Introducing Dr. Marc J. Shapiro

FALL/WINTER 2003-2004 Number 16

PNews UpO date from the STDe part ment of Sur geryOp UNIVERSITY . HOSPITAL . AND . HEALTH . SCIENCES . CENTER . AT. STONY . BROOK

Introducing Providing Minimally Invasive Treatment Of Dr. Marc J. Shapiro Varicose Veins Our New Chief of General Surgery, New Endovenous Approach Offers Trauma, Surgical Critical Care, An Alternative to Vein Stripping And Burns An estimated 20% of adult Ameri- cans have painful varicose veins in the e are very pleased to introduce leg. Venous refl ux, often the underlying WMarc J. Shapiro, MD, FACS, who cause of varicose veins, frequently forces joined our faculty in October as chief of people to dramatically change their life- general surgery, trauma, surgical criti- style, especially when they work on their cal care, and burns. He comes to Stony feet and can no longer tolerate being on Brook from St. Louis University where their feet all day. he served as director of trauma surgery Whether the initial cause is genet- and surgical critical care, as well as ics, pregnancy, prolonged standing, assistant director of the emergency de- excess weight, inadequate exercise, or a partment. damaged saphenous vein, the physiol- At Stony Brook, Dr. Shapiro will ogy of varicose veins is nearly always have an active practice at University the same. Hospital. His clinical expertise includes The valves in the saphenous (leg) all aspects of traumatology; the man- vein are incompetent resulting in ve- agement of injured patients; and the Dr. Marc J. Shapiro nous refl ux, and the veins near the skin pre- and post-operative critical care of surface are stretched and distorted from surgical patients. the increased pressure caused by blood Dr. Shapiro has special expertise in treating the acute surgical abdomen; the fl owing in the wrong direction. abdominal compartment syndrome; resuscitation; management of single and mul- Although the condition is rarely tiple organ failure; and thoracoabdominal injuries, including lung, heart, spleen, life threatening, it is often painful and liver, bowel, and urinary system. unattractive. Dr. Shapiro’s current research interests are in the areas of shock, hypoxia, resuscitation, anemia, and transfusion alternatives. Recently published studies A prominent physician in his fi eld, Dr. Shapiro has numerous achievements found that at 12 and 24 months to his credit, including serving as the immediate past president, St. Louis Surgical following percutaneous closure, Society; past president, American College of Surgeons, MO Chapter; past chair, Missouri Committee of Trauma (ACS); past president, McClure Surgical Society; 90% of treated veins remained member, EMS Division, Department of Health, Missouri and Illinois; council mem- refl ux free and a signifi cant ber, Society of Critical Care Medicine; member, National Board of Medical Examin- reduction of limb pain, fatigue, ers; and advisor, American Association for the Surgery of Trauma. and edema was observed. Additional honors are inclusion, Top 40 Under 40 (CBS); inclusion, Who’s Who in America and 2000 Notable Men, American Biographical Institute; recipient, (Continued on Page 2) (Continued on Page 3) INTRODUCING OUR NEW with diseases of the small bowel, ga Alpha Honor Medical Society, and Colorectal Surgeon colon, rectum, and anus. In addition also selected for inclusion in Who’s Who to his practice in surgical oncology, he in American Colleges and Universities. will also practice general surgery as a In 2002, he completed his colorectal specialist. residency in general surgery at Weill Medical College of Cornell A colorectal specialist, University, training at both New York Dr. Rivadeneira will also Presbyterian Hospital-Cornell Medical practice general surgery, Center and Memorial Sloan-Kettering in addition to doing Cancer Center. surgical oncology. At Weill Cornell Medical College from 1997 to 1999, he did a two-year NIH-funded surgical oncology re- Dr. Rivadeneira has a major search fellowship investigating cancer- interest in laparoscopic and other minimally invasive procedures for the mediated immunology and nutrition. treatment of colon and rectal diseases, Among his current research interests Dr. David E. Rivadeneira including cancer. are tumor immunology, the effect of minimally invasive surgery on the im- e are very pleased to introduce His expertise encompasses the mune system, and surgical nutrition. David E. Rivadeneira, MD, who surgical management of infl ammatory In June 2003, Dr. Rivadeneira hasW joined our faculty as an assistant bowel disease including ileoanal res- received the Lahey Clinic Alumni professor of surgery and member of ervoir (Parks j-pouch), diverticulitis, Association award for outstanding our Division of Surgical Oncology. He familial polyposis, rectovaginal fi s- academic achievement in colon and comes to Stony Brook from the Lahey tula, incontinence, prolapse, anorectal rectal surgery. Clinic in Massachusetts, where he re- abscess, fi stula, fi ssure, and hemor- cently completed his fellowship train- rhoids. He also performs colonoscopy. For consultations/appointments with ing in colon and rectal surgery. Board-certifi ed in surgery, Dr. Dr. Rivadeneira, please call (631) 444-4545. At Stony Brook, Dr. Rivadeneira Rivadeneira received his MD from will provide a full range of consulta- Howard University in 1995. For his tive, diagnostic, and therapeutic ser- outstanding performance as a medical vices involving surgery for patients student, he was elected to Alpha Ome-

