The Laboratory of Urological Oncology is approximately 2,500 square feet and contains 4 laboratory modules, a cold room, equipment room, and fluorescent microscopic/darkroom. The laboratory modules include an immunology module, a recombinant DNA facility, an organic biosynthesis facility and a tissue culture facility. The laboratory is fully computerized with both Mac and PC-based systems, which are wired to the Cornell University Network. Office space is available for fellows and residents.

Basic research projects include: study of the function of prostatic specific membrane antigen and several monoclonal antibodies which bind to its extracellular domain, development of antibodies to allow molecular subsetting of renal cancers, development of RT-PCR assays to detect circulating renal cancer cells; and synthesis and testing of ganglioside vaccines for renal cancer treatment. Current clinical protocols include monoclonal antibody therapy studies in prostate and renal cancer.

Molecular diagnostics and therapeutics in urological oncology:
The thrust of the Laboratory of Urological Oncology is the study of the cell biology of urological cancers at a molecular level and the translation of this understanding into improved diagnostics and therapeutics. Recombinant DNA and hybridoma technology provide the basic tools utilized to accomplish the molecular dissection of these cancers.

For example, in renal cancer, we have generated and characterized the largest panel of established human renal cancer cell lines and monoclonal antibodies (mAbs) to kidney differentiation antigens. In most cases, the chromosomal location of the antigens has been mapped and, in several cases, the gene cloned and the function defined. This work has allowed the molecular phenotyping of renal cancer and more precise understanding of the histogenesis of the disease. We have shown, for the first time, that 30% of renal cancers derive from the proximal convoluted tubule, 20% from the straight portion of the proximal tubule, and 50% from a proximal tubular progenitor cell. It has also allowed an understanding that there are molecular subtypes of renal cancer and that these subtypes have differing patterns of clinical behavior. With colleagues at the Ludwig Institute for Cancer Research (at Memorial Sloan-Kettering Cancer Center), we conducted clinical trials with these mAbs in patients with renal cancer. These studies have demonstrated the ability of mAbs, most notably mAb G250, to specifically and sensitively target disseminated renal cancer sites in patients. This antibody is now in an international phase III registration trial. The G250 antigen-carbonic anhydrase IX is regulated by the HIF (hypoxia inducible) pathway and has been shown by several groups to have prognostic significance.

In prostate cancer, we developed the first series of mAbs to the extracellular domain of prostate specific membrane antigen (PSMA). PSMA is the most well-established, prostate cancer-restricted, cell membrane antigen yet defined. These mAbs were the first to specifically bind to viable PSMA-expressing cells. We demonstrated, for the first time, that PSMA and mAbs that bind PSMA, are internalized via an endocytic pathway. We also demonstrated that PSMA is expressed by neovascular endothelial cells of all solid tumors but not by normal vascular endothelial cells. We selected one of our mouse antibodies, designated J591, and de-immunized it by genetic engineering techniques. The de-immunized antibody has been used in multiple clinical trials that have demonstrated success in specifically targeting metastatic prostate cancers as well as the neovasculature of other solid tumors. This antibody was licensed to industry for clinical development. Radiolabeled and cytotoxin-conjugated J591 are now in multi-center phase II trials.

General Urology Laboratory
Diane Felsen Ph.D
Associate Research Professor of Pharmacology in Urology
Co-Director, Laboratory for Advances in Urologic Research

This laboratory is a multi-disciplinary laboratory in the Department of Urology. The co-directors are Diane Felsen, PhD, Associate Research Professor of Pharmacology in Urology and Dix P. Poppas, MD, Assistant Professor of Urology and Director, Division of Pediatric Urology. This laboratory is involved in investigating several aspects of the physiological and pathophysiological aspects of the urinary tract system and in developing alternative methods of wound closure in urologic and other surgeries. Among the current projects are the following:

