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Endocrine Surgery

Research Highlights

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Drs. Fahey and Zarnegar in the research lab
Our group has focused on clinical and basic science research in a variety of aspects of endocrine disorders. Most thyroid cancer is diagnosed preoperatively by obtaining a biopsy of the thyroid using fine needle aspiration (FNA). However, a significant proportion of these biopsies are hard to interpret. Therefore, patients are having surgical resection of their thyroid to differentiate benign for cancerous lesions when the FNA cannot distinguish between them.

For Our Patients

Click below for helpful information about your visit.

With the increasing prevalence of thyroid cancer our researchers have been developing new techniques for differentiating benign thyroid nodules from thyroid cancer without surgery. Recently, our group identified a molecular basis for differentiating benign from malignant thyroid cancer. Based on these initial studies we plan to initiate clinical trials in patients with thyroid nodules. The aim of these studies is to optimize the preoperative evaluation in order to help direct the surgery, or guide the decision not to have surgery.

Our group is also involved in multiple clinical studies focused on improved diagnosis, and management of numerous endocrine disorders. Many of these studies are multicenter involving other prominent centers for the management of endocrine disorders worldwide.

Recent Publications

  1. Zarnegar R, Lee J, Brunaud L, Lindsey S, Kebebew E, Clark OH, Duh QY. Good blood pressure control on anti-hypertensives, not response to spironolactone, predicts improved outcome after adrenalectomy for aldosteronoma. Accepted in Surgery: Publication Pending
  2. Zarnegar R, Bloom AI, Lee J, Kerlan RK, Wilson MW, Laberge JM, Gordon R, Kebebew E, Clark OH, Duh QY. Is Adrenal Venous Sampling Necessary in all patients with hyperaldosteronism prior to adrenalectomy? Accepted in Journal of Vascular and Interventional Radiology: Publication Pending.
  3. Lee J, Sogutlu G, Leard L, Zarnegar R, Bailey J, Golden J, Hays S, Kebebew E, Duh QY, Clark OH. Lung transplantation for pulmonary metastases and radiation-induced pulmonary fibrosis after radioactive iodine ablation of extensive lung metastases for papillary thyroid carcinoma. Thyroid. 2007. 358(1):66-72
  4. Fernandez-Ranvier GG, Khanafshar E, Jensen K, Zarnegar R, Lee J, Kebebew E, Duh QY, Clark OH. Parathyroid carinoma, atypical parathyroid adenoma, or parathyromatosis? Cancer. 2007. 110(2):255-64
  5. Lubitz C, Fahey TJ III. Gene Expression Profiling of Thyroid Tumors: Clinical Applicability. Nature Clinical Practice Endocrinology and Metabolism, 2006 Sep;2(9):472-3.
  6. Lubitz C, Ugras SK, Kazam JJ, Zhu B, Scognamiglio T, Chen Y-T, Fahey TJ III. Microarray Analysis of Thyroid Nodule Fine Needle Aspirates Accurately Classifies Benign and Malignant Lesions. J Molecular Diagnostics, 2006 Sep;8(4):490-8.
  7. Marchal F, Elias D, Rauch P, Zarnegar R, Leroux A, Stines J, Verhaeghe JL, Guillemin F, Carteaux JP, Villemot JP; Prevention of Biliary Lesions That May Occur During Radiofrequency Ablation of the Liver: Study on the Pig. Ann Surg 2006; 243(1): 82-88
  8. Klein M, Brunaud L, Muresan M, Barbe F, Marie B, Sapin R, Vignaud JM, Chatelin J, Angioi-Duprez K, Zarnegar R, Weryha G, Duprez A; Recombinant human thyrotropin stimulates thyroid angiogenesis in vivo. Thyroid. 2006;16(6): 531-536
  9. Brunaud L, Kebebew E, Sebag F, Zarnegar R, Clark OH, Duh QY; Observation or laparoscopic adrenalectomy for adrenal incidentoloma? A surgical decision analysis. Med Sci Monit. 2006; 12(9): CR 355-362
  10. Triponez F, Poder L, Zarnegar R, Goldstein R, Roayaie K, Feldstein V, Lee J, Kebebew E, Duh QY, Clark OH; Hook needle-guided excision of recurrent differentiated thyroid cancer in previously operated neck compartments: a safe technique for small non-palpable recurrent disease. J Clin Endocrinol Metab. 2006
  11. Brunaud L, Bresler L, Zarnegar R, Ayav A, Cormier L, Tretou S; Does Robotic Adrenalectomy Improve Patient Quality of Life when Compared to Laparoscopic Adrenalectomy? World J Surg 2004; 28(11): 1180-1185
  12. Park JW, Zarnegar R, Kanauchi H, Wong MG, Hyan WC, Ginzinger DG, Lobo M, Cotter P, Duh QY, Clark OH: Troglitazone, the Peroxisome Proliferators-Activated Receptor-Gamma Agonist, Induces Antiproliferation and Redifferentiation in Human Thyroid Cancer Cell Lines. Thyroid 2005; 15(3): 222-231
  13. Lubitz C, Fahey TJ III The Differentiation of Benign and Malignant Thyroid Nodules. Adv Surg 39:355-77, 2005.
