General Surgery Research

The Breast Health Global Initiative (BHGI)

The Breast Health Global Initiative (BHGI)

anderson-color_thumb Benjamin O. Anderson, MD – Professor – Chair and Director, Breast Health Center – Full Member, Div of Public Health Sciences, Fred Hutchinson Cancer Research Center – Director, Breast Health Clinic, University of Washington/Seattle Cancer Care Alliance The global breast cancer problem cannot be solved in a single large step. It takes small incremental BHGI-logo-2C-stackedsteps in different parts of the world at different times that allow advances to be made. In 2002, with the co-sponsorship of the Fred Hutchinson Cancer Research Center and Susan G. Komen for the Cure®, we established the Breast Health Global Initiative (BHGI) in Seattle as an ongoing public-private global health alliance devoted to medically underserved women with a mission to develop, implement and study evidence-based, economically feasible, and culturally appropriate guidelines for low-and middle-income countries (LMCs) to improve breast health outcomes of women around the world. Complete Research Report >>

Application of Nanotechnology in the Diagnosis and Treatment of Hepatocellular Carcinoma

Application of Nanotechnology in the Diagnosis and Treatment of Hepatocellular Carcinoma

parkJames O. Park, MD Assistant Professor With over 660,000 new cases and 630,000 resultant deaths estimated in 2009, primary liver cancer, or hepatocellular carcinoma (HCC), is the fifth most prevalent malignancy and the third leading cause of cancer-related deaths worldwide. Although 80% of cases occur in developing regions where hepatitis B infection is endemic, the incidence of HCC in the United States is rising at epidemic proportions as a result of the rampant spread of hepatitis C four decades ago. The incidence of hepatitis C cirrhosis is projected to peak in 2015. However, a sharp decline in HCC is not anticipated for several decades due to the current epidemic of obesity which will in part replace hepatitis C as the etiology of HCC. Obese patients with metabolic syndrome can develop non-alcoholic steatohepatitis (NASH) with progression to cirrhosis and resultant HCC. The lethality of HCC is demonstrated by its equal annual incidence and mortality, and the dismal 8-month median survival without treatment. However, when HCC is detected at an early stage, curative treatments such as surgical resection, liver transplantation, and ablative therapies can be implemented, achieving 5-year survival rates of up to 75%, highlighting the importance of early detection. Complete Research Report >>

The Role of the TSC1/2 Complex in Tumor Development

The Role of the TSC1/2 Complex in Tumor Development

yeung Raymond S. Yeung, MD Professor Over the last several decades, the study of hereditary tumor syndromes has laid a solid foundation forthe genetic basis of cancer. While the number of patients suffering from these syndromes is small, the identification and elucidation of the underlying genetic pathways have shown to be of broad relevance to many forms of sporadic human cancers. Investigations have found that the majority of hereditary tumors involve mutations of certain tumor suppressor genes. This latter class of genes has diverse functions including cell cycle regulation, DNA repair, apoptosis, protein degradation, cell-cell interaction, and signal transduction. However, a common feature of these genes is the “two-hit” genetic mechanism to inactivate their function during tumorigenesis. In the case of hereditary cancers, the first hit is inherited as a germline mutation of one of the alleles of the tumor suppressor gene, and the second hit is an acquired somatic mutation of the remaining allele of the same gene. This results in the loss of function of the tumor suppressor, thus creating a setting to promote tumor development. Complete Research Report >>

GI Center Surgery Research

The Center for Videoendoscopic Surgery The Center for Esophageal and Gastric Surgery

There is considerable discussion regarding “success” rates for laparoscopic anti-reflux surgery (LARS). Our experience with the long-term follow-up of these patients taught us that the success or failure of this operation is much more difficult to define. For example, there are patients who are extremely satisfied with the degree to which their symptoms have been controlled even though the esophageal acid exposure has not completely returned to normal. On the other hand, there are patients whose presenting symptoms have essentially disappeared but who have developed substantial side effects of the operation and for whom the quality of life has deteriorated. As our experience grew, we realized that instead of talking about “success” or “failure” of the operation, we ought to analyze the multiple domains affected by the operation and try to define the results in the context of each domain. We felt this type of comprehensive assessment would bring clarity that would allow physicians to understand how to best describe the expectations to patients in the different domains – the ultimate way to define a true informed consent.


Brant K. Oelschlager, MD


Carlos A. Pellegrini, MD


Roger P. Tatum, MD


Andrew S. Wright, MD


Saurabh Khandelwal, MD

Complete Research Articles from The Center for Videoendoscopic Surgery and The Center for Esophageal and Gastric Surgery >>



Surgical Care and Outcomes Assessment Program (SORCE)

flumDavid R. Flum, MD, MPH Professor Over the last decade, “outcomes” research became a catch phrase for healthcare administrators, providers and researchers, but outcomes research means different things to different people. For some, it is viewed as a way to provide more services for fewer dollars. For others, it means finding ways to regulate physician variability to improve care. Neither of these definitions fully describes the potential of this form of research. I believe outcomes research means moving beyond a research culture that shows us what can be done by surgeons, to one that emphasizes what should be done by surgeons. The “should” in that statement indicates a balance of the feasibility of an operative procedure with an assessment of the burden of that operation on the patient and society. Only by determining the impact of procedures in their totality can we understand what should be done rather than simply what can be done. Complete Research Report >>

WISH Research

WISH – Educating to Improve Health Through Safe Patient Care

satavaRichard M. Satava, MD Professor In the first four years of its formal existence, WISH – WWAMI Institute for Simulation in Healthcare – has contributed to UW Medicine’s mission “To Improve Health.” WISH has supported this mission through the education of medical students, residents, nurses and practicing physicians, through the creation of curricula, and through research in applied engineering and education − all using the platform of simulation and modeling. Much has been accomplished to fulfill these goals as WISH continues to both mature and expand. Even in these tumultuous financial times, WISH has maintained a stable basis to continue both the training and research missions. In addition, by performing rigorous analysis of successes and failures, the initial programs have been strengthened by continuous improvement. Complete Research Report >>