he gave a presentation ter and director of its gastrointestinal • Antibiotic use and resistant organisms titled “Treatment of the Skin Mani- oncology program. • Chest trauma festations of Tuberous Sclerosis: My Dr. Pierre Castera (’89) is prac- • Eldercare: a surgeon’s perspective 14-Year Experience,” at the First Inter- ticing colorectal surgery in Kansas City, MO. His Colon and Rectal Clinic • End of life and palliative care national Research Consensus Meet- • Evolution of gram-positive ing on Tuberous Sclerosis, held in of K.C. has three offices, and he is on resistant organisms Washington. His paper, “Two-Phase staff at Saint Luke’s Hospital of Kan- • Nutrition in the critically ill Laser Treatment of the Cutaneous sas City and Saint Luke’s Northland • Pathophysiology of ARDS Manifestations of Tuberous Sclerosis,” Hospital. • Pelvic fractures has been accepted for publication in Dr. Steven J. Busuttil (’94) is an • Pregnancy and trauma the Journal of the American Society of assistant professor of surgery (vascu- • Public health and the law Plastic Surgeons. Dr. Mausner’s prac- lar surgery) at Case Western Reserve • Shock tice is devoted exclusively to plastic University, and chief of vascular sur- Vascular Surgery • Carotid endarterectomy and CABG and cosmetic surgery of the face and gery of the Cleveland Veterans Affairs • Chronic venous insufficiency body. He has appeared on television, Medical Center. • Endoscopic treatment of severe hand and axillary hyperhidrosis • Endovascular surgery To submit alumni news online AND to find current mailing • Limb salvage surgery addresses of our alumni, please visit the Department’s • Management of venous thromboembolism website at www.uhmc.sunysb.edu/surgery GENERAL SURGERY ALUMNI: Please send your e-mail • Minimally invasive vascular interventions www.address—for inclusion in the Alumni Directory—to • Surgery for stroke prevention [email protected] • Treatment of diabetic vascular disease

— 12 — DEPARTMENT OF SURGERY • UNIVERSITY HOSPITAL AND HEALTH SCIENCES CENTER • STONY BROOK UNIVERSITY DEPARTMENT OF SURGERY • UNIVERSITY HOSPITAL AND HEALTH SCIENCES CENTER • STONY BROOK UNIVERSITY — 13 — Some Recent Publications (Continued from Page 10) OUR ELECTRONIC Gelato MC, Mynarcik D, McNurlan MA. Soluble tumour necrosis factor alpha receptor 2, a serum marker of resistance to the anabolic actions of growth hor- PHYSICIAN DIRECTORY mone in subjects with HIV disease. Clin Sci (Lond) 2002;102:85-90. he Department provides a physician directory as part of its website—please Gilchrist BF, Scriven R, Sanchez J, Panetta T, Klotz visit us at the following address to find information about our individual D, Nguyen M, Ramenofsky ML. The application surgeonsT (see sample page below), as well as our programs in patient care, of vascular technology to esophageal and airway strictures. J Pediatr Surg 2002;37:47-9. education, research, and community service: Januszkiewicz A, Essen P, McNurlan MA, Ringden O, Garlick PJ, Wernerman J. A combined stress www.uhmc.sunysb.edu/surgery hormone infusion decreases in vivo protein synthesis in human T lymphocytes in healthy volunteers. Metabolism 2001;50:1308-14. MD: Columbia University (1988). Kanaan SA, Murayama KM, Merriam LT, Dawes LG, Residency Training: General Surgery, Columbia- Prystowsky JB, Rege RV, Joehl RJ. Risk factors for conversion of laparoscopic to open cholecystectomy. Presbyterian Medical Center. J Surg Res 2002;106:20-4. Fellowship Training: Cardiothoracic Surgery, Mayo Karpeh MS. Influence of laparoscopic staging on therapy Clinic, Rochester, MN. of stomach carcinoma [German]. Chirurg 2002;73: 306-11. Board Certification: Thoracic Surgery; Surgery. Specialties: Surgery for all forms of adult heart dis- Kim HJ, Karpeh MS. Surgical approaches and outcomes in the treatment of gastric cancer. Semin Radiat ease, including high-risk states after acute myocardial Oncol 2002;12:162-9. infarctions and congestive heart failure; aneurysm sur- Kleger GR, Turgay M, Imoberdorf R, McNurlan MA, gery; thoracic vascular surgery; valve repair surgery; Garlick PJ, Ballmer PE. Acute metabolic acidosis decreases muscle protein synthesis but not albumin electrophysiological surgery, including the new maze synthesis in humans. Am J Kidney Dis 