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UCSF UROLOGY
 

UCSF UROLOGY

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    UCSF UROLOGY UCSF UROLOGY Document Transcript

    • UNIVERSITY OF CALIFORNIA, SAN FRANCISCO SCHOOL OF MEDICINE UCSF UROLOGY WINTER 2003 Genitourinary Trauma: Saving Lives...and Organs Treatment of genitourinary trauma is to UCSF from around the country for not a staple of most urology prac- reconstructive procedures. tices, but UCSF Urology Vice Chair- UCSF Urology Department Chair Pe- man Jack W. McAninch, MD, has ter Carroll, MD, is emphatic in his earned a premier reputation for re- praise of McAninch. “Jack has con- constructing these challenging in- tributed more to our understanding juries. McAninch has built his exper- of these injuries and how to care for tise on his work at San Francisco them than any other urologist,” said General Hospital, where he has Carroll. “His commitment to San served as Chief of Urology for the Francisco General is unflagging, and past 26 years. As the designated so is his enthusiasm and energy for trauma center for the city of San his work.” Francisco, the hospital cares for McAninch and his team have assem- scores of patients each year who bled an extensive database on pa- have suffered kidney or other geni- tients treated at SFGH and on others tourinary injuries. The UCSF urotrau- referred to UCSF, information that ma team is one of only a few in the has proven to be a powerful tool for United States that performs a high clinical outcomes research. They volume of this specialized surgery, regularly review the database to de- and, as a result, patients are referred termine treatment efficacy, and pro- duce up to ten manuscripts on their findings each year. McAninch also serves as editor of Traumatic and Reconstructive Urology, the definitive textbook in the field. Improving salvage rates following kidney trauma One of the most impressive uses of the SFGH database has been the de- velopment of guidelines for the man- agement of renal trauma that are now accepted worldwide. McAninch and his team have used data amassed on more than 3,000 renal injuries treated over the last 25 years to study clinical $35 Million Gift Supports outcomes and refine management protocols. McAninch advocates a Cancer Research conservative approach to kidney in- CONTENTS The Helen Diller Family has con- juries; surgical exploration is per- Genitourinary trauma 1 tributed $35 million to UCSF to formed only after thorough evaluation Letter from the chair 2 support the construction of a new of the extent of injury with CT imag- Nutrition in prostate cancer 4 cancer research building at UCSF ing. At SFGH, exploratory surgery is Female incontinence 5 Mission Bay. The Urologic Oncolo- required in only 2% of patients with New space 6 gy Research Program will occupy a blunt trauma, 45% of stab wounds, Resident research 7 significant portion of the new Mis- and 76% of gunshot wounds. When New faculty 8 sion Bay facility, along with the surgery is performed, urologists iso- Cancer Research Institute and the Top residents 9 (See Genitourinary Trauma on page 3) Honors & awards 10 Brain Tumor Research Center. In- cluded in this generous gift, the Clinical trials 11 University of California largest contribution from individual San Francisco Recent publications 11 donors in UCSF history, are re- Faculty 12 sources to establish a prostate cancer research fund, under the di- rection of the Department of Urolo- School of Medicine gy. For details, see page 2. Department of Urology
    • Letter from the chair (Genitourinary Trauma from page 1) A Donor’s Vision for Cancer Care late the renal vessels early to control stricture repair, with a bleeding, vastly improving the 90% long-term success It is my great pleasure to share with you the news that the Helen Diller Family chances for successful reconstruc- rate. The UCSF team has made a $35 million gift to UCSF and the Department of Urology to support tion of the organ. Kidney salvage has also defined the construction of a new cancer research building at UCSF Mission Bay and to rates are 85% in patients who under- role of sonourethrog- establish an endowed fund for prostate cancer research. The Urologic Oncolo- go renal exploration. raphy in determining gy Research Program will occupy a large portion of the new building, which will which repair technique also accommodate researchers within the UCSF Cancer Research Institute and Training a new gener- is most appropriate for the Brain Tumor Research Center. In all, the new facility will more than double each patient. By identi- the existing space dedicated to cancer research at UCSF. ation of urologists in fying strictures too long for resection and end- McAninch has a distinguished history of lead- The facility will be named the Helen Diller Family Cancer Research Building in these complex proce- to-end anastomosis, ership in urological professional societies. Peter R. Carroll, MD recognition of the family’s pivotal role in making the research center possible. Currently President-Elect of the Society of Construction of this five-story building, designed by noted architect Rafael dures is a focus of sonourethrography can International Urology, he has previously served Viñoly, will provide more than 160,000 square feet for research. preoperatively identify the UCSF program. which patients should as president of the American Urological Asso- This generous gift, the largest contribution from individual donors in UCSF histo- be treated with flap or ciation, the American Board of Urology, and ry, also includes resources to establish the Helen Diller Family Prostate Cancer Complex urogenital reconstruction graft procedures. the Society of Genitourinary Reconstructive Research Fund. This endowment will support our department’s many clinical and Surgeons. His recognition last year as Man of Based on experience gleaned