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Archive for November, 2010

Moderating the Effects of Obesity on Liver Cancer Progression

Saturday, November 20th, 2010

A hormone produced by fat cells could be a tool for diagnosing and treating liver cancer, scientists at Emory University School of Medicine have shown.

Fat cells secrete a variety of hormones, some of which can have tumor growth-stimulating effects. However, scientists have dubbed adiponectin a “guardian angel” hormone because it appears to protect against the effects of obesity on metabolism and cardiovascular health.

The results, scheduled for publication in the November issue of the journal Hepatology, suggest that treatments that mimic or enhance adiponectin’s effects could enhance survival for obese individuals with liver cancer.

“Our study presents important clinical implications since hepatocellular carcinoma has the highest increased risk associated with obesity compared to other cancers such as prostate, kidney, colon, and stomach,” says senior author Neeraj Saxena, PhD, assistant professor of medicine (digestive diseases) at Emory University School of Medicine.

The first author of the paper is Dipali Sharma, PhD, assistant professor of hematology and medical oncology at Emory University School of Medicine and Winship Cancer Institute.

Hepatocellular carcinoma is one of the most common tumor types worldwide, but is relatively rare in the United States. The rate is increasing because of hepatitis C and obesity. Obesity is associated with increased risk and progression of a number of cancers including colon, prostate, breast, and liver cancers. Obese people have about a 1.5-fold increase in their risk of all types of cancer, but for liver cancer, obesity increases the risk 4.5-fold.

Obese populations tend to have higher circulating levels of the hormone leptin, but they may be resistant to some of its appetite-controlling effects. Weight loss tends to increase adiponectin, and low levels of adiponectin are found in patients with aggressive tumors.

One of the main roles of adiponectin is to counteract the effects of leptin. Adiponectin also regulates glucose levels and the breakdown of fatty acids. The levels of adiponectin can partially predict tumor growth, size and disease-free survival in human liver cancers, the authors found. In addition, they found that exposing liver cancer cells to adiponectin can reduce their ability to proliferate and invade other tissues, both in cell culture and in animal models.

“Taken together our results suggest an attractive molecular strategy: employing adiponectin analogues for potential therapy of metastatic hepatocellular carcinoma,” Saxena says.

Previous research by Sharma and Saxena has shown that adiponectin can also inhibit migration and invasion by breast cancer cells. (LINK)

Anti-diabetic drugs known as thiazolidinediones can increase adiponectin’s activity, but they have side effects on the heart that has led to their restriction by the FDA. The effects of injecting high levels of the hormone directly are unknown and need to be tested. Scientists are investigating other ways to increase a patient’s adiponectin, as wells as mutant forms of the leptin protein that may block leptin’s effects on cancer cells. Some natural compounds, such as those found in green tea, may be able to mimic the effects of adiponectin.

The research was supported by the National Cancer Institute and the National Institute of Diabetes and Digestive and Kidney Diseases.

Reference: D. Sharma et al. Adiponectin antagonizes the oncogenic actions of leptin in hepatocellular carcinogenesis. Page #’s. Hepatology (Nov 2010).


Gary A. Levengood, MD

Saturday, November 20th, 2010

Gary A. Levengood, M.D., Board Certified Orthopedic Surgeon and Founder of Sports Medicine South L.L.C, has been practicing for nearly 20 years offering the most advanced, orthopedic treatments to help restore his patient’s natural mobility. In an effort to achieve superior results, Dr. Levengood offers customized knee resurfacing implants designed uniquely for each patient’s anatomy, decreasing the amount of bone removal and pain after surgery.

Dr. Levengood has performed more than 1,000 total knee replacements (TKRs), but believes that it’s not the only option for people suffering from knee pain. Since TKRs only come in a set of 5-6 pre-determined sizes for patients, physicians must fit the patient’s knee to the implant. A traditional TKR also requires complete removal of the ends of the femur (thigh bone) and tibia (shin bone), often including one or both of the ACL and PCL.  This can result in a painful procedure and knee kinematics that can feel very different than the native kinematics of the patient, something that many physicians will hear from patients when they talk about how it feels.

