The University of Colorado Hospital
(Service Chief: Mark Geraci, M.D.; Head Division of Pulmonary Sciences and Critical Care Medicine)
University Hospital is a 280-bed facility, recently ranked in the top 10 respiratory hospitals by US World Report, which serves the state of Colorado. It is also a referral center for a seven-state region and referrals are received from national and international sources. University Hospital has become privatized and this has allowed for many new programs and the expansion of old ones. The facility is modern in all respects and well staffed. The critical care tower contains 54 medical and surgical ICU beds. There are separate coronary and medical ICU which are the focus for training in critical care medicine along with the Surgical ICU, Burn Unit, and Bone Marrow Transplant Unit. The pulmonary function and rehabilitation laboratory is adjacent to the pulmonary outpatient center and available for patient evaluation, teaching and research. There is also a sleep laboratory. Active heart, liver, bone marrow, kidney-pancreas, and lung transplantation programs are in place. The divisional research laboratories are in the medical school. Specialized centers of excellence in lung transplantation, lung volume reduction surgery, cystic fibrosis, pulmonary hypertension, emphysema and critical care are in place.
Denver Veterans Administration Medical Center (DVAMC)
(Chief of Pulmonary and Critical Care Section: Edward Dempsey, M.D.)
The Denver Veterans Administration Hospital is a 300-bed facility serving veterans and their families in the state of Colorado and serves as a regional referral center from neighboring states. It has a new intensive care unit and a well equipped and computerized pulmonary function laboratory. A new sleep laboratory has recently been established and supports a major research effort. The divisional activities in lung cancer are centered here.
Denver Health Medical Center (DHMC) (formerly Denver General Hospital)
(Acting Head of Pulmonary/ Critical Care Service: Michael Hanley, M.D.)
This modern city and county 300-bed hospital, ranked in the top 24 respiratory hospitals in the USA by US World Report, is well equipped and staffed and one sees the pulmonary critical care complications of acute disease. It has a 23-bed intensive care unit as well as a neurotrauma unit where acute respiratory failure is a common occurrence. In addition, outpatient experiences with AIDS and tuberculosis are acquired at DHMC. Clinical studies in acute respiratory failure and protocols dealing with the ambulatory care of asthma and chronic obstructive pulmonary disease are ongoing.
National Jewish Medical and Research Center (NJMRC)
(Acting Head of Pulmonary Section, Kevin Brown, M.D.; Chairman of Medicine, Richard Martin, M.D.)
National Jewish Medical and Research Center, historically known as a referral center for tuberculosis and other pulmonary diseases, handles the tuberculosis problems of the state of Colorado and serves as a referral center for the nation, and, indeed, the world. It is ranked as the top respiratory hospital in the USA by US World Report. It is known for its management of difficult problems of mycobacterial diseases including drug-resistant tuberculosis and the care of patients with atypical mycobacterial diseases. It has an excellent mycobacteriology laboratory --- one of the best in the nation. The medical services are actively engaged in the study and management of difficult bronchial asthma, COPD, interstitial lung disease and related disorders, occupational and environmental lung diseases, as well as immune deficiency. The pulmonary function laboratory and clinical immunology labs are outstanding and formal laboratory experience is offered during this rotation. During this rotation sleep study interpretation is taught and various electives in occupational lung disease, interstitial lung disease, pulmonary rehabilitation, and pulmonary radiology are available. Correlative sessions stressing physiology and immunology take place regularly. Several basic laboratories of the division reside here.
Columbia Rose Medical Center (CRMC)
(Head of Pulmonary Section: William Pluss, M.D.)
Columbia Rose Medical Center is a private facility located across the street from the Denver Veterans Administration Medical Center. This modern 300 bed hospital has a pulmonary and critical care disease service as part of the University of Colorado Denver program as well as a medicine service with University housestaff. Experience with referral private practice is offered. A complete pulmonary function laboratory is available and diagnostic techniques are performed with staff supervision on a large number of patients referred to this hospital.
St. Anthony's Central Hospital (SAC)
(Program Director, Critical Care Medicine: Thomas Bost, M.D.)
St. Anthony's Central Hospital (SAC) is our newest affiliate. It is a tertiary care medical center, but the primary reason for first year fellows is it is one of the major trauma centers in the state of Colorado with a major emphasis on critical care medicine. Although this is a private hospital, there are housestaff from the University of Colorado in surgery, as well as family medicine. The major emphasis for the first year critical care fellow is exposure to trauma, surgical intensive care, neurosurgical intensive care, as well as medical intensive care. Many interventional trials are conducted at this site, in which the trainee has the opportunity to participate.
Research Facilities
Cardiovascular Pulmonary Research Laboratory (CVP)
(Director: Kurt Stenimark M.P.)
There is a longstanding collaboration between the Divisions of Pulmonary Sciences and Critical Care Medicine and Cardiology. The focus of research is on man's adaptation to hypoxia, encompassing high altitude pulmonary edema (HAPE), acute and chronic pulmonary hypertension, acute lung injury and control of ventilation. The lab offers the unique opportunity to participate in all levels of research, spanning the gamut from human research through cellular electrophysiology and molecular biology.