from McAninch and his team basic science investigations in prostate cancer diagnosis, treatment and preven- the Year by the National Kidney Foundation of working with SFGH patients, McAn- have also performed tion. Overall, the gift will enable our department to expand urologic oncology re- Northern California was the latest in a long list inch and his team have built a large more than 150 urethral search, and replace dated infrastructure with new space and equipment. of honors and awards. referral practice in reconstructing reconstructions in pa- Construction of the new building will begin pending final approval by the UC traumatically injured tissues. Urethral tients who have suf- Board of Regents. The new facility will join the recently completed Genentech strictures that impair a man’s ability fered traumatic rupture Hall at the 43-acre UCSF Mission Bay campus on San Francisco’s eastern to void urine are a major focus of of the urethra. These waterfront. When it is fully developed, the new campus will include 2.65 million their work. Most often caused by ex- patients undergo a suprapubic cys- square feet of biomedical research and teaching space. ternal trauma, urethral strictures can tostomy with urinary diversion at the The University in general and our department in particular have established a also result from internal injury from a time of their injury. Restoring their wonderful relationship with the Diller family. Family members have engaged in catheterization or an endoscopic team achieves good cosmetic and ability to void involves removing scar regular exchanges of ideas with faculty, providing insightful guidance on re- procedure. Most patients referred to functional use in men who would tissue and reattaching the urethral search areas of mutual interest. The Dillers, who are native San Franciscans, UCSF have been previously treated otherwise remain badly disfigured. ends. This task is usually complicat- share a heartening belief that UCSF cancer researchers are on the verge of dis- by referring physicians with internal ed by anatomic distortions of the Training the next generation coveries that will improve lives around the world. We gratefully thank them for urethrotomy or dilation, but success pelvis, prostate and urethra caused their confidence and enthusiasm for our work. Their remarkable generosity is rates for these procedures tend to be by the initial injury. Nonetheless, the Training a new generation of urolo- an inspiration to all of us. quite low, according to McAninch. team has an excellent 95% success gists in these complex procedures is rate, due in part to detailed preoper- a focus of the UCSF program. At any The Department of Urology has experienced a tremendous increase in re- McAninch has performed approxi- ative planning. Routine tests such as one time, two UCSF urology resi- sources and space over the past year. Our advocates and donors continue to mately 730 stricture repairs, and has cystography and urethrography are dents rotate through San Francisco provide substantial support and guidance, and I appreciate their efforts on our developed several techniques to ad- supplemented with magnetic reso- General Hospital, where they treat behalf. I am grateful to the strong leadership at UCSF for providing critically dress the more challenging obstruc- nance imaging to establish the full not only genitourinary trauma, but al- needed space to accommodate our programmatic growth. Finally, I recognize tions. A penile circular fasciocuta- extent of the injury. so the full range of urologic diseases. the extraordinary dedication of my faculty, housestaff and staff, whose hard neous skin flap, for example, allows work is essential to our growth and to the achievement of our tripartite mission: for one-stage reconstruction of long, The UCSF team also specializes in Fourteen years ago, UCSF created a to educate, to care, and to discover. complex strictures. Since developing reconstructing the genitals of men unique SFGH-based fellowship in the procedure 14 years ago, McAn- who have suffered traumatic skin urological trauma and genitourinary In this newsletter we also highlight the remarkable work of Jack McAninch, MD, inch has used this skin flap in more loss, burns or infection. By employing reconstruction, a program McAninch Professor and Vice Chair of the department. I, like so many others, have benefit- than 150 patients with an 85% long- complex reconstructive procedures directs and of which he is particularly ed from Jack’s remarkable experience and expertise. Jack’s roles in the depart- term success rate. UCSF urologists and expert wound care, the UCSF proud. Almost all the fellows have ment as an educator, clinician and Vice Chair are critical to our continued suc- also use buccomucosal grafts for subsequently accepted positions in cess. I am personally grateful for his wisdom, leadership and continued support. academic medical centers in the Helen Diller United States or abroad, where they Urethrogram demonstrating a proximal bulbar stricture following a straddle injury share their expertise with a new gen- Sincerely, eration of physicians. Peter R. Carroll, MD Professor and Chair of Urology Ken and Donna Derr-Chevron Endowed Chair in Prostate Cancer 3 2
