The Orthopaedic and Cosmetic Surgery Services in the College of Pittsburgh and also the Hands & UpperEx Center have further enhanced the collaboration and mix-fertilization of the particular Hands and Upper Extremity Fellowship Programs. This format provides an unparalleled experience of both skeletal and soft tissue facets of adult and pediatric hands surgery, including microsurgery, conducted both in an instructional setting along with a private surgery center atmosphere.
Trainees both in fellowship programs will attend joint conferences, didactic lectures, and Journal Clubs together. Rotation through both Orthopaedics and Cosmetic Surgery would create a diverse experience of every aspect of hands and upper extremity conditions. Backward and forward fellowships, there’s a total of seven positions for candidates finishing their residency learning Cosmetic Surgery, Orthopaedic Surgery, and/or General Surgery. Matched candidates may have the chance to become trained by 10 full-time faculty people, perform surgical treatments inside a condition-of-the-art free standing surgery center, in addition to complex upper extremity renovation and microsurgical procedures in the College Health Center of Pittsburgh. The school people include Frederick Imbriglia, MD, Glenn Buterbaugh, MD, Robert Goitz, MD, William Hagberg, MD, Marshall Balk, MD, Robert Kaufmann, MD, Aaron Grand, MD, Alex Spiess, MD, Alex Davit, MD, and Kia Washington, MD. Nearly all physicians have Certificates of Added Qualification in hands surgical procedures or are qualified for that CAQ.
Within the 12-month fellowship-training period, experience and responsibility are progressively elevated by the finish from the program each fellow feels safe and competent in most regions of shoulder, elbow and hands surgery, and microsurgical techniques.
Prerequisite resident education should be finished in an over-all surgery, orthopaedic surgery, or cosmetic surgery program accredited through the Accreditation Council for Graduate Medical Education (ACGME) or even the Royal College of Physicians and Surgeons of Canada.
Duration and Scope
The College of Pittsburgh Cosmetic Surgery Hands Program is really a one-year, ACGME accredited hands surgery fellowship program.
While a minumum of one clinical research study resulting in presentation and publication is anticipated throughout the fellowship year, significant fundamental and applied fundamental science research possibilities can be found. For individuals interested, research experience could be acquired in across the country known fundamental science research laboratories in the College of Pittsburgh.
The Tissue Engineering Laboratory
The Tissue Engineering Laboratory is directed by Kacey G. Marra, PhD, Assistant Professor of Surgery and Bioengineering. This laboratory conducts scientific analysis in multiple interdisciplinary areas. The scope of projects center around the fields of nerve regeneration and tissue engineering. Novel biomaterials are now being created for skin, bone, and nerve regeneration, having a strong concentrate on polymeric materials, both native and artificial. This laboratory isolates preadipocytes from human adipose tissue, and it is exploring applying these adult stem cells in soft tissue renovation. Of latest interest rates are the differentiation of preadipocytes into adipocytes, neural progenitor cells, and osteoblasts for tissue engineering applications. The 2 regions of concentration for hands surgery are: novel nerve regeneration techniques and immunobiology of rat dendritic cells.
Vascularized Composite Tissue Allograft Laboratory
Underneath the guidance of Mario Solari, MD, PhD residents and guys receive an chance to have fun playing the UPMC VCA lab throughout their year lengthy fellowship. Major soft tissue and skeletal defects, including limb amputation, represent a deficit of form and performance, in addition to diminution of quality of existence for that individuals. However, any rebuilding measures to enhance these non-existence threatening conditions must address a fragile balance of risks and benefits. As experiments in vascularized composite allotransplantation are now being conducted, numerous human hands transplants happen to be performed worldwide, including 8 braches in the College of Pittsburgh. These allografts require a powerful maintenance regimen of medicines, submitting the grateful recipients towards the significant morbidities of chronic, systemic immunosuppression. To deal with the danger-benefit ratio, therefore, our laboratory investigates novel approaches to inducing ability to tolerate vascularized composite allografts without lengthy-term immunosuppression. We’re employing a minimally toxic, non-myeloablative regimen in order to obtain mixed chimeric miniature swine, to have ability to tolerate allogenic vascularized composite allografts. This huge animal protocol entails utilization of an anti-CD3 immunotoxin, in conjuction rich in dose hematopoietic donor cell infusion and short-term cyclosporin administration. Ability to tolerate the musculoskeletal servings of grafts continues to be achieved.
Future research will concentrate on the tolerance from the epidermal elements and also the mechanisms behind skin allograft rejection.Dendritic cells happen to be a very active section of research within the fields of cancer immunology and transplantation. Several groups have investigated the tolerogenic purpose of these unique antigen-presenting cells, and postulated mechanisms for his or her manipulation. Our laboratory is concentrating on using host dendritic cells as carriers of foreign peptide and inducers of donor specific tolerance. We advise to make use of donor antigen-pulsed host dendritic cells, in conjuction with antilymphocyte serum, to induce ability to tolerate vascularized composite allografts within an orthotopic, rat hindlimb model.
Other future avenues of research range from the xenotransplantation of composite tissues, and using thymoglobulin like a tolerance induction agent.
Immunobiology of Rat Dendritic Cells
Dendritic cells (Electricity) are recognized to be the best antigen presenting cells (APCs) and be capable to stimulate naïve T-cells and initiate immune response. Electricity result from bone marrow hematopoietic stem cells and therefore are under 1% of circulating bloodstream mononuclear cells. Electricity induce peripheral tolerance via several mechanisms such as the deletion of autoreactive T-cells and induction of regulatory mechanisms. The purpose of this project would be to generate subsets of Electricity from rat bone marrow and spleen with abilities to manage T cell responses in vitro. These characteristics are mediated with the differential ability of Electricity subsets to secret cytokines along with the degree of costimulatory molecule expression. The purified dendritic cells is going to be characterised according to phenotype by flow cytometry, cytokine production, and ability to stimulate allogeneic T-cells inside a primary MLR. The character of T cell responses caused by Electricity subsets is decided in Electricity-T cell co-culture experiments for that generation of regulatory T cell population(s).
Application for that Hands Surgery Fellowship
Applications for that Hands Surgery Fellowship beginning This summer 1, 2014 is going to be recognized until The month of january 30, 2013.
You will have to register using the NRMP (http://www.nrmp.org/fellow/registration.html) for that Combined Musculoskeletal Matching Program (CMMP).
Please submit the next information together with your application packet:
- Completed Universal Hands Application
- Copy of USMLE Step I, II and III Scores
- Personal Statement
- Three recommendations, including one out of your program director.
You might send your completed Hands Fellowship Application materials to:
Hands Surgery Fellowship Coordinator
Department of Cosmetic Surgery
3550 Terrace Street
Scaife Hall, Suite 664
Pittsburgh, PA 15261
Fellowship Creative – Hands Down (Live Video)
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