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spring 2011
Insight and news from Johns Hopkins Medicine
What Do These
Have in Common?
See how Johns Hopkins researchers
lead groundbreaking studies that may transform lives
Contents
S P R I N G 2 011
ore than Skin
4| MDeep Qu ic k Con s u lt
Discover why people of all
ethnicities should check for
skin cancer.
Good Night, Sleep
5|Tight Sleep apnea could be
affecting your child’s health
and development.
10|An Unbeatable Team First Pe rson
Surgeons guided Steve
Lucido back to normal after
prostate cancer.
Just
old age
– or brain
fluid
buildup?
11|Investigating
S econ d Opi n ion
Minimally Invasive Uncover whether this
surgical technique may
be right for you.
ON THE COVER
6| Promising Pursuits
Meet Johns Hopkins
researchers who are
exploring ways to make
our lives better.
Join Our Online
Communities
@HopkinsMedNews
YouTube.com/johnshopkinsmedicine
Search Johns Hopkins Medicine
Learn more
News and publications
Hopkinsmedicine.org/news
Clinical trials
Trials.johnshopkins.edu
ealth seminars
H
Hopkinsmedicine.org/healthseminars
|
2 | johns hopkins health
spring 2011
S
ure, poor balance, forgetfulness and
trouble with vision and hearing can all
come with advancing age. But sometimes symptoms like these can mask a
condition called hydrocephalus—aka fluid
on the brain. Although the disorder can occasionally be secondary to head trauma, brain
infections or bleeding in the brain, often there
is no identifiable cause. So it’s not surprising
that older adults suffering with the condition can easily be misdiagnosed, says Johns
Hopkins neurologist Abhay Moghekar, M.D.
Key signs of hydrocephalus—trouble with
balance, motor control, memory and urinary
continence—can mimic symptoms of other
conditions that typically show up in older
adults, like weakened joints, osteoarthritis,
nerve disorders and Parkinson’s disease. “The
symptoms of hydrocephalus are so common,”
Moghekar says, “that diagnosis really needs a
good clinician.”
Diagnosis begins with an MRI, but other
tests must be done to confirm the need for
surgery in which shunts are inserted into the
brain to drain fluid.
For more information, appointments or
consultations, call 877-546-1872 or visit
hopkinsmedicine.org/neuro.
877-546-1872 | hopkinsmedicine.org/usa
healthinsights
get
engaged
Get Answers
to Your Health
Questions When
You Need Them
Eight in 10 Internet users have looked
online for health information, whether
it’s to research symptoms or get support
in caring for a loved one. Johns Hopkins
Medicine has teamed with a new consumer health Web site designed to
gather the collective wisdom of many
different health organizations in one
place, making it easier for you to get the
answers you need.
The site, sharecare.com, comes from, among others, physician and popular television personality Dr. Oz. Visitors can explore health topics presented in an intuitive Q&A
format, covering subjects that run the gamut from diabetes to infections to brain tumors.
Sharecare.com gives you convenient access to vetted health knowledge from Johns
Hopkins experts as well as videos and books by Johns Hopkins clinicians, and reminders
about Johns Hopkins online seminars and other events.
For more information, visit sharecare.com/group/johns-hopkins-medicine.
With Inflammatory Bowel Disease,
Sticking to Treatment Is Key
Adjusting to life with a chronic medical condition is never easy. For the approximately
1 million Americans who have inflammatory
bowel disease (IBD), an often-debilitating
disorder of the gastrointestinal tract, there
is pain, the need for medication and
unpredictability. Both forms of IBD, Crohn’s
disease and ulcerative colitis, are characterized by inflammation of the digestive tract
and can cause abdominal pain, diarrhea and
weight loss.
Treatment for either form of IBD
requires taking medications for the long
haul, says Mark Lazarev, M.D., a Johns
Hopkins gastroenterologist who specializes
in treating patients who have these conditions. All medications aim to bring symptoms
under control and reduce flare-ups by
decreasing and suppressing inflammation.
Still, finding which treatment is going to work
best for each patient can take time. Patients
sometimes think they only need to take their
medications when they’re having symptoms.
