Treatment of genitourinary trauma isnot a staple of most urology prac-tices, but UCSF Urology Vice Chair-man Jack W. McAninch, MD, hasearned a premier reputation for re-constructing these challenging in-juries. McAninch has built his exper-tise on his work at San FranciscoGeneral Hospital, where he hasserved as Chief of Urology for thepast 26 years. As the designatedtrauma center for the city of SanFrancisco, the hospital cares forscores of patients each year whohave suffered kidney or other geni-tourinary injuries. The UCSF urotrau-ma team is one of only a few in theUnited States that performs a highvolume of this specialized surgery,and, as a result, patients are referred

to UCSF from around the country forreconstructive procedures.

UCSF Urology Department Chair Pe-ter Carroll, MD, is emphatic in hispraise of McAninch. “Jack has con-tributed more to our understandingof these injuries and how to care forthem than any other urologist,” saidCarroll. “His commitment to SanFrancisco General is unflagging, andso is his enthusiasm and energy forhis work.”

McAninch and his team have assem-bled an extensive database on pa-tients treated at SFGH and on othersreferred to UCSF, information thathas proven to be a powerful tool forclinical outcomes research. Theyregularly review the database to de-termine treatment efficacy, and pro-duce up to ten manuscripts on theirfindings each year. McAninch alsoserves as editor of Traumatic andReconstructive Urology, the definitivetextbook in the field.

Improving salvage rates followingkidney trauma

One of the most impressive uses ofthe SFGH database has been the de-velopment of guidelines for the man-agement of renal trauma that are nowaccepted worldwide. McAninch andhis team have used data amassed onmore than 3,000 renal injuries treatedover the last 25 years to study clinicaloutcomes and refine managementprotocols. McAninch advocates aconservative approach to kidney in-juries; surgical exploration is per-formed only after thorough evaluationof the extent of injury with CT imag-ing. At SFGH, exploratory surgery isrequired in only 2% of patients withblunt trauma, 45% of stab wounds,and 76% of gunshot wounds. Whensurgery is performed, urologists iso-

(See Genitourinary Trauma on page 3)

Genitourinary Trauma: Saving Lives...and Organs

WINTER 2003

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University of CaliforniaSan Francisco

School of MedicineDepartment of Urology

Genitourinary trauma 1

Letter from the chair 2

Nutrition in prostate cancer 4

Female incontinence 5

New space 6

Resident research 7

New faculty 8

Top residents 9

Honors & awards 10

Clinical trials 11

Recent publications 11

Faculty 12

UNIVERSITY OF CALIFORNIA, SAN FRANCISCOSCHOOL OF MEDICINE

CONTENTS

$35 Million Gift SupportsCancer ResearchThe Helen Diller Family has con-tributed $35 million to UCSF tosupport the construction of a newcancer research building at UCSFMission Bay. The Urologic Oncolo-gy Research Program will occupy asignificant portion of the new Mis-sion Bay facility, along with theCancer Research Institute and theBrain Tumor Research Center. In-cluded in this generous gift, thelargest contribution from individualdonors in UCSF history, are re-sources to establish a prostatecancer research fund, under the di-rection of the Department of Urolo-gy. For details, see page 2.

late the renal vessels early to contro lbleeding, vastly improving thechances for successful re c o n s t r u c-tion of the organ. Kidney salvagerates are 85% in patients who under-go renal exploration.

Complex urogenital reconstruction

Based on experience gleaned fromworking with SFGH patients, McAn-inch and his team have built a largereferral practice in reconstructingtraumatically injured tissues. Urethralstrictures that impair a man’s abilityto void urine are a major focus oftheir work. Most often caused by ex-ternal trauma, urethral strictures canalso result from internal injury from acatheterization or an endoscopicprocedure. Most patients referred toUCSF have been previously treatedby referring physicians with internalurethrotomy or dilation, but successrates for these procedures tend to bequite low, according to McAninch.

McAninch has performed appro x i-mately 730 stricture repairs, and hasdeveloped several techniques to ad-d ress the more challenging obstruc-tions. A penile circular fasciocuta-neous skin flap, for example, allowsfor one-stage reconstruction of long,complex strictures. Since developingthe pro c e d u re 14 years ago, McAn-inch has used this skin flap in morethan 150 patients with an 85% long-term success rate. UCSF uro l o g i s t salso use buccomucosal grafts for

s t r i c t u re re p a i r, with a90% long-term successrate. The UCSF teamhas also defined therole of sonoure t h ro g-raphy in determiningwhich repair techniqueis most appropriate foreach patient. By identi-fying strictures too longfor resection and end-to-end anastomosis,s o n o u re t h rography canp reoperatively identifywhich patients shouldbe treated with flap orgraft pro c e d u res.

McAninch and his teamhave also performedmore than 150 urethralreconstructions in pa-tients who have suf-fered traumatic ruptureof the urethra. Thesepatients undergo a suprapubic cys-tostomy with urinary diversion at thetime of their injury. Restoring theirability to void involves removing scartissue and reattaching the urethralends. This task is usually complicat-ed by anatomic distortions of thepelvis, prostate and urethra causedby the initial injury. Nonetheless, theteam has an excellent 95% successrate, due in part to detailed preoper-ative planning. Routine tests such ascystography and urethrography aresupplemented with magnetic reso-nance imaging to establish the fullextent of the injury.

The UCSF team also specializes inreconstructing the genitals of menwho have suff e red traumatic skinloss, burns or infection. By employingcomplex reconstructive pro c e d u re sand expert wound care, the UCSF

team achieves good cosmetic andfunctional use in men who would otherwise remain badly disfigure d .