  14. Finley D, Lubitz C, Wei C, Zhu B, Fahey TJ III. Advancing the Molecular Diagnosis of Thyroid Nodules: Defining Benign Lesions by Molecular Profiling. Thyroid, 15(6):562-8, 2005.
  15. Lubitz C, Gallagher L, Finley D, Zhu B, Fahey TJ III. Molecular Analysis of Minimally Invasive Follicular Carcinomas by Gene Profiling. Surgery, 138:1042-8, 2005.
  16. DeRubertis BG, McGinty J, Rivera M, Miskovitz PF, Fahey TJ III. Laparoscopic distal pancreatectomy for inflammatory pseudotumor of the pancreas. Surgical Endoscopy, 18:1001, 2004.
  17. Finley D, Arora, N, Zhu B, Gallagher L, Fahey TJ III. Molecular Profiling Distinguishes Papillary Carcinoma from Benign Thyroid Nodules. J Clin Endo Metab, 89:3214-23, 2004.
  18. Finley D, Zhu B, Barden CB, Fahey TJ III. Discrimination of Benign and Malignant Thyroid Nodules by Molecular Profiling. Annals of Surgery, 240: 425-36, 2004.
  19. Finley D, Zhu B, Fahey TJ III. Molecular Analysis of Hurthle Cell Neoplasms by Gene Profiling. Surgery, 136:1160-8, 2004.
  20. Teng L, Specht MC, Barden CB, Fahey TJ III. Antisense hTERT inhibits thyroid cancer cell growth. J Clin Endo Metab, 88:1362-1366, 2003.
  21. Barden CB, Shister KW, Zhu B, Guiter G, Greenblatt DY, Zeiger MA, Fahey TJ III. Classification of Follicular Thyroid Tumors by Molecular Signature: Results of Gene Profiling. Clinical Cancer Research, May, 2003.
  22. Finley D, Fahey TJ III. Molecular diagnosis of thyroid carcinoma: Review of biological markers and advances in microarray technology. Recent Res Devel Cancer 5:117-130, 2003.
  23. Brunaud L, Zarnegar R, Wada N, Ituarte P, Clark OH, Duh Q-Y: Incision Length for Standard Thyroidectomy and Parathyroidectomy. When is it Minimally Invasive? Arch Surg. 2003; 138: 1140-1143
  24. Brunaud L, Zarnegar R, Wada N, Magrane G, Wong M, Duh Q-Y, Davis O, Clark OH: Chromosomal Aberrations by Comparative Genomic Hybridization in FNMTC. Thyroid 2003; 13(7): 621-629
  25. Hung, C.J, Ginzinger D, Zarnegar R, Kanauchi H, Wong M, Kebebew E, Clark OH, Duh Q-Y; Expression of Vascular Endothelial Growth Factor-C in Benign and Malignant Thyroid Tumors. JCEM 2003; 88(8): 3694-3699
  26. Specht MC, Tucker O, Hocever M, Gonzalez D, Teng L, Fahey TJ III. Cyclooxygenase-2 Expression in Thyroid Nodules. JCE M 87(1):358-363, 2002.
  27. Nadler, EP, Novikov A, Landzberg BR, Pochapin MB, Centeno B, Fahey TJ III and Spigland N. The Use of Endoscopic Ultrasound in the Diagnosis of Solid Pseudopapillary Tumors of the Pancreas in Children, J Pediatr Surg 37:1370-73, 2002.
  28. Zarnegar R, Brunaud L, Kanauchi H, Wong M, Ginzinger D, Fung M, Duh Q-Y, Clark OH: Increasing the Effectiveness of Radioiodine Therapy in Thyroid Cancer using Trichostatin A, a Histone Deacetylase Inhibitor. Surgery. 2002 Dec; 132 (6): 984-90; discussion 990
  29. Brunaud L, Cormier L, Ayav A, Klein M, Roumier X, Zarnegar R, Bresler L, Boissel P: La taille d'un phéochromocytome influence-t-elle les résultants de son exérèse par voie laparoscopique? Ann Chir 2002; 127(5): 362-369
  30. Specht MC, Romero M, Barden CB, Esposito C, Fahey TJ III. Characteristics of Patients Having Thyroid Surgery Under Regional Anesthesia. JACS, 193(4):367-372, 2001
  31. Specht MC, Barden CB, Fahey TJ III. p44/p42-MAP Kinase Expression in Papillary Thyroid Carcinomas Surgery, 130:936-40, 2001.
  32. McLean AL, Broussard E, McCarter MD, Calvo T, LoPresti P, Marzulli V, Fahey TJ III. Laparoscopic marsupialization of nonparasitic splenic cysts. Contemp Surg 56:541-5, 2000.
  33. Teng L, Tucker O, Malchoff C, Vaughan ED, Jacobson J, Fahey TJ III. Telomerase activity in the differentiation of benign and malignant adrenal tumors. Surgery, 124:1123-7, 1998.
  34. Siegelman M, Mohabeer A, Fahey TJ III, Tomlinson G, Mayambala C, Jafari S, Noll WW, Thibodeau SN, Dawson DB. Rapid, nonradioactive screening for mutations in exons 10, 11, and 16 of the RET protooncogene associated with inherited medullary thyroid carcinoma. Clin Chemistry. 43:453-7, 1997.
  35. Yashima K, Vuitch F, Gazdar AF, Fahey TJ III. Telomerase activity in benign and malignant thyroid diseases. Surgery 122:1141-6, 1997.
  36. Fahey TJ III, Reeve TS, Delbridge L. Increasing incidence and changing presentation of thyroid cancer over a thirty year period. BJS 82:518-520, 1995.
  37. Lean CL, Delbridge L, Russell P, May GL, Roman S, Fahey TJ III, Dowd S, Mountford CE. Diagnosis of benign follicular thyroid lesions by proton magnetic resonance on fine needle biopsy. JCE&M 80:1306-11, 1995.

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