Dr. Levengood provides counsel to each of his patients based on their age, activity level and other mitigating factors in their life.  For younger or more active patients with osteoarthritis in just a part of their knee, he will recommend patient-specific implants that can provide patients with a less invasive, bone-sparing alternative to TKR surgery. Dr. Levengood has regularly prescribed an advanced line of patient-specific implants developed by ConforMIS since last year. He has helped to bring the latest innovation, the iDuo® G2, to market by participating in the early evaluations of the implant by a limited group of surgeons prior to broad commercial release.

Personalized partial knee implants are designed to the exact shape and size of a patient’s knee preserving far more bone and tissue than a standard knee replacement and helping to maintain a more natural feeling knee. Because they are more minimally invasive, treating only the diseased compartments, they can also preserve all ligaments, an important driver of knee kinematics.

The iDuo G2 is a personalized bicompartmental knee resurfacing device that preserves more of a patient’s own bone and all of their ligaments for those suffering from knee pain in two out of the three compartments of the knee. ConforMIS also offers a custom, personalized solution unicompartmental device, the iUni® G2, for patients whose arthritic damage is limited to one compartment of the knee. These implants also simplify the surgical procedure, allowing for a less traumatic surgery for the patient and to safeguard further surgeries. Dr. Levengood has performed more than 20 patient-specific implants thus far, and says his patients are happy with the end results.

Dr. Levengood’s specialties include arthroscopic surgery, sports medicine, and joint arthroplasty. In addition, he supports the local community by serving as Team Physician for Brookwood High School, Orthopedic Consultant for Loganville High School, and Medical Director of Gwinnett Gymnastics Center. He has traveled internationally with the U-17 national men’s soccer team as their physician.

Dr. Levengood is the current Team Physician of the Georgia Force, a Gwinnett arena football team and the Atlanta Silverbacks Soccer team; he is also the Medical Director for the Georgia State Soccer Association’s Olympic Development program and is Chief of Orthopedics at Gwinnett Medical Center. Formerly, he served as the Team Physician for the Atlanta Silverbacks from 2000 – 2007.


Silverman and Jidarian Join Piedmont Heart Institute

Saturday, November 20th, 2010

Cardiologist Barry Silverman, M.D., and thoracic surgeon Anoush Jidarian, M.D., joined Piedmont Heart Institute’s medical team.

Dr. Jidarian is a graduate of UMDNJ – The New Jersey Medical School in Newark, N.J., where she completed her surgical internship and residency, serving as administrative chief resident. She completed an additional residency in cardiothoracic surgery at the University of Pittsburgh Medical Center in Pittsburg, Penn., as well as her fellowship in minimally invasive thoracic surgery at Cedars-Sinai Medical Center in Los Angeles, Calif. She is board certified in general surgery and thoracic surgery.

A graduate of Ohio State University in Columbus, Ohio, Dr. Silverman completed his internship and residency at Vanderbilt University Hospital in Nashville, Tenn. He completed his fellowship at John Hopkins University Hospital in Baltimore, Md. Dr. Silverman was the director of Physician Education at Northside Hospital for 30 years, and has been a member of the Emory University Department of Medicine clinical faculty for 37 years. He is board certified in cardiology and internal medicine.

Dr. Silverman’s brother, the late Mark E. Silverman, M.D., was a cardiologist at Piedmont for over 30 years, also serving as chief of cardiology, until his untimely passing in November 2008.

“We are honored to help continue his legacy as Dr. Silverman joins the Piedmont family,” said Charles L. Brown III, M.D., chief medical officer for Piedmont Heart Institute.


Children’s Debuts Advanced Interventional Radiology Suite

Saturday, November 20th, 2010

Children’s Healthcare of Atlanta unveiled an Interventional Radiology suite at the Children’s at Egleston campus.  The suite, similar to one housed at Children’s at Scottish Rite, features the most advanced pediatric imaging equipment available for Interventional Radiology in Atlanta and will assist radiologists in performing complex, minimally invasive procedures that allow faster recovery times for patients.

“The image quality and treatment options afforded by this technology enhance diagnostics and also provide treatment options for serious medical conditions through venograms, embolization, sclerotherapy, thrombolysis, cholangiography and biliary drainage, joint aspiration or injection, nephrostograms, nephrostomies and more,” said Melinda Dobbs, manager of Radiology at Children’s at Egleston.