Training the next generation

Training a new generation of uro l o-gists in these complex pro c e d u res isa focus of the UCSF program. At anyone time, two UCSF urology re s i-dents rotate through San FranciscoGeneral Hospital, where they tre a tnot only genitourinary trauma, but al-so the full range of urologic diseases.

Fourteen years ago, UCSF created aunique SFGH-based fellowship inurological trauma and genitourinaryreconstruction, a program McAninchdirects and of which he is particularlyproud. Almost all the fellows havesubsequently accepted positions inacademic medical centers in theUnited States or abroad, where theyshare their expertise with a new gen-eration of physicians.

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Peter R. Carroll, MD

Helen Diller

A Donor’s Vision for Cancer Care

It is my great pleasure to share with you the news that the Helen Diller Familyhas made a $35 million gift to UCSF and the Department of Urology to supportconstruction of a new cancer research building at UCSF Mission Bay and toestablish an endowed fund for prostate cancer research. The Urologic Oncolo-gy Research Program will occupy a large portion of the new building, which willalso accommodate researchers within the UCSF Cancer Research Institute andthe Brain Tumor Research Center. In all, the new facility will more than doublethe existing space dedicated to cancer research at UCSF.

The facility will be named the Helen Diller Family Cancer Research Building inrecognition of the family’s pivotal role in making the research center possible.Construction of this five-story building, designed by noted architect RafaelViñoly, will provide more than 160,000 square feet for research.

This generous gift, the largest contribution from individual donors in UCSF histo-r y, also includes re s o u rces to establish the Helen Diller Family Prostate CancerR e s e a rch Fund. This endowment will support our department’s many clinical andbasic science investigations in prostate cancer diagnosis, treatment and pre v e n-tion. Overall, the gift will enable our department to expand urologic oncology re-s e a rch, and replace dated infrastructure with new space and equipment.

Construction of the new building will begin pending final approval by the UCBoard of Regents. The new facility will join the recently completed GenentechHall at the 43-acre UCSF Mission Bay campus on San Francisco’s easternwaterfront. When it is fully developed, the new campus will include 2.65 millionsquare feet of biomedical research and teaching space.

The University in general and our department in particular have established awonderful relationship with the Diller family. Family members have engaged inregular exchanges of ideas with faculty, providing insightful guidance on re-search areas of mutual interest. The Dillers, who are native San Franciscans,share a heartening belief that UCSF cancer researchers are on the verge of dis-coveries that will improve lives around the world. We gratefully thank them fortheir confidence and enthusiasm for our work. Their remarkable generosity isan inspiration to all of us.

The Department of Urology has experienced a tremendous increase in re-sources and space over the past year. Our advocates and donors continue toprovide substantial support and guidance, and I appreciate their efforts on ourbehalf. I am grateful to the strong leadership at UCSF for providing criticallyneeded space to accommodate our programmatic growth. Finally, I recognizethe extraordinary dedication of my faculty, housestaff and staff, whose hardwork is essential to our growth and to the achievement of our tripartite mission:to educate, to care, and to discover.

In this newsletter we also highlight the remarkable work of Jack McAninch, MD,P rofessor and Vice Chair of the department. I, like so many others, have benefit-ed from Jack’s remarkable experience and expertise. Jack’s roles in the depart-ment as an educator, clinician and Vice Chair are critical to our continued suc-cess. I am personally grateful for his wisdom, leadership and continued support.

Sincerely,

Peter R. Carroll, MD

Professor and Chair of Urology

Ken and Donna Derr-Chevron Endowed Chair in Prostate Cancer

Letter from the chair(Genitourinary Trauma from page 1)

Urethrogram demonstrating a proximal bulbar stricture following a straddle injury

McAninch has a distinguished history of lead-ership in urological professional societies.C u r rently President-Elect of the Society of I n t e rnational Uro l o g y, he has previously servedas president of the American Urological Asso-ciation, the American Board of Uro l o g y, andthe Society of Genitourinary ReconstructiveSurgeons. His recognition last year as Man ofthe Year by the National Kidney Foundation ofN o r t h e rn California was the latest in a long listof honors and award s .

Training a new gener-ation of urologists inthese complex pro c e-d u res is a focus ofthe UCSF pro g r a m .

have some degree of incontinence,and 15% report experiencing thisproblem daily.

Lue is principal investigator for theSCOR-funded basic science pro-ject, which will explore the molecu-lar and genetic mechanisms of in-continence and the use of matrix-based therapy as a scaffold forbladder and urethral re p l a c e m e n t .Co-investigators include EmilTanagho, MD, an authority on uro-dynamics and neuro u ro l o g y, andmolecular biologist Ching-ShwunLin, PhD, director of the KnuppeMolecular Urology Laboratory.

The project builds on NIH-funded re-search currently being conducted atUCSF on the development of an ani-mal model for female urinary inconti-nence and the use of acellular matrixfor the treatment of urinary tract dis-orders. Techniques developedthrough in vitro and animal studiesby Tanagho’s research team led tothe recent successful use at UCSF ofrabbit bladder acellular matrix for re-pair of a urethral stricture in a man.With these encouraging results, Lueand Tanagho are studying whetheracellular matrix with or withoutgrowth factor treatment can be usedto treat female stress urinary inconti-nence in animal models.

In addition to basic scientific re-search, two clinical projects arefunded through the SCOR. Brown,who directs the UCSF Women’sContinence Center, serves as princi-pal investigator for a study that willexplore how diabetes affects lowerurinary tract dysfunction and infec-tions. The study will follow aprospective cohort of 400 womenwith type 2 diabetes age-matchedwith 400 nondiabetic controls. Theproject builds on Brown’s previouswork, which showed that this in-creasingly common disease increas-

es a woman’s risk of developing in-continence by 50-60%.