Investigating the pathophysiology of ureteral obstruction: Unilateral ureteral obstruction [UUO] results in decreases in renal function and in renal fibrosis. This clinical problem is found in both the adult and pediatric urologic populations. Using a well-established model of ureteral obstruction, we have characterized the fibrotic changes that occur. Current studies are designed to understand the mechanism of fibrosis, with the goal of eventual pharmacologic or genetic manipulation. Two candidate targets are transforming growth factor-beta TGF-β and nitric oxide [NO]. TGF-β is a multi-functional cytokine with effects on wound healing, cell proliferation, fibrosis and tumorigenesis. It exerts its profibrotic effect by increasing the synthesis, as well as decreasing the degradation, of the extracellular matrix. NO is also a multi-functional cytokine, which however, appears to be antifibrotic. We are presently studying the fibrotic response to UUO in rats in the presence of a TGF-β antibody and in mice which have the gene for the synthesis of NO deleted.

Investigating the pathophysiology of bladder outlet obstruction: Bladder outlet obstruction can lead to various changes in bladder function, including increased bladder capacity, increased voiding frequency, spontaneous bladder contractions and changes in bladder compliance. We have recently developed methodologies for measuring bladder function in conscious animals. The focus of this research is on the role of the NO system in the normal and obstructed bladder. We are carrying out experiments using both pharmacological manipulation of the NO system, as well as using mice in which the gene for the synthesis of NO has been deleted. Another aspect of this work is to examine the role of elastin in the development of bladder compliance in both normal and obstructed bladder. For these experiments, we are using transgenic mice, which overexpress elastin.

Development of Alternative methods of Wound Closure: We have been involved in the development of biological solders, as alternatives to suture, and the use of lasers to effect wound closure in the presence of these solders. The use of laser-activated solders can surmount some of the problems inherent in sutured wounds, such as leakage and surgeon-to-surgeon variability. Furthermore, solders may be usable in various body compartments where suture is not suitable.

The solder which we have developed is a 50% human albumin solder. This solder has been supplemented with various growth factors, in order to determine if such compounds can accelerate or strengthen wound closure.

Minimally Invasive Surgery: Our group is actively involved in developing instruments and methodology to perform minimally invasive laparoscopic procedures in pediatric surgery. These techniques involve applying minimally invasive laparoscopic techniques to nephrectomy, nephroureterectomy, bladder reconstruction and ureteral reimplantation. Furthermore, we are combining our knowledge of laser tissue welding [see above] with minimally invasive surgery to begin evaluating applications for tissue welding during laparoscopic reconstructive surgery.

Laboratory: The laboratory consists of two rooms containing approximately 400 square feet each. The laboratories are equipped to carry out tissue culture, molecular biology[ including PCR], tissue tensile strength measurements, microscopy and general biochemical techniques. Small animal surgery can be carried out in the laboratories, and large animal surgery facilities are available either on the same floor as the labs, or in the institutional animal facilities.

Projects: Role of TGF-β in ureteral obstruction
Role of Nitric oxide in ureteral obstruction
Role of elastin in bladder function
Role of nitric oxide in bladder function
Development of solder for laser tissue welding
Development of minimally invasive laparoscopic techniques

Male Reproductive Physiology
Marc Goldstein, M.D
Professor of Urology
Professor of Reproductive Medicine

Animal Studies
Rat Vasosvasostomy Suture Material Study: We are completing studies on anastomotic healing, patency and tissue reaction after microsurgical vasovasostomy in the rat employing three different suture materials. No studies have been performed previously to determine what the ideal suture material for these anastomoses is. In view of the high late stricture rate after human vasovasostomy, these studies will have considerable impact in clinical practice. Preliminary results indicate that absorbable synthetic sutures are the most desirable for these anastomoses. This is in contradistinction to current clinical teaching which recommends polyprolene or nylon sutures.

Rat Vasoepididymostomy Technique Study: Microsurgical vasoepididymostomy is currently the most technically difficult operation in all of microsurgery. Even in experienced hands the patency rates after microsurgical vasoepididymostomy in humans are between 50 and 70 percent. Three new techniques are compared in the rat. End-to-end, end-to-side and a new pull through end-to-side technique. Preliminary results indicate that the newer pull throughout end-to-side technique has substantially higher patency rates then the other two techniques. Use of this method in the first human anastomoses has yielded patency in all three cases.