Interventional Radiology delivers treatment through catheters or tiny instruments inserted into the body with the aid of computed tomography (CT), fluoroscopy (X-ray) or ultrasound.  It is commonly used to perform biopsies and to place shunts, feeding and drainage tubes, and peripherally inserted catheters (PICCs).  Interventional Radiology also offers an alternative to surgery for serious medical conditions such as vascular malformations, blood clots and kidney or liver abnormalities.  While the advanced suite is new to Children’s at Egleston, the Radiology teams at Children’s have long averaged more than 2,000 minimally invasive, image-guided procedures annually.

To maximize patient access to interventional procedures, Children’s is actively recruiting a full-time interventional radiologist for Children’s at Egleston.


NFMGMA Educational Session

Wednesday, November 17th, 2010

November 17, 2010 at Northside Medical Campus, Old Milton Parkway. For more information, visit NFMGMA’s web site


Saint Joseph’s Acquires Peachtree Cardiovascular and Thoracic Surgeons

Monday, November 15th, 2010

Saint Joseph’s Heart and Vascular Institute announced that Peachtree Cardiovascular & Thoracic Surgeons (PCV) has joined Saint Joseph’s Medical Group.  According to Saint Joseph’s, the addition of PCV will create the largest and most comprehensive cardiovascular institute in Georgia.

With the addition of PCV, Saint Joseph’s expands to more than 100 cardiovascular physicians, broadening its specialties to include: robotically assisted adult intracardiac, revascularization, and thoracic procedures, heart valve repair, artificial mechanical heart implantation, and congenital heart surgery. “We offer the full spectrum of cardiothoracic surgery from transplant and artificial hearts to endoscopic cardiac robotic surgery using the daVinci Surgical System,” says Douglas Murphy, MD, PCV Cardiothoracic Surgeon and Chief of Cardiothoracic Surgery at Saint Joseph’s Hospital.    “We have the largest daVinci experience in the world, as well as the world’s leading program to train other cardiothoracic surgeons pursuing robotic surgery.”

The physicians joining Saint Joseph’s from Peachtree Cardiovascular include Douglas A. Murphy, MD ; David A. Langford, MD; Steven K. Macheers, MD; Averel B. Snyder, MD; Jeffrey S. Miller, MD; Sudhir P. Srivastava, MD; T. Sloane Guy, MD.


Atlanta AMGMA Meeting

Thursday, November 11th, 2010

November 11, 2010 at The Retreat at Dunwoody.  For more information, visit AMGMA’s web site.


GCS Now Offering Provenge as Prostate Cancer Treatment

Wednesday, November 10th, 2010

Georgia Cancer Specialists (GCS) was recently selected as the first non-urology group in Georgia to administer the new drug Provenge (Sipuleucel-T), which was approved earlier this year for the treatment of asymptomatic or minimally symptomatic metastatic hormone resistant prostate cancer.

Dr. Mansoor Saleh, principal investigator and director of clinical research at GCS, said, “Provenge represents a new form of targeted immunotherapy in which the patient’s own immune system cells can be sensitized to attack prostate cancer cells in the patient’s body. This is but the beginning of a new era of therapies whereby we can ‘re-train’ our immune system to detect cancer cells as foreign and mount an immunologic attack.”

A course of Sipuleucel-T treatment consists of three basic steps:

1. Extraction of the patient’s own white blood cells, which include specialized antigen presenting cells (APC). This process is called leukapheresis and is akin to donating blood cells during a blood drive.
2. Incubation of APCs with the target protein, including prostatic acid phosphatase (PAP), which is found on a majority of prostate cancer cells.
3. Re-infusion of APCs into the patient, allowing them to immunize the patient against prostate cancer cells.
A complete Sipuleucel-T treatment represents three APC infusions over the span of a month.

The treatment is currently available through the GCS-Northside office. Previously, the only site in Georgia where a patient could receive this therapy was at a urology practice where initial clinical trials were performed. As the leukapheresis and manufacturing capabilities expand, more patients will be offered this therapy, and the program will expand into more GCS offices, providing access to this treatment to patients all over the state.

The FDA’s approval of Provenge was based on the ability of this novel targeted therapy to increase the overall survival in this patient population. The adverse reactions are mild and include low-grade fever and/or chills during the infusion.


Professional Symposium, Women’s Health: From Where We Sit

Saturday, November 6th, 2010

November 6, 2010 at the Cobb Energy Performing Arts Centre.  For more information, contact at Atlanta Center for Reproductive Medicine



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