A second clinical project will examinereproductive and hormonal risk fac-tors for incontinence by providingfunding to continue studying a multi-ethnic group of 2100 women receiv-ing care through the Kaiser Perma-nente Medical Care plan. David H.Thom, MD, MPH, PhD, serves asprincipal investigator for this project,which traces risk factors for inconti-nence through medical records, inter-views and databases availablethrough the Kaiser system.

SCOR activities also include juniorfaculty training in clinical research,and a fellowship in clinical researchmethods. If you would like further information on the program, please visit www.ucsf.edu/scor.

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The idea of reducing cancer risk withdietary changes is an appealing con-cept to many prostate cancer pa-tients; UCSF investigators haveshown that a large percentage ofmen with prostate cancer alter theirlifestyle, primarily with diet, even ifthey receive conventional treatmentfor their disease. Epidemiologic stud-ies link many dietary factors with in-creased or decreased risk of devel-oping prostate cancer, but themolecular mechanisms of action formost of these nutrients are not wellunderstood.

To help clarify the effect of diet onmen’s prostate health, the UCSFUrology Department is involved in amultidisciplinary study that will mea-sure the effects of two popular nutri-tional supplements on prostate can-cer cells. They are lycopene, an an-tioxidant found in tomatoes, and fishoil that is rich in omega-3 fatty acids.The Molecular Effects of NutritionSupplements (MENS) trial, which isfunded by a grant from the NationalCancer Institute, is led by urologiconcologist Christopher Haqq, MD,PhD, epidemiologist June Chan,ScD, and urologist Peter Carroll, MD.Other investigators include urologistKatsuto Shinohara, MD, and statisti-cian Vivian Weinberg, PhD.

“Cell cultures and animal models, al-though helpful in some respects, do

not adequately represent what hap-pens when humans consume partic-ular foods,” said Haqq. “The MENStrial is designed to provide specificinformation on how lycopene andfish oil affect prostate cancer cells inthe course of normal metabolism.”

Participation is open to men with fa-vorable-risk prostate cancer whohave opted for watchful waiting astheir therapeutic course. Men will berandomized to take either placebo,lycopene or fish oil supplements fora three-month period, with the goalof enrolling 34 men in each studyarm. Prostate biopsies, serum sam-ples, and detailed dietary surveyswill be collected at the beginningand end of the study period.

The major aim of the trial is to deter-mine whether intake of each nutri-tional supplement correlates with theexpression of specific genes inprostate tissue, as measured bymolecular biology tools, includinghigh fidelity RNA amplification andcDNA array analysis. The re-searchers hypothesize that lycopenesupplementation will be associatedwith decreased expression of genesthat promote production of insulin-like growth factor-I (IGF-I), a hor-mone linked to the risk of prostatecancer. Investigators believe that fishoil supplementation may be associ-ated with decreased expression ofCox-2 genes, which indicate cellularinflammatory responses. As part ofthe study, researchers will also ana-lyze the correlation between baselinegene expression patterns and self-reported dietary habits to see if in-gesting certain foods is linked toparticular gene expression profiles.

Subjects will be followed for an addi-tional nine months after the three-month dietary intervention to monitorclinical progression of prostate can-cer. It is hoped that this study willprovide significant insight into theactual effects of dietary manipulationon both benign and malignantprostate cells.

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Dean Ornish

Dean Ornish, MD, C l i n i c a lP rofessor of Medicine andP resident of the Pre v e n t i v eMedicine Research Institute inSausalito, CA has been col-laborating with Department

Chair Peter Carrroll, MD, on aunique clinical trial. Preliminary find-ings from this study were pre s e n t e dat the spring 2003 American Uro l o g-ical Association meeting, and one-year results have been submitted forp u b l i c a t i o n .

This is the first randomized, con-t rolled clinical trial to determine ifc o m p rehensive changes in lifestylemay affect the pro g ression ofp rostate cancer.

Ninety men with prostate cancerwho had previously chosen not toundergo conventional tre a t m e n t ,with prostate specific antigen (PSA)between 4-10, and Gleason score sunder 7 were randomly assigned toan experimental group or a non-intervention control group. All menw e re followed regularly for signs ofp ro g ression. The intervention con-sisted of a low-fat vegan diet sup-plemented with soy and antioxi-dants, moderate aerobic exerc i s e ,s t ress management and group sup-port. In addition to measuring quar-terly PSA, serum from patients wasadded to a common humanp rostate cancer cell line (LNCaP).

None of the experimental group par-ticipants received conventional tre a t-ment during the first year, while sixof the control patients did. After oney e a r, PSA values decreased signifi-cantly in the experimental group buti n c reased significantly in the contro lg roup. Changes in PSA were associ-ated with degree of lifestyle change.Substantial modifications in lifestylew e re re q u i red for PSA to decrease.

Serum from experimental patientsinhibited growth of LNCaP cells sig-nificantly more than serum from con-t rol patients. There was a strong cor-relation between adherence to thelifestyle intervention and changes inLNCaP cell growth in both gro u p s .

In summary, one-year data indicatethat comprehensive and intensivelifestyle changes may cause a signif-icant decrease in PSA in patientswith early, low-grade prostate can-c e r. Long-term follow-up is planned.

CAN LIFESTYLE CHANGES AFFECT PROSTATE CANCER?

Studying the Role of Nutrition in Prostate Cancer

Dean Ornish

Under the direction of Chris Haqq, MD,assistant professor of medicine, GuitingLin, PhD in the Knuppe Molecular Uro l o-gy Laboratory, has made 260 glass genechips for the SCOR project to identifygenes that are associated with urinaryincontinence. Pictured is a chip that hasreacted with tissue RNA from the ure-thra. The chip contains 21,600 genes.