Dr. Marc J. Shapiro (Continued from Page 1) “Attending Physician of the Year” in critical care medicine at the Uni- POST-OP is published by the Department of Surgery award, 1991, 1993, St. Louis University; versity Health Center of Pittsburgh University Hospital and Health Sciences Center editorial board, Air Medical Journal, Air (1984-85). Stony Brook University Med, and New Surgery; and reviewer, He subsequently joined the sur- Stony Brook, New York Journal of Trauma, Critical Care Medicine, gical faculty at St. Louis University, Editor-in-Chief Surgery, Annals of Surgery, Journal of the rising to the position of professor of John J. Ricotta, MD American College of Surgeons, Intensive surgery and anesthesiology. Writer/Editor Jonathan Cohen, PhD Care Medicine, and Clinical Intensive Dr. Shapiro is a fellow of the Care. American College of Surgeons and Contributing Editor Andrew E. Toga, FACHE His memberships include the the American College of Critical Advisory Board American Surgical Association, the As- Care Medicine. He is a diplomate of Enrique Criado, MD sociation of Academic Surgeons, and the American Board of Surgery with Alexander B. Dagum, MD Arnold E. Katz, MD the Society of University Surgeons. certifi cation in surgery and surgical Irvin B. Krukenkamp, MD Cedric J. Priebe, Jr., MD Dr. Shapiro received his MD critical care. Marc J. Shapiro, MD from the University of Michigan in All correspondence should be sent to: 1979—after receiving an MS from that For consultations/appointments with Dr. Shapiro, patients should call Dr. Jonathan Cohen institution in 1975. He completed his Writer/Editor, POST-OP (631) 444-4545 for general surgery. Department of Surgery residency training in general surgery Health Sciences Center T19 at Henry Ford Hospital in Detroit For consultations concerning surgical Stony Brook, NY 11794-8191, USA (1979-84), and his fellowship training critical care, physicians should call (631) 444-1045.

— 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 — Treating Varicose Veins INTRODUCING OUR NEW (Continued from Page 1) Vascular Surgeon Until recently the standard treatment for saphenous vein refl ux has been vein ligation and stripping, a surgical procedure that requires stripping of the saphenous vein from the leg and gener- ally requires a long recovery with signifi - cant postoperative bruising and pain. At Stony Brook, our vascular surgeons now provide a new treatment option known as percutaneous closure or ablation. This minimally invasive technique 1. Catheter inserted. relies on a simple needle stick to gain access to the saphenous vein, thus avoid- Dr. Antonios P. Gasparis ing incisions in the skin for exposure of the vein. For selected patients, this ap- e are very pleased to introduce proach offers considerable benefi ts. Antonios P. Gasparis, MD, who Percutaneous closure of the sa- hasW joined our faculty as an assistant phenous vein has proven itself to be a professor of surgery and member of promising alternative to traditional vein our Division of Vascular Surgery. stripping surgery for venous refl ux. The Board-certifi ed in surgery and procedure is becoming increasingly pop- with expertise in endovascular surgery, Dr. Gasparis recently completed ular as physicians become more familiar his fellowship training in vascular with this treatment and its associated surgery here at Stony Brook. His out- benefi ts. standing performance merited his ap- HIGHLIGHTS OF 2. Vein warmed and pointment to our faculty. THE PROCEDURE PERCUTANEOUS collapses. CLOSURE During the summer of 2003, Dr. ITSELF Gasparis completed special advanced Percutaneous closure • Relief of symptoms training in endovascular surgery at of the saphenous vein is • Short recovery Texas Tech University Health Sciences done by placing a catheter Center in Lubbock. • Return to normal At Stony Brook, Dr. Gasparis (thin tube) into the saphe- activities within nous vein to deliver radio- 1-2 days will practice the full range of general frequency energy or laser vascular and endovascular surgery, • Same-day procedure adding further experience to our endo- energy to the vein wall, vascular program. causing it to collapse and • Local or regional anesthesia Dr. Gasparis will provide the seal shut. The physician typ- new minimally invasive endovenous ically makes a single, small • Reduced postoperative pain treatment of varicose veins known as puncture near the knee and percutaneous closure (see page 1). inserts the slender catheter • Minimal temporary In addition, he will serve as bruising into the saphenous vein. medical director of Stony Brook’s Non- The catheter is then • Good cosmetic 3. Catheter slowly Invasive Vascular Laboratory and as withdrawn, closing vein. outcome with co-director of the multidisciplinary positioned near the groin, minimal to energized, and slowly with- no scarring Leg and Foot Ulcer Treatment Group. drawn, sealing the vein A graduate of New York Uni- shut. There are no stitches, versity, Dr. Gasparis received his MD from SUNY-Syracuse in 1996, and and most patients return to completed his residency in general normal activity within a day surgery there in 2001. or two. (Continued on Page 5) For consultations/appointments with Dr. Gasparis, please call (631) 444-4545.