But the best chance for treatment success,
Lazarev says, involves patients taking their
medication every day as prescribed, and
consulting with their doctors if they feel the
medication isn’t working, or if they are experiencing any kind of side effect.
“We see many patients who are feeling
well and decide to stop the medication,”
Lazarev says. “If people stop the medications,
they’re going to relapse. IBD does not go
away on its own.”
Learning about your health
just got easier than ever.
From the comfort of your
own home or wherever you
have an Internet connection, you can access Johns
Hopkins’ new online health
education programs and
engage real-time with a
Johns Hopkins physician.
These online educational programs
allow you to learn more
about health topics ranging from common sinus issues to
complex neurological conditions.
Each program features a 20- to
30-minute presentation by a Johns
Hopkins physician followed up by
an interactive Q&A session where
viewers are encouraged to submit
their questions via e-mail. All questions are kept anonymous and
confidential.
Check out upcoming programs
that include diagnosing and
treating pediatric sleep apnea
and living with and managing
the symptoms of inflammatory
bowel disease. You can also
view previous online presentations at hopkinsmedicine.org/
healthseminars.
FREE
Online Seminar
Weighing the
Options:
The Benefits and Risks
of IBD Medications
Wednesday, May 25, 7–8 p.m.
Join Johns Hopkins inflammatory bowel
disease specialist Mark Lazarev, M.D., as he
discusses IBD, available medical treatment
options and the risks and benefits of
various therapies. To register, visit
hopkinsmedicine.org/
healthseminars.
For more information, appointments
or consultations, call 877-546-1872
or visit hopkins-gi.org.
hopkinsmedicine.org/usa | 877-546-1872
spring 2011
johns hopkins health | 3
|
quickconsult
More than
Skin Deep
Cancer doesn’t care about
the color of your skin, so
make sure to get an easy
and painless annual
screening
Should I worry about skin
cancer if I have darker skin?
Doesn’t the pigment in brown
skin protect me?
Risks and types of skin cancer can vary widely
among different ethnic groups. If you have brown
skin, the increased pigment does protect you from
skin cancers caused primarily by sun exposure.
But the sun isn’t the only cause. For example, the
most common type of skin cancer in AfricanAmericans—called squamous cell carcinoma—
can develop from chronic trauma or a chronic
wound. For people with brown skin, melanomas
tend to occur in areas that aren’t exposed to the
sun, such as the soles of the feet, palms of the
hands, nail beds and inside the mouth.
How do I check for skin
cancer?
Check your skin about once a month, in addition
to a yearly routine follow-up with your doctor.
Be on the lookout for moles with asymmetry (dissimilar halves), irregular borders and a diameter
larger than 6 millimeters, or the size of a pencil
eraser. Change is really the name of the game, so
alert your physician if you notice a mole that has
changed in size, color or shape.
|
4 | johns hopkins health
spring 2011
Why should I go
to Johns Hopkins?
Johns Hopkins offers a full spectrum of skin cancer clinical care from
diagnosis to medical and surgical treatment. We have specialized programs for people who are at higher risk for skin cancers because of family
history. Other programs such as our unique Ethnic Skin Program focus
on the special skin cancer risks that affect ethnic groups like AfricanAmericans, Hispanics, Asians and Native Americans. And our multidisciplinary melanoma service combines the expertise of dermatologists,
surgical oncologists, and plastic and reconstructive surgeons.
What happens if skin cancer is discovered
during a screening?
When caught early, most skin cancers can be easily treated as an outpatient procedure with a very high cure rate. The specific treatment varies
depending on the type of skin cancer. For the most common types, Mohs
micrographic surgery is often used. Mohs is a technique used to remove the
cancer-containing tissue while leaving behind the most normal tissue. It has
up to a 99 percent cure rate and is especially useful for treating skin cancers
on the head and neck. It’s one of the many treatment options for skin cancer available at Johns Hopkins. Your doctor will discuss your options and
help you choose the best treatment. n
For more information, appointments or consultations,
call 877-546-1872 or visit hopkinsmedicine.org/dermatology.
877-546-1872 | hopkinsmedicine.org/usa
FREE
Online Seminar
Good Night,
Sleep Tight
Pediatric
Sleep Apnea
Wednesday, May 18, 7–8 p.m.
