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Department of Internal Medicine

Department of Internal Medicine

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Fellowship Program Brochure

 

UC DAVIS

SCHOOL OF MEDICINE

GASTROENTEROLOGY FELLOWSHIP PROGRAM 2008


 

Introduction


For more than 25 years, the Gastroenterology Fellowship program at the University of California Davis has developed a reputation for the training of outstanding clinical and academic gastroenterologists. The Gastroenterology fellowship program comprises three or more years of training that is tailored to the fellows’ career goals. Both clinical and investigative aspects of gastroenterology and hepatology are included in the curriculum. UC Davis has made a long-term commitment to increasing representation of women and members of minority groups in its fellowship training programs and particularly encourages applications from such individuals.

The Program


Three fellows (2 Clinical Tract and 1 Research Tract) are selected each year based upon their clinical abilities and potential to become outstanding gastroenterologists and hepatologists. In the first year of the program, all trainees develop the clinical and procedural skills necessary to become competent as a sub-specialist in gastroenterology. Experience is gained in both the inpatient and outpatient setting with an emphasis on maintaining continuity of care.

Procedures in which first year trainees become proficient include upper endoscopy, esophageal dilation, hemostasis, endoscopic treatment of varices, colonoscopy and polypectomy. In addition, training in liver biopsy under ultrasound guidance is included.

During the second year of training, protected time is provided for research. Those fellows in the Research Tract are afforded more time for research. Under the guidance of a faculty mentor, the trainee develops a research proposal tailored to their interests and future goals. Clinical skills are maintained with weekly GI clinic and endoscopy.

The third year of training for Clinical Tract fellows allows further experience in endoscopic procedures, inflammatory bowel disease, motility, hepatology or other areas of interest. A fourth year of endoscopic ultrasonography (EUS) and ERCP training is also offered as part of a separate training program. Research Tract fellows continue their mentored research and development of applications for future funding.

Trainees spend the majority of their time at the UC Davis Medical Center but also rotate through the Mather VA Medical Center. Night and weekend call is divided among all nine fellows. Fellows are responsible for night and weekend call at both UCDMC and the Mather VA Medical Center.

Throughout the year, one half-day per week is devoted to education of the trainees. Pathology, radiology and pathophysiology conferences are held along with weekly GI Grand Rounds and monthly Journal Club.
 
The Hospitals

UC Davis Medical Center
The primary location of training, the UC Davis Medical Center, is a 500-plus bed, tertiary care facility located in Sacramento that cares for both complex as well as routine medical conditions. The endoscopy unit includes state-of-the-art equipment including a digital X-ray facility for fluoroscopic procedures with capabilities for standard endoscopic procedures, ERCP, EUS, mucosal resection and stent placement. Specific clinics are held for Motility, Biliary, Pancreatic, Inflammatory Bowel and Liver diseases.

Mather VA Medical Center
A new hospital at the Mather VA Medical Center opened in 2002. In addition to inpatient facilities, the new hospital provides added research space including a metabolic ward and an NIH funded Clinical Research Center. Current inpatient and outpatient facilities provide care for over 150,000 veterans living in the Sacramento, Yolo and Placer counties.

Research

A broad range of research opportunities is available to fellows throughout their training. Those interested in an academic career can pursue basic, translation and clinical research experiences. Unique opportunities at UC Davis include an NIH funded General Clinical Research Center, K30 Mentored Clinical Scientist Training Program and the recently established Clinical and Translational Science Center, 1 of only 12 in the country established with a $24.8 million grant from the NIH.
 


Life in Sacramento/Davis

Current fellows live in Sacramento or the surrounding region including the college town of Davis approximately 12 miles from the UC Davis Medical Center. Although the region has undergone tremendous growth over the past several years, housing remains affordable. Centrally located, Sacramento is within 90 miles of both Lake Tahoe and San Francisco and even closer to the wine country of Napa Valley. The relatively mild climate allows outdoor activities year round. A plethora of cultural and sporting events can be found in Sacramento and Davis. In 2002, Time magazine and the Civil Rights Project of Harvard University identified Sacramento as the most racially/ethnically integrated city in the US.

The Faculty

In recent years the faculty has grown in size and diversity of interests.  The interests of the faculty within the Division of Gastroenterology include both clinical and basic research in gastroenterology and hepatology. Several affiliated investigators within and outside the School of Medicine offer additional opportunities for education and research.

 
Lorenzo Rossaro, MD
Professor of Medicine
Chief, Division of Gastroenterology and Hepatology

Dr. Lorenzo Rossaro received his medical training at the University of Padova, Italy and was a Fulbright Scholar at the University of Pittsburgh.  His interests are in viral hepatitis, liver transplantation and complications of liver cirrhosis. He is the Principal Investigator in several clinical trials for the treatment of Hepatitis C, hepato-renal syndrome, acute liver failure, and hepatic encephalopathy.  He was honored in 2002 with the Outstanding Faculty Teacher Award by the resident of the Department of Internal Medicine.  Since becoming Chief of the Division, he has expanded his efforts to promote the growth of the Division’s activities and accomplishments.

Selected publications:

Rossaro L, Troppmann C, McVicar JP, Sturges M, Fisher K, Meyers FJ. A strategy for the simultaneous provision of pre-operative palliative care for patients awaiting liver transplantation. Transpl Int. 2004 Sep; 17(8):473-5.

Schiodt FV, Rossaro L, Stravitz RT, Shakil AO, Chung RT, Lee WM; Acute Liver Failure Study Group. Gc-globulin and prognosis in acute liver failure. Liver Transpl. 2005 Oct; 11(10):1223-7.

