GASTROENTEROLOGY gastRoenteRology

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                                           Visvanathan at Monash University          Hepatitis B
                                           and epidemiology statistician Dr          – A liner correlation exists between
                                           Vijaya Sundararajan at Department           hepatitis B (HBV) DNA levels and
                                           of Human Services.                          fibrosis stage in HBEAG negative
                                                                                       but not HBEAG positive chronic
                                           The department is involved in clinical
                                                                                       hepatitis B patients
                                           outcomes research on the impact
                                           of many new gastro intestinal             – Longitudinal DNA levels in chronic
                                           technologies including MRCP,                hepatitis B (CHB) patients with
                                           PILLCAM, EUS, single and double             normal and abnormal ALT levels
St. Vincent’s Department of
                                           balloon enteroscopy, narrow band            show little change over time
Gastroenterology maintains an
active research program in the             imaging and chromoendoscopy               – Serum HBeAg and HBsAg
fields of hepatitis, inflammatory          and Halo ablation. The department,          concentrations: changing levels
bowel disease and new endoscopic           with the support of the hospital,           during the natural history of
technology, with the aim of                has been able to introduce the              chronic hepatitis B
translating this into improved             latest endoscopic technologies to         – Virological Heterogeneity in
clinical care to patients.                 investigate the gastrointestinal tract.     hepatitis B positive women;
                                                                                       quantitative HBeAg estimation
                                           The department also has the largest
About us                                                                               distinguishes those with
                                           number of patients with chronic
                                                                                       subpopulations of Basal Core
Our department is the largest              inflammatory bowel disease and has
                                                                                       Promoter mutations
gastroenterology department in             been actively involved in a number
Victoria covering a broad clinical         of international clinical trials in the   Inflammatory bowel disease
spectrum. We have three main areas         management of new agents in               – Individual coping style as a
of interest: viral hepatitis and fatty     inflammatory bowel disease. An active       moderating factor between
liver, new endoscopic technology and       research collaboration exists with          disease activity, quality of life
its best clinical use and inflammatory     the Department of Immunology at             and psychological wellbeing in
bowel disease.                             St. Vincent’s, looking at basic aspects     Crohn’s disease
                                           of inflammatory bowel disease.
A large number of patients are referred                                              – Poor health related quality of life
for the management of chronic viral                                                    in patients with fistulising perianal
                                           Projects in progress or completed           Crohn’s disease
hepatitis. For the last 15 years we have
kept a comprehensive database of           Hepatitis C                               – Psychological impact of a stoma in
patients referred with chronic hepatitis   Value of rapid virological response         patients with Crohn’s disease
C and chronic hepatitis B. These are       in predicting hepatitis C treatment       – High incidence of inflammatory
the largest such databases in Australia    outcomes                                    bowel disease in Australia: results
and have been the basis of a number                                                    of the first prospective population-
                                           – Treating hepatitis C in prison:
of published research papers and                                                       based Australian incidence study
                                             experience in Victoria
abstracts. The viral hepatitis group
has an ongoing research collaboration      – Community versus hospital-based         Endoscopy
with Prof Stephen Locarnini at the           hepatitis C treatment in Victoria       The national bowel cancer screening
Victorian Infectious Diseases Reference    – Treating hepatitis C in rural           program – a prospective case series
Laboratory, and has established new          patients: the St. Vincent’s Share       of 34 patients
links with immunologist Dr Kumar             Care program
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     Highlights                               Sr Katherine Mellor, Nurse;               Prasad S, Wilson JL, Desmond PV,
                                              Dr Tin Nguyen, Gastroenterologist;        Chen RYM
     – Large number of selected
                                              Dr Arachchi NJ, Gastroenterologist;       – ‘Experience of endoscopic
       presentations at Australian
                                              Dr Shyam Prasad, Gastroenterologist;        ultrasonography for cystic lesions
       Gastroenterology Week (AGW)
                                              Dr Jacqui Richmond, Nurse;                  of the pancreas in a tertiary-
     – Young investigator award (Dr
                                              Dr Marno Ryan, Gastroenterologist;          level hospital’, United European
       Jarrad Wilson) at Australian
                                              Dr Gideon Shaw, Gastroenterologist;         Gastroenterology Week
       Gastroenterology Week (AGW)
                                              Dr Andrew Taylor, Gastroenterologist;
       November 2008 for the first data                                                 Prasad S, Chong AKH, Kalade AV,
                                              Dr Alexander Thompson,
       on the incidence of inflammatory                                                 Kemp WW, Colman JC, Desmond PV,
                                              Gastroenterologist; Dr Jarrad Wilson,
       bowel disease in Australia                                                       Chen RYM
                                              Gastroenterologist
     – NHMRC funding for Dr Peter de Cruz                                               – ‘An elevated hepatic venous
                                                                                          pressure gradient is associated
                                              Higher degrees conferred in 2008
     Research applications in the                                                         with specific findings at endoscopic
     clinical setting                         – Mark Lust, PhD, University of             ultrasonography’, United European
                                                Melbourne                                 Gastroenterology Week
     – Improved psychiatric service for
       patients on interferon treatment       – Alexander Thompson, PhD,
                                                                                        Thompson AJ, Chang J, Skinner NA,
       for HCV                                  University of Melbourne
                                                                                        Lewin S, Visvanathan K, Desmond PV,
     – Increased interferon treatment                                                   Locarnini S
                                              Selected presentations
       for HCV in prison                                                                – ‘Increased innate and adaptive
                                              Patterson S, George J, Strasser SI, Lee
     – Improved diagnostic yield for                                                      immune pressure is responsible
                                              AU, Sievert W, Nicoll AJ, Desmond PV,
       investigation of occult GI bleeding.                                               for the reduced transcriptional
                                              Roberts SK, Angus PW
                                                                                          activity of intrahepatic covalently
     The team                                 – ‘A prospective study of tenofovir
                                                                                          closed circular DNA that occurs in
                                                disoproxil fumarate for patients
     Assoc Prof Paul Desmond,                                                             HBeAg negative chronic hepatitis B’,
                                                with chronic hepatitis B who have
     Director; Dr Sally Bell, Deputy                                                      American Association for the Study
                                                previously failed lamivudine and
     Director; Dr Steven Brown,                                                           of Liver Disease
                                                have significant viral replication
     Gastroenterologist; Dr Robert Chen,
                                                despite at least 24 weeks of adefovir   Thompson AJ, Shudo E, Ribeiro R,
     Gastroenterologist; Dr William
                                                dipivoxil therapy’, American            Visvanathan K, Desmond PV, Lau GK,
     Connell, Gastroenterologist;
                                                Association for the Study of            Perelson AS, Locarnini S
     Dr Catherine Croagh,
                                                Liver Disease                           – ‘New insights into HBV
     Gastroenterologist; Dr Peter De
                                                                                          pathogenesis from kinetic analysis
     Cruz, Gastroenterologist; Dr Barbara     Prasad S, Kalade A, Desmond PV,
                                                                                          of HBeAg titre decay during potent
     Demediuk, Gastroenterologist;            Taylor A
                                                                                          antiviral therapy’, American
     Dr Marios Efthymiou,                     – ‘Deep small bowel intubation at
                                                                                          Association for the Study of
     Gastroenterologist; Dr Mayur Garg,         double balloon enteroscopy is
                                                                                          Liver Disease
     Gastroenterologist; Dr David Iser,         subject to a learning curve’, United
     Gastroenterologist; Dr Andrius             European Gastroenterology Week
     Kalade, Gastroenterologist; Prof
     Michael Kamm, Gastroenterologist;
                                                                                                                        GAStROENtEROlOGy         53



Publications                                    Liu H, Li YQ, Zhao YA, Zhang JP, Zhang JN,      Preiss S, Littlejohn M, Angus P, Thompson
                                                Guo YT, Xie XJ, Zhang TG, Desmond PV            A, Desmond P, Lewin SR, Sasadeuz J,
Arachchi NJ, Mellor K, Watson K, Tuck E, Bell
                                                2008, ‘Confocal endomicroscopy for in           Matthews G, Dore GJ, Shaw T, Sozzi V, Yuen
SJ, Desmond PV 2008, ‘Treating hepatitis C
                                                vivo detectin of microvascular architecture     L, Lau G, Ayres A, Thio C, Avihingsanon
in prison: experience in Victoria’, Abstract
                                                in normal and malignant lesions of              A, Ruxrungtham K, Locarnini S, Revill PA
                                                upper gastrointestinal tract’, Journal of       2008, ‘Defective hepatitis B virus DNA
Chetty N, Coupar IM, Tan YY, Desmond
                                                Gastroenterology and Hepatology, 23, 1,         is not associated with disease status
PV, Irving HR 2008, ‘Distribution of
                                                56-61                                           but is reduced by polymerase mutations
serotonin receptors and interacting
                                                                                                associated with drug resistance’,
proteins in the human sigmoid colon’,
                                                Mellor K, Arachchi NJ, Watson KJR, Bell SJ,     Hepatology 48, 3, 741-749
Neurogastroenterology Motility
                                                Desmond PV 2008, ‘Treating hepatitis C
                                                in rural patients: the St. Vincent’s hospital   Sawhney G, DeCruz P, Moss A, Hebbard
Crawford DHG, Roberts S, Weltman M,
                                                shared care programme’, Abstract of the         G 2008, ‘Patterns of gastroenterology
Cheng WSC, Sievert W, McCaughan G,
                                                6th Australasian Viral Hepatitis Conference.    advanced training in Australia from 2006 to
Desmond PV, Alston AW, DePamphilis J,
                                                Journal of Gastroenterology & Hepatology,       2008’, Abstract Journal of Gastroenterology
Marks P, Dore GJ 2008, ‘Baseline factors
                                                23 Supplement 6:A353-A354.                      & Hepatology. 23 Supplement 4:A196
associated with rapid and early virological
responses in HCV genotype 1 patients
                                                Moore GT, Brown SJ, Winterhalter AC, Lust       Smith EK, Bowden S, Bell SJ, Desmond
treated with induction dosing pegylated
                                                M, Salvaris EJ, Selan C, Nandurkar HH,          PV, Cowie B, DeCruz 2008, ‘Improving
interferon: the chariot study’, 43rd Annual
                                                Desmond PV, Cowan PJ, d’Apice AJ 2008,          diagnostic rates of hepatitis E in Australia’,
Meeting of the European Association for the
                                                ‘Glycosylation changes in hFUT1 transgenic      Abstract Journal of Gastroenterology &
study of the liver April 23-27 2008
                                                mice increase TCR signalling and apoptosis      Hepatology. 23 Supplement 4:A189.
                                                resulting in thymocyle maturation arrest’,
Kalade AV, Taylor A, Lee W, Smith P,
                                                Molecular immunology, 45, 8, 2401-10            Wilson J, Kalade A, Prasad S, R C, B T, S B,
Desmond PV 2008, ‘Cumulative diagnostic
                                                                                                S M, Desmond P, Chen R 2008, ‘Diagnosis
medical radiation exposure in patients with
                                                Nguyen T, Locarnini S, Desmond P 2008,          of solid pancreatic masses by endoscopic
Crohn’s disease and potential reduction of
                                                ‘Changing landscape of antiviral resistance     ultrasound guided fine needle aspiration’,
cancer risk through small bowel magnetic
                                                management in chronic hepatitis B’, Journal     Journal of Internal Medicine
resonance enterography’, Abstracts United
                                                of Gastroenterology and Hepatology, 23, 9,
European Gastroenterology Week
                                                1314-7
Kalade AV, Taylor A, Lee W, Smith P,
                                                Nguyen TQ, Kalade A, Prasad S, Desmond
Desmond PV 2008, ‘Prospective comparison
                                                P, Wright G, Hart D, Conron M, Chen RYM
of magnetic resonance enterography and
                                                2008, ‘Endoscopic ultrasound guided fine
CT enterography in detection of strictures
                                                needle aspiration (EUS-FNA) of mediastinal
in small bowel Crohn’s disease’, Abstracts
                                                lesions – experience in an Australian
United European Gastroenterology Week
                                                tertiary hospital’, Abstract Journal of
                                                Gastroenterology & Hepatology, 23
Kalade AV, Taylor A, Lee W, Smith P,
                                                Supplement 4:A223
Desmond PV 2008, ‘Prospective evaluation
of accuracy and outcomes of magnetic
                                                Preiss S, Thompson A, Chen X, Rodgers S,
resonance enterography in small bowel
                                                Markovska V, Desmond P, Visvanathan
Crohn’s disease’, Abstracts United European
                                                K, Li K, Locarnini S, Revill PA 2008,
Gastroenterology Week 2008
                                                ‘Characterisation of the innate immune
                                                signalling pathways in hepatocyte cell
Kalade AV, Eddie LWF, Conron M, Wright
                                                lines’, Journal of Viral Hepatology, 15, 12,
GM, Desmond PV, Hicks RJ, Chen R 2008,
                                                888-900
‘Endoscopic ultrasound-guided fine-needle
aspiration when combined with positron
emission tomography improves specificity
and overall diagnostic accuracy in
unexplained mediastinal lymphadenopathy
and staging of non small-cell lung cancer’,
Journal of Internal Medicine, 38, 11, 837-44