SCOR DesignationInnovative Prostate Cancer Research

The major aim of thetrial is to determinewhether intake ofeach nutritional sup-plement correlateswith the expression of specific genes inprostate tissue, asmeasured by molecu-lar biology tools.

Multidisciplinary Research on Female Incontinence

Many women are chronically trou-bled by urinary incontinence, yet thiswidespread problem has receivedrelatively little scientific study. Withits recent designation by the NationalInstitutes of Health as a SpecializedCenter of Research (SCOR) in LowerUrinary Tract Function, UCSF isspearheading a wide range of scien-tific studies on this issue.

Urogynecologist Jeanette S. Brown,MD, who directs the SCOR, andurologist Tom F. Lue, MD, co-direc-tor, are widely recognized for theirwork on clinical and basic scienceaspects of this common problem.Together, they are coordinating theefforts of a talented group of multi-disciplinary investigators studyingthe underlying molecular mecha-nisms of urinary incontinence, theepidemiology of the disorder andclinical outcomes of treatment.SCOR investigators include mem-bers of the UCSF Departments ofObstetrics, Gynecology and Repro-ductive Sciences, Urology, FamilyMedicine, Geriatrics, and Epidemiol-ogy & Biostatistics; the UCSF Wom-en’s Health Clinical Research Center;and the Northern California KaiserDivision of Research.

The UCSF SCOR designation, whichconcluded a highly competitiveaward process, was one of 11 grant-ed by the National Institutes ofHealth Office of Research on Wom-en’s Health in October 2002 to sup-port programs affecting women’smedical needs. The UCSF award iscoadministered by the National Insti-tute of Diabetes and Digestive andKidney Diseases.

“Lower urinary tract dysfunction, in-cluding incontinence, significantlyimpairs quality of life and accountsfor billions of dollars each year inhealth care expenditures,” said Lue.Up to 50% of women over age 60

The UCSF SCOR designation, which concluded ahighly competitive award process, was one of 11granted by the National Institutes of Health...to support programs affecting women’s medical needs.

Urology Launches New WebsiteThe Department of Urology revamped and launched a newc o m p rehensive website early in 2003. The website, located atu ro l o g y.ucsf.edu, is a re s o u rce for patients, residency and fel-lowship applicants, community physicians, and anyone inter-ested in learning more about the department and its pro g r a m s .The website includes information about the department’s fac-u l t y, facilities, training programs, clinical trials, residency andfellowship programs, continuing medical education and othereducational events, and news. A patient information sectionp rovides downloadable information, a listing of free services atthe University and links to other re s o u rc e s .

Unlike other urology residency pro-grams, UCSF offers participants afifth year of postgraduate trainingdevoted to basic science re s e a rc h .This reflects the department’s com-mitment to training future academicleaders in the field. Residents electto work with a faculty mentor whooversees their re s e a rch training, en-suring that the year is a pro d u c t i v eexperience. This year’s resident re-s e a rch efforts have produced partic-ularly intriguing and notable findings.

Donna Deng, MD, has worked withu rologist Tom Lue, MD, in investigat-ing the use of embryonic rat stemcells to treat incontinence and ere c-tile dysfunction. The stem cells werefirst diff e rentiated into nerve andsmooth muscle cells, impre g n a t e dwith growth factors, and then im-planted in rat models of urinarys t ress incontinence and ere c t i l edysfunction resulting from nerve in-j u r y. Deng and Lue used histochem-ical staining to verify that the cellsw e re alive, then administered vari-ous functional tests to see whetherthe injury had improved as a re s u l tof stem cell treatment. Results arenot yet available for the inconti-nence model, but the erectile modelhas shown positive preliminary re-sults. Some animals have shownvery clear improvement in ere c t i l efunction, in some cases re t u rn i n gclose to baseline function, four tosix weeks after stem cell implanta-tion. Such re s e a rch could lead toi m p roved outcomes for many pa-tients undergoing treatment for avariety of conditions.

Rajveer Purohit, MD, MPH, h a sworked with faculty member C h r i sHaqq, MD, PhD, at the Mount ZionCancer Research Center on a pro-ject examining genetic predictors of

metastases in prostate cancer pa-tients. The team used cDNA mi-c roarray technology to examinegene expression in tissue samplestaken from primary prostate cancertumors in nine patients found tohave lymph node metastases at thetime of radical pro s t a t e c t o m y, andnine risk-matched patients who didnot have lymph node involvement.The results, which won an award inbasic sciences when Purohit pre-sented them at the Northern Cali-f o rnia Urology Residents’ Seminar,revealed elevated expression of 20to 30 genes in patients whose tu-mors had metastasized. Upre g u l a t-ed genes included those coding forextracellular matrix proteases, lym-phocyte-specific factors, neural-specific factors, and expressed se-quence tags. The results suggestthat metastatic disease can be pre-dicted using gene arrays and thatpatients with over- e x p ression ofthese factors in their primary tu-mors should be treated as high-riskpatients. In addition, new targ e t sfor novel treatment may be found.

Edward Yun, MD, has focused hisre s e a rch on examining the geneticbasis for racial diff e rences inp rostate cancer. The incidence ofp rostate cancer in African Americanmen is estimated to be 60% to70% higher than in Caucasians,and they tend to develop the dis-ease at an advanced stage. Whendiagnosed, African Americans tendto have higher PSA levels and tu-mors of a higher grade and stage.R e s e a rchers have hypothesizedthat diet, socioeconomic factorsand health care access may con-tribute to this disparity. Working atthe San Francisco Veterans Aff a i r sMedical Center with Raj Dahiya,

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Resident ResearchWith the completion of extensiverenovations at Parnassus andMount Zion, the Department ofU rology has more than doubled itsacademic space, streamlined andupgraded its outpatient facilities,and consolidated its Program inU rologic Oncology into a newly re-furbished wing at Mount Zion.