Ichiki Y, He XS, Shimoda S, Ishibashi H, Keeffe EB, Rossaro L, Gershwin ME. T cell immunity in hepatitis B and hepatitis C virus infection: implications for autoimmunity. Autoimmun Rev. 2005 Feb; 4(2):82-95.

Aoki CA, Rossaro L, Ramsamooj R, Brandhagen D, Burritt MF, Bowlus CL. Liver hepcidin mRNA correlates with iron stores, but not inflammation, in patients with chronic hepatitis C. J Clin Gastroenterol. 2005 Jan; 39(1):71-4.

Rossaro L, Tran TP, Ransibrahmanakul K, Rainwater JA, Csik G, Cole SL, Prosser CC, Nesbitt TS.Hepatitis C videoconferencing: the impact on continuing medical education for rural healthcare providers.Telemed J E Health. 2007 Jun;13(3):269-77.

Leung PS, Rossaro L, Davis PA, Park O, Tanaka A, Kikuchi K, Miyakawa H, Norman GL, Lee W, Gershwin ME; Acute Liver Failure Study Group.Antimitochondrial antibodies in acute liver failure: implications for primary biliary cirrhosis.Hepatology. 2007 Nov;46(5):1436-42.
 
Anthony P. Albanese, M.D.
Director, Chemical Dependency Division
Director, Hepatitis C Program – Mather VA Medical Center
Associate Clinical Professor of Medicine
VA-Site Director of Internal Medicine Residency Training Program

Dr. Albanese is a clinical gastroenterologist and hepatologist with interests in addiction medicine, Hepatitis C and alcoholic liver disease.  He served as a member to the University of Miami liver/gastrointestinal transplant team and as the Co-Medical Director of the Addiction Treatment Program at Mount Sinai Medical Center in Florida for six years before moving to Sacramento.
 
Selected Publications:

Albanese A, Jeffers LJ. Advances in Diagnostic Laparoscopy. In: Advanced Therapeutic Endoscopy, 2nd Ed.  O’Phelan & Barkin eds.  New York: Raven Press

Albanese AP, Vargas C, Schiff ER. Diagnosis and Treatment of Hepatitis C. Internal Medicine, June 1993.  14(6): 40-46.

Ungo JR, Jones D, Ashkin D, Hollender ES, Bernstein D, Albanese AP, Pitchenik AE.  Antituberculosis Drug-Induced Hepatotoxicity, The Role of Hepatitis C virus and the Human Immuno-deficiency Virus. American Journal of Respiratory and Critical Care Medicine, 1998.  157: 1871-1876.

Albanese AP, Gevirtz C, Oppenheim B, Field JM, Ables I, Eustace JC.  Outcome and Six Month Follow Up of Ultra-Rapid Opiate Detoxification. Journal of Addictive Diseases, 2000.  19(2): 11-28.

 
Amar Al-JuBuri, M.D.
Assistant Clinical Professor of Medicine

Dr. Al-Juburi provides consult and endoscopy service in general gastroenterology.  His clinical practice focuses on gastrointestinal motility disorders.  He has had significant contribution in the management of gastroparesis.   He is currently collaborating with Dr. Juan Garcia on a project that involves the use of gastric electrical stimulation in the treatment of drug-refractory gastroparesis.  Dr. Al-Juburi’s other areas of interest include gastroesophageal reflux disease and irritable bowel syndrome.


Selected Publications:

1. 2002 Al-Juburi A, Scott MA, Shah HR, J-P Raufman. Heterozygosity for Factor V Leiden and G20210A Prothrombin Genotypes in a Patient with Mesenteric Vein Thrombosis.  Digestive Diseases and Sciences 47(3):601-606.

2. 2003 Abell T, Luo J, Tabbas M, Batista O, Malinowaki S, Al-Juburi A.  Gastric Electrical Stimulation for Gastroparesis Improves Nutritional Parameters at Short, Intermediate, and Long-Term Follow up.  Journal of Parenteral and Enteral Nutrition 27:277-281.

3. 2004 Luo J, Al-Juburi A, Rashed H, O’Dorisio T, Marchal B, Starkebaum W, Abell T.  Gastric Electrical Stimulation is Associated with Improvement in Pancreatic Exocrine Function.  Pancreas 29(2) e41-44.

4. 2005 Al-Juburi A, Granger S, Barnes J, Voeller G, Beech D, Amiri H, Abell T.  Laparoscopy Shortens Length of Stay in Patients with Gastric Electrical Stimulators.  The J. of the Society of Laparoendoscopic Surgeons 9:1-6.

5. 2005 Oubre B, Luo J, Al-Juburi A, Voeller G, Familoni B, Abell T.  A Pilot Study on Gastric Electrical Stimulation on Patients with Surgery Associated Gastroparesis.  South Medical Journal 98:693-697.

6. 2005 Ayinala S, Batista O, Goyal A, Al-Juburi A, Abidi N, Familoni B, Abell T.  Temporary Gastric Electrical Stimulation with Orally or PEG-placed Electrodes in Patients with Drug-Refractory Gastroparesis.  Gastrointestinal Endoscopy 61:455-461.

7. 2007 Anand C, Al-Juburi A, Familoni B, Rashed H, Cutts  T, Abidi N, Johnson W, Minocha A, Abell T.  Gastric Electrical Stimulation is Safe and Effective: A Long-Term Study in Patients with Drug-Refractory Gastroparesis in Three Regional Centers.  Digestion 75:2-3.

 
Thomas Amankonah, M.D.
Transplant Hepatologist


Dr. Amankonah is a transplant hepatologist and gastroenterologists with interests in hepatitis B and general clinical hepatology as well as transplant hepatology.