Learn more about pediatric sleep
apnea and treatment options from
Stacey Ishman, M.D., Johns Hopkins
pediatric otolaryngologist (ear, nose
and throat doctor). To register, visit
hopkinsmedicine.org/
healthseminars.
Put concerns to rest for children who
have a surprising disease: sleep apnea
I
t’s no secret that children need
plenty of rest. But what you may not know is a
sneaky sleep thief could be absconding with their
health and social development.
Although parents usually think of sleep apnea as
an adult disorder, it can strike at a young age. For
a condition known as pediatric obstructive sleep
apnea, “the prime time is between ages 2 and 6, but
I’ve seen it in newborns and teenagers,” says Stacey
Ishman, M.D., an otolaryngologist (ear, nose and
throat doctor) at Johns Hopkins.
When sleep apnea robs kids of a healthy amount
of shut-eye, they’re not only tired, but they also can
become irritable, hyperactive or aggressive. Wornout kids have a tougher time remembering facts and
focusing in school.
“Studies actually show that up to 50 percent of
kids with ADHD [attention deficit hyperactivity
disorder] have sleep-disordered breathing or sleep
apnea,” Ishman says. If left untreated, sleep apnea
can undermine your child’s health in surprising
ways, from putting the kibosh on growth hormone,
hopkinsmedicine.org/usa | 877-546-1872
which is secreted mostly at night, to putting your
child at greater risk for heart disease later in life.
Do you notice loud snores coming from your
baby monitor or child’s bedroom? There is reason
to suspect sleep apnea.
“The most common symptom is snoring that
usually happens regularly and is often loud enough
to hear through a closed door,” Ishman says. She
advises parents to listen for pauses in their child’s
breathing, which may sound like gasps or snorts,
during REM sleep, typically between 1 and 6 a.m.
For the only definitive diagnosis, children need
overnight sleep studies.
Pediatric sleep apnea is commonly treated
by a tonsillectomy and adenoidectomy, Ishman
says. Other treatment options include medication, weight management for overweight children
and continuous positive airway pressure (CPAP)
therapy. n
For more information, appointments or
consultations, call 877-546-1872 or visit
hopkinsmedicine.org/otolaryngology.
spring 2011
Days in
a Daze
Remember the exhaustion of caring for a wakeful
newborn? That’s the same
tiredness suffered by the
estimated 2 to 4 percent of
American kids with sleep
apnea, says Stacey Ishman,
M.D., an otolaryngologist at
Johns Hopkins. Symptoms
include:
w D
aytime
sleepiness
or
daydreaming
H
yperactive behavior
L earning difficulties
A
ggressive, defiant
behavior
M
orning headaches
D
ifficulty waking in the
morning
M
ood changes and
irritability
w Inattention
w
w
w
w
w
w
johns hopkins health | 5
|
Promisin
Pursu
How Johns Hopkins researchers
lead groundbreaking studies that
may transform lives
|
6 | johns hopkins health
spring 2011
877-546-1872 | hopkinsmedicine.org/usa
ng
uits
S
c i e n t i f i c r e s e a r c h can seem
an endeavor far removed from most of our everyday lives. But much of it, whether it involves
studying strands of DNA or electrical signals
in the brain, is driven by the conviction that
someday the insights will be applied to restoring people’s
health—or even better, that it can help ensure they don’t
get sick in the first place.
As caught up as they may be in the process of basic
scientific insight, researchers are always looking for those
connections, and are thrilled to find them. Sure, they
know all too well that in the end their discoveries may not
turn out to be the hoped-for break. But just having a shot
at relieving human suffering is the great underlying motivator in biology research.