At Parnassus, urology outpatientand academic offices are now side-by-side on the sixth floor of the Am-bulatory Care Center. The outpatientspace has been completely re n o v a t-ed and includes on-site, state-of-the-art fluoro s c o p y, uro d y n a m i c

testing and cystoscopy. Uro l o g y ’sacademic and administrative unitsa re now located in beautifully re-modeled offices adjacent to the clin-ic, which has significantly impro v e dinteraction and continuity betweenclinical and business services.

At Mount Zion, the Program in Uro-logic Oncology is no longer scat-t e red among several temporary of-fices, but has been consolidated in-to bright and expansive space onthe sixth floor of the “A” building.The new site brings together uro-logic oncology and male infertilityfaculty; residents and fellows; aca-demic, clinical trials and outre a c hs t a ff; and urology outcomes andepidemiology re s e a rch teams.Working in close proximity will fos-ter collegiality among the faculty,re s e a rchers, and staff in this fast-g rowing, multidisciplinary pro g r a m .

This summer, the medical centeropened new operating rooms, a seven-bed intensive care unit andancillary services at Mount Zion,paving the way for the transition of a range of cancer surgical activitiesf rom the Parnassus campus. Ex-panded inpatient services at MountZion are now provided by uro l o g y,b reast oncology, gastro e n t e ro l o g yand gynecology, as well as headand neck, melanoma, thoracic and

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PhD, Yun has been examining ge-netic factors that might contributeto the disease in four groups ofmen: African Americans with andwithout prostate cancer and Cau-casians with and without the dis-ease. Tissue samples were obtainedf rom transrectal biopsy and fro mradical pro s t a t e c t o m y. Immunohis-tochemistry was then used to mea-s u re protein expression and re a l -time PCR was used to measure mR-NA expression. Yun reported hisfindings at the AUA annual meetingthis year in Chicago, specifically,that levels of the enzyme CYP1A1, aknown carcinogen, were incre a s e din African American men withp rostate cancer. If borne out by fur-ther study, CYP1A1 might provide amarker for identifying African Ameri-can men at high risk for developingp rostate cancer and for detectingcancer at an earlier, more tre a t a b l e ,stage. This could lead to many morelives being saved each year.

The reception area in the new Urology outpa-tient office

Al Arroyo, urology technician, in the new cys-toscopy suite at Parn a s s u s .

general oncology surg e r y. The ex-pansion coincides with the appoint-ment of Peter Carroll, MD, as theclinical cancer center’s first surg e o nin chief. These steps facilitate imple-mentation of the strategic plan forthe clinical cancer center, more thandouble inpatient capacity, andb roaden and solidify the surg i c a lp resence at the Mount Zion campus.

By hybridizing cDNA from both tumor and normalsamples onto the gene chip, the relative expre s-sion of thousands of genes can be evaluated.

New Space Facilitates Growth and Consolidation

Top residents match to UCSF

Jeanette Brown, MD

Professor

Obstetrics, Gynecology and Repro-ductive Sciences, Epidemiology &Biostatistics and Urology

Jeanette Brown, MD, who has beenUCSF faculty in the Department ofObstetrics, Gynecology and Repro-ductive Sciences since 1986, joinedthe Department of Urology with ajoint appointment in December 2002.Brown’s notable research includes amultivariate analysis of risk factorsfor urinary incontinence, risks associ-ated with urge incontinence, risk fac-tors associated with stress and urgeincontinence, and lower urinary tractdysfunction and urinary incontinenceamong women with diabetes.

B rown has been director of the UCSFWo m e n ’s Continence Center and theWo m e n ’s Urologic Research Centersince 1990. In 1993, while maintain-ing her faculty appointment, Bro w nbegan and completed a two-year fel-lowship in Epidemiology, Biostatisticsand Clinical Research at UCSF. Thefellowship supplied Brown with thetools needed to build the Wo m e n ’sU rologic Research Center. Today thismultidisciplinary group of basic andclinical investigators collaborates toconduct translational re s e a rch on thefemale urethra, bladder, pelvic floorand urinary incontinence. Bro w n ’sappointment in Urology will help tofoster additional collaborations, in-cluding the UCSF Specialized Centerof Research on Lower Urinary Tr a c tFunction in Women, which is led byB rown and Urology Vice Chair To mLue, MD (see page 5).

Maxwell Meng, MD

Assistant Professor

Urology

Maxwell Meng, MD, received his un-dergraduate training from HarvardCollege, where he obtained his de-gree in biochemical sciences magna

cum laude. He then attended theJohns Hopkins School of Medicine,where he was inducted into the Al-pha Omega Alpha honor society.Meng obtained his general surgeryand urology training at the Universityof California, San Francisco. Menghas combined an interest in urologiconcology and minimally invasivesurgery, completing fellowships inboth under the guidance of PeterCarroll, MD, and Marshall Stoller,MD. In January 2003, upon comple-tion of his fellowships, Meng was ap-pointed to a faculty position.

Meng specializes in urologic cancersand laparo s c o p y, and is part of themultidisciplinary urologic oncologyteam located at the Mount Zion Can-cer Center. Meng’s clinical intere s t sinclude the diagnosis and manage-ment of genitourinary malignancy, andminimally invasive treatment of benignand malignant diseases. His curre n tlaboratory re s e a rch projects includethe development of novel therapeuticinterventions for bladder cancer, andthe study of molecular markers top redict disease behavior in pro s t a t ec a n c e r. Meng is an experiencedrobotic surgeon and is actively in-volved in the development of newtechnologies for minimally invasives u rg e r y.