Effects of Marlex Mesh on the Spermatic Cord: Marlex mesh is currently being used for thousands of inguinal hernia repairs in men of all ages. Marlex mesh is successful for hernia repair because of the intense desmoplastic reaction it invokes in the tissue around it resulting in solid repair of hernia. When Marlex mesh is used for repair, the Marlex is in direct contact with the spermatic cord. During our studies of iatrogenic injuries to the vas deferens in humans, (Journal of Urology) we noticed that several patients with iatrogenic vasal injuries had undergone Marlex mesh repair of the inguinal hernias. This led us to employ a dog model for the study of the effects of Marlex mesh on the spermatic cord of dogs. Marlex mesh repair was compared to standard Shouldice repairs. Results presented at the 1997 AUA indicate that Marlex causes intense reaction in the spermatic cord, narrowing of the vasal lumen and impaired testicular function. We are now proceeding with a larger study comparing Marlex mesh plugs plus patches in comparison to Gortex patches.

Microsurgical Hypospadius Repair in the Dog: We have described the first large dog model to mimic hypospadius and demonstrated the success of microsurgical technique for hypospadius repair in the dog. During the course of this study a new apparatus for the creation of a free graft tubularized skin flap has been demonstrated. A patent has been obtained for this apparatus. This work was presented at the 1997 Annual Meeting of the American Urological Association.

Restoration of Spermatogenesis After Scrotal Placement of the Experimental Cryptorchid Rat Testes: Assessment of germ cell apoptosis and eNOS expression. In this study cryptorchidism induced germ cell apoptosis and orchidopexy restored spermatogenesis and lowered levels of germ cells apoptosis. This finding also suggests that NO and/or one of its byproducts is associated with germ cell apoptosis in cryptorchidism. In addition, we found that germ cell apoptosis increases following ischemic reperfusion injury in a rat postischemic model.

Human Studies:
Microdot Technique of Vasovasostomy: We have introduced a new method for precision placement of sutures for vasovasostomy. We have employed this technique in 200 men and achieved a 99% patency rate, the highest currently reported in the world. (Journal of Urology)

Topical Perioperative Antibiotic Prophylaxis: We have shown that the use of topical antibiotic prophylaxis (Neomycin irrigation) can prevent wound infection in 1500 clean microsurgical varicocelectomies without the use of systemic antibiotics.

Intraoperative Varicocele Anatomy: A Microsurgical Study of the Inguinal vs. Subinguinal Approach: We have compared the anatomy for inguinal vs subinguinal varicocelectomy and determined that the branching of the testicular vessels occurs primarily during its course through the inguinal canal. (1997 Annual Meeting of the American Society of Reproductive Medicine.)

Sexual Medicine Program
John P. Mulhall, M.D.
Director of the Sexual Medicine Program
Associate Professor of Urology

Dr. Mulhall directs the Sexual Medicine Research Laboratory at Cornell. This laboratory is involved in the study of Peyronie's disease and the impact of nerve injury during radical prostatectomy on erectile tissue structure and function. Other research being conducted presently includes studies of erectile dysfunction as a predictor of coronary artery disease; preserving erectile function after radical prostatectomy; sleep disorder-associated erectile dysfunction; and testosterone supplementation in males and females with sexual dysfunction.

Laparoscopy and Minimally Invasive Surgery
Joseph Del Pizzo, M.D.
Assistant Professor of Urology

The Endourology section of the Department of Urology has been developed by Dr. R. Ernest Sosa and now is run by Dr. Del Pizzo. It remains active in its clinical, research and teaching endeavors. We support one endourology fellow who has research and clinical responsibilities. The endourology fellow gains experience in both prostatology and in endourology. Our recent endourology fellows have gone on to establish endourology programs and prostate centers at other institutions. Dr. Steven Shichman at the University of Connecticut (1993); Dr. Miguel Angel Lopez at the University of Caracas (1994); Dr. Hassan Razvi at the University of Western Ontario (1995); Dr. Thomas Martin in New Haven, CT (1996); Dr. Michael Stifelman at New York University (2000); Dr. Joseph Del Pizzo at Weill Medical College of Cornell University (2001); Dr. Ravi Munver at UMDNJ (Newark/Hackensack University Med Center) (2002). Each year we support one research fellow who functions in the laboratory as well as in clinical activities.