    • CAN LIFESTYLE CHANGES AFFECT PROSTATE CANCER? Dean Ornish, MD, Clinical Innovative Prostate Cancer Research SCOR Designation Professor of Medicine and President of the Preventive Studying the Role of Nutrition in Prostate Cancer Multidisciplinary Research on Female Incontinence Medicine Research Institute in Dean Ornish Sausalito, CA has been col- The idea of reducing cancer risk with not adequately represent what hap- The UCSF SCOR designation, which concluded a laborating with Department dietary changes is an appealing con- pens when humans consume partic- Chair Peter Carrroll, MD, on a cept to many prostate cancer pa- ular foods,” said Haqq. “The MENS highly competitive award process, was one of 11 unique clinical trial. Preliminary find- tients; UCSF investigators have trial is designed to provide specific ings from this study were presented shown that a large percentage of information on how lycopene and granted by the National Institutes of Health...to at the spring 2003 American Urolog- men with prostate cancer alter their fish oil affect prostate cancer cells in support programs affecting women’s medical needs. ical Association meeting, and one- lifestyle, primarily with diet, even if the course of normal metabolism.” year results have been submitted for they receive conventional treatment Participation is open to men with fa- Many women are chronically trou- have some degree of incontinence, publication. for their disease. Epidemiologic stud- vorable-risk prostate cancer who bled by urinary incontinence, yet this and 15% report experiencing this This Dean Ornish is the first randomized, con- ies link many dietary factors with in- have opted for watchful waiting as widespread problem has received problem daily. trolled clinical trial to determine if creased or decreased risk of devel- their therapeutic course. Men will be relatively little scientific study. With Lue is principal investigator for the oping prostate cancer, but the randomized to take either placebo, its recent designation by the National SCOR-funded basic science pro- comprehensive changes in lifestyle molecular mechanisms of action for lycopene or fish oil supplements for Institutes of Health as a Specialized ject, which will explore the molecu- may affect the progression of most of these nutrients are not well a three-month period, with the goal Center of Research (SCOR) in Lower lar and genetic mechanisms of in- prostate cancer. understood. of enrolling 34 men in each study Urinary Tract Function, UCSF is continence and the use of matrix- Ninety men with prostate cancer spearheading a wide range of scien- arm. Prostate biopsies, serum sam- based therapy as a scaffold for who had previously chosen not to undergo conventional treatment, The major aim of the ples, and detailed dietary surveys tific studies on this issue. bladder and urethral replacement. will be collected at the beginning Urogynecologist Jeanette S. Brown, Co-investigators include Emil with prostate specific antigen (PSA) trial is to determine and end of the study period. MD, who directs the SCOR, and Tanagho, MD, an authority on uro- between 4-10, and Gleason scores whether intake of The major aim of the trial is to deter- urologist Tom F. Lue, MD, co-direc- dynamics and neurourology, and under 7 were randomly assigned to mine whether intake of each nutri- tor, are widely recognized for their molecular biologist Ching-Shwun an experimental group or a non- intervention control group. All men each nutritional sup- tional supplement correlates with the work on clinical and basic science Lin, PhD, director of the Knuppe expression of specific genes in aspects of this common problem. Molecular Urology Laboratory. were followed regularly for signs of plement correlates prostate tissue, as measured by Together, they are coordinating the The project builds on NIH-funded re- progression. The intervention con- molecular biology tools, including efforts of a talented group of multi- search currently being conducted at Under the direction of Chris Haqq, MD, sisted of a low-fat vegan diet sup- with the expression high fidelity RNA amplification and disciplinary investigators studying UCSF on the development of an ani- assistant professor of medicine, Guiting plemented with soy and antioxi- the underlying molecular mecha- Lin, PhD in the Knuppe Molecular Urolo- dants, moderate aerobic exercise, of specific genes in cDNA array analysis. The re- nisms of urinary incontinence, the mal model for female urinary inconti- gy Laboratory, has made 260 glass gene searchers hypothesize that lycopene nence and the use of acellular matrix chips for the SCOR project to identify stress management and group sup- port. In addition to measuring quar- prostate tissue, as supplementation will be associated epidemiology of the disorder and for the treatment of urinary tract dis- genes that are associated with urinary clinical outcomes of treatment. incontinence. Pictured is a chip that has with decreased expression of genes orders. Techniques developed terly PSA, serum from patients was measured by molecu- that promote production of insulin- SCOR investigators include mem- through in vitro and animal studies reacted with tissue RNA from the ure- thra. The chip contains 21,600 genes. added to a common human bers of the UCSF Departments of like growth factor-I (IGF-I), a hor- by Tanagho’s research team led to prostate cancer cell line (LNCaP). lar biology tools. mone linked to the risk of prostate Obstetrics, Gynecology and Repro- the recent successful use at UCSF of None of the experimental group par- cancer. Investigators believe that fish ductive Sciences, Urology, Family rabbit bladder acellular matrix for re- To help clarify the effect of diet on es a woman’s risk of developing in - ticipants received conventional treat- oil supplementation may be associ- Medicine, Geriatrics, and Epidemiol- pair of a urethral stricture in a man. men’s prostate health, the UCSF ogy & Biostatistics; the UCSF Wom- continence by 50-60%. ment during the first year, while six ated with decreased expression of With these encouraging results, Lue of the control patients did. After one Urology Department is involved in a Cox-2 genes, which indicate cellular en’s Health Clinical Research Center; A second clinical project will examine and Tanagho are studying whether year, PSA values decreased signifi- multidisciplinary study that will mea- inflammatory responses. As part of and the Northern California Kaiser reproductive and hormonal risk fac- acellular matrix with or without cantly in