ur otolaryngology service continues to provide the nerve. When connected to his colleagues in speech, lan- only program in cochlear implantation in Suffolk an external microprocessor guage, and hearing have made County.O This high-tech surgery is performed by our expert that resembles a hearing cochlear implantation a medical in the relatively new surgical discipline of otology-neurotol- aid, the implant analyzes reality at Stony Brook. ogy that focuses on problems of the ear related to hearing, incoming sounds and balance, and facial nerves. produces a series of electri- For consultations/appointments with Dr. Smouha, please call Eric E. Smouha, MD, associate cal impulses that directly (631) 444-4109/-4122. professor of surgery and neurosurgery, stimulate the hearing initiated our cochlear implant program nerve. What a patient treated by Dr. in 1990 through a collaboration with According to Dr. Smouha said two weeks after members of Stony Brook’s clinical pro- Smouha, cochlear implant her cochlear implant was first gram in speech, language, and hearing. surgery has achieved turned on: Thanks to this collaboration, the lives of splendid results in selected I started to lose my hear- adult patients with profound deafness patients, and is suitable for ing when I was 35, nearly have been dramatically changed for the treating profoundly deaf 25 years ago. At work I was better—now that after years of hearing adults and children 1 year very bitter . . . I was angry, Dr. Eric E. Smouha loss, they can hear again. of age and older. Certain isolated, all by myself. Amaz- Now, too, the lives of young children with such deaf- patients have been able ingly enough, since I’ve had ness are able to discover—for the first time—the world of to gain the ability to hold the implant I can now hear hearing through cochlear implants. conversations—often with- normal speech for the first Cochlear implantation represents a new technology out lipreading; to speak on time. I’m able to understand that makes hearing possible for patients with profound the telephone; and to hear speech. I can hear my son, I bilateral deafness, who cannot benefit from conventional environmental sounds. can communicate better, I can hearing aids. The first cochlear implant device was ap- Cochlear implant talk to people, I can socialize proved by the FDA in 1985. surgery requires a highly- with people. trained multidisciplinary I can also hear the birds Cochlear implant surgery has achieved team of specialists to pro- chirping—I hear the different splendid results in selected patients, and is vide the necessary post- types of songs, too. That is suitable for treating profoundly deaf adults operative programming of something new for me. I can and children 1 year of age and older. the implanted device and hear the hissing of the gas, the the rehabilitation that pa- creaking of the floor—things The operation, which can be done on an outpatient tients need on entering the I couldn’t hear before with basis, involves implanting an electronic device through the world of sound. the regular hearing aid I had, mastoid bone, behind the ear. The implant has an electrode The collaborative ef- an extremely powerful one. array that is tunneled into the inner ear, next to the hearing forts of Dr. Smouha and Now I can even hear the wind blowing. Some Recent Publications* Criado E. Regarding “thrombin injection for failed stent Gasparis AP, Ricotta L, Cuadra SA, Char DJ, Purtill Bemmelen P, Char D, Giron F, Ricotta JJ. Angiographic graft repair of perforated atherosclerotic aortic ulcer.” WA, Van Bemmelen PS, Hines GL, Giron F, Ricotta improvement after rapid intermittent compression J Vasc Surg 2003;37:222-3. JJ. High-risk carotid endarterectomy: fact or fiction. treatment [ArtAssist(R)] for small vessel obstruction. J Vasc Surg 2003;37:40-6. Ann Vasc Surg 2003;17:224-8. Criado E. Review of Vascular Access in Clinical Practice. Cardiovasc Surg 2003;11:251. Ilson DH, Bains M, Kelsen DP, O’Reilly E, Karpeh M, Coit Bilfinger TV. Surgical viewpoints for the definitive treat- D, Rusch V, Gonen M, Wilson K, Minsky BD. Phase ment of lung cancer. Respir Care Clin N Am 2003;9: Doblas M, Gutierrez R, Fontcuberta J, Orgaz A, Lopez P, I trial of escalating-dose irinotecan given weekly 141-62. Criado E. Thoracodorsal sympathectomy for severe with cisplatin and concurrent radiotherapy in locally hyperhydrosis: posterior bilateral versus unilateral advanced esophageal cancer. J Clin Oncol 2003;21: Char D, Ricotta JJ, Ferretti J. Endovascular repair of staged sympathectomy. Ann Vasc Surg 2003;17: 2926-32. an arteriovenous fistula from a ruptured hypogastric 97-102. artery aneurysm—a case report. Vasc Endovascular Irie H, Gao J, Gaudette GR, Cohen IS, Mathias RT, Salt- Surg 2003;37:67-70. Durham RM, Moran JJ, Mazuski JE, Shapiro MJ, Baue man AE, Krukenkamp IB. Both metabolic inhibition AE, Flint LM. Multiple organ failure in trauma patients. and mitochondrial K(ATP) channel opening are Cho K, Brathwaite CE, Ahmad A. Image of the month: J Trauma 2003;55:608-16. myoprotective and initiate a compensatory sarcolem- biliopancreatic limb obstruction resulting in gastric mal outward membrane current. Circulation 2003;108 staple line dehiscence. Arch Surg 2003;138:455. Gasparis AP, Hines GL, Ricotta JJ. Contemporary man- Suppl 1:II341-7. agement of “High-Risk” patients with carotid stenosis. * The names of faculty authors appear in boldface. Heart Dis 2003;5:345-8.