Laparoscopy: In adults, we are active in performing adrenalectomies, nephrectomies, partial nephrectomy, and extirpitative pelvic surgery (prostatectomy, cystectomy.) We expect to begin to utilize laparoscopic access for cryoablation of selected, small (<3 cm), hormonally active adrenal lesions. IRB approval has been obtained for this study. In the Pediatric Section, laparoscopic bilateral adrenalectomy in female patients with CAH is being pioneered. By removing these patient's adrenal glands, hormonal management is simplified and their quality of life improved. Based on research performed in our laboratories, we have already demonstrated the feasibility and become demonstrated leaders in the field of hand-assisted laparoscopy and laparoscopic nephrectomy for renal donation.

Endourology: We have utilized an array of flexible and rigid fiber optic endoscopes to evaluate and treat lesions in normal urinary tracts, covering the kidney to the urethra. We have moved on to apply these minimally invasive techniques in pregnancy, in pediatric patients and in reconstructed urinary systems. Improvements in instrumentation, development of miniaturized instruments permit us to diagnose and treat strictures, urothelial tumors and stones anywhere in the urinary tract. We couple our prowess in treatment stone disease with a program of evaluation and prevention to prevent stone recurrences.

Looking ahead, tumors of all types are being diagnosed at an earlier stage. Organ preserving treatments are possible. We are applying various energy forms to treat localized lesions with the combined monitoring of ultrasound and endoscopy. In the future we anticipate MRI guided percutaneous surgery will be possible. Taken together, these minimally invasive technologies will permit the early treatment of tumors in the urinary system with minimal patient morbidity. Our combined efforts in Endourology strive in this direction.

List of clinical and basic research projects

Basic Research:
Cryoablation of renal and adrenal tissues in the dog model

Clinical Research:
IRB approved:
Cryoablation of renal and adrenal lesions
Dissolving ureteral stent development
Topical EMLA for analgesia in outpatient lithotripsy treatments
High frequency ultrasound (MRI-guided) - IRB approval pending

Clinical Research (Retrospective):
Percutaneous nephrolithotomy - techniques to minimize blood loss
Endoscopic management of upper tract transitional cell cancers
Endoscopic removal of large stone burdens form continent urinary diversions
Effects of expanding indications for renal laparoscopic surgery

Pediatric Urology
Dix Poppas, M.D.
Richard Rogers Associate Professor of Urology
Director, Pediatric Urology and Reconstructive Surgery

Pediatric Urology within the Department of Urology is pursuing a wide range of research interests focused in wound healing, kidney development, and alternative methods of tissue reconstruction as well as developing new instruments for minimally invasive surgery. All of our research projects include residents and medical students. We also involve our visiting fellows in these research projects.

The majority of research interests are focused in the area of laser tissue welding. This technique provides an alternative method for tissue approximation optimizing a leak proof repair that can be performed in a very rapid fashion. We are conducting preclinical experiments for hypospadias repair in children as well as areas in bladder reconstruction and ureteral reconstruction. We are also supporting an area in cardiothoracic research to provide techniques and developments for coronary artery bypass surgery. As part of this research, we are involved in developing tissue solders which are protein fluids that increase the strength of tissue bonding as well as developing laser systems that can optimize the ability for a surgeon to learn the technique and to be able to apply it in a reproducible manner.

We have a large effort directed towards developing new instrumentation and methodology for defining laparoscopic intervention and extirpative surgery as it pertains to the pediatric urologic population. We have performed a number of laparoscopic nephrectomies and nephroureterectomies with specially designed instruments which significantly decrease operative time, hospital stay, and a marked improvement in the cosmetic result in these children. We have also developed new techniques for the laparoscopic orchidopexy which we call a concealed orchidopexy. It leaves the child with no evidence of an incisional scar.

An additional section of our laboratory is focused on fibrosis in the kidney and the bladder and how transforming growth factor beta-1 (TGF-β) is involved in this fibrotic process. We are developing experience with neutralizing antibodies to TGF-β in an effort to develop a clinical application for children who have congenital obstructive uropathies.