Selected Publications:

1. Paterson RL. Kelleher CA. Amankonah TD. Streib JE. Xu JW. Jones JF. Gelfand EW. Model of Epstein-Barr Virus Infection of the Human Thymocytes:Expression of Viral Genome and Impact on Cellular Receptor Expression in the T-Lymphoblastic Cell Line, HPB-ALL. Blood 1995;85(2): 456-464.

2. Paterson RL. Kelleher CA . Streib JE. Amankonah TD. Xu JW. Jones JF. Gelfand EW. Activation of Human Thymocytes After Infection by EBV. The Journal of Immunology. 1995;154(3):1440-9.

3. Vierling JM and Amankonah TD. Primary Sclerosing Cholangitis. In: Gallbladder and Biliary Tract Diseases(2000). N. Afdahl(ed). Marcel Dekker, Inc., New York. Pp 659-705.

4. Amankonah TD. Strom CB. Vierling JM. Petrovic LM. Inflammatory Pseudotumor of The Liver as the first manifestation of Crohn's Disease. Am J Gastroenterol.  2001; 96(8):2520-2.
 
Christopher L. Bowlus, MD
Associate Professor of Medicine
Director, Fellowship Training Program

Dr. Bowlus provides clinical service primarily in Hepatology. His specific clinical and research interests are in autoimmune liver diseases, particularly Primary Sclerosing Cholangitis (PSC).  His lab investigates the immunogenetic mechanisms of autoimmune diseases with the use of basic immunologic techniques, human genetics and genetically manipulated mice. Recent focus in the lab has been on elucidating the pathogenic mechanisms of PSC. This has included genetic studies and the establishment of a PSC DNA bank.

Current clinical and translational studies include:

• Studies of Primary Sclerosing Cholangitits (STOPSC), a multi-center registry of North American to investigate the natural history and genetic basis of PSC

• Effects Of Rituximab (Rituxan®) On B Cell And AMA Response In Patients With Primary Biliary Cirrhosis

• Effects Of Exenatide (Byetta®) On Liver Biochemistry, Liver Histology And Lipid Metabolism In Patients With Non-Alcoholic Fatty Liver Disease

Selected publications:

Cheunsuk S., Lian ZX, Yang G, Gershwin ME, Gruen JR, Bowlus CL. The thymic protease Prss16 is not required for T cell development. Molecular and Cellular Biology 2005 25:789-796.

Bowlus CL, Willner I, Zern MA, Reuben A, Chen P, Holladay B, Xie L, Woolson
RF, Strange C. Factors associated with advanced liver disease in adults with alpha1-antitrypsin deficiency. Clin Gastroenterol Hepatol 2005 Apr;3(4):390-6.

Aoki CA, Dawson K, Kenny TP, Gershwin ME, Bowlus CL. Gene expression by PBMC in primary sclerosing cholangitis: evidence for dysregulation of immune mediated genes. Clin Dev Immunol 2006 Jun-Dec;13(2-4):265-71.

Bowlus CL, Karlsen TH, Broomé U, Thorsby E, Vatn M, Schrumpf E, Lie BA, Boberg KM. Analysis of MAdCAM-1 and ICAM-1 polymorphisms in 365 Scandinavian patients with primary sclerosing cholangitis. J Hepatol 2006 Nov;45(5):704-10.

Buse JB, Klonoff DC, Nielsen LL, Guan X, Bowlus CL, Holcombe JH, Maggs DG,
Wintle ME.  Metabolic effects of two years of exenatide treatment on diabetes, obesity, and hepatic biomarkers in patients with type 2 diabetes: an interim analysis of data from the open-label, uncontrolled extension of three double-blind, placebo-controlled trials. Clin Ther 2007 Jan;29(1):139-53.


Juan Carlos Garcia, M.D.
Assistant Professor
Clinic Director

Dr. Garcia’s interests are in gut motility and extra-esophageal manifestations of gastroesophageal reflux disease. He directs the motility lab at UCDMC performing, esophageal and rectal manometry as well as 48 hour pH probes.  He also participates as part of a team in the investigation of the mucosal immune response in patients with HIV.

Selected Publications:

Garcia JC, Persky SE, Bonis PA, Topazian M. Abscesses in Crohn's disease: outcome of
medical versus surgical treatment. J Clin Gastroenterol 2001; 32:409-12.

Belafsky PC, Godin DA, Garcia JC, Rahim N. “Comparison of Data Obtained from sedated versus Unsedated Wireless Telemetry Capsule Placement: Does sedation affect the results of Ambulatory 48 hour pH testing?”. Laryngoscope 2005; 115: 1109-1113.


Joseph W Leung, MD., FRCP (Edinburgh, Glasgow and London), FACP., FACG., FHKCP.

Dr Joseph Leung is currently the Mr. and Mrs. CW Law Professor of Medicine at the University of California, Davis and Chief of Gastroenterology for the Veterans Affairs Northern California Health Care System.  He graduated as Bachelor of Medicine and Bachelor of Surgery from the University of Hong Kong in 1975 and obtained his Doctor of Medicine degree from the Chinese University of Hong Kong in 1986. 

In 1994, he joined the University of California, Davis Medical Center as Chief of Gastroenterology and Endoscopy where he served in that position for 7 years. Dr. Leung received many distinguished awards including the Alberta Heritage Foundation Visiting Scientist at the University of Calgary, Canada in 1988.  He was awarded Fellowship of the Hong Kong College of Physicians in 1987, Fellowship of the Royal College of Physicians, Edinburgh in 1989, Fellowship of the Royal College of Physicians and Surgeons, Glasgow in 1991, Fellowship of the Royal College of Physicians, London in 1994 and Fellowship of the American College of Physicians in 1996.  He was appointed visiting professor to a number of universities in the Philippines, Korea, China as well as the US. He is currently the Governor for the American College of Gastroenterology, Northern California Region and Regional Councilor for the ACG Region V.