the experimental group but sure the effects of two popular nutri- the study, researchers will also ana- Division of Research. tors for incontinence by providing growth factor treatment can be used increased significantly in the control tional supplements on prostate can- lyze the correlation between baseline funding to continue studying a multi- The UCSF SCOR designation, which to treat female stress urinary inconti- group. Changes in PSA were associ- cer cells. They are lycopene, an an- gene expression patterns and self- concluded a highly competitive nence in animal models. ethnic group of 2100 women receiv- ated with degree of lifestyle change. tioxidant found in tomatoes, and fish reported dietary habits to see if in- ing care through the Kaiser Perma- award process, was one of 11 grant- In addition to basic scientific re- Substantial modifications in lifestyle oil that is rich in omega-3 fatty acids. gesting certain foods is linked to nente Medical Care plan. David H. ed by the National Institutes of search, two clinical projects are were required for PSA to decrease. The Molecular Effects of Nutrition particular gene expression profiles. Thom, MD, MPH, PhD, serves as Health Office of Research on Wom- funded through the SCOR. Brown, Supplements (MENS) trial, which is principal investigator for this project, Serum from experimental patients Subjects will be followed for an addi- en’s Health in October 2002 to sup- who directs the UCSF Women’s funded by a grant from the National port programs affecting women’s which traces risk factors for inconti- inhibited growth of LNCaP cells sig- tional nine months after the three- Continence Center, serves as princi- nence through medical records, inter- Cancer Institute, is led by urologic medical needs. The UCSF award is nificantly more than serum from con- month dietary intervention to monitor pal investigator for a study that will views and databases available oncologist Christopher Haqq, MD, coadministered by the National Insti- trol patients. There was a strong cor- clinical progression of prostate can- explore how diabetes affects lower through the Kaiser system. PhD, epidemiologist June Chan, tute of Diabetes and Digestive and relation between adherence to the cer. It is hoped that this study will urinary tract dysfunction and infec- ScD, and urologist Peter Carroll, MD. Kidney Diseases. SCOR activities also include junior lifestyle intervention and changes in provide significant insight into the tions. The study will follow a Other investigators include urologist faculty training in clinical research, LNCaP cell growth in both groups. actual effects of dietary manipulation “Lower urinary tract dysfunction, in- prospective cohort of 400 women Katsuto Shinohara, MD, and statisti- and a fellowship in clinical research on both benign and malignant cluding incontinence, significantly with type 2 diabetes age-matched In summary, one-year data indicate cian Vivian Weinberg, PhD. methods. If you would like further prostate cells. impairs quality of life and accounts with 400 nondiabetic controls. The that comprehensive and intensive “Cell cultures and animal models, al- information on the program, for billions of dollars each year in project builds on Brown’s previous lifestyle changes may cause a signif- though helpful in some respects, do please visit www.ucsf.edu/scor. 4 health care expenditures,” said Lue. work, which showed that this in- 5 icant decrease in PSA in patients Up to 50% of women over age 60 creasingly common disease increas- with early, low-grade prostate can- cer. Long-term follow-up is planned.
    • New Space Facilitates Growth and Consolidation Resident Research With the completion of extensive testing and cystoscopy. Urology’s Unlike other urology residency pro- metastases in prostate cancer pa- PhD, Yun has been examining ge- renovations at Parnassus and academic and administrative units grams, UCSF offers participants a tients. The team used cDNA mi- netic factors that might contribute Mount Zion, the Department of are now located in beautifully re- fifth year of postgraduate training croarray technology to examine to the disease in four groups of Urology has more than doubled its modeled offices adjacent to the clin- devoted to basic science research. gene expression in tissue samples men: African Americans with and academic space, streamlined and ic, which has significantly improved This reflects the department’s com- taken from primary prostate cancer without prostate cancer and Cau- upgraded its outpatient facilities, interaction and continuity between mitment to training future academic tumors in nine patients found to casians with and without the dis- and consolidated its Program in clinical and business services. leaders in the field. Residents elect have lymph node metastases at the ease. Tissue samples were obtained Urologic Oncology into a newly re- At Mount Zion, the Program in Uro- to work with a faculty mentor who time of radical prostatectomy, and from transrectal biopsy and from furbished wing at Mount Zion. logic Oncology is no longer scat- oversees their research training, en- nine risk-matched patients who did radical prostatectomy. Immunohis- At Parnassus, urology outpatient tered among several temporary of- suring that the year is a productive not have lymph node involvement. tochemistry was then used to mea- and academic offices are now side- fices, but has been consolidated in- experience. This year’s resident re- The results, which won an award in sure protein expression and real- by-side on the sixth floor of the Am- to bright and expansive space on search efforts have produced partic- basic sciences when Purohit pre- time PCR was used to measure mR- bulatory Care Center. The outpatient the sixth floor of the “A” building. ularly intriguing and notable findings. sented them at the Northern Cali- NA expression. Yun reported his space has been