Our group is also conducting clinical and laboratory research in collaboration with Dr. Maria New and Dr. Madeline Harbison from the department of pediatrics focusing on the adrenal genital syndrome and the use of laparoscopic bilateral adrenalectomy in a subset of patients who are not responsive to traditional hormonal therapy.

Another section of our laboratory research is focused on the use of antiangiogenic molecules in the prevention of superficial bladder cancer. Our lab has been studying the effects of human urine before and after treatment with BCG therapy for superficial bladder cancer. We have identified a number of endogenous molecules that have very potent antiangiogenic activity and are upregulated and expressed following BCG therapy. This area of research suggests that certain immunostimulatory agents may actually produce an angiogenic inhibitory environment in human urine which may have some effect on limiting bladder growth and metastasis.

Effect of Solder Components on Proliferation, Survival and Function of Fibroblasts: Albumin solder has been successfully used in laser tissue welding. However, some fractions of albumin and certain contaminants create unfavorable conditions for the growth and function of cells. Fibroblasts represent the first line of repair during the formation of scar. The goals of the project are (1) to study cell cycle, apoptosis, production of collagen, adherence and expression of integrins by fibroblasts after their exposure to different types of albumin and (2) using different growth factors, to improve the function of fibroblasts in this model.
Project in collaboration with Dr. Diane Felsen

Role of Myofibroblasts in Tissue repair: Certain conditions, generate transformation of fibroblasts into myofibroblasts; which is desirable because of their higher contraction characteristics and therefore their ability to provide a closer contact between the edges of the wound. Using smooth muscle actin expression and high level of active TGFβ secretion as a marker of myofibroblasts, we'll study factors that lead to the generation of myofibroblasts.

Effect of Laser Energy on Human Skin Tissue Repair: Using human skin tissue implanted into nude rats, we'll verify the most effective parameters of laser welding for the optimal healing of surgical wounds in human skin.

Inhibition of Platelet Activation during Ligation of Blood Vessels: Ligation of blood vessels by means of laser welding is often complicated by thrombus formation. The goal of this project is: (1) to study the role of platelet activation in thrombus formation and (2) if significant activation of platelets takes place- to prevent activation of platelets using monoclonal antibodies.

Solid Protein Solder for Vaso-vasostomy: A cylindrical solid solder will be used with a low power laser to join severed vas deferens

Carbon Black as a Universal Laser Chromophore during tissue welding: Carbon Black will be characterized as a solder Chromophore, for laser wavelengths in the visible and I.R. spectra.

Hypospadias Repair Using Laser Tissue Welding: The ain of this study is to investigate potential applications for human albumin as a tissue bonding agent for hypospadias repair. The study is designed to provide pre-clinical data to support an FDA application for human albumin as a soldering agent for laser welding.

Effect of Proteases from Urine on Lasered Solder Degradation: Surgical repair of hypospadias by means of laser tissue welding can be complicated by a rapid degradation of albumin solder. Because urine itself might play a role in this process, degradation of lasered albumin solder in urine will be investigated.

Laparoscopic Laser Tissue Welding for Enterocystoplasty: Using the technique of laser welding, we will be developing new instruments and methodology to perform bladder reconstruction using minimally invasive laparoscopic techniques.

Effect of Laser Tissue Welding on the Repair of Cardiovascular Tissue: The goal of this study is to evaluate the application of laser tissue welding using a human protein solder for the repair of carotid artery anastomosis. This initial investigation will allow us to develop a better understanding for applying these techniques for coronary artery by-pass surgery using a minimally invasive approach.

