Surgery Research Labs

Research in the Department of Surgery is both clinical and translational. Experts from multiple disciplines study specific diseases and disorders in order to improve human health and well-being. As the state's only academic health center that receives public funding, OHSU's breakthrough research leads to new cures, new standards of care, and a better understanding of the basic science that drives biomedical discovery.

Please explore our numerous research divisions and projects, including research in cancer, nutrition, trauma care, general surgery and vascular surgery.

Featured Projects

Volunteer Opportunities

Contact Us

Samantha Underwood, MS, CCRP 
Research Manager
tel 503 494-8481
fax 503 494-6519

TOP-UP

A Randomized Trial of Supplemental Parenteral Nutrition in Under and Over Weight Critically Ill Patients

Principal Investigator
Robert Martindale, M.D., Ph.D.

What is the TOP-UP study?
The purpose of this study is to examine the effect of giving additional nutrition through an intravenous (IV) line inserted into the arm (called parenteral nutrition or PE) compares with the standard of care nutrition in critically underweight and overweight patients. Another purpose of this study is to understand if a larger study of this patient population is possible.

Who will be included?
Any critically ill patients in the ICU who are receiving nutrition through a feeding tube and mechanical ventilation will be eligible.

What is involved?
All patients will be scheduled to receive standard nutrition through a feeding tube into their stomach (enteral nutrition or EN) whether or not they are participating in the study. Patients who are enrolled into the study will be placed into one of two treatment groups (listed below). Half of the participants will be randomized (like flipping a coin) to the experimental group and half to the control group.

Experimental Group (supplemental nutrition)
Patients in this group will also be given a nutrition supplement through an intravenous (IV) line inserted in their arm. The supplemental IV nutrition is a mixture of amino acids (proteins), fat, and sugar. Amino acids are one of the building blocks for proteins and play an important role in the body’s essential functions. The sugars and fat are the chief source of energy in the body. The supplemental IV nutrition will be given to them in addition to the enteral nutrition to provide added calories and protein.

Control Group (regular nutrition)
Patients in this group will not receive any supplemental nutrition through an intravenous (IV) line for at least the first 7 days of the study.

If patients receive the supplemental IV nutrition, they will get the supplemental nutrition for at least 7 days during their stay in the ICU. If they leave the ICU before 7 days, the IV treatment will continue until day 8 or until they are able to eat enough food by mouth. Feeding through the stomach (enteral nutrition) will be stopped when their feeding tube comes out.

If patients (or their family’s) agree to participate in this study, study staff members will collect and store information about them in a secured database. This information will be about their general health, medical history, reason for being admitted into the ICU, and nutritional status. Patients will also be asked questions about their quality of life and health status as part of this study. They will be asked these questions at the beginning of the study, when they are discharged from the hospital, and 3 months and 6 months after they were admitted into the ICU. For the 3 month and 6 month follow-up assessments, we will call the patients and ask them these questions over the phone.

During the time patients are given enteral and/or supplemental nutrition as part of this study, we will collect data about how well they comply with taking the nutrition and whether there are any interruptions in the nutrition being given.

In order to measure physical strength, patients will be asked to take part in activities to see about the strength of their muscles while they are in the hospital. To do this, we will ask them to do a 6-minute walk test just prior to when they are discharged from the hospital, if they agree and are able to. This test measures how far they can walk in 6 minutes.

We will also ask that patients complete a hand grip test when you are discharged from the ICU and from the hospital. This test measures how hard they can grip. Patients will have to hold a small device in their hand and grip the device three times in a row for 5 seconds each. We will measure the pressure of their grip in pounds and record this information.

The femoral ultrasounds are done to assess the muscle layer thickness. These ultrasounds will be done at or around admission into the hospital, and then each week patients are admitted for up to 4 weeks. This ultrasound requires that they lay flat in their bed so that technician may put gel on their thigh and move the ultrasound probe along their thigh for up to 20 minutes to take measurements.