John Witte, PhD

Professor

Epidemiology & Biostatistics andUrology

John Witte, PhD, joined the depart-ments of Epidemiology & Biostatis-tics and Urology in September fromCase Western Reserve UniversitySchool of Medicine. Witte earned hismaster’s degree from the Universityof California, Berkeley, and a PhD inepidemiology from the University ofCalifornia, Los Angeles. After receiv-ing his degree in Los Angeles, hewas an Assistant Professor of Pre-ventive Medicine at the University ofSouthern California.

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Benjamin Breyer, MD

Breyer earned his MD from the Uni-versity of Chicago Pritzker School ofMedicine. His honors and awards in-clude membership in the AlphaOmega Alpha honor medical society,honors in all third-year clinical clerk-ships, and the Calvin Fentress Re-search Fellowship Award. His re-search in the molecular oncologylaboratory, directed by Tong-ChuanHe, MD, PhD, has resulted in 11publications, including two about vi-ral vectors and gene therapy, whereBreyer is first author.

Sean Doyle, MD

Doyle earned his MD from the Uni-versity of Texas Southwestern Medi-cal School at Dallas, Texas, where hewas recipient of the SouthwesternMedical Foundation Scholarship foracademic achievement. His most re-cent research under the direction ofArthur Sagalowsky, MD has investi-gated the outcomes of patients who

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have undergone radical cystectomyfor bladder cancer. Doyle is a mem-ber of the Alpha Omega Alpha HonorMedical Society.

Jared Whitson, MD

Whitson earned his MD fromColumbia University College of Physi-cians and Surgeons in New York. Hewas a National Institutes of Healthsummer research fellow in 2000. In1998, funding from an AmericanHeart Association student researchgrant led to published work, entitled“The Systemic Procoagulative Re-sponse to PTFE Implants in PatientsUndergoing Femoropopliteal Bypassor Arteriovenous Fistula Grafts.” Un-der the direction of James McKier-nan, MD, at Columbia University,Whitson studied the relationship be-tween levels of a serum tumor markerfor renal cell carcinoma and tumorhistology, stage and survival.

At Case, Witte was honored with ateaching award, the 1999-2000 Glen-nan Fellowship, given for innovationin teaching and education. He washonored again in 2002-2003 with theVisiting Scientist award from the In-ternational Agency for Research onCancer in Lyon, France. Witte’s re-search program constitutes appliedand methodological genetic epidemi-ology, with the overall aim of deci-phering the mechanisms underlyingcomplex diseases. His applied workis focused on prostate cancer, andcomplements other work done at theUCSF Prostate Cancer Center.Witte’s genetic epidemiology studies

examine the genetic basis of prostatecancer, and have included searchesacross the human genome and workon specific candidate genes. Suc-cesses have included the isolation ofdistinct chromosomal regions thatappear to harbor prostate cancercausing genes, and the first genome-wide scan for genes linked to the ag-gressiveness of prostate cancer.

New faculty

Benjamin Breyer

Sean Doyle

Jared Whitson

Jeanette Brown

Maxwell Meng

John Witte

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Laurence Baskin, MD, was fundedby the National Institutes of Healthfor his proposal “Hypospadias, Geni-tal Tubercle Differentiation and En-docrine Disruptors.” The NIH alsoawarded Baskin a grant with theUCSF Children’s Hospital and thePediatric Clinical Research Center toset up a prospective database tostudy outcomes of children with uri-nary tract infections.

Baskin was elected to a five-yearterm on the executive committee ofthe American Academy of Pediatrics’Section of Urology, nominated to or-ganize the Society of Pediatric Urol-ogy’s April 2003 meeting in Chicago,and selected to serve a five-year edi-torial board term on the Journal ofUrology’s pediatric section.

Peter Carroll, MD, was one of threenew members elected to the ClinicalSociety of Genitourinary Surgeons.The society brings together out-standing urological authorities; mem-bership is limited to urologists whohave made major contributions tothe advancement of Urology.

Carroll was appointed surgeon-in-chief at the UCSF Mount Zion Com-prehensive Cancer Center. He is thefirst to hold this position.

June Chan, ScD, presented the bestclinical research poster, entitled“Post-Diagnostic Diet and the Risk ofProstate Cancer Recurrence andMortality: Health Professionals Fol-low Up Study,” at the March 2003UCSF Prostate Cancer Retreat.

Chan won a CaPCURE researchaward in June 2003 for a project tostudy serum nutrient predictors ofprostate cancer bone metastasesand death. This research will seek toidentify modifiable risk factors to de-lay the onset of painful and often fa-tal bone metastases.

Gerald Cunha, PhD, c o - o rganized theSecond Timberline Symposium onEpithelial Development. In April 2003Cunha presented the 9th annual Don-ald S. Coffey Lecture at the Societyfor Basic Urologic Research Springmeeting in Chicago. His pre s e n t a t i o nwas entitled, "Thirty-Five Years ofS t romal-Epithelial Interactions in theP rostate: What Have We Learn e d ? "

Rajvir Dahiya, PhD, was awardedfunding for two prostate cancer re-search proposals totaling $2.3 millionin direct cost. Work on a National In-stitutes of Health grant entitled “DNAMethylation in Aging, Race andProstate Cancer” and co-led by Peter Carroll, MD, began in October2002 and will run through September2007. A Veterans Affairs merit reviewaward on genetic factors in race-related prostate cancer was fundedthrough January 2009.