Population Council Laboratory: Genetics of Male Infertility
Peter N. Schlegel, M.D.
Chairman, Department Of Urology

This laboratory space of 200 square feet is located in room 531 of the Weiss Building in The Population Council has been maintained through a long-standing cooperative agreement between The Cornell Department of Urology and The Population Council. The laboratory is staffed by a technician who works with a male reproduction fellow in research. The laboratory is equipped with molecular biology reagents, equipment and supplies needed to perform almost any modern molecular analysis. We have recently acquired a WAVE gene analysis machine (differential HPLC) that allows rapid-throughput evaluation of hundreds of gene products to identify polymorphisms or gene mutations that may be responsible for human disease. This is also the site of our clinical genetics laboratory where we have performed numerous studies on the Y chromosome of infertile men. This Y microdeletion test is a PCR-based analysis of submicroscopic deletions of the Y chromosome that has been performed on over 1,200 men with severe male factor infertility. This has provided us with a DNA bank for analysis of gene mutations using WAVE analysis with subsequent DNA sequencing. A Perkin-Elmer PCR amplification unit, extensive gel electrophoresis equipment, and a chemiluminometer are also available within the laboratory. Core resources for cryopreservation of tissue, ultracentrifuges, scintillation counting, DNA sequencing, protein sequencing, electron microscopy and photographic imaging facilities are available. All facilities are available to perform genetic studies in my laboratory, as well as technicians for these core facilities who are present to help utilize core facilities and equipment.

Urodynamics and Bladder Function
Alexis E. Te, M.D.
Director, Urodynamics Center
Associate Professor of Urology

The main focus of the unit is to advance the opportunities available to provide diagnostic and treatment modalities for patients with pelvic disorders including urinary incontinence as well as abnormalities in urinary storage and voiding. Our state of art urodynamic laboratory is set up with sophisticated equipment from Laborie Medical Technologies that enables us to provide more accurate diagnosis with printouts of viewed fluoroscopy imaging of bladder and bladder neck as seen during the study. The urodynamics recording can be linked to all national research libraries for normative comparisons. In addition, information obtained from the studies can be saved and retrieved for analysis at a later time. Ongoing research has been performed to 1) delineate the value of new technologies for treatment of BPH (e.g., KTP laser, Thermoflex), 2) evaluate medical therapy of voiding problems (alfuzosin, phenoxybenzamine), and 3) investigate the underlying pathophysiology in patients with interstitial cystitis and other voiding disorders (RDP58 studies.) This represents a combined clinical and basic research approach that has expanded from the time that Dr. Te was a faculty member at Columbia until he joined the faculty here at Cornell 3 years ago.

Grants - NIH
Urodynamic and Multiethnic Variability of Men Treated by Minimally Invasive Surgical Therapies
Funding source: NIH
Duration: 2002-2007

Grants --- Industry

The long-term efficacy and safety of alfuzosin 10mg OD (once a day) on the risk of acute urinary retention and the need for surgery in patients with BPH (benign prostatic hyperplasia). A two-year, randomized, multicenter, double-blind, parallel group, placebo-controlled study.

A double-blind randomized parallel group study of alfuzosin 10mg OD (once a day) versus placebo in the management of acute urinary retention in patients with a first episode due to BPH (Benign Prostatic Hyperplasia)

A Double-Blind Placebo-Controlled, Pilot Study to Teat Patients with Moderate to Severe Progressive Benign Prostatic Hypertrophy with Phenoxybenzamine (Dibenzyline).

A Postmarket data collection study of the uroflometry effects and symptom alleviations of the Thermoflex System in patients suffering form benign prostatic hyperplasia (BPH)

A Multi-Center Clinical Evaluation of the 80W KTP Laser Prostatectomy for the Treatment of Benign Prostatic Hyperplasia

A Multi Center Study of the Tolerability, Efficacy, and Safety of Transperineal Prostatic Block or Transrectal Ultrasound Block as Primary Methods of Local Anesthesia for Interstitial Laser Thermal Therapy In An Outpatient Clinic Setting In Subjects with Symptomatic Benign Prostatic Hyperplasia.

A Multicenter, Phase IIb, Four Arm, Dose Finding, Randomized, Placebo-Controlled Study to Determine the Long Term Prostate Cancer Chemoprevention Efficacy and Safety of 20 mg, 40 mg & 60 mg Daily of GTx-006 in Men with High Grade Prostate Intraepithelial Neoplasia (PIN)

Evaluation of RDP58 in a mouse model of acute and chronic interstitial cystitis. Funding source: Sangstat, Inc. Studies performed by Ricardo Gonzalez, M.D., presented at the Valentine Essay Contest as well as at the Annual Meeting of the American Urological Association, 2003.