Dr Leung's research interests include endoscopic hemostasis for peptic ulcer bleeding and endoscopic management of biliary obstruction.  His current research focuses on the role of bacterial biofilm and biliary sludge in stent blockage and methods to prevent stent occlusion. He has published over 130 peer review papers, more than 200 abstracts, 65 book chapters and 2 books.  He is an associate editor for Gastrointestinal Endoscopy and a reviewer for several GI journals.

Selected Publications:

Leung, JW; Liu, YL; Cheung, SW; Chan, RCY; Inciardi, JF; Cheng, AF.  Effect of antibiotic-loaded hydrophilic stent in the prevention of bacterial adherence: a study of the charge, discharge, and recharge concept using ciprofloxacin. Gastrointestinal Endoscopy 2001; 53(4)1-437.

Leung, JW; Liu, YL Lau, GCT; Chan, RCY; Lai, ACW; Ling, TKW; Cheng,AF.  Bacteriologic analyses of bile and brown pigment stones in patients with acute cholangitis. Gastrointestinal Endoscopy, 2001;54(3)340-345. 

Leung, JW; Liu, YL; Chan, RCY; Ling, TKW; Cheng, AF.  Effects of adherence factors and human bile on bacterial attachment and biliary stent blockage: an in vitro study. Gastrointestinal Endoscopy, 2002; 56(1):72-77.

Cotton, PB, Connor P, McGee D, Jowell P, Nickl N, Schutz S, Leung J, Lee J, Libby E. Colonoscopy: practice variation among 69 hospital-based endoscopists. Gastrointestinal Endosc 2003, 57:352-7.

Leung J, Lee W, Chin A, Chang A, Mann N. Can positioning the patient in the right lateral position during recovery prevent post ERCP pancreatitis? – an in vitro evaluation. International Medical Journal, 2004, 11:37-40.

Mann NS, Leung JW. Pathogenesis of esophageal rings in eosinophilic esophagitis. Med Hypotheses. 2005, 64:520-3.
 
Nirmal S. Mann, MD,MS,Ph.D.,D.Sc. FRCPC,AGAF,FASGE,FACG, MACP
Professor of Clinical Medicine

Dr. Mann has expertise and interest in all modern diagnostic and therapeutic gastroenterologic and hepatologic procedures including esophageal manometry, EUS, ERCP, electrogastrography and nutrition.  He has also been actively involved in the teaching of medical students, residents and fellows. He currently is the instructor of the second year medical school course in gastroenterology and hepatology.

His present research interest is in the evaluation of orocecal time by lactulose H2 breath test in various conditions.

Selected publications:

Mann, NS.  Gastrointestinal transit in alcoholic cirrhosis. American Journal of Gastroenterology 1995; 90(8):1367-8.

Mann, NS; Shinkle, JM.  Effect of clonidine on gastrointestinal transit time. Hepato-Gastroenterology 1998; 45(22):1023-5.

Mann, NS; Prasad, VM; Panelli, F.  Evaluation of pancreas and other abdominal organs by colonoscopic ultrasound. Hepato-Gastroenterology 2000; 47(32):560-2.
 
Surinder K. Mann, MD
Associate Clinical Professor of Medicine
VA Northern California Healthcare System

Dr. Mann is a clinical gastroenterologist with a wide variety of interests. Her practice at the VA includes all GI procedures including endoscopic ultrasound and ERCP and Capsule Endoscopy.

 Selected publications:

Diphenhydramine as an adjunct to sedation for Colonoscopy: a double blind randomized, placebo controlled study...Gastrointestinal Endoscopy Volume 63, No 1 : 2006 page 87-94

Impact of Capsule Endoscopy on Clinical Outcomes. DDW 2006

Case report of Jejunal Vericeal Bleeding diagnosed by Capsule Endoscopy. DDW 2007

The value of EGD in Patients Referred for Open Access Screening Colonoscopy and found to have anemia. DDW 2007

Options for screening Colonoscopy without sedation (In press Gastrointestinal Endoscopy)


George Meyer, MD
Clinical Professor of Medicine
 
Dr. Meyer is a clinical gastroenterologist with experience in medical education having served as the Internal Medicine Residency Program Director at three other institutions. His current interests are in endoscope cleaning; antibiotic prophylaxis for GI procedures; esophageal motility; eosinophilic esophagitis; cyclic vomiting syndrome; celiac sprue and macro enzymes.
 
 Selected publications:

Meyer, GW. Diagnostic physiology testing in gastroenterology; esophageal testing. Practical Gastroenterology 1999; 23:28-36
 
Meyer, GW. Antibiotic prophylaxis for GI procedures. UpToDate 1999-2004
 
Meyer, GW. Endoscope disinfection. UpToDate 2002-2004
 
Meyer, GW. Chronic abdominal wall pain. UpToDate 2002-2004  
 
Meyer, GW, Gerhardt DC and Castell DO. Peristaltic Pressure Profiles of the Human Esophagus. J Clin Gastro 2000;30:270-273.
 
Meyer, GW. Extraabdominal sources of chronic or recurrent abdominal pain. In Chronic Abdominal Pain, Olden KW, ed, Johns Hopkins University Press, Baltimore, MD in press.