Breast Cancer Prevention Plan

Develop a Breast Cancer Prevention Plan by Determining what Genetic Changes Transform Normal Stem Cells into Cancer Stem Cells

Principal Investigator: SuEllen Pommier, MD

What is the purpose of this study?

This study moves us closer toward understanding how breast cancer begins. Our research and that of others shows that breast cancer likely starts in normal breast stem cells.  It is thought that normal breast stem cells are responsible for the normal development of breast tissue. When the genetic material (DNA) of normal breast stem cells becomes damaged, these cells are changed into breast cancer stem cells. Because stem cells are quite powerful, a defective stem cell, called a cancer stem cell, is a serious disease threat. Therefore, as a strong step towards a cure we must determine the genetic defects that change normal breast stem cells into breast cancer stem cells. This study will try to achieve that that goal.

Why do this study?

The genetic differences between normal and cancer stem/progenitor cells that are identified in this study will be used to make a catalog of abnormalities that are found in cancer stem cells. Other cancer stem cells can then be studied to see if they have similar abnormalities. From this information, scientists can determine how breast cancer begins and how to develop medications that will cure this disease.

Who will be included?

Women will be asked to participate if they are undergoing an operation to remove cancer from the breast or an operation to reduce the size of their breasts.

What is involved?

The size of the tissue samples that will be collected during operation and used in this study will be up to the size of a sugar cube in total. In the laboratory, breast stem cells will be removed from the tissues and the genetic material collected. Using molecular tests, scientists will examine genes in the stem cells that are known to be involved in normal cell behavior and in cancer. From this study we will learn what makes normal stem cells different than cancer stem cells.

Breast Cancer Stem Cells

Gene Expression and Mutation Profiles in Breast Cancer Stem Cells

Principal Investigator: SuEllen Pommier, Ph.D.

What is the purpose of this study?

This study moves us closer toward understanding how breast cancer begins. Our research and that of others shows that breast cancer likely starts in normal breast stem cells.  It is thought that normal breast stem cells are responsible for the normal development of breast tissue. When the genetic material (DNA) of normal breast stem cells becomes damaged, these cells are changed into breast cancer stem cells. Because stem cells are quite powerful, a defective stem cell, called a cancer stem cell, is a serious disease threat. Therefore, as a strong step towards a cure we must determine the genetic defects that change normal breast stem cells into breast cancer stem cells. This study will try to achieve that that goal.

Why do this study?

The genetic differences between normal and cancer stem/progenitor cells that are identified in this study will be used to make a catalog of abnormalities that are found in cancer stem cells. Other cancer stem cells can then be studied to see if they have similar abnormalities. From this information, scientists can determine how breast cancer begins and how to develop medications that will cure this disease.

Who will be included?

Women who are planning to undergo an operation to remove cancer in the breast or an operation to reduce the size of their breasts will be recruited.

What is involved?

For this study, breast tissue specimens will be obtained from women undergoing reduction mammoplasty, with no previous history of breast cancer and from women who have been diagnosed with breast cancer. Samples for this study will be obtained at the time of the operation. For cancer patients samples will be collected at the time of the mastectomy or lumpectomy, prior to any neoadjuvant chemotherapy, hormonal therapy or radiation treatment. No additional tissue will be removed for this study that would not have been removed during a   lumpectomy, mastectomy or breast reduction surgery.

The size of the tissue samples that will be collected during operation and used in this study will be about the size of a sugar cube. In the laboratory, breast stem cells will be removed from the tissues and the genetic material collected. Using molecular tests, scientists will examine genes in the stem cells that are known to be involved in normal cell behavior and in cancer. From this study we will learn what makes normal stem cells different than cancer stem cells.

    Esophageal Cancer

    Impact of Cellular Markers on Clinical Response after Treatment for Esophageal Cancer

    Principal Investigator: James Dolan, MD

    What is the purpose of this study?

    We are attempting to improve the treatment process for patients with esophageal cancer. This cancer is increasing in incidence and is difficult to treat or cure which leads to poor survival even after current treatment with chemotherapy, radiation and surgery. In this study, we will use cancer tissue that is already available to us to test for the presence of a specific group of cancer cell markers that have been, individually, found to predict either good or poor outcomes after the treatment of esophageal cancer.