National Jewish Medical and Research Center (NJMRC)
(Head of Pulmonary Section and Review: Kevin Brown, M.D. and Chairman of Medicine: Richard Martin, M.D.)
The NJMRC has a major investigative program in basic immunology ranging from immunoglobulin structure and function, T-cell function, complement, immune complexes to host defenses as well as extensive research into physiological disturbances in pulmonary disease, with emphasis on smooth muscle function, exercise-induced bronchospasm, respiratory muscle strength and lung mechanics. Didactic conferences are held weekly and the application of pulmonary physiology to clinical problems is stressed. The asthma, interstitial lung diseases, and occupational lung diseases programs are centered here.
Divisional Research Laboratories in the Medical School (DL)
(Director: Mark Geraci, M.D.)
The divisional laboratories comprise approximately 16,000 square feet of laboratory space divided into six laboratories for four investigators. These include: Dr. Norbert Voelkel who studies biology of pulmonary hypertension and the role of lipid mediators in pulmonary biology as well as pathobiology of emphysema; Dr. Mark Geraci who studies the enzyme prostacyclin synthase and its role in vascular remodeling and cell proliferation; and Dr. Edward Abraham who investigates basic mechanisms in acute lung injury and multiple organ failure; as well as a number of other investigators. There is also a core laboratory which includes an assortment of equipment for the support of pulmonary fellow training. The divisional laboratories are equipped to support most aspects of general molecular biology, biochemistry and cell biology, including sequence analysis, assessment of gene expression and also evaluation of ion channel activity by patch clamp techniques.
Pulmonary Hypertension Center (PHC)
(Director: Norbert Voelkel, M.D. and Clinical Director: David Badesch, M.D.)
The Pulmonary Hypertension Center (PHC) at the University Hospital and the Veterans Hospital was established in 1992 to offer clinical expertise and active research to patients with severe pulmonary hypertension. The PHC combines the skills of cardiologists, pulmonologists, hematologists, rheumatologists and pharmacologists to create a critical mass of clinician-scientists. The care of pulmonary hypertension patients: includes evaluation for lung transplantation and experimental therapies. The relationship between collagen-vascular disorders and primary pulmonary hypertension and the action of growth factors involved in the malignant forms of pulmonary vasculopathies are under active clinical and experimental investigation.
Adult Cystic Fibrosis Center (ACFC)
(Director: Jerry Nick, M.D.)
Directed by Dr. Jerry Nick and staffed by a clinical nurse specialist, respiratory therapist, nutritionist, and exercise physiologist. Provides state-of-the-art care and research for patients with CF over the age of 17. Participates in most major national multicenter therapy trials as well as locally initiated research protocols.
Lung Transplant (LTX) and Lung Volume Reduction Surgery (LVRS) Programs
(Medical Director: Martin Zamora, M.D.)
The Lung Transplant Program (LTX) was established in 1992 and has become one of the most active programs in the country. Single, double and heart-lung transplants have been performed for a variety of pulmonary parenchymal and vascular disorders. The lung transplant group is a multidisciplinary team consisting of cardiothoracic surgeons, transplant pulmonologists, nurse coordinators and physical and respiratory therapists. A one-year transplant fellowship may be arranged at the end of which the fellow will be a United Network Organ Sharing (UNOS)-qualified transplant physician. Applicants for this position will be a M.D. who has completed a three year pulmonary fellowship and is either board certified or eligible in pulmonary medicine and has an interest in pursuing an academic career in pulmonary transplant medicine and biology. Fellows will be involved with and acquire a working knowledge of all aspects of lung transplant patient care including donor and recipient selection and management, postoperative ventilator care, immunosuppressive therapy, infectious prophylaxis, histologic interpretation in grading of lung biopsies for rejection and long-term outpatient follow-up. Research opportunities exist for both clinical and basic science projects.
The LVRS Program is a collaborative effort between UH and NJMRC. Started in 1994, UH/NJMRC was recently awarded one of 18 seven year NIH/HCFA Grants to study the efficacy of LVRS. The lung transplant fellow will also be involved with the care of LVRS patients. Clinical research opportunities exist for this program.
COPD Center
Director: Norbert Voelkel, M.D.
Clinical Director: William Vandivier, M.D.
The recently established COPD Center combines all aspects of obstructive lung diseases in one multidisciplinary working group. The clinical focus is on new biomarkers of COPD on pathogenesis and development of new therapies. Both COPD and lung cancer are related because of a shared susceptibility and shared xenobiotic attack on the lung cells. Chronic inflammation and lung cell apoptosis are likely important factors determining the chronic progressive tissue destruction and the emergence of apoptosis-resistant cell phenotypes.
The COPD Center facility shares faculty with the Lung Transplant and the Lung Cancer groups.
Several different animal models of emphysema are under detailed investigation.