Treating Varicose Veins (Continued from Page 3) OUR ELECTRONIC In one study that also assessed PHYSICIAN DIRECTORY patient satisfaction at 6 months, he Department provides a physician directory as part of its website—please 98% of patients indicated they visit us at the following address to find information about our individual would recommend this treatment surgeonsT (see sample below), as well as our programs in patient care, educa- option to a friend with similar tion, research, and community service: For consultations/appointments leg-vein problems. with Dr. Smouha, please call www.uhmc.sunysb.edu/surgery (631) 444-4109/-4122. The procedure is minimally invasive and can be performed under MD: Pennsylvania State University (1983). local anesthesia on an outpatient basis. Residency Training: General Surgery, Hospital of the Patients have reported feeling little, if University of Pennsylvania. any, pain during the procedure, and Fellowship Training: Surgical Oncology, Memorial most return to their normal activity Sloan-Kettering Cancer Center. within a day. Some common side ef- Board Certification: Surgery. fects may include temporary tender- Specialties: General surgical oncology; management ness and numbness. of cancers of the gastrointestinal tract, soft tissue Most patients report a noticeable (melanoma, sarcoma, and other cancers), and breast. improvement in their symptoms in 1-2 Additional: Chief of Surgical Oncology, Stony Brook weeks following the procedure, and University Hospital; Fellow, American College of experience good cosmetic outcomes Dr. Martin S. Karpeh, Jr. Surgeons (FACS); member/examination committee, with little to no scarring. Society of Surgical Oncology; member, American Society of Clinical Oncology; As this newly developed endo- see selected publications (click here for online abstracts/full text of journal venous procedure becomes more com- articles via National Library of Medicine). monly used, more and more insurance Language Spoken: English. companies are covering the costs, Consultations/Appointments: 631-444-2565. when deemed medically necessary. At Stony Brook, our physicians perform percutaneous closure on an Maitra SR, Bhaduri S, Valane PD, Tervahartiala T, Sorsa T, of linear array endoscopic ultrasound and helical Ramamurthy N. Inhibition of matrix metalloproteinases computed tomography for the staging of periampullary outpatient basis at our new Ambula- by chemically modified tetracyclines in sepsis. Shock malignancies. Ann Surg Oncol 2003;10:890-7. 2003;20:280-5. tory Surgery Center, next to University Sarela AI, Turnbull AD, Coit DG, Klimstra D, Brennan MF, Hospital. Maitra SR, Chen E, Rosa D, Valane PD, El-Maghrabi MR, Karpeh MS. Accurate lymph node staging is of greater Brathwaite CE. Modulations of signal transduction prognostic importance than subclassification of the T2 pathways during sepsis and the effects of insulin and category for gastric adenocarcinoma. Ann Surg Oncol For consultations/appointments with our mifepristone. Acad Emerg Med 2003;10:1-8. 2003;10:783-91. vascular specialists, please call (631) 444-4545. Martinez SR, Gelfand M, Hourani HS, Sorrento JJ, Scott BH, Seifert FC, Glass PS. Does gender influence Mohan EP. Cardiac injury during needle localized resource utilization in patients undergoing off-pump surgical breast biopsy. J Surg Oncol 2003;82:261-5. coronary artery bypass surgery? J Cardiothorac Vasc Anesth 2003;17:346-51. McLarty A, Mann N, Lawson WE, Foster A. Womens heart health series: a mini-symposium. Med Sci Monit Shabtai M, Waltzer WC, Ayalon A, Shabtai EL, Malinow- 2003;9:RA102-9. ski K. Down regulation of CD45 expression on CD4 T cells during acute renal allograft rejection: evidence Irie H, Krukenkamp IB, Brinkmann JF, Gaudette Ng EK, Panesar N, Longo WE, Shapiro MJ, Kaminski DL, of a decline in T suppressor/inducer activity. Int Urol GR, Saltman AE, Jou W, Glatz JF, Abumrad NA, Tolman KC, Mazuski JE. Human intestinal epithelial Nephrol 2002-2003;34:555-8. Ibrahimi A. Myocardial recovery from ischemia and smooth muscle cells are potent producers of IL-6. is impaired in CD36-null mice and restored by Mediators Inflamm 2003;12:3-8. Shapiro MJ, Gettinger A, Corwin HL, Napolitano L, Levy myocyte CD36 expression or medium-chain M, Abraham E, Fink MP, MacIntyre N, Pearl RG, fatty acids. Proc Natl Acad Sci U S A 2003;100: Ricotta JJ, Char DJ, Cuadra SA, Bilfinger TV, Wall LP, Shabot MM. Anemia and blood transfusion in trauma 6819-24. Giron F, Krukenkamp IB, Seifert FC, McLarty AJ, patients admitted to the intensive care unit. J Trauma Saltman AE, Komaroff E. Modeling stroke risk after 2003;55:269-74. Kattan MW, Karpeh MS, Mazumdar M, Brennan MF. coronary artery bypass and combined coronary artery Postoperative nomogram for disease-specific bypass and carotid endarterectomy. Stroke 2003;34: Sneddon AA, Koll M, Wallace MC, Jones J, Miell JP, survival after an R0 resection for gastric carci- 1212-7. Garlick PJ, Preedy VR. Acute alcohol administration noma. J Clin Oncol 2003;21:3647-50. inhibits the refeeding response after starvation in Ricotta JJ, Wall LP. Treatment of patients with combined rat skeletal muscle. Am J Physiol Endocrinol Metab Kooby DA, Suriawinata A, Klimstra DS, Brennan coronary and carotid atherosclerosis. J Cardiovasc 2003;284:E874-82. MF, Karpeh MS. Biologic predictors of survival Surg (Torino) 2003;44:363-9. in node-negative gastric cancer. Ann Surg Zhu W, Ma Y, Cadet P, Yu D, Bilfinger TV, Bianchi E, Ste- 2003;237:828-35; discussion 835-7. Rivadeneira DE, Pochapin M, Grobmyer SR, Lieberman fano GB. Presence of reticuline in rat brain: a pathway MD, Christos PJ, Jacobson I, Daly JM. Comparison for morphine biosynthesis. Brain Res Mol Brain Res 2003;117:83-90.

— 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 — Residency Update Since the class of 1975 entered the profession of surgery, 158 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.

2003 Graduating Residents Name Career Direction General Surgery Salvador Cuadra, MD Vascular surgery fellowship at UMDNJ-Newark Tomasz Kozlowski, MD Transplantation fellowship at Johns Hopkins U Paul Mancuso, MD Colorectal surgery fellowship at Thomas Jefferson U Steve Martinez, MD Surgical oncology fellowship at John Wayne Cancer Institute, Santa Monica, CA Vascular Surgery Antonios Gasparis, MD Assistant professorship, Department of Surgery (Vascular), SUNY-Stony Brook Our accredited vascular surgery Otolaryngology residency (fellowship) was established in 1980 by our Division of Vascular Adam Schaffner, MD Facial plastic and reconstructive surgery fellowship, Stanford University Medical Center Surgery, and since then, 23 vascular surgeons have been trained at Stony Critical Care Brook. John Platz, MD General surgery, North Shore-Long Island Jewish Health System, Manhasset, NY; New Hyde Park, NY Our accredited residency in New Chief Residents otolaryngology was established Name Medical School (Grad. Year) in 1993 by our Division of Otolaryngology-Head and Neck Elliott Chen, MD Temple U (’98) Surgery, and since then, seven Piotr Dumicz, MD Stony Brook U (’99) otolaryngology-head and neck surgeons have been trained at Stony Vitaly Lyaskovsky, MD SUNY Downstate (’99) Brook. Denise Ortega, MD Cornell (’99) Baljeet Uppal, MD New Delhi (’93) Our accredited residency (fellowship) in surgical critical care Incoming Residents/All Categorical PGY-1* was established in 2000 by our Section Name Medical School (Grad. Year) of Trauma/Surgical Critical Care, and Michelle Azu, MD U of Missouri-Columbia (’03) since then, three surgeons have been trained in surgical critical care at Jeffrey Chang, MD Syracuse U (’03) Stony Brook. Daniel Rutigliano, DO NY College of Osteopathy (’03) Sepehr Sajjad, MD Ross U (’03) Khaled Salhab, MD U of London (’03) * As of July 1, 2003.