    Why do this study?

    Tissue from biopsies of patients with esophageal cancer will be the only tissue used for testing. One group will comprise tissue from patients who are known to have responded well to medical and surgical treatment and the other group will use tissue derived from patients who are known to have responded poorly to medical and surgical treatment. Tissue from each group will be tested for the presence of a defined group of cell markers that have been individually linked to good or poor outcomes after treatment of esophageal cancer. The two groups will then be compared in regard to the measured levels of the markers present on the cancer cells and we will attempt to determine, by direct comparison of the two groups, what arrangement of cell markers predict a good or a bad outcome after treatment.

    Who will be included?

    This study will use the tissue and data that have already been collected from esophageal cancer patients and stored in the Natural History of Esophageal Cancer and Related Diseases (ECRD) tissue bank (eIRB #1759). We would also like to obtain tissue and limited (non-PHI related) information from non-consented subjects by utilizing a Waiver of Authorization.

    What is involved?

    All esophageal cancer patients are currently approached to join the ECRD (IRB1759) study during the course of their treatment at OHSU. Those who choose to join the study are evaluated and treated according to current medical and surgical standards of care in order to attempt to cure them of their cancers. As part of the ECRD study, tissue gathered during pre-treatment biopsy and postoperative surgical specimens are currently stored in the ECRD tissue bank. Portions of this tissue will be used in this proposed study and will be tested for the presence of a certain set of cell markers. Subject study data will be collected by the ECRD as part of their routine study practice. In addition, esophageal tissue and subject data will be gathered on subjects who have had an esophageal surgical procedure for esophageal cancer at OHSU. For these non-consented subjects, a Waiver of Authorization will be obtained from the OHSU IRB. No personal health information will be collected on non-consented subjects. Subjects will not be contacted as part of this study. Subjects are assigned a unique identifier which is linked to the subject tissue id number. Specific data variables will be requested from the ECRD or queried from OHSU medical records. All data transfers will occur using a shared secure network server.

    N-TA3CT

    Non-Invasive Treatment of Abdominal Aortic Aneurysm Clinical Trial

    Principal Investigator
    Amir Azarbal, M.D.

    Study Purpose
    The primary aim of this study is to determine if doxycycline (100 mg bid) will inhibit (by at least 40%) the increase in greatest transverse diameter of small abdominal aortic aneurysms (3.5-5.0 cm in men, 3.5-4.5 cm in women) over a 24-month period of observation in comparison to a placebo-treated control group.

    Study Procedure
    N-TA^3CT is a randomized, double-blind, placebo-controlled test of the hypothesis that doxycycline 100 mg bid, will reduce the rate of increase of maximum transverse diameter of small (3.5-5.0 cm among men and 3.5 to 4.5 cm among women) abdominal aortic aneurysms. The primary outcome is abdominal aortic aneurysm (AAA) maximum transverse diameter determined by CT scans at two-year follow-up with allowance for baseline (pre-randomization) diameter. Based on an anticipated growth rate of 2.5 mm per year in the placebo group and the current threshold at which surgical intervention will be offered to trial participants, (5.5 cm in men, 5.0 cm in women), the upper limit of AAA size for inclusion has been set at 5.0 cm for men and 4.5 cm for women. Among these subjects, the threshold for repair would be exceeded only by those exhibiting persistent growth. Secondary outcomes will determine if doxycycline affects other measures, e.g., MMP-9 levels in plasma and whether these effects are related to aneurysm growth. Fifteen clinical sites have identified pools of over 900 patients with small aneurysm who meet the proposed inclusion/exclusion criteria. Two hundred forty-eight patients will be randomized to placebo or doxycycline and their aneurysms followed for change in diameter at six-month intervals using CT imaging. The alternative hypothesis is that doxycycline will inhibit the expansion rate by 40% during the two years of observation. Patients enrolling in N-TA^3CT must be able to give consent for their participation themselves and meet study eligibility criteria.

    For more information, contact Amir Azarbal, M.D.