completely renovat- The new site brings together uro- The reception area in the new Urology outpa - Donna Deng, MD, has worked with fornia Urology Residents’ Seminar, findings at the AUA annual meeting tient office this year in Chicago, specifically, ed and includes on-site, state-of- logic oncology and male infertility urologist Tom Lue, MD, in investigat- revealed elevated expression of 20 the-art fluoroscopy, urodynamic faculty; residents and fellows; aca- ing the use of embryonic rat stem to 30 genes in patients whose tu- that levels of the enzyme CYP1A1, a demic, clinical trials and outreach cells to treat incontinence and erec- mors had metastasized. Upregulat- known carcinogen, were increased staff; and urology outcomes and tile dysfunction. The stem cells were ed genes included those coding for in African American men with general oncology surgery. The ex- epidemiology research teams. first differentiated into nerve and extracellular matrix proteases, lym- prostate cancer. If borne out by fur- pansion coincides with the appoint- Working in close proximity will fos- smooth muscle cells, impregnated phocyte-specific factors, neural- ther study, CYP1A1 might provide a ment of Peter Carroll, MD, as the ter collegiality among the faculty, with growth factors, and then im- specific factors, and expressed se- marker for identifying African Ameri- clinical cancer center’s first surgeon Al Arroyo, urology technician, in the new cys- researchers, and staff in this fast- planted in rat models of urinary quence tags. The results suggest can men at high risk for developing toscopy suite at Parnassus. in chief. These steps facilitate imple- growing, multidisciplinary program. stress incontinence and erectile that metastatic disease can be pre- prostate cancer and for detecting mentation of the strategic plan for dysfunction resulting from nerve in- dicted using gene arrays and that cancer at an earlier, more treatable, This summer, the medical center the clinical cancer center, more than jury. Deng and Lue used histochem- patients with over-expression of stage. This could lead to many more opened new operating rooms, a double inpatient capacity, and ical staining to verify that the cells these factors in their primary tu- lives being saved each year. seven-bed intensive care unit and broaden and solidify the surgical were alive, then administered vari- mors should be treated as high-risk ancillary services at Mount Zion, presence at the Mount Zion campus. ous functional tests to see whether patients. In addition, new targets paving the way for the transition of the injury had improved as a result for novel treatment may be found. a range of cancer surgical activities from the Parnassus campus. Ex- of stem cell treatment. Results are Edward Yun, MD, has focused his panded inpatient services at Mount not yet available for the inconti- research on examining the genetic Zion are now provided by urology, nence model, but the erectile model basis for racial differences in breast oncology, gastroenterology has shown positive preliminary re- prostate cancer. The incidence of and gynecology, as well as head sults. Some animals have shown prostate cancer in African American and neck, melanoma, thoracic and very clear improvement in erectile men is estimated to be 60% to function, in some cases returning 70% higher than in Caucasians, close to baseline function, four to and they tend to develop the dis- six weeks after stem cell implanta- ease at an advanced stage. When tion. Such research could lead to diagnosed, African Americans tend improved outcomes for many pa- to have higher PSA levels and tu- By hybridizing cDNA from both tumor and normal samples onto the gene chip, the relative expres- tients undergoing treatment for a mors of a higher grade and stage. sion of thousands of genes can be evaluated. variety of conditions. Researchers have hypothesized Rajveer Purohit, MD, MPH, has that diet, socioeconomic factors worked with faculty member Chris and health care access may con- Haqq, MD, PhD, at the Mount Zion tribute to this disparity. Working at Cancer Research Center on a pro- the San Francisco Veterans Affairs Urology Launches New Website ject examining genetic predictors of Medical Center with Raj Dahiya, The Department of Urology revamped and launched a new 6 comprehensive website early in 2003. The website, located at urology.ucsf.edu, is a resource for patients, residency and fel- lowship applicants, community physicians, and anyone inter- ested in learning more about the department and its programs. The website includes information about the department’s fac- 7 ulty, facilities, training programs, clinical trials, residency and fellowship programs, continuing medical education and other educational events, and news. A patient information section provides downloadable information, a listing of free services at the University and links to other resources.
    • New faculty Jeanette Brown, MD cum laude. He then attended the Johns Hopkins School of Medicine, At Case, Witte was honored with a examine the genetic basis of prostate Professor where he was inducted into the Al- teaching award, the 1999-2000 Glen- cancer, and have included searches Obstetrics, Gynecology and Repro- nan Fellowship, given for innovation across the human genome and work pha Omega Alpha honor society. ductive Sciences, Epidemiology & in teaching and education. He was on specific candidate genes. Suc- Meng obtained his general surgery Biostatistics and Urology honored again in 2002-2003 with the cesses have included the isolation of and urology training at the University Jeanette Brown, MD, who has been of California, San Francisco. Meng Visiting Scientist award from the In- distinct chromosomal regions that UCSF faculty in the Department of has combined an interest in urologic ternational Agency for Research on appear to harbor prostate cancer Obstetrics, Gynecology