Johns Hopkins is home to researchers who have thrown
themselves into dramatic hunts for treatments and cures
spun off from basic research, with all the frustrating setbacks and exhilarating leaps that are part and parcel of
these quests. Here are five of these searchers, each at the
center of a project whose trail has led to a promising, if
tentative, avenue of treatment. Every research story is personal, but all share the medical researcher’s dual commitment to both scientific discovery and helping people. >
To learn more about The Johns Hopkins Institute for
Basic Biomedical Sciences, visit hopkinsmedicine.org/
institute_basic_biomedical_sciences.
hopkinsmedicine.org/usa | 877-546-1872
spring 2011
johns hopkins health | 7
|
The Squirrel’s Secret
R
onald Cohn, M.D., was mulling over the way that muscles
can shrink in debilitating ways in children and adults with a number
of disorders, as well as in the elderly. So Cohn, a researcher in Johns
Hopkins’ McKusick-Nathans Institute of Genetic Medicine, did what
most of us do when confronted with a puzzle.
“We wanted to learn from someone who has already solved the problem,” he says. In the case of muscle atrophy, the go-to experts turned out
to be ground squirrels. “Squirrels can hibernate for six months without
losing muscle,” explains Cohn, who specializes in both pediatrics
and genetics. “We wanted to understand how they do it, and see if
there’s a way to apply to it human conditions.”
Backed by a prestigious “New Innovator” grant of $1.5 million from the National Institutes of Health, Cohn had squirrels
shipped in from Wisconsin. Soon the critters were hibernating
in comfortable nests in basement refrigerators underneath
Cohn’s lab, breathing a mere four times a minute. When the
squirrels were eventually warmed, woken and chipper, their
muscles showed no sign of atrophy, or any of the scar tissue that
normally forms around injuries.
“They had been sitting in the refrigerator for months,” he
says, “not eating or drinking, and their muscles were acting like the
muscles in an athlete who is both running marathons and lifting weights.”
Something was clearly protecting the squirrels’ muscles during the long disuse.
Cohn and his team took to their microscopes, along with a range of state-of-theart genetic tests. They soon came up with a crucial clue: During hibernation the
squirrels’ muscle cells were pumping out high levels of a protein that isn’t normally
much seen in muscles.
Now Cohn and his team are studying that protein, called SGK, and
looking at the effects of raising levels of the protein in the muscles of nonhibernating mice.
“We’re hoping we can find that this protein is of some broad benefit to
muscle,” he says. “If it is, the results could eventually be helpful to patients
with many different types of inherited and acquired forms of muscle diseases,
and to those suffering from age-related muscle loss.”
For more
information
about research
at Johns Hopkins
Medicine,
visit hopkins
medicine.org/
research.
|
When a Gene
Does This, and
Not That
‘‘H
ow is your
brain different
than your colon?”
asks Andrew
Feinberg, M.D., M.P.H. That’s
not a silly riddle, explains
the Johns Hopkins cancer
researcher; it’s an intriguing
question that eventually could
point the way to breakthrough
treatments. That’s because every
cell in your colon has exactly the
same genes as every cell in your brain—and every other cell in your
body. (Except for sperm or egg cells, which have half as many genes.)
We think of genes as blueprints for how to build a You, cell by cell—
except why do the exact same blueprints produce very different body
parts? Even so-called identical twins can have significantly different
characteristics, in spite of identical genes.
“One twin can have autism while the other doesn’t,” Feinberg
explains.
8 | johns hopkins health
spring 2011
Several years ago Feinberg started to suspect those surprising differences might provide a critical clue to understanding and perhaps
preventing cancer. After all, he notes, there are many instances in the
human body where cells invade and spread into other organs as a normal and healthy biological process—including pregnancy. What could
make a cell with the same set of genes invade organs when it isn’t supposed to, thus becoming a cancer? The
answer, Feinberg reckoned, may have to
do with the way that segments of some
genes may undergo subtle chemical
changes called “methylation.”
“There’s a real interplay between
genes, the environment, and what happens in the body as it grows and ages,”
he says.
To better understand the effect of
methylation, Feinberg and colleagues
have led the way in mapping out which
genes seem to be affected by methylation in different people, with an eye to
spotting possible links to cancer, as well
as to other diseases and characteristics,
including obesity, psychiatric disorders and
aging-related ills. For starters, knowing
where to look for methylation could help
identify people at risk for certain disorders.
Over the long term, these methylation maps
could suggest strategies for drugs and other
treatments that might undo or compensate
for the effects of methylation.
877-546-1872 | hopkinsmedicine.org/usa
When
Genes
Weaken
Lungs
T
o a medical researcher, the term
“idiopathic” is like a red flag before a bull.
