Medicine

Head of Discipline
Professor Warwick Britton, Associate Professor John