2001;38: Dr. Allison J. McLarty procedure for arrhythmias (irregular heartbeats); 1199-207. minimally invasive surgery. Lujan S, Criado E, Puras E, Izquierdo LM. Duplex scan- ning or arteriography for preoperative planning of Additional: See recent publications. lower limb revascularisation. Eur J Vasc Endovasc Language Spoken: English. Surg 2002;24:31-6. Consultations/Appointments: 631-444-1820. Nygren J, Thorell A, Brismar K, Essen P, Wernerman J, Email (to contact Dr. McLarty directly): [email protected] McNurlan MA, Garlick PJ, Ljungqvist O. Glucose flux is normalized by compensatory hyperinsulinae- mia in growth hormone-induced insulin resistance in healthy subjects, while skeletal muscle protein Parathyroid Surgery synthesis remains unchanged. Clin Sci (Lond) Shabtai M, Ye H, Frischer Z, Martin J, Waltzer WC, (Continued from Page 3) 2002;102:457-64. Malinowski K. Increased expression of activation markers in renal cell carcinoma infiltrating lympho- The entire MIRP operation can usu- Martin RC 2nd, Jaques DP, Brennan MF, Karpeh M. cytes. J Urol 2002;168:2216-9. Achieving RO resection for locally advanced gastric ally be performed through a small (about cancer: is it worth the risk of multiorgan resection? Shabtai M, Ye H, Kono K, Takayam T, Terashima K, Tsu- J Am Coll Surg 2002;194:568-77. kuda K, Frischer Z, Waltzer WC, Malinowski K. 1-inch) incision in the lower neck. It takes Immune inhibitory effects of renal cell carcinoma less than an hour and generally requires Martin RC 2nd, Jaques DP, Brennan MF, Karpeh M. (RCC) extract on lectin and alloantigenic induced Extended local resection for advanced gastric cancer: peripheral blood and tumor infiltrating lymphocyte local anesthesia, the use of which enables increased survival versus increased morbidity. Ann blastogenesis. Urol Oncol 2002;7:1-5. Surg 2002;236:159-65. the patient to go home a few hours after Shabtai M, Ye H, Waltzer WC, Shabtai EL, Frisher Z, surgery. Pan D, Portlock C, Karpeh MS. Lymphoproliferative Malinowski K. Immune suppression-related T-cell disorders of the gastrointestinal tract. In: Zbar AP, subset interrelationships and specific regimen-re- Once the problem parathyroid Guillou PJ, Bland KI, Syrigos KN, editors. Immunol- lated factor analysis of cell surface differentiation gland has been removed, a blood sample ogy for Surgeons. London: Springer, 2002: 429-43. and activation markers in renal allograft recipients. Transplant Proc 2002;34:3180-2. is drawn from the patient and sent for Ricotta JJ. Presidential address: on old dogs and new tricks. J Vasc Surg 2002;36:657-62. Shoup M, Brennan MF, Karpeh MS, Gillern SM, rapid assay of PTH. Stony Brook’s special McMahon RL, Conlon KC. Port site metastasis after laboratory services can provide the results Rodrigues Borges AG, Suresh K, Mirza H, Katz JP, diagnostic laparoscopy for upper gastrointestinal Simandl SL, Bilfinger TV, Cohn PF. False aneu- tract malignancies: an uncommon entity. Ann within half an hour. A drop in the level rysm of the mitral-aortic intervalvular fibrosa after Surg Oncol 2002;9:632-6. uncomplicated aortic valve replacement. J Am Soc of the hormone to normal or near-normal Echocardiogr 2002;15:743-5. Tasiemski A, Hammad H, Vandenbulcke F, Breton range helps the surgeon be confident that C, Bilfinger TV, Pestel J, Salzet M. Presence of Saltman AE, Aksehirli TO, Valiunas V, Gaudette GR, chromogranin-derived antimicrobial peptides in the operation is complete, and whether or Matsuyama N, Brink P, Krukenkamp IB. Gap junc- plasma during coronary artery bypass surgery and not another “normal” gland will need to be tion uncoupling protects the heart against ischemia. evidence of an immune origin of these peptides. J Thorac Cardiovasc Surg 2002;124:371-6. Blood 2002;15;100:553-9. removed. Shabtai M, Slanetz CA, Ye H, Waltzer WC, Malinowski Weber SM, Karpeh MS. Randomized clinical trials in Usually it is not necessary to find any K. Inhibition of lectin induced peripheral blood gastric cancer. Surg Oncol Clin N Am 2002;11: other parathyroid glands, but the experi- lymphocyte proliferation by colorectal cancer 111-31, ix. extract: a preliminary report of three cases [Hebrew]. ence of the surgeon will determine wheth- Harefuah 2002;141:862-4, 932. er more surgery is needed.