and Repro- oncology and minimally invasive Cancer in Lyon, France. Witte’s re- causing genes, and the first genome- ductive Sciences since 1986, joined surgery, completing fellowships in search program constitutes applied wide scan for genes linked to the ag- Jeanette Brown the Department of Urology with a both under the guidance of Peter and methodological genetic epidemi- gressiveness of prostate cancer. joint appointment in December 2002. Carroll, MD, and Marshall Stoller, ology, with the overall aim of deci- Brown’s notable research includes a MD. In January 2003, upon comple- phering the mechanisms underlying multivariate analysis of risk factors tion of his fellowships, Meng was ap- complex diseases. His applied work for urinary incontinence, risks associ- pointed to a faculty position. is focused on prostate cancer, and ated with urge incontinence, risk fac- complements other work done at the Meng specializes in urologic cancers tors associated with stress and urge UCSF Prostate Cancer Center. and laparoscopy, and is part of the incontinence, and lower urinary tract Witte’s genetic epidemiology studies multidisciplinary urologic oncology dysfunction and urinary incontinence team located at the Mount Zion Can- among women with diabetes. cer Center. Meng’s clinical interests Brown has been director of the UCSF include the diagnosis and manage- Women’s Continence Center and the ment of genitourinary malignancy, and Maxwell Meng Women’s Urologic Research Center minimally invasive treatment of benign since 1990. In 1993, while maintain- and malignant diseases. His current ing her faculty appointment, Brown laboratory research projects include began and completed a two-year fel- lowship in Epidemiology, Biostatistics the development of novel therapeutic interventions for bladder cancer, and Top residents match to UCSF and Clinical Research at UCSF. The the study of molecular markers to fellowship supplied Brown with the predict disease behavior in prostate Benjamin Breyer, MD have undergone radical cystectomy tools needed to build the Women’s cancer. Meng is an experienced for bladder cancer. Doyle is a mem- Urologic Research Center. Today this Breyer earned his MD from the Uni- robotic surgeon and is actively in- ber of the Alpha Omega Alpha Honor multidisciplinary group of basic and versity of Chicago Pritzker School of volved in the development of new Medical Society. clinical investigators collaborates to Medicine. His honors and awards in- technologies for minimally invasive conduct translational research on the clude membership in the Alpha surgery. Jared Whitson, MD female urethra, bladder, pelvic floor Omega Alpha honor medical society, honors in all third-year clinical clerk- Whitson earned his MD from Benjamin Breyer John Witte and urinary incontinence. Brown’s John Witte, PhD Columbia University College of Physi- appointment in Urology will help to ships, and the Calvin Fentress Re- Professor search Fellowship Award. His re- cians and Surgeons in New York. He foster additional collaborations, in- was a National Institutes of Health Epidemiology & Biostatistics and search in the molecular oncology cluding the UCSF Specialized Center summer research fellow in 2000. In Urology laboratory, directed by Tong-Chuan of Research on Lower Urinary Tract 1998, funding from an American Function in Women, which is led by John Witte, PhD, joined the depart- He, MD, PhD, has resulted in 11 publications, including two about vi- Heart Association student research Brown and Urology Vice Chair Tom ments of Epidemiology & Biostatis- ral vectors and gene therapy, where grant led to published work, entitled Lue, MD (see page 5). tics and Urology in September from Breyer is first author. “The Systemic Procoagulative Re- Case Western Reserve University sponse to PTFE Implants in Patients Maxwell Meng, MD School of Medicine. Witte earned his Sean Doyle, MD Undergoing Femoropopliteal Bypass Assistant Professor master’s degree from the University Doyle earned his MD from the Uni- or Arteriovenous Fistula Grafts.” Un- of California, Berkeley, and a PhD in Urology versity of Texas Southwestern Medi- der the direction of James McKier- Sean Doyle epidemiology from the University of Maxwell Meng, MD, received his un- cal School at Dallas, Texas, where he nan, MD, at Columbia University, California, Los Angeles. After receiv- dergraduate training from Harvard was recipient of the Southwester n Whitson studied the relationship be- ing his degree in Los Angeles, he College, where he obtained his de- Medical Foundation Scholarship for tween levels of a serum tumor marker was an Assistant Professor of Pre- gree in biochemical sciences magna academic achievement. His most re- for renal cell carcinoma and tumor ventive Medicine at the University of cent research under the direction of histology, stage and survival. Southern California. Arthur Sagalowsky, MD has investi- gated the outcomes of patients who 8 9 Jared Whitson
    • Clinical trials Clinical trials of new therapies for urological disorders are a department priority. The department and affiliated programs are conducting more Honors & awards than 35 investigational studies. Several ongoing trials are listed below. For more information, please visit our clinical trials website at urology.ucsf.edu/clinicalTrials.html or contact Meg Randall at 415/885-7329 (mrandall@cc.ucsf.edu) or Joyce Alejo at 415/353-7348 Laurence Baskin, MD, was funded Carroll was appointed surgeon-in- Zhong Wang, MD, for “Hypospadias Lue was selected as one of America’s (jalejo@urol.ucsf.edu) by the National Institutes of Health chief at the UCSF Mount Zion Com- and Microarray Gene Chip Analysis.” top doctors by Men’s Health Maga- for his proposal “Hypospadias, Geni- prehensive Cancer Center. He is the Kirsten Greene, MD, was selected by zine. He was featured for his work on • The Molecular Effects of Nutri- Prednisone in Patients