“When we call a disease ‘idiopathic,’ it basically
means we have no idea what causes it,” says Mary
Armanios, M.D. “And when we don’t know what causes it, we
usually can’t even begin to treat it.”
That’s why Armanios, a Johns Hopkins medical oncologist
and researcher, felt a bolt of excitement when she stumbled on a
surprising clue to a common and often devastating disease called
idiopathic pulmonary fibrosis (IPF) that leaves lungs mysteriously swelled with scarring. It meant she might have a chance to
strip away that frustrating first word from the disorder for some
patients, and open avenues to possible treatments.
Armanios had been studying a young man who had some of
the symptoms of IPF, which can in some ways resemble premature
aging, including hair that grays before high school and a thinning of some kinds of blood cells. (In fact, the disease was first
identified by Sir William Osler, one of the founders of the Johns
Hopkins University School of Medicine, who in 1892 noted that
certain patients had apparently succumbed to an unrecognized
disorder that left their lungs gray and shrunken.) The connection between IPF and premature aging had always been hazy,
but Armanios took a closer look at the young man’s genes and
found a distinctive pattern in the ends of the DNA known
as telomeres—a pattern that proved to turn up in many others with IPF, which often runs through families. Clearly, this
telltale disturbance in the telomere genes was the source of
the disorder, which meant that in these cases, the “I” could be
dropped from IPF. Armanios and others could begin the search
for ways to repair the damage caused by this gene problem.
Armanios’ efforts are already paying off by providing a
possible way of identifying people who are at higher risk
of the disorder, and who may be able to delay the onset
of symptoms by avoiding secondhand smoke and other
insults to their vulnerable lungs. (Most IPF
patients aren’t themselves smokers.) Right
now the most effective
treatment for the
full-blown illness is a
lung transplant, but
Armanios hopes to
use her genetic insight
to bring other tools
to bear.
“This form of the disease
affects about 15 percent of
the families that IPF turns
up in,” Armanios says.
“Over time we may be able
to learn how to intervene
with the progress of the
disease for these people,
or offer better treatments,
or improve the outcomes
for those who get lung
transplants.”
hopkinsmedicine.org/usa | 877-546-1872
Hairy Science
W
e hear with cells that have tiny hair bundles
on top and line our inner ears. Incoming sounds vibrate some
of these hair bundles, releasing a substance called glutamate
from their cells, which in turn triggers an electrical signal in nerve
fibers connected to the hair cells. That signal travels along the nerve to the brain,
which interprets the signal as a sound. But if only it were as simple as it, well,
sounds. The process of converting each and every incoming sound wave to a useful electrical
signal, notes Johns Hopkins neuroscientist Elisabeth Glowatzki, Ph.D., is in fact a complex
mechanical, chemical and electrical symphony of exquisite precision.
“We’re trying to zoom in to every one of these steps to understand how the inner ear shapes
the electrical signal in response to sound,” she says. “We need to understand how it all works if
we’re going to understand how hearing can deteriorate, and maybe how it can be repaired.”
To that end, Glowatzki’s team has pioneered a technique for recording electrical signals right
at the end of the nerve fibers where they’re generated, providing a never-before-seen peek at
the details of the signal. And that window into the inner ear’s signals is already providing new
insights. For example, one long-standing mystery is how an inner-ear hair cell manages to
generate a signal quickly and cleanly enough to allow catching the millionths-of-a-second delay
between when a sound reaches the two ears—a delay that enables the brain to tell what direction the sound is coming from. Now Glowatzki’s group is looking closely at the way the hair
cells coordinate the release of glutamate at their interfaces with as many as 20 nerve fibers to get
that precise timing.
These sorts of insights could pay off in much better inner-ear implants for people who have
hearing loss.
“Today’s implants use quite crude electrical stimulation of the nerve fibers in the inner
ear,” Glowatzki says. “If we can piece together the different steps that are involved in converting sound signals into electrical signals in nerve fibers, we should be able to design
an implant that can reproduce these signals better and produce a much more
realistic sound.”
name that FIELD
W
hat’s in a name? Even in science, a lot more than
you might think. That’s what Johns Hopkins researcher
Katherine Wilson, Ph.D., realized while writing a review on
the structural proteins that make up the cell’s nucleus—that
part of a cell that envelops and organizes our genes and affects much of
what happens in the rest of the cell and thus in our bodies.