— 14 — DEPARTMENT OF SURGERY • UNIVERSITY HOSPITAL AND HEALTH SCIENCES CENTER • STONY BROOK UNIVERSITY DEPARTMENT OF SURGERY • UNIVERSITY HOSPITAL AND HEALTH SCIENCES CENTER • STONY BROOK UNIVERSITY — 15 — Division Briefs (Continued from Page 12) Circulating Acrp30/Adiponectin in 10, 2002, and will also be featured in of Limb-Threatening Ischemia” (co- HIV-Associated Lipodystrophy”; this the next edition of Castle Connolly’s author: Dr. Paul S. van Bemmelen, study was conducted with colleagues Top Doctors: New York Metro Area. assistant professor of surgery and in endocrinology and cell biology. As a member of our endovas- co-director of Stony Brook’s Leg and She had presented findings of this cular surgery team, Dr. Ricotta has Foot Ulcer Treatment Group) at the research in the spring at the meeting patent applications filed for an en- Trends in Vascular Surgery: North- of the Federation of American Societ- dovascular stapling device and for a western University Vascular Sympo- ies for Experimental Biology (FASEB), novel endovascular graft, and is cur- sium, held in December in Chicago. held in New Orleans. rently trying to bring these concepts to Dr. Ricotta has recently been ap- reality by collaborating with industry. pointed to be a section editor of two Surgical Oncology Among Dr. Ricotta’s recent pre- major textbooks on vascular surgery: Dr. Brian J. O’Hea, assistant sentations are “What Is a ‘High-Risk Vascular Surgery edited by Dr. Robert professor of surgery and director of Patient’ for CEA: Is the Cardiologist’s B. Rutherford et al. (Saunders) and the Carol M. Baldwin Breast Care Definition Valid?” (re: high-risk carot- forthcoming in its sixth edition, and Center, has again been cited as a id endarterectomy) at the 29th Annual Vascular Surgery: Principles and Tech- “doctor of excellence” in New York Veith Symposium: Montefiore Sympo- niques edited by Dr. Henry Haimovici Magazine’s “How to Find the Best sium on Vascular and Endovascular et al. (McGraw-Hill/Appleton & Doctors,” published on June 10, 2002, Issues, Techniques and Horizons (‘02), Lange) and forthcoming in its fifth and will also be featured in the next held in November in New York, and edition. edition of Castle Connolly’s Top Doc- “Mechanical Pump in the Treatment tors: New York Metro Area. Botox Therapy Performing Skull Base Surgery Transplantation (Continued from Page 5) (Continued from Page 4) Dr. Kazimierz Malinowski, research associate professor of surgery look tired, angry, or displeased. But Serial observation, stereotactic and director of the histocompatibility until this improvement was actually radiation, image-guided surgery, and and immunogenetics laboratory, gave demonstrated in clinical studies, the minimally invasive techniques are a presentation titled “Plasminogen manufacturer of Botox was prohib- favored whenever possible. When Activator Inhibitor-1 Promotes For- ited from making this claim for it. appropriate, more invasive proce- mation of Endothelial Microparticles By April 2002, the FDA was sat- dures are recommended. The choice with Procoagulant Potential” at the isfied by its review of studies indicat- of treatment depends on the type and American Heart Association’s 2002 ing that Botox reduced the severity location of the lesion, the patient’s Scientific Sessions held in November of frown lines for up to 120 days. The symptoms and their duration, and the in Chicago, and another presenta- agency then granted approval to use age and health of the patient. tion titled “Use of Sirolimus and the drug for this condition in people Together, Dr. Smouha and Dr. Low-Dose Tacrolimus in High-Risk between the ages of 18 and 65. Davis have used their combined mul- Renal Allograft Recipients” at the Botox therapy is one of the saf- tidisciplinary expertise to successfully 19th International Congress of the est available for reduction of wrin- treat hundreds of patients. They are Transplantation Society held in Au- kles. In the amounts used for wrinkle committed to providing the best care gust in Miami. Both presentations therapy, the only possible side effects for each individual patient, in a caring featured research conducted by Dr. are temporary and localized to the and compassionate environment. Malinowski and colleagues based at area of injection. It should be noted In addition to our expert surgi- Stony Brook. that the degree of improvement is cal team, skilled specialists in inter- variable. Occasionally, there is no ventional neuroradiology, stereotactic Vascular Surgery improvement, and another form of radiosurgery, and neuroanesthesiol- Dr. John J. Ricotta, professor treatment may be required. ogy enhance our services. The team is and chairman of surgery, has again further supported by physician assis- been cited as a “doctor of excellence” tants and nurse practitioners, most of in New York Magazine’s “How to Find whom have many years of experience the Best Doctors,” published on June directly in the field of brain and spine surgery.