— 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 — 1 Dr. John Ricotta (left) and Dr. Eugene Mohan (right) with our 2003 graduating chief residents (from left to right), Drs. Steve Martinez, Salvador Cuadra, Paul Mancuso, and Tomasz Kozlowski, at the graduation banquet held on June 15 at Flowerfield, St. James, NY.

Our 2 Our graduating otolaryngology resident (center), Dr. Adam Schaffner, with 2003 Drs. Arnold Katz (right) and Dr. Ricotta.

3 Our graduating vascular surgery resident (center), Dr. Antonios Gasparis, with Dr. Enrique Criado (right) and Dr. Ricotta. graduates

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

Dr. Gregory S. Zito (’86) in the Dr. Alex F. Argotte (’97), who • Adventitial gene transfer of NAD(P)H spring was appointed to the posi- lives in Mayfi eld, KY, last spring oxidase inhibitor suppresses balloon injury- induced neointimal proliferation in the rat tions of chief of surgery, president of received his board certifi cation in carotid artery. Midwestern Vascular Surgical the medical staff, and cancer liaison surgery. His new direction is bariat- Society. at Mercy Medical Center in Rockville ric surgery. For community service, • Adventitial gene transfer of NAD(P)H oxi- Centre, NY. He has had a private he serves as head soccer coach for dase inhibitor suppresses increased super- practice there since 1990. At Mercy, he Mayfi eld High School, and has trans- oxide following balloon angioplasty in the rat served on the executive committee of formed the boys’ unsuccessful team carotid artery. AHA Council for Hypertension the medical staff for over fi ve years, into a winning team. Research. in the capacity of vice president and Dr. Hector M. Dourron (’01) In April, he published a paper secretary. He also serves as the sec- just fi nished his vascular fellowship about the same area of research: tion chief of the surgical intensive care at Henry Ford Hospital in Detroit, • Jacobson GM, Dourron HM, Liu J, Carret- unit. and has joined a group practice of ero OA, Reddy DJ, Andrzejewski T, Pagano Dr. James C. Maurer (’88), who seven vascular surgeons in Atlanta, PJ. Novel NAD(P)H oxidase inhibitor sup- also completed his training in trauma/ GA. In September 2002, he received presses angioplasty-induced superoxide surgical critical care at Stony Brook, the Charles C. Guthrie Award of the and neointimal hyperplasia of rat carotid artery. Circ Res 2003;92:637-43. is director of surgical critical care and Midwestern Vascular Surgical So- associate director of trauma services at ciety, in Madison, WI; and the 18th A personal note: Daughter Madi- the New York Hospital Medical Center Annual Aventis Pharma Hyperten- son Brooke is two-plus years old, and of Queens, an affi liate of the New York sion Research Clinical Award of the a new baby arrived in May—a girl Hospital-Cornell University Medical American Heart Association, in Or- named Katie Elizabeth. Center. He oversees all care in the sur- lando, FL. His presentations at these gical intensive care unit and manages meetings included two abstracts: the trauma program. His contributions to the surgical literature include works To submit alumni news online AND to find cur rent mail ing relating to hemorrhagic shock and ad dress es of our alum ni, please vis it the Department’s web- vascular trauma, and various topics site at www.uhmc.sunysb.edu/sur gery on the metabolism of the critical care/ GENERAL SURGERY ALUM NI: Please send your e-mail trauma patient and interventional www.ad dress—for in clu sion in the Alum ni Di rec to ry—to procedures in this group. Dr. Maurer [email protected] contributes to resident education in surgery and critical care, as well as in clinical nutrition. 20TH ANNIVERSARY OF FIRST OPEN-HEART SURGERY Dr. Frank L. Ross (’90) tells us n February 2003, University Hospital celebrated the 20th anniversary of the fi rst open- that in January 2003 he was awarded heart operation performed at Stony Brook, as part of a ceremonial wall-breaking and his second board certifi cation in un- Icelebration marking the expansion and relocation of the Heart Center. dersea and hyperbaric medicine. Per- Former faculty member, Dr. Constance E. Anagnostopoulos, now professor of surgery, sonal notes: He and his wife, Valerie, Columbia University College of Physicians, performed the fi rst open-heart operation here in had their second child, Paige Sarah, in 1983, with the establishment of our cardiothoracic service. He was in attendance to speak at May; their son, Justin, turned three in the anniversary celebration. September. Dr. Ross also says that he The building of the new Heart Center is a key component of the hospital’s fi ve-year, remembers 9-11 with sorrow: in 2001, $300 million Master Plan. Expected to be completed in early 2004, the state-of-the-art on that day, he was attending a confer- Heart Center will house three cardiac catheterization laboratories, two electrophysiology ence in New York City, and responded laboratories, 28 recovery beds, a dedicated lobby, administrative space and support services. to the WTC tragedy by doing volun- Phase II, expected to be completed in early 2005, includes the creation of a dedicated teer work (“surgical standby”) at NYU 10-bed coronary intensive care unit and a 25-bed “stepdown” unit. Downtown Hospital.