with Tax- tal Tubercle Differentiation and En- first to hold this position. the medical students as one of five re- erectile dysfunction in the April 2003 tional Supplements (MENS) ane Resistant Hormone Refracto- docrine Disruptors.” The NIH also June Chan, ScD, presented the best cipients of the 2003 Housestaff Teach- publication. Prostate Cancer Study (CC ry Prostate Cancer (02555) awarded Baskin a grant with the clinical research poster, entitled ing Award. Awards are given to the Jack McAninch, MD, is serving as 03553) • A Randomized Study Comparing UCSF Children’s Hospital and the “Post-Diagnostic Diet and the Risk of most outstanding clinical teachers and President-elect of the Society of In- • A Randomized Phase II Trial of 4 Monthly Doses of MDX-010 as Pediatric Clinical Research Center to Prostate Cancer Recurrence and residents and are nominated by the ternational Urology. The society was Interferon Alfa-2B or Interferon a Single Agent or Used in Com- set up a prospective database to Mortality: Health Professionals Fol- graduating class of medical students. founded in 1907 in Paris and has a Alfa-2B Plus Bevacizumab in Pa - bination with a Single Dose of study outcomes of children with uri- low Up Study,” at the March 2003 worldwide membership. McAninch is tients with Advanced Renal Car - Docetaxel in Patients with Hor - Greene was also elected to the Alpha nary tract infections. UCSF Prostate Cancer Retreat. the third society president from the cinoma (CALGB 90206) mone-Refractory Prostate Cancer Omega Alpha Honor Medical Society Baskin was elected to a five-year United States in the last 30 years. • A Randomized Phase II Study of (CC 02559) Chan won a CaPCURE research by the graduating class of 2003 stu- term on the executive committee of award in June 2003 for a project to dent members of UCSF’s chapter. McAninch was elected fellow to the BMS 247550 or Mitoxantrone and the American Academy of Pediatrics’ study serum nutrient predictors of She was one of three UCSF house- American Surgical Association. The Section of Urology, nominated to or- prostate cancer bone metastases staff members selected from several association was founded in 1880 and ganize the Society of Pediatric Urol- ogy’s April 2003 meeting in Chicago, and death. This research will seek to identify modifiable risk factors to de- hundred eligible candidates. Two UCSF urology residents received is the major society of academic sur- geons in the United States. Recent publications and selected to serve a five-year edi- lay the onset of painful and often fa- awards at the 29th annual Northern Marc Shuman, MD, was appointed torial board term on the Journal of tal bone metastases. Members of the department have published extensively in the past year. California Urology Residents’ Semi- to the National Cancer Institute’s Ini- Urology’s pediatric section. A few recent highlights are noted below. Gerald Cunha, PhD, co-organized the nar. Kirsten Greene, MD, was award- tial Review Group Cancer Center Peter Carroll, MD, was one of three Second Timberline Symposium on ed third place for clinical research Subcommittee. The peer-review com- Chan JM; Stampfer MJ; Ma J; developing human fetal penis and new members elected to the Clinical Epithelial Development. In April 2003 and Rajveer Purohit, MD, MPH, was mittee reviews cancer center grant Gann P; Gaziano JM; Pollak M; urethra. Cell and Tissue Research. Society of Genitourinary Surgeons. Cunha presented the 9th annual Don- awarded third place in the basic sci- applications submitted to the NCI, Giovannucci E. 2002 307(2):145-53. The society brings together out- ald S. Coffey Lecture at the Society ences division. makes recommendations to the Na - standing urological authorities; mem- Insulin-like growth factor-I (IGF-I) and Lin CS; Xin ZC; Lin G; Lue TF. for Basic Urologic Research Spring Sarah Knight, PhD, received two tional Cancer Advisory Board and bership is limited to urologists who IGF binding protein-3 as predictors Phosphodiesterases as therapeutic meeting in Chicago. His presentation awards for improving assessment of surveys the status of research. Shu - have made major contributions to of advanced-stage prostate cancer. targets. Urology. 2003 61(4):685-91. was entitled, "Thirty-Five Years of patient preference in localized man’s term began in July 2002 and the advancement of Urology. Journal of the National Cancer Insti- Meng MV; Freise CE; Kang SM; Stromal-Epithelial Interactions in the prostate cancer from the Veterans runs through June 2006. tute. 2002 94(14):1099-106. Prostate: What Have We Learned?" Duh QY; Stoller ML. Affairs Health Services Research and Wendell (Van) Van Auken, BEE, Cooperberg MR; Grossfeld GD; Development Program. The awards MBA, a UCSF Prostate Cancer Re- Techniques to optimize vascular Rajvir Dahiya, PhD, was awarded Lubeck DP; Carroll PR. included an advanced research ca- search Advocate, was appointed to control during laparoscopic donor funding for two prostate cancer re- National practice patterns and time reer development award and an the Integration Panel for the De- nephrectomy. Urology. 2003 61(1): search proposals totaling $2.3 million trends in androgen ablation for local- investigator-initiated merit grant. partment of Defense Prostate 93-7; discussion 97-8. in direct cost. Work on a National In- ized prostate cancer. Journal of the Paul Turek, MD, was stitutes of Health grant entitled “DNA Cancer Research Program. The Paris PL; Albertson DG; Alers JC; David Latini, PhD, was selected as a National Cancer Institute. 