BREAST CARE OTOLARYNGOLOGY-HEAD TRAUMA/SURGICAL VASCULAR SURGERY John S. Brebbia, MD AND NECK SURGERY (ENT) CRITICAL CARE Enrique Criado, MD Martyn W. Burk, MD, PhD Arnold E. Katz, MD Robert D. Barraco, MD John J. Ricotta, MD Martin S. Karpeh, Jr., MD Denise C. Monte, MD Collin E.M. Brathwaite, MD Paul S. van Bemmelen, MD, PhD Louis T. Merriam, MD Ghassan J. Samara, MD John S. Brebbia, MD Brian J. O’Hea, MD Maisie L. Shindo, MD James A. Vosswinkel, MD Eric E. Smouha, MD BURN CARE Collin E.M. Brathwaite, MD PEDIATRIC SURGERY Please visit our website at John S. Brebbia, MD Thomas K. Lee, MD Harry S. Soroff, MD Cedric J. Priebe, Jr., MD www.uhmc.sunysb.edu/surgery Richard J. Scriven, MD CARDIOTHORACIC SURGERY PLASTIC AND Thomas V. Bilfinger, MD, ScD RECONSTRUCTIVE Irvin B. Krukenkamp, MD SURGERY Allison J. McLarty, MD Balvant P. Arora, MBBS For consultations/appointments with our physicians, please call Frank C. Seifert, MD Alexander B. Dagum, MD • (631) 444-4550 for our specialists in breast care Steven M. Katz, MD • (631) 444-1820 for our specialists in cardiothoracic surgery GENERAL/ • (631) 444-4545 for our specialists in general/gastrointestinal surgery GASTROINTESTINAL SURGICAL ONCOLOGY • (631) 444-4121 for our specialists in otolaryngology-head and neck surgery (ENT) SURGERY John S. Brebbia, MD • (631) 444-4538 for our specialists in pediatric surgery Arif Ahmad, MD Martyn W. Burk, MD, PhD • (631) 444-4545 for our specialists in plastic and reconstructive surgery Robert D. Barraco, MD Martin S. Karpeh, Jr., MD • (631) 444-4545 for our specialists in surgical oncology Collin E.M. Brathwaite, MD Louis T. Merriam, MD • (631) 444-2209 for our specialists in transplantation John S. Brebbia, MD Brian J. O’Hea, MD • (631) 444-1045 for our specialists in trauma/surgical critical care Martyn W. Burk, MD, PhD • (631) 444-2565 for our specialists in vascular surgery Louis T. Merriam, MD TRANSPLANTATION • (631) 723-5000 for our specialists at Stony Brook Outpatient Services in James A. Vosswinkel, MD John J. Ricotta, MD Hampton Bays: breast care - general/gastrointestinal surgery - pediatric Wayne C. Waltzer, MD surgery - vascular surgery

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______DEPARTMENT OF SURGERY ______UNIVERSITY HOSPITAL AND ______HEALTH SCIENCES CENTER ______STONY BROOK UNIVERSITY ______Stony Brook, New York 11794-8191

In this issue . . . ■ Introducing Our New Chiefs of Vascular Surgery & Surgical Oncology ■ New General/Trauma Surgeon ■ Performing Minimally Invasive Parathyroid Surgery ■ Performing Skull Base Surgery ■ Providing Botox Therapy ■ New Podiatric Surgeon ■ Electronic Physician Directory ■ Residency Update & Alumni News ■ Division Briefs—And More!

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