 
Thomas Prindiville, MD
Professor of Medicine

The focus of Dr. Prindiville’s bench research activities are on the etiology of inflammatory bowel disease.  In particular, his research has focused on infectious agents as possible etiologic factors in the development of IBD. Now the current goals are to evaluate regulatory genes in patients with IBD. Clinical research projects are diverse and the following represent several of these investigations. The molecular pathology of pancreatic cancer is being evaluated utilizing EUS guided FNA samples and micro-array analysis. A randomized prospective study to evaluate IBD patients clinical responses and changes in luminal biota with various diets is being conducted.  The biota component will be evaluated before and after diet utilizing a 16 S rDNA micro-array. In IBD patients with strictures a prospective study is being conducted correlating EUS features and response to therapeutic intervention by Kenalog injection and pneumatic dilation. The use of Allopurinol and low dose 6 MP is being evaluated in a prospective manner in IBD patients that are known rapid metabolizers of 6 MP.

Selected publications:

Park, O., et al., Analysis of the foxp3/scurfin gene in Crohn's disease. Ann N Y Acad Sci, 2005. 1051: p. 218-28.

Sankaran, S., et al., Gut mucosal T cell responses and gene expression correlate with protection against disease in long-term HIV-1-infected nonprogressors. Proc Natl Acad Sci U S A, 2005. 102(28): p. 9860-5.

Suryaprasad, A.G. and T. Prindiville, The biology of TNF blockade. Autoimmun Rev, 2003. 2(6): p. 346-57.

Tanaka, A., et al., Genomic analysis of differentially expressed genes in liver and biliary epithelial cells of patients with primary biliary cirrhosis. J Autoimmun, 2001. 17(1): p. 89-98.

Prindiville, T.P., et al., Bacteroides fragilis enterotoxin gene sequences in patients with inflammatory bowel disease. Emerg Infect Dis, 2000. 6(2): p. 171-4.

Tanaka, A., et al., Are infectious agents involved in primary biliary cirrhosis? A PCR approach. J Hepatol, 1999. 31(4): p. 664-71.

Prindiville, T.P., et al., Analysis of function, specificity and T cell receptor expression of cloned mucosal T cell lines in Crohn's disease. J Autoimmun, 1996. 9(2): p. 193-204.

Prindiville, T., M. Cantrell, and K.H. Wilson, Ribosomal DNA sequence analysis of mucosa-associated bacteria in Crohn's disease. Inflamm Bowel Dis, 2004. 10(6): p. 824-33.
 
Otis Stephen, M.D.

Assistant Clinical Professor

Otis Stephen treats all aspects of general gastroenterology and hepatology, with a particular emphasis on small bowel enteroscopy, including Double-balloon enteroscopy, Single-balloon enteroscopy, and Spiral enteroscopy.  His current clinical investigations involve the diagnostic and therapeutic applications of small bowel enteroscopy in small bowel mucosal diseases and obscure gastrointestinal bleeding.  Additionally, Dr Stephen’s clinical interests include evaluation of chronic diarrhea, therapeutic applications of endoscopy in Barrett’s esophagus and esophageal dysplasia, and advancements in colorectal cancer screening and polypectomy.

Selected publications:

Neuschwander-Tetri BA, Talkad V, Stephen FO, “Induced thrombospondin expression in the mouse pancreas during pancreatic injury.” The International Journal of Biochemistry & Cell Biology. 2006 Jan; 38(1):102-9.

Cecilia R. Terrado, MD
Assistant Clinical Professor

Dr. Terrado is a clinical gastroenterologist.  She is currently the Instructor for Medical Students and GI Medical Student Cases.  Dr. Terrado’s clinical interests are diagnosis, intervention ad treatment of general digestive disease such as GERD, inflammatory bowel, functional bowel and motility disorders.  She takes interest in the application of up to date medical therapies and endoscopic techniques such as the small bowel capsule studies.  She believes successful treatment lies in the active participation of both patient and physician in disease management.


Natalia J. Török, M.D.
Assistant Professor of Medicine

Dr. Török started her current position at UC Davis in January of 2004 after finishing her training and being on faculty at the Mayo Clinic, Rochester.  Her main interest is in Hepatology.  She is a clinician-scientist with active research projects focusing on mechanism(s) of liver fibrogenesis. As a clinician, she’s involved with managing patients with liver cancer, cholestatic diseases and also taking care of patients following liver transplant.

Selected publications:

Torok N, Marks D, Hsiao K, Oswald BJ, McNiven MA. Vesicle movement in rat hepatocytes is reduced by ethanol exposure: alterations in microtubule-based motor enzymes. Gastroenterology 1997; 113:1938-48.

Torok NJ, Larusso EM, McNiven MA. Alterations in vesicle transport and cell polarity in rat hepatocytes subjected to mechanical or chemical cholestasis. Gastroenterology 2001; 121:1176-84.

Torok NJ, Higuchi H, Bronk S, Gores GJ. Nitric oxide inhibits apoptosis downstream of cytochrome C release by nitrosylating caspase 9. Cancer Res. 2002; 62:1648-53.

Canbay A, Taimr P, Torok N, Higuchi H, Friedman S, Gores GJ. Apoptotic body engulfment by a human stellate cell line is profibrogenic. Lab Invest. 2003; 83:655-63.

Zhan SS, Jiang JX, Wu J, Halsted C, Friedman SL, Zern MA, Torok NJ. Phagocytosis of apoptotic bodies by hepatic stellate cells induces NADPH oxidase and is associated with liver fibrosis in vivo. Hepatology. 2006; 43(3):435-43.

Seo S, Maganti K, Khehra M, Ramsamooj R, Tsodikov A, Bowlus C, McVicar J, Zern M, Torok N.  De novo nonalcoholic fatty liver disease after liver transplantation. Liver Transpl. (In press).