T h ree California Urology Foundationa w a rds totaling $26,000 were award-ed to departmental members for novelre s e a rch in January 2003. Donna Deng, MD, received an awardfor a proposal elucidating the effect ofimplanted embryonal stem cells forurinary incontinence. Rajveer Purohit, MD, received fundingfor a proposal entitled “Larg e - s c a l ecDNA Array Analysis of Predictors ofMetastasis in Prostate Cancer,” and

Clinical trials of new therapies for urological disorders are a departmentpriority. The department and affiliated programs are conducting morethan 35 investigational studies. Several ongoing trials are listed below.For more information, please visit our clinical trials website aturology.ucsf.edu/clinicalTrials.html or contact Meg Randall at 415/885-7329 (mrandall@cc.ucsf.edu) or Joyce Alejo at 415/353-7348(jalejo@urol.ucsf.edu)

Honors & awards

Clinical trials

Recent publications

Prednisone in Patients with Tax-ane Resistant Hormone Refracto-ry Prostate Cancer (02555)

• A Randomized Study Comparing4 Monthly Doses of MDX-010 asa Single Agent or Used in Com-bination with a Single Dose ofDocetaxel in Patients with Hor-mone-Refractory Prostate Cancer(CC 02559)

Chan JM; Stampfer MJ; Ma J; Gann P; Gaziano JM; Pollak M; Giovannucci E.Insulin-like growth factor-I (IGF-I) andIGF binding protein-3 as pre d i c t o r sof advanced-stage prostate cancer.J o u rnal of the National Cancer Insti-tute. 2002 94(14):1099-106.Cooperberg MR; Grossfeld GD;Lubeck DP; Carroll PR.National practice patterns and timet rends in androgen ablation for local-ized prostate cancer. Journal of theNational Cancer Institute. 20039 5 ( 1 3 ) : 9 8 1 - 9 .Elliott SP; Metro MJ; McAninch JW.Long-term followup of the ventrallyplaced buccal mucosa onlay graft inbulbar urethral reconstruction. Jour-nal of Uro l o g y. 2003 169(5):1754-7.Elliott SP; Shinohara K; Logan SL;C a r roll PR.Sextant prostate biopsies pre d i c tside and sextant site of extracapsu-lar extension of prostate cancer.J o u rnal of Uro l o g y. 20021 6 8 ( 1 ) : 1 0 5 - 9 .Kane CJ; Lubeck DP; Knight SJ;Spitalny M; Downs TM; Gro s s f e l dG; Pasta DJ; Mehta SS; Carroll PR. Impact of patient educational levelon treatment for patients withp rostate cancer: Data from CaP-SURE. Uro l o g y. 2003 62:1035-1039.Kim KS; Liu W; Cunha GR; Russell DW; Huang H; Shapiro E;Baskin LS.E x p ression of the androgen re c e p t o rand 5 alpha-reductase type 2 in the

developing human fetal penis andu rethra. Cell and Tissue Researc h .2002 307(2):145-53.Lin CS; Xin ZC; Lin G; Lue TF.Phosphodiesterases as therapeutict a rgets. Uro l o g y. 2003 61(4):685-91.Meng MV; Freise CE; Kang SM; Duh QY; Stoller ML.Techniques to optimize vascular c o n t rol during laparoscopic donorn e p h re c t o m y. Uro l o g y. 2003 61(1):93-7; discussion 97-8.Paris PL; Albertson DG; Alers JC;Andaya A; Carroll P; Fridlyand J;Jain AN; Kamkar S; Kowbel D; Krijtenburg PJ; Pinkel D; Schro d e rFH; Vissers KJ; Watson VJ; Wildha-gen MF; Collins C; Van Dekken H.H i g h - resolution analysis of paraff i n -embedded and formalin-fixedp rostate tumors using comparativegenomic hybridization to genomicm i c roarrays. The American Journ a lof Pathology. 2003 162(3):763-70.Xu EY; Lee DF; Klebes A; Tu rek PJ;K o rnberg TB; Reijo Pera RA.Human BOULE gene rescues mei-otic defects in infertile flies. Hu-man Molecular Genetics. 20031 2 ( 2 ) : 1 6 9 - 1 7 5 .Veltman JA; Fridlyand J; Pejavar S;Olshen AB; Korkola JE; DeVries S;C a r roll P; Kuo WL; Pinkel D; Albertson D; Cord o n - C a rdo C; Jain AN; Waldman FM.Array-based comparative genomichybridization for genome-wides c reening of DNA copy number inbladder tumors. Cancer Researc h .2003 63:2872-2880.

Zhong Wang, MD, for “Hypospadiasand Microarray Gene Chip Analysis.”

Kirsten Gre e n e , M D , was selected bythe medical students as one of five re-cipients of the 2003 Housestaff Te a c h-ing Aw a rd. Aw a rds are given to themost outstanding clinical teachers andresidents and are nominated by thegraduating class of medical students.

Greene was also elected to the AlphaOmega Alpha Honor Medical Societyby the graduating class of 2003 stu-dent members of UCSF’s chapter.She was one of three UCSF house-staff members selected from severalhundred eligible candidates.

Two UCSF urology residents receivedawards at the 29th annual NorthernCalifornia Urology Residents’ Semi-nar. Kirsten Greene, MD, was award-ed third place for clinical researchand Rajveer Purohit, MD, MPH, wasawarded third place in the basic sci-ences division.

Sarah Knight, PhD, received twoawards for improving assessment ofpatient preference in localizedprostate cancer from the Veterans Affairs Health Services Research andDevelopment Program. The awardsincluded an advanced research ca-reer development award and an investigator-initiated merit grant.

David Latini, PhD, was selected as afellow for the National Cancer Insti-tute–funded 2003 Culture and Litera-cy Institute training program at theMoffitt Cancer Center in Tampa, Flori-da. The training program began witha week of training in Tampa and hascontinued with monthly online train-ing sessions and mentoring.