“There were 81,000 papers on the biology of the cytoskeleton that
turned up in computer searches, but only 110 papers with the keyword
‘nucleoskeleton,’ ” she says. “People were doing great work. They just weren’t
making their papers ‘visible’ to bioinformatic searches.” She hopes this
situation will improve soon.
No wonder: Defective nucleoskeletal proteins are at the heart of several
important disorders. Wilson herself is focusing on X-linked Emery-Dreifuss
muscular dystrophy—the third most common type, and one that affects
only boys. Its cause turns out to be the lack of a nuclear membrane protein that is needed for the nucleus to respond appropriately to mechanical
force. The potentially good news is that it’s a small protein that seems a
good candidate for gene therapy, a treatment technique in which a harmless virus
could potentially deliver emerin into the muscles of boys who have the disorder.
“It’s still very experimental,” Wilson concedes. “First we need to show that it can
help emerin-deficient mice.” That’s what Wilson hopes to do soon. Backed by a
private grant, she recently teamed up with a gene-therapy researcher who just happens to have been her biochemistry teacher in college, and applied for a Muscular
Dystrophy Association grant to cover mouse and therapeutic virus costs.
With three young children, Wilson says it’s exhilarating to be back in the saddle
after a few years of sleep-deprivation. “After having done so much basic science
work with this protein emerin, it’s very exciting to be working on something that
could turn out to be a human therapy.” n
spring 2011
johns hopkins health | 9
|
firstperson
An Unbeatable Team
Faced with a diagnosis that every man dreads, Steve Lucido
discovered life can return to normal after prostate cancer treatment
My doctor
Men,
Cancer
and
Hope
w
w
w
ore than
M
2 million men
in the U.S. are
prostate cancer
survivors.
rostate cancer is
P
the second most
common form
of cancer in men
(after skin cancer).
adical
R
prostatectomy
surgery at Johns
Hopkins’ Brady
Urological Institute
is considered to
be the gold standard for cancer
treatment.
dropped the bombshell when I was age 56—just when my
wife and I were beginning to enjoy our newfound freedom after the youngest of our
three children had graduated from college and I was semi-retired as a real
estate developer. I lived a healthy and active lifestyle—I ran every day
and enjoyed paragliding, snowboarding, kayaking and mountain rescue
near our home in Beaver Creek, outside Vail, Colo. So I was stunned
when a routine blood test revealed my prostate-specific antigen
(PSA) level had suddenly shot up, a red flag for prostate cancer.
Even before a biopsy confirmed my worst fears, I dove into research
about prostate cancer and treatments. I discovered that Johns Hopkins
specializes in a way of performing prostate cancer surgery that minimizes
the dreaded long-lasting side effects—incontinence and impotence—
that once made the cure seem even worse than the disease. The surgical
technique spares the nerve bundles near the prostate.
I read all the bios of the different surgeons at Johns Hopkins online
and gravitated toward Dr. Edward Schaeffer. Not only is he a surgeon, but a researcher, and that’s exactly the type of person I
wanted to deal with a situation like mine. I fired off an e-mail
to him with my bio, diagnosis and how I found out I had
cancer. I was surprised when he called me about five minutes after I hit “send.” We talked for at least 45 minutes,
and when I hung up the phone I knew he was my surgeon.
Dr. Schaeffer performed my open radical prostatectomy on Oct. 6, 2008, and afterward he told me he felt
really good about the surgery. He felt that he had gotten
everything and was confident that I was going to heal
well and be cancer-free.