 
Walter Trudeau, MD
Professor Emeritus

Dr. Trudeau is a recognized leader in the pathophysiology and treatment of gastrointestinal bleeding due to peptic ulcer disease and portal hypertension. He remains clinically active and continues to be involved in clinical investigations.

Selected publications:

Trudeau, WL; McGuigan, JE.  Relations between serum gastrin levels and rates of gastric hydrochloric acid secretion. New England Journal of Medicine 1971; 284(8):408-12.

Sheikh, RA; Trudeau, WL.  Randomised trial of octreotide for long term management of cirrhosis after variceal hemorrhage. Gastrointestinal Endoscopy 1998; 48(3):328-30.

Sheikh RA, Trudeau WL.  Evaluation of endoscopic variceal ligation in prophylactic therapy for bleeding of oesophageal varices: a prospective, controlled trial compared with endoscopic injection sclerotherapy. Gastrointestinal Endoscopy 2000; 51(2):245-7.
 
Shiro Urayama, MD
Assistant Professor of Clinical Medicine
EUS Fellowship Program Director

Dr. Urayama’s interests are in endoscopic research involving GI malignancies, in particular pancreaticobiliary & esophagogastric cancers. He is investigating applications of newer technologies in diagnosis & therapy of GI cancers (endoscopic ultrasound, photodynamic therapy, etc.) through collaboration with researchers at Lawrence Livermore Laboratories. Molecular biological techniques are utilized in the analyses of endoscopically collected specimen and animal and cell culture models to investigate the tumorigenesis and chemoresistance of pancreatic adenocarcinoma.

Selected publications:

Urayama S, Musch MW, Straus D, Retsky J, Chang EB. Dexamethasone protection of rat intestinal epithelial cells against oxidant injury is mediated by induction of heat shock
protein 72. J Clin Invest 1998; 102:1860-1865.

John Lee, Urayama S. Endoscopy Around the World. Gastrointestinal Endoscopy 2000;52:138-140.

Lee JG, Urayama S. Early diagnosis and treatment of pancreatic dysplasia in patients with a family history of pancreatic cancer. Gastrointest Endosc 2000; 52:138-40.

Nguyen NT, Roberts PF, Follette DM, Lau D, Lee J, Urayama S, Wolfe BM,
Goodnight JE. Evaluation of minimally invasive surgical staging for esophageal cancer.
Am J Surg 2001; 182:702-6.

Urayama S. Role of EUS in definitive diagnosis and staging of lung adenocarcinoma localized to superior mediastinum. 2001 ACG Annual Meeting Abstract.

Stein M, Schneider PD, Ho HS, Eckert R, Urayama S, Bold RJ. Percutaneous transhepatic portography with intravascular ultrasonography for evaluation of venous involvement of hepatobiliary and pancreatic tumors. J Vasc Interv Radiol 2002; 13:805-14.

Umphress JL, Pecha RE, Urayama S. Biliary stricture caused by portal biliopathy: diagnosis by EUS with Doppler US. Gastrointestinal Endosc; 2004, 60(6):1021-1024.

Tran QN, Urayama S, Meyers FJ. Endoscopic ultrasound-guided celiac plexus neurolysis for pancreatic cancer pain: a single-institution experience and review of the literature. J Support Oncol. 2006 Oct;4(9):460-2.
 
Mark Zern, MD
Professor of Medicine
Director, Transplant Research Program

A researcher and active clinical hepatologist for more than 25 years, Dr. Zern is the author of more than 100 articles.  His research interests include the targeting of therapeutics to the liver by means of liposomes, the molecular basis of liver fibrosis, gene therapy of alpha-1 antitrypsin deficiency disease, the differentiation of human embryonic stem cells along a hepatocyte lineage, and the development of a bioartificial liver.

Selected publications:

Wege, H, Le, HT, Chui, MS, Liu, L, Wu, J, Giri, R, Malhi, H, Sappal, BS, Kumaran, V, Gupta, S, and MA Zern. Telomerase reconstitution immortalizes human fetal hepatocytes without disrupting their differentiation potential. Gastroenterology 124:432-444. 2003. 

Wege, H, Chui, MS, Le, HT, Tran, JM and MA Zern.  SYBR green real-time telomeric repeat amplification protocol for the rapid quantification of telomerase activity.  Nucleic Acids Research (31):2 e3 2003.

Cordelier, P, Zern, MA and DS Strayer. HIV-1 proprotein processing as a target for gene therapy. Gene Therapy 10: 467-477, 2003.
 
Zalzman, M, Gupta, S, Giri, RK, Berkovich, I, Sappal, BS, Karnieli, O, Zern, MA, Fleischer,N and S Efrat. Reversal of hyperglycemia in mice by using human expandable insulin-producing cells differentiated from fetal liver progenitor cells. Proc. Natl. Acad. Sci. USA. 100: 7253-7258, 2003.

Wege, H., Chui, M.S., Le, H.T., Strom, S.C., and M.A. Zern. In Vitro expansion of human hepatocytes is restricted by telomere-dependent replicative aging. Cell Transplantation. 12: 897-906, 2003.

Shirahashi, H, Wu, J, Yamamoto, N, Catana, A, Wege, H, Wager, B, Okita, K and MA Zern. Differentiation of human and mouse embryonic stem cells along a hepatocyte lineage. Cell Transplantation. 13: 197-211, 2004.

Wu, J, Liu, J, Yen, YD, Catana, C, and MA Zern. Liposome-mediated extracellular superoxide dismutase gene delivery protects against acute liver injury in mice.  Hepatology 40: 195-204, 2004.

Duan, YY, Wu, J, Zhu, JL, Strayer, DS, and MA Zern. Gene therapy for human alpha 1-antitrypsin deficiency in an animal model using SV40-derived vectors.  Gastroenterology 127: 1222-1232, 2004.