2003 elected to the presti- Methylation in Aging, Race and Integration Panel is responsible Andaya A; Carroll P; Fridlyand J; fellow for the National Cancer Insti- 95(13):981-9. gious Haile T. Debas Prostate Cancer” and co-led by for distributing an annual budget Jain AN; Kamkar S; Kowbel D; tute–funded 2003 Culture and Litera- Elliott SP; Metro MJ; McAninch JW. Academy of Medical Ed- Peter Carroll, MD, began in October of approximately $80 million. Krijtenburg PJ; Pinkel D; Schroder cy Institute training program at the Long-term followup of the ventrally FH; Vissers KJ; Watson VJ; Wildha- ucators. The Academy is 2002 and will run through September Moffitt Cancer Center in Tampa, Flori- The committee receives propos- dedicated to enhancing als that have already undergone placed buccal mucosa onlay graft in gen MF; Collins C; Van Dekken H. 2007. A Veterans Affairs merit review da. The training program began with scientific review, and is respon- bulbar urethral reconstruction. Jour- High-resolution analysis of paraffin- the status of teachers of award on genetic factors in race- a week of training in Tampa and has nal of Urology. 2003 169(5):1754-7. embedded and formalin-fixed medical students at related prostate cancer was funded continued with monthly online train- sible for funding a comprehen- UCSF, and promotes through January 2009. sive and balanced portfolio of Elliott SP; Shinohara K; Logan SL; prostate tumors using comparative ing sessions and mentoring. research grants. Carroll PR. genomic hybridization to genomic Paul Turek and rewards teaching Three California Urology Foundation Wendell Van Auken Tom Lue, MD, was presented with Sextant prostate biopsies predict microarrays. The American Journal excellence and curricular awards totaling $26,000 were award- the Henry Weyrauch Award at the side and sextant site of extracapsu- of Pathology. 2003 162(3):763-70. innovation. His application was ed to departmental members for novel March 2003 Western Urologic Forum lar extension of prostate cancer. Xu EY; Lee DF; Klebes A; Turek PJ; selected for membership by na- research in January 2003. meeting for best scientific presenta- Journal of Urology. 2002 Kornberg TB; Reijo Pera RA. tional and international experts in Donna Deng, MD, received an award tion. In May 2003 he was selected as 168(1):105-9. medical education for his work for a proposal elucidating the effect of Human BOULE gene rescues mei- the William R. Smart Teaching Award Kane CJ; Lubeck DP; Knight SJ; otic defects in infertile flies. Hu- with the medical school curricu- implanted embryonal stem cells for recipient. The teaching award is given Spitalny M; Downs TM; Grossfeld man Molecular Genetics. 2003 lum and his teaching skills. Turek urinary incontinence. by the UCSF Department of Urolo- G; Pasta DJ; Mehta SS; Carroll PR. 12(2):169-175. celebrated his membership in Rajveer Purohit, MD, received funding gy’s residents for excellence in resi- September at a ceremony and for a proposal entitled “Large-scale Impact of patient educational level Veltman JA; Fridlyand J; Pejavar S; dent teaching. dinner with other members of cDNA Array Analysis of Predictors of on treatment for patients with Olshen AB; Korkola JE; DeVries S; the Committee. Metastasis in Prostate Cancer,” and prostate cancer: Data from CaP- Carroll P; Kuo WL; Pinkel D; SURE. Urology. 2003 62:1035-1039. Albertson D; Cordon-Cardo C; Kim KS; Liu W; Cunha GR; Jain AN; Waldman FM. 10 Russell DW; Huang H; Shapiro E; Array-based comparative genomic Baskin LS. hybridization for genome-wide Expression of the androgen receptor screening of DNA copy number in and 5 alpha-reductase type 2 in the bladder tumors. Cancer Research. 2003 63:2872-2880.
    • Faculty Peter Carroll, MD Hiep Thieu Nguyen, MD Professor and Chair Assistant Professor Specialty: Urologic Oncology Specialty: Pediatric Urology Tom Lue, MD Renee Reijo Pera, PhD Professor and Vice Chair Assistant Professor, Genetics, Specialty: Erectile Dysfunction Obstetrics, Gynecology and Repro- and Neurourology ductive Sciences, Physiology, and Urology Jack McAninch, MD Professor and Vice Chair Mack Roach III, MD Specialty: Urologic Trauma and Professor, Radiation Oncology Urogenital Reconstructive Surgery and Urology Specialty: Radiation Oncology Laurence Baskin, MD Associate Professor Katsuto Shinohara, MD Specialty: Pediatric Urology Associate Professor Specialty: Urologic Oncology Jeanette Brown, MD and Urologic Ultrasonography Professor, Obstetrics, Gynecology and Reproductive Sciences, Marc Shuman, MD Epidemiology & Biostatistics, and Professor, Medicine and Urology Urology Specialty: Medical Oncology Editor June Chan, ScD Eric Small, MD Peter Carroll Assistant Professor Professor, Medicine and Urology Managing Editor Malinda Walker Epidemiology & Biostatistics Specialty: Urologic Oncology Contributing Editor and Urology Marshall Stoller, MD Leslie Lingaas Gerald Cunha, PhD Professor Copy Editor Professor, Anatomy, Obstetrics, Specialty: Endourology, Daniel Rowe Gynecology and Reproductive Laparoscopy and Stone Disease Design Victoria Magbilang Sciences, and Urology Emil Tanagho, MD Photography Rajvir Dahiya, PhD Professor Cherie Cordellos, Christine Jegan, Jennifer Sauer Professor Specialty: Neurourology, Produced by University Reconstructive Urology, Urinary Frank Hinman, Jr., MD Incontinence and Urodynamics Publications/Public Affairs, PR 146, 12.03 Clinical Professor Paul Turek, MD UCSF Urology is published by Christopher Kane, MD the Department of Urology to Associate Professor present developments in re- Associate Professor Specialty: Male Infertility and search and clinical practices Specialty: Laparoscopy and Reproduction made within the department. Urologic Oncology Please send comments and Frederic Waldman, MD, PhD inquiries to: Sara Knight, PhD Professor, Laboratory Medicine Newsletter staff Assistant Professor and Urology UCSF Department of Urology Psychiatry and Urology San Francisco, CA 94143-1695 415/885-7723 John Witte, PhD Ching-Shwun Lin, PhD Professor, Epidemiology & mwalker@urol.ucsf.edu Associate Professor Biostatistics and Urology Maxwell Meng, MD Assistant Professor University of California Specialty: Laparoscopy and San Francisco Urologic Oncology School of Medicine Department of Urology