Today, I’m extremely grateful for Dr. Schaeffer’s
expertise and the cutting-edge surgical techniques available at Johns Hopkins that have made it possible for me to
remain cancer-free for more than two years—without the
dreaded side effects. In fact, I learned to surf shortly after
my surgery, and soon I’m hoping to learn to sail. n
In His Own Words
To watch a video of Steve Lucido telling his story, visit
hopkinsmedicine.org/mystory. For more information,
appointments or consultations, call 877-546-1872.
|
10 | johns hopkins health
spring 2011
Investigating
Minimally
Invasive
secondopinion
The facts versus
the hype of this
surgical technique
A
lthough minimally invasive
surgery is nothing new, the number
of conditions that can be treated with
it continues to grow. Despite its
surging popularity, however, it isn’t always the
right answer.
How do you know, then, when it’s right
for you?
In its broadest terms, minimally invasive
surgery can be used anywhere there is a cavity,
or a potential cavity, in the body, says Anne
Lidor, M.D., assistant professor of surgery at
The Johns Hopkins Hospital and a leader in
physician training and education in minimally
invasive surgery. It typically replaces open
surgery with those involving small incisions,
robotics or lasers.
“The impetus for it is to decrease pain
and improve convalescence,” adds Mohamad
Allaf, M.D., director of minimally invasive and
robotic surgery in the Department of Urology.
There are all types of minimally invasive surgeries for all types of conditions, he says. Most
people tend to think of laparoscopic surgery,
during which a telescopic lens magnifies the
area of surgery and enables a doctor to operate
within the confines of a small incision.
Technology has improved so much that
surgeries can be conducted using a robotic
arm that works in ways a surgeon’s hands or
fingers cannot, says Allaf, whose department
performs more than 1,000 minimally invasive
surgeries a year.
The most common in the U.S., Lidor
says, is laparoscopic gallbladder surgery.
But the technique can be used almost
anywhere in the body for a multitude of
conditions, ranging from pancreatic cancer
to weight-loss surgery.
But before you jump on the minimally
invasive bandwagon, consult with your physician first; the technique is not for everyone.
Allaf points out, for example, that a patient
with a large tumor will likely require the
traditional open surgery, as there is rarely
enough space to operate laparoscopically. Also,
“patients with lots of previous abdominal surgeries, with lots of scar tissue, can’t always have
laparoscopic surgery,” Lidor says. “The same is
true if you have a bad heart or lungs. You have
to look at the individual patient.” n
Excluding
Factors
The ideal candidate for
minimally invasive surgery
is a healthy patient who has
never had previous surgery.
Despite how the term is
bandied about, however, it’s
not always the best option.
If any of the following
conditions apply, minimally
invasive procedures may
not be for you.
w You suffer from severe
heart or lung disease.
w You have had multiple
surgeries.
w You have a lot of scar
tissue in the abdomen.
w You have advanced cancer.
For more information, appointments or consultations, call 877-546-1872 or
visit hopkinsmedicine.org/minimally_invasive_robotic_surgery.
hopkinsmedicine.org/usa | 877-546-1872
spring 2011
johns hopkins health | 11
|
Non Profit Org.
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Johns Hopkins Health
Marketing and Communications
901 S. Bond St., Suite 550
Baltimore, MD 21231
The Johns Hopkins Hospital has been consecutively ranked
the No. 1 hospital in America by U.S.News & World Report
for 20 years. hopkinsmedicine.org/usnews
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To find this issue online or
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Write
Johns Hopkins Health
c/o Marketing and Communications
901 S. Bond St., Suite 550
Baltimore, MD 21231
WASHINGTON, D.C.
Call
877-546-1872
W
e are pleased to offer you Johns Hopkins USA, a
convenient link to Johns Hopkins’ expertise—no matter
where you live. With one call, a caring, knowledgeable
coordinator will guide you through the best medical care in a way that
is tailored to your needs. And to ensure your trip to Baltimore is smooth
and comfortable, we’ll help you:
n S
chedule medical appointments with the right specialists
Make travel, lodging and transportation arrangements
n Know what to bring and what to expect
n
UNITED STATES
CANADA
To learn more or to request assistance, call
877-546-1872 or visit hopkinsmedicine.org/usa.
Kathy Smith
Director, Market Development
Steven J. Kravet, M.D.
Physician Adviser
Johns Hopkins Health is published quarterly by
the Marketing and Communications office of
Johns Hopkins Medicine. Information is intended
to educate our readers and is not a substitute
for consulting with a physician.
Designed by McMurry.