 
Associated Faculty

M. Eric Gershwin, MD
Distinguished Professor of Medicine
The Jack and Donald Chia Professor of Medicine
Chief, Division of Rheumatology, Allergy and Clinical Immunology

The interest of Dr. Gershwin’s laboratory is in further understanding the molecular basis of immune regulation in autoimmunity.  He is particularly interested in primary biliary cirrhosis (PBC); previous work from the laboratory has identified the autoantigens that are involved.  Clones are being used not only for diagnostic purposes but also to define relevant epitomes.  He is also interested in the molecular genetic basis of systemic lupus erythematosus.  Molecular and genetic tools are being utilized to study the genes contributing to susceptibility to human PBC and murine lupus as well as the cellular and subcellular mechanisms that led to immunopathology.

Selected publications:

Kita H, Lian ZX, Van de Water J, He XS, Matsumura S, Kaplan M, Luketic V,
Coppel RL, Ansari AA, Gershwin ME.  Identification of HLA-A2-restricted CD8(+) cytotoxic T cell responses in primary biliary cirrhosis: T cell activation is augmented by immune complexes cross-presented by dendritic cells. J Exp Med 2002; 195:113-23.

Kita H, Matsumura S, He XS, Ansari AA, Lian ZX, Van de Water J, Coppel RL,
Kaplan MM, Gershwin ME. Quantitative and functional analysis of PDC-E2-specific autoreactive cytotoxic T lymphocytes in primary biliary cirrhosis. J Clin Invest. 2002; 109:1231-40
Bruggraber SF, Leung PS, Amano K, Quan C, Kurth MJ, Nantz MH, Benson GD, Van
de Water J, Luketic V, Roche TE, Ansari AA, Coppel RL, Gershwin ME.  Autoreactivity to lipoate and a conjugated form of lipoate in primary biliary cirrhosis. Gastroenterology 2003; 125:1705-13.

Selmi C, Mayo MJ, Bach N, Ishibashi H, Invernizzi P, Gish RG, Gordon SC,
Wright HI, Zweiban B, Podda M, Gershwin ME.  Primary biliary cirrhosis in monozygotic and dizygotic twins: genetics, epigenetics, and environment.Gastroenterology. 2004; 127:485-92.

Amano K, Leung PS, Xu Q, Marik J, Quan C, Kurth MJ, Nantz MH, Ansari AA, Lam
KS, Zeniya M, Coppel RL, Gershwin ME. Xenobiotic-induced loss of tolerance in rabbits to the mitochondrial autoantigen of primary biliary cirrhosis is reversible. J Immunol 2004; 172:6444-52.

Lan R, P. Leung, A. Ansari, R. Coppel and M. Eric Gershwin.  Solving the primary biliary cirrhosis puzzle: The emerging image of immunopathology in primary biliary cirrhosis.  Clinical and Applied Immunology Reviews 2005; 5:271-284.

Gershwin, M.E., C. Selmi, H.J. Worman, E.B. Gold, M. Watnik, J. Utts, K.D. Lindor, M.M. Kaplan  J.M. Vierling and the USA PBC Epidemiology Group.  Risk factors and comorbidities in primary biliary cirrhosis:  a controlled interview-based study of 1032 patients.  Hepatology 2005; 42:1194-1202.


Charles Halsted, MD
Professor of Medicine
Director, Clinical Nutrition Research Unit

Dr. Halsted's research focuses on chronic alcoholism and regulation of folate absorption and metabolism. The micropig is used to study the pathogenesis of alcoholic liver disease with a focus on the relationship of this disease to abnormalities in folate and methionine metabolic pathways. Folate absorption and metabolism is also studied in cell culture systems using a variety of molecular techniques. The significance of a novel gene polymorphism that affects folate absorption is studied in various diseases associated with folate deficiency and hyperhomocysteinemia. Research training is available in areas of molecular regulation of intestinal enzymes and genetic screening to study the molecular regulation of methionine metabolic pathways in the liver.

Selected publications:

Niemela O, Parkkila S, Pasanen M, Viitala K, Villanueva JA, Halsted CH. Induction of cytochrome P450 enzymes and generation of protein-aldehyde adducts are associated with sex-dependent sensitivity to alcohol-induced liver disease in micropigs. Hepatology. 1999;30:1011-7.

Halsted CH, Villanueva JA, Devlin AM, Niemela O, Parkkila S, Garrow TA,
Wallock LM, Shigenaga MK, Melnyk S, James SJ. Folate deficiency disturbs hepatic methionine metabolism and promotes liver injury in the ethanol-fed micropig. Proc Natl Acad Sci U S A 2002; 99:10072-7.

Morin I, Devlin AM, Leclerc D, Sabbaghian N, Halsted CH, Finnell R, Rozen R. Evaluation of genetic variants in the reduced folate carrier and in glutamate carboxypeptidase II for spina bifida risk. Mol Genet Metab. 2003;79:197-200.

Villanueva JA, Halsted CH. Hepatic transmethylation reactions in micropigs with alcoholic liver disease. Hepatology. 2004;39(5):1303-10.

Halsted CH. Nutrition and alcoholic liver disease. Semin Liver Dis. 2004;24:289-304.