RESIDENT RESEARCH OPPORTUNITIES IN THE DEPARTMENT OF UROLOGY AT CORNELL

Our residency program is attuned to the need of exposing all residents to both basic and clinical research even if their career path is for clinical urology. Therefore during the first year, Diane Felsen, Ph.D. meets with the residents to pick a topic of investigation during the resident six month exposure to basic research during the PGY-2 year. In the PGY-2 year the residents will choose amongst the active laboratories in the institution (see attached list). During this time the resident will have a mentor for a specific project and they then learn how to submit proposals for animal and patient research, to prepare experimental design and to carry out the experiments. The residents are encouraged to present their work at national meetings and also at the annual N.Y. Academy of Medicine Residents Essay Day. Following the PGY-2 year, most of the residents will continue to refine their work, often expanding the experimental data for further presentations.

Aside from the formal research, the residents are encouraged to participate in clinical programs with the attendings in areas of their interest.

During the year there are routine research conferences held by various of the particular laboratory groups, and not only the who are actively participating in the program, but other residents are encouraged to participate.

In our Thursday afternoon Basic Science/Didactic Conference each resident gives a seminar on the research that they carried out during their research period. There is also a Monday morning Grand Rounds conference devoted to review of the papers for the resident essay day as well as for presentations to be made at the American Urological Association Annual meeting.

Finally, Dr. Peter Schlegel meets with the residents for the Journal Club and reviews the methodology for manuscript presentation and intellectual critique of articles.

The result of this fairly intense research orientation is manifested by the activities of our residents following training with most entering fellowships and academic urology (see attached list of activities of Residents and Fellows).

Research Laboratory Synopsis

1) Laboratory for Advances in Urologic Research, Directed by Diane Felsen, Ph.D.
Interests: Obstructive Uropathy, Bladder Aging, Bladder Physiology, Cytokines in Urology, Nitric Oxide and Interstitial Cystitis.

2) Laboratory for Minimally Invasive Surgery and Wound Healing, Directed by Dix P. Poppas, M.D.
Interests: Use of laser welding in wound healing, use of growth factors in facilitating wound healing, development of minimally invasive techniques including new laparoscopic techniques.

3) Laboratory for the Development of New Techniques for Male Infertility, Directed by Dr. Marc Goldstein and Philip Li.
New technical procedures for the treatment of male infertility are developed in this laboratory. There is also a teaching lab for microsurgical training for the residents to enhance their clinical skills in this area.

4) Laboratory for Molecular Biology of Male Infertility, Directed by Peter N. Schlegel, M.D.
This laboratory in conjunction with the Population Council at Rockefeller University is interested in the genetic basis of male infertility and normal spermatogenesis in human males.

5) Laboratory in Urologic Oncology, Directed by Neil H. Bander, M.D. and David Nanus, M.D.
This large and well-funded laboratory is primarily interested in the use monoclonal antibodies and their conjugates for the treatment of both prostatic cancer and bladder cancer. The laboratory extends from basic science, molecular biology in the identification of new specific monoclonal antibodies to the performance with the clinical trials.

6) Laboratory of Renal Physiology on Genito-Urinary Development; In collaboration with Dr. Doris Herzlinger.
This laboratory is dedicated to the study of the embryogenesis of the kidney, bladder and prostate. Dr. Herzlinger has a joint appointment with the Department of Urology.

7) Laboratory for Cytokine Therapy for Renal Cell Carcinoma - Manikkam Suthanthiran, M.D., in Nephrology
This laboratory has a long-standing interest in immunology against transplant rejection. A secondary goal of the laboratory is the understanding of the treatment of renal cell carcinoma with the development of appropriate cells lines for the study of specific cytokine therapy particularly low dose interleukin-2 against kidney cancer.

8) Laboratory of Sexual Dysfunction, Directed by John P. Mulhall, M.D.
Dr. Mulhall has participated in numerous clinical studies for the treatment of male sexual dysfunction including the newer oral agents. In addition, he has developed models for the study of Peyronnie's disease and maintains an active laboratory that is investigating the role of viral infection in the pathogenesis of this disabling condition.