Tom Lue, MD, was presented withthe Henry Weyrauch Award at theMarch 2003 Western Urologic Forummeeting for best scientific presenta-tion. In May 2003 he was selected asthe William R. Smart Teaching Awardrecipient. The teaching award is givenby the UCSF Department of Urolo-gy’s residents for excellence in resi-dent teaching.

• The Molecular Effects of Nutri-tional Supplements (MENS)Prostate Cancer Study (CC03553)

• A Randomized Phase II Trial ofInterferon Alfa-2B or InterferonAlfa-2B Plus Bevacizumab in Pa-tients with Advanced Renal Car-cinoma (CALGB 90206)

• A Randomized Phase II Study ofBMS 247550 or Mitoxantrone and

Lue was selected as one of America’stop doctors by Men’s Health Maga-zine. He was featured for his work onerectile dysfunction in the April 2003publication.

Jack McAninch, MD, is serving asPresident-elect of the Society of In-ternational Urology. The society wasfounded in 1907 in Paris and has aworldwide membership. McAninch isthe third society president from theUnited States in the last 30 years.

McAninch was elected fellow to theAmerican Surgical Association. Theassociation was founded in 1880 andis the major society of academic sur-geons in the United States.

Marc Shuman, MD, was appointedto the National Cancer Institute’s Ini-tial Review Group Cancer CenterSubcommittee. The peer-review com-mittee reviews cancer center grantapplications submitted to the NCI,makes recommendations to the Na-tional Cancer Advisory Board andsurveys the status of research. Shu-man’s term began in July 2002 andruns through June 2006.

Wendell (Van) Van Auken, BEE,M B A , a UCSF Prostate Cancer Re-s e a rch Advocate, was appointed to

the Integration Panel for the De-partment of Defense Pro s t a t eCancer Research Program. TheIntegration Panel is re s p o n s i b l efor distributing an annual budgetof approximately $80 million.The committee receives pro p o s-als that have already underg o n escientific re v i e w, and is re s p o n-sible for funding a compre h e n-sive and balanced portfolio ofre s e a rch grants.

Paul Turek, MD, waselected to the presti-gious Haile T. DebasAcademy of Medical Ed-ucators. The Academy isdedicated to enhancingthe status of teachers ofmedical students atUCSF, and promotesand rewards teachingexcellence and curricular

innovation. His application wasselected for membership by na-tional and international experts inmedical education for his workwith the medical school curricu-lum and his teaching skills. Turekcelebrated his membership inSeptember at a ceremony anddinner with other members of the Committee.

Members of the department have published extensively in the past year.A few recent highlights are noted below.

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Paul Turek Wendell Van Auken

Peter Carroll, MDProfessor and Chair Specialty: Urologic Oncology

Tom Lue, MDProfessor and Vice ChairSpecialty: Erectile Dysfunction and Neurourology

Jack McAninch, MDProfessor and Vice ChairSpecialty: Urologic Trauma and Urogenital Reconstructive Surgery

Laurence Baskin, MDAssociate ProfessorSpecialty: Pediatric Urology

Jeanette Brown, MDProfessor, Obstetrics, Gynecologyand Reproductive Sciences, Epidemiology & Biostatistics, andUrology

June Chan, ScDAssistant ProfessorEpidemiology & Biostatistics and Urology

Gerald Cunha, PhDProfessor, Anatomy, Obstetrics, Gynecology and Reproductive Sciences, and Urology

Rajvir Dahiya, PhDProfessor

Frank Hinman, Jr., MDClinical Professor

Christopher Kane, MDAssociate ProfessorSpecialty: Laparoscopy and Urologic Oncology

Sara Knight, PhDAssistant Professor Psychiatry and Urology

Ching-Shwun Lin, PhDAssociate Professor

Maxwell Meng, MDAssistant ProfessorSpecialty: Laparoscopy and Urologic Oncology

Hiep Thieu Nguyen, MDAssistant ProfessorSpecialty: Pediatric Urology

Renee Reijo Pera, PhDAssistant Professor, Genetics, Obstetrics, Gynecology and Repro-ductive Sciences, Physiology, andUrology

Mack Roach III, MDProfessor, Radiation Oncology and UrologySpecialty: Radiation Oncology

Katsuto Shinohara, MDAssociate ProfessorSpecialty: Urologic Oncology and Urologic Ultrasonography

Marc Shuman, MDProfessor, Medicine and UrologySpecialty: Medical Oncology

Eric Small, MDProfessor, Medicine and UrologySpecialty: Urologic Oncology

Marshall Stoller, MDProfessorSpecialty: Endourology, Laparoscopy and Stone Disease

Emil Tanagho, MDProfessorSpecialty: Neurourology, Reconstructive Urology, Urinary Incontinence and Urodynamics

Paul Turek, MDAssociate ProfessorSpecialty: Male Infertility and Reproduction

Frederic Waldman, MD, PhDProfessor, Laboratory Medicine and Urology

John Witte, PhDProfessor, Epidemiology & Biostatistics and Urology

Faculty

University of CaliforniaSan Francisco

School of MedicineDepartment of Urology

EditorPeter Carroll

Managing EditorMalinda Walker

Contributing EditorLeslie Lingaas

Copy EditorDaniel Rowe

DesignVictoria Magbilang

PhotographyCherie Cordellos, ChristineJegan, Jennifer Sauer

Produced by University Publications/Public Affairs,PR 146, 12.03

UCSF Urology is published bythe Department of Urology topresent developments in re-search and clinical practicesmade within the department.

Please send comments andinquiries to:Newsletter staffUCSF Department of UrologySan Francisco, CA 94143-1695415/885-7723mwalker@urol.ucsf.edu