— 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 — • A new technique of electrocautery in laparo- New England Medical Center in scopic Roux-en-Y gastric bypass [authors: Division Briefs Ahmad S, Cho K, Brathwaite C] Boston, MA, sponsored by the Tufts University School of Medicine and the New England Otolaryngology Society. Dr. Louis T. Merriam, assistant Cardiothoracic Surgery The title of his lecture was “Ethics and Dr. Thomas V. Bilfinger, profes- professor of surgery, gave an oral pre- Spirituality in Otolaryngology-Head sor of clinical surgery, presented three sentation of his study abstract, “The and Neck Surgery.” studies in May at the International Emergency Surgical Service: A New Dr. Katz, together with Dr. John Conference of the American Thoracic Philosophy in Surgery,” at the meeting F. Stanievich of SUNY-Buffalo, is cur- Society held in Seattle: of the Association of Program Direc- rently investigating the present-day at- tors in Surgery, held in May in Van- • How does clinical suspicion alter PET scan titudes toward prayer and spirituality interpretation in the evaluation of lung couver, BC, Canada. among academic and practicing oto- cancer? [authors: Sachs S, Bilfinger TV] larngologists and how they approach • Impact of PET on clinical decision making Otolaryngology-Head and this subject with their residents and/ in a university-based multidisciplinary lung Neck Surgery or their patients. cancer practice [authors: Sachs S, Bilfinger Dr. Arnold E. Katz, professor of TV] Dr. Maisie L. Shindo, associ- clinical surgery and chief of otolaryn- ate professor of surgery and director • Likelihood of a definitive PET result in a gology-head and neck surgery, in col- of head and neck oncology, has been targeted lung cancer referral population laboration with Dr. Adam J. Singer of [authors: Sachs S, Jacobi A, Bilfinger TV] elected a senior examiner for the the Department of Emergency Medi- American Board of Otolaryngology, cine, has developed a porcine model in recognition of her long and distin- The abstracts of these studies for studying the effects of hemostatic guished career in residency training were published in a special supple- agents in epitaxis in patients with un- in otolaryngology-head and neck sur- ment of the American Journal of Respira- derlying coagulopathies. Their paper, gery. tory and Critical Care Medicine. “A Porcine Model: Hemostatic Effects At the 2003 Annual Meeting of Dr. Allison J. McLarty, assistant of Octylcyanoacrylate,” was presented the American Academy of Otolaryn- professor of surgery, was honored in September at the Association for gology-Head and Neck Surgery, Dr. as the 2002 “Woman of the Year in Research in Otolaryngology during Shindo presented two courses: “Evalu- Health” by the local Village Times Her- the Annual Meeting of the American ation and Management of Unilateral ald for her continuing contributions to Academy of Otolaryngology-Head Vocal Fold Paralysis” and “Treatment heart health. In addition to her respon- and Neck Surgery, held in Orlando, of Hyperthyroid Disorders: What Sur- sibilities at Stony Brook University FL. geons Need to Know.” Hospital and Northport VA Medical Dr. Katz is also the principal Dr. Shindo is currently investi- Center, Dr. McLarty chairs the Wom- investigator of the study, “Octylcyano- gating the effects of radiation therapy en’s Heart Health Group, a multidisci- acrylate for Epitaxis: A Pilot Study in for squamous cell carcinoma of the plinary group focused on the effect of Patients with Hereditary Hemorrhagic head and neck on extraesophageal heart disease on women; participates Telangiectasia.” manifestations of reflux. in Heart-to-Heart, a program designed In addition, at the Annual Meet- Dr. Eric E. Smouha, associate to teach elementary school students ing of the American Academy of Oto- professor of surgery and neurosurgery about heart disease; and works dili- laryngology-Head and Neck Surgery, and director of otology-neurotology, gently to bring vital information about he presented his instruction course, has recently become an Active Fellow heart disease to underserved areas. “Reconstruction of Large Facial De- of the Triological Society, by virtue of fects after Mohs Surgery.” having been elected and having writ- General/Gastrointestinal In May, Dr. Katz delivered the ten a scholarly thesis—“Surgery of the Surgery visiting professor lecture at a confer- Inner Ear with Hearing Preservation: Dr. Collin E.M. Brathwaite, ence—Contemporary Interfaces: Spiri- Serial Histological Changes”—that, associate professor of surgery, and tuality in Medicine—sponsored by the in September, was published in the Dr. Arif Ahmad, assistant professor of Buffalo Otolaryngology Society and society’s journal, Laryngoscope. surgery, presented the following study the Center for Excellence in End-of- Founded in 1895, the American at the Annual Meeting of the Society Life Education Research and Practice, Laryngological, Rhinological and Oto- of American Gastrointestinal Endo- held in Buffalo, NY. logical Society—aka The Triological scopic Surgeons, held in March in Los In June, Dr. Katz delivered the Society—is one of the most prestigious Angeles: Werner Chasin Lecture at the Tufts- societies in otolaryngology. Active