 
Kent K.C. Lloyd, DVM, PhD
Associate Dean for Research and Graduate Education Programs
Professor of Anatomy, Physiology, and Cell Biology,
School of Veterinary Medicine

Dr. Lloyd is a research physiologist with expertise in targeted mutagenesis of the laboratory mouse. His primary research focuses on the physiology of enterogastric reflexes as a model for positive and negative feedback mechanisms and pathways operating between organs.  Dr. Lloyd is also involved in the development of new means for preservation and resuscitation of genetically altered mice.  Dr. Lloyd serves as the Associate Director of the UC Davis Mouse Biology Program, Principal Investigator and Director of the NIH-sponsored Mutant Mouse Regional Resource Center (MMRRC)-UC Davis, and leads or co-leads the Murine Molecular Constructs Laboratory, the Murine Targeted Genomics Laboratory, the Murine Genetic Analysis Laboratory, and the Murine Cryopreservation and Recovery Laboratory.

Selected publications:

Patierno S, Zellalem W, Ho A, Parsons CG, Lloyd KCK, Tonini M, Sternini C. N-methyl-D-aspartate receptors mediate endogenous opioid release in enteric neurons after abdominal surgery. Gastroenter 2005; 128:2009-2019.

Whited KL, Lu D, Tso P, Lloyd KCK, Raybould HE. Apolipoprotein A-IV is involved in detection of lipid in the intestine. J Physiol (accepted 2005).

Whited KL, Lloyd KCK, Kopin A, Raybould HE. Targeted disruption of the murine CCK-1 receptor gene reduces intestinal lipid-induced feedback inhibition of gastric function. Am J. Physiol (submitted 2005).

 
Helen E. Raybould, DVM
Professor of Anatomy, Physiology, and Cell Biology, School of Veterinary Medicine

Dr. Raybould’s research is focused on understanding the neural and humoral control mechanisms that regulate function of the proximal gastrointestinal tract.  Specifically, she is interested in the role of the afferent innervation of the stomach and intestine and how lumenal stimuli, such as the components of lumenal nutrients, regulate function.  This is of fundamental physiological importance and also there is good evidence that these afferent pathways are altered in a number of GI disorders, including functional bowel disease, IBD, and ileus. 

Selected publications:

Kim M, Cooke HJ, Javed NH, Carey HV, Christofi F, Raybould HE. D-glucose releases 5-hydroxytryptamine from human BON cells as a model of enterochromaffin cells.
Gastroenterology 2001; 121:1400-6.

Glatzle J, Kalogeris TJ, Zittel TT, Guerrini S, Tso P, Raybould HE. Chylomicron components mediate intestinal lipid-induced inhibition of gastric motor function. Am J Physiol Gastrointest Liver Physiol 2002; 282:G86-91.

Glatzle J, Sternini C, Robin C, Zittel TT, Wong H, Reeve JR Jr, Raybould HE. Expression of 5-HT3 receptors in the rat gastrointestinal tract. Gastroenterology 2002; 123:217-26.

Raybould HE, Glatzle J, Robin C, Meyer JH, Phan T, Wong H, Sternini C. Expression of 5-HT3 receptors by extrinsic duodenal afferents contribute to intestinal inhibition of gastric emptying. Am J Physiol Gastrointest Liver Physiol. 2003; 284:G367-72.

Raybould HE.  The future of GI and liver research: editorial perspectives. IV. Visceral afferents: an update. Am J Physiol Gastrointest Liver Physiol 2003; 284:G880-2.


 
Jay V. Solnick, MD, PhD
Professor of Medicine (Infectious Diseases) and of Medical Microbiology & Immunology
Center for Comparative Medicine

Research in Dr. Solnick’s laboratory focuses on the pathogenesis of Helicobacter pylori. Our major goal is to understand the regulation of bacterial virulence genes and host immune response during experimental infection in the rhesus macaque model. In addition to standard methods of microbiology and molecular biology, we use real time reverse transcription PCR and microarray technology to understand host and bacterial gene transcription. We are also using the macaque model to study how H. pylori is transmitted.

Selected publications:

Mattapallil JJ, Dandekar S, Canfield DR, and Solnick JV. A predominant Th-1 type of immune response is induced early during acute Helicobacter pylori infection in rhesus macaques. Gastroenterol, 2000, 118: 307-15.

Solnick, JV, Canfield DR, Hansen LM, and Torabian SZ.  Immunization with recombinant Helicobacter pylori urease in specific pathogen free rhesus monkeys (Macaca mulatta), Infect Immun, 2000, 68: 2560-2565.

Solnick JV, Hansen LM, Canfield, DR and Parsonnet J.  Determination of the infectious dose of Helicobacter pylori during primary and secondary infection in the rhesus monkey (Macaca mulatta), Infect Immun, 2001, 69: 6887-92.

Solnick JV, Hansen LM, Canfield DR. The [14]-C Urea Breath Test is Not Sensitive for Detection of Acute Helicobacter pylori Infection in Rhesus Monkeys (Macaca mulatta), 2002, 47:298-303.

Dandekar, S., Reay E, Taylor, EM, and Solnick, JV. Apoptosis of gastric lymphocytes in Helicobacter pylori-infected rhesus macaques.  Dig Dis Sci, 2003, 48: 1073-80.
Solnick, JV, Hansen, LM, Salama, NR, Boonjakuakul, JK, and Syvanen, M.  Modification of Helicobacter pylori outer membrane protein expression during experimental infection of rhesus macaques.  Proc Natl Acad Sci USA, 2004, 101: 2106-2111.
Boonjakuakul, JK, Syvanen, M, Suryaprasad, A, Bowlus, C, and Solnick, JV.  A transcription profile of Helicobacter pylori in the human stomach reflects its physiology in vivo.  J Infect Dis, 2004, 190: 946-956.
Boonjakuakul, J.K, Canfield, D.R., and Solnick, J.V. Comparison of Helicobacter pylori virulence gene expression in vitro and in the rhesus macaque.   Infect and Immun, 2005, 73: 4895-4904.