— 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 — Fellowship is achieved by presenting In June, Dr. Dagum presented the Dr. Brian J. O’Hea, assistant pro- a thesis in the field of otolaryngology following study at the Annual Meeting fessor of surgery and director of the considered acceptable to a panel of of the Canadian Society of Plastic Sur- Carol M. Baldwin Breast Care Center, peers. Dr. Smouha’s thesis is based geons, held in Whistler, British Colum- in October was honored as the recipient on his original research in the area of bia: “Skeletal Reconstruction of the of the First Annual Dr. Michael A. Maf- hearing preservation. Upper Extremity with Vascularized fetone Medical Research Award pre- Dr. Smouha’s recent presenta- Fibula Graft: Clinical Applications, sented by the Carol M. Baldwin Breast tions include: Techniques, and Results” [authors: Sle- Cancer Research Fund. sarenko Y, Dagum A, Hurst L, Wang E, Dr. David E. Rivadeneira, assistant • The management of acute facial nerve McGovern S]. professor of surgery, presented three palsy. Annual Meeting of the American studies at the National Meeting of the Academy of Otolaryngology-Head and Neck Surgical Oncology American Society of Colon and Rectal Surgery, Orlando, FL, September 2003. Dr. Martin S. Karpeh, Jr., associ- Surgeons, held in June in New Orleans: • Surgical decision-making in cholesteatoma. ate professor of surgery and chief of • Benefits of hand-assisted laparoscopic restor- Annual Meeting of the American Academy surgical oncology, has made several ative proctocolectomy: a comparative study of Otolaryngology-Head and Neck Surgery, presentations this year, among which [authors: Rivadeneira D, Marcello P, Roberts Orlando, FL, September 2003. P, Rusin L, Murray J, Coller J, Schoetz D] are: • Pediatric hearing loss. Management of • Local treatment of gastric cancer with sur- • Hand-assisted laparoscopic mesorectal exci- challenges in otology. Weill Medical College gery alone. Annual Meeting of the American sion [author: Rivadeneira D] of Cornell University, New York, NY, June Society for Therapeutic Radiology and On- 2003. • Vacuum-assisted closure of complex wounds cology, Salt Lake City, UT, October 2003. of the perineum: a new paradigm in perineal • Cholesteatoma. Otolaryngology-Head and • Value of laparoscopy in the staging of wound care [authors: Rivadeneira D, Schoetz Neck Surgery Grand Rounds, Albert Ein- resectable pancreatic and periampullary D, Marcello P, Casey K, Loehner D, Rusin L, stein College of Medicine, Bronx, NY, May malignancies. Annual Conference of Gastric Murray J, Coller J, Roberts P] 2003. Cancer: Hepatobiliary and Pancreatic Can- • Diagnosis and treatment of facial nerve cer, Williamsburg, VA, October 2003. In September and November, palsy. Neurology Grand Rounds, North • Changing trends in GE junction adenocar- Dr. Rivadeneira was an invited faculty/ Shore University Hospital, Manhassset, NY, cinoma. International Gastric Cancer Con- instructor at a workshop on hand- April 2003. gress, Rome, Italy, June 2003. access laparoscopic intestinal surgery, • A prospective randomized trial comparing sponsored by the Department of Colon Dr. Smouha is currently work- gastrectomy and standard chemotherapy and Rectal Surgery at the Lahey Clinic ing on 3-dimensional imaging for the versus standard chemotherapy alone in in Burlington, MA. planning of cholesteatoma surgery. radiologic M0 but operatively defined stage IV gastric cancer. American College of “The hand-assisted approach [to Surgeons Oncology Group, Montreal, PQ, Plastic and Canada, June 2003. laparoscopic restorative proctocolectomy] Reconstructive Surgery should definitely replace conventional Dr. Alexander B. Dagum, as- • Minimally invasive surgery in gastric tumors. laparoscopic methods of restorative Memorial Sloan-Kettering Cancer Center: sociate professor of surgery and chief proctocolectomy. If you’re going to do Advanced Minimally Invasive Surgery in of plastic and reconstructive surgery, this in a minimally invasive manner, Oncology, New York, NY, May 2003. there’s no harm in putting a hand inside was elected in May to Alpha Omega • The selective management of advanced the abdomen. Alpha Honor Medical Society, the gastric cancer; who should get adjuvant only national honor medical society in therapy. International Symposium Advances “I believe that the addition of the the world. Its aims are the promotion in Gastric Cancer, Krakow, Poland, January hand reduces the learning curve for of scholarship and research in medical 2003. laparoscopic colectomy, allowing schools, the encouragement of a high nonlaparoscopic colorectal surgeons and standard of character and conduct At the ASTRO meeting in Salt residents to perform more technically among medical students and gradu- Lake City, Dr. Karpeh with Dr. Leon- challenging procedures like laparoscopic ates, and the recognition of high at- ard Gunderson gave the Presidential restorative proctocolectomy.” tainment in medical science, practice, Course, an audience interactive special and related fields. To fulfill its mission, Dr. David E. Rivadeneira, as quoted in General session titled “The Role of Adjuvant Surgery News, (October 2003), in the report on it elects outstanding medical students, or Neoadjuvant Radiation Therapy in his study presented at the latest National Meeting graduates, alumni, faculty, and honor- Gastric Cancer”—one of the areas of of the American Society of Colon and Rectal ary members to its ranks. his expertise. Surgeons.

— 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 — Surgical Research Dr. Malinowski has recently Dr. Criado’s video titled Thora- Dr. Peter J. Garlick, professor earned a new category of qualifica- codorsal Sympathectomy for Hyper- of surgery and director of surgical re- tion with the New York State De- hidrosis, of which he is a co-author, search, in April gave the Presidential partment of Health, and earned a received the second-place award in Invitation Lecture of the American certificate of qualification to act as a the video competition at the Annual Society of Nutritional Sciences—“Peter laboratory director in the category of Meeting of the European Society for Reeds: Original Scientist and Warm- engraftment monitoring [in addition Vascular Surgery, held in Dublin in hearted Human Being”—at the soci- to histocompatibility (serology, DNA) September. ety’s annual meeting in San Diego. and therapeutic substance monitoring He has made four presentations and quantitative toxicology]. at professional meetings in recent Transplantation In addition, he has joined the months of studies conducted with Dr. Kazimierz Malinowski, re- editorial board of the bimonthly jour- members of the vascular team at search associate professor of surgery nal, International Urology and Nephrol- Stony Brook: and director of the histocompatibility ogy, a truly international reading for • Endovascular treatment of a tracheoinnomi- and immunogenetics laboratory, imple- healthcare professionals working in nate artery fistula [authors: Wall P, Criado mented four new ultra-sophisticated the fields of renal medicine and urol- E]. NYU Medical Center, New York, NY; September 2003. lab tests to further ensure optimum ogy. outcomes in organ transplants: • Radial artery hyperhemic response is pre- dictive of radial artery-based native fistula • High resolution SSP of HLA class II Vascular Surgery failure [authors: Wall LP, Gasparis A, van DNA sub-typing Dr. Enrique Criado, associate Bemmelen P, Criado E, Ricotta J]. Periph- professor of surgery and chief of vas- • Reference strand conformation analysis eral Vascular Surgery Society, Chicago, IL; (RSCA) of A, B, and C locus of MHC cular surgery, has recently completed June 2003. a preliminary study on cerebral pro- • Long-term results of percutaneous thrombin • Solid phase ELISA for the detection of panel tection during carotid stenting using reactive IgG antibodies (PRA) to HLA class I injection of iatrogenic pseudoaneurysms and class II antigens carotid flow reversal. This novel ap- [authors: Gasparis A, van Bemmelen P, Cal- proach has been very successful, and lahan S, Criado E, Ricotta J]. Association • Frozen B lymphocyte panel for detection of may serve as a viable treatment op- of Program Directors in Vascular Surgery, HLA class II antibodies tion for blocked carotid arteries. Bethesda, MD; April 2003. • Dialysis access under DOQI: a continuing challenge [authors: Wall LP, Gasparis A, Tonight, there is hope at Stony Brook because highly- Callahan S, Yoo P, van Bemmelen P, Criado “trained cancer physicians will continue to provide the best E, Ricotta J]. Society for Clinical Vascular breast cancer care anywhere—and there is hope because Surgery, Miami, FL; March 2003. Mike Maffetone and Carol Baldwin had the vision and the commitment to get it all started. Dr. John J. Ricotta, professor and From the acceptance speech of Dr. Brian J. O’Hea” on receiving the First Annual chairman of surgery, has again been Dr. Michael A. Maffetone Medical Research Award, at the Sixth Annual Dinner Dance Gala of the Carol M. Baldwin Breast Cancer Research Fund, held in cited as a “doctor of excellence” in October at the Planting Fields Arboretum in Oyster Bay, NY. New York Magazine’s “How to Find the first met Mike Maffetone when I arrived here at As we reflect on the past, it is also time to ponder Best Doctors,” published on June 16, Stony Brook in 1996. Many of you knew Mike. Mike the future. And tonight’s message about the future I was totally committed to the breast cancer cause. is a message of hope. Community outreach 2003, and will also be featured in the Carol Baldwin chose Stony Brook as her partner in programs and other public awareness campaigns next edition of Castle Connolly’s Top the breast cancer cause—and how fortunate we all have resulted in early detection. are that she did. Doctors: New York Metro Area. Recent advances in treatment have resulted in Dr. Ricotta has recently been ap- In my mind, nobody deserves more credit for improved cure rates for the first time ever. More pointed to the Vascular Surgery Board making this happen than Mike Maffetone. He was than 90% of all breast cancers are now diagnosed pivotal in organizing the Carol Baldwin Breast at localized and regional stages, for which 5-year of the American Board of Surgery and Center. He was the brains behind the Carol Bald- survival rates are 97% and 79%, respectively. to the Advisory Council for Vascular win Research Fund. He always supported our breast center, and he always supported me. Tonight, ladies and gentlemen, there is hope for Surgery of the American College of the future because Carol Baldwin and her family Surgeons. Tonight, as I receive the Michael Maffetone Medical will continue to raise money for breast cancer Research Award, we are all reminded of the debt of research. gratitude that we owe Mike for his vision and his lead- ership in the breast cancer program at Stony Brook. There is hope because world-class scientists in This was his legacy and I will always remember Mike the Stony Brook community will continue to work in this way. I will be forever grateful to Mike, and I tirelessly in search of newer treatments. There is want his wife Dawn and their three beautiful children hope because breast cancer activists have kept to know how much he really helped us. this issue in the forefront of public awareness.

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 Collin E.M. Brathwaite, MD Antonios P. Gasparis, MD Martin S. Karpeh, Jr., MD Denise C. Monte, MD John S. Brebbia, MD John J. Ricotta, MD Louis T. Merriam, MD Ghassan J. Samara, MD Marc J. Shapiro, MD Brian J. O’Hea, MD Maisie L. Shindo, MD James A. Vosswinkel, MD Eric E. Smouha, MD BURN CARE John S. Brebbia, MD PEDIATRIC SURGERY Marc J. Shapiro, MD Thomas K. Lee, MD Harry S. Soroff, MD Cedric J. Priebe, Jr., MD Richard J. Scriven, MD CARDIOTHORACIC SURGERY Please visit our website at Thomas V. Bilfinger, MD, ScD PLASTIC AND www.uhmc.sunysb.edu/surgery Irvin B. Krukenkamp, MD RECONSTRUCTIVE Allison J. McLarty, MD SURGERY For consultations/appointments with our physicians, please call Frank C. Seifert, MD Balvant P. Arora, MD • (631) 444-4550 for our specialists in breast care Alexander B. Dagum, MD • (631) 444-2565 for our specialists in burn care GENERAL/ Steven M. Katz, MD • (631) 444-1820 for our specialists in cardiothoracic surgery GASTROINTESTINAL • (631) 444-4545 for our specialists in general/gastrointestinal surgery SURGERY SURGICAL ONCOLOGY • (631) 444-4121 for our specialists in otolaryngology-head and neck surgery (ENT) Collin E.M. Brathwaite, MD John S. Brebbia, MD • (631) 444-4545 for our specialists in pediatric surgery John S. Brebbia, MD Martyn W. Burk, MD, PhD • (631) 444-4545 for our specialists in plastic and reconstructive surgery Martyn W. Burk, MD, PhD Martin S. Karpeh, Jr., MD • (631) 444-2565 for our specialists in surgical oncology Louis T. Merriam, MD Louis T. Merriam, MD • (631) 444-2209 for our specialists in transplantation David E. Rivadeneira, MD Brian J. O’Hea, MD • (631) 444-4545 for our specialists in trauma/surgical critical care Marc J. Shapiro, MD David E. Rivadeneira, MD • (631) 444-2565 for our specialists in vascular surgery James A. Vosswinkel, MD • (631) 723-5000 for our specialists at Stony Brook Outpatient Services in TRANSPLANTATION Hampton Bays: breast care - general/gastrointestinal surgery - pediatric surgery John J. Ricotta, MD - vascular surgery Wayne C. Waltzer, MD The State University of New York at Stony Brook is an equal opportunity/affirmative action educator and employer. This publication can be made available in an alternative format upon request.

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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 Chief of General Surgery, Trauma, Surgical Critical Care, and Burns ■ New Colorectal Surgeon ■ New Vascular Surgeon ■ Performing Minimally Invasive Treatment of Varicose Veins ■ Cochlear Implantation Surgery for Profound Deafness ■ Electronic Physician Directory ■ Residency Update & Alumni News ■ Division Briefs—And More! — 12 — DEPARTMENT OF SURGERY • UNIVERSITY HOSPITAL AND HEALTH SCIENCES CENTER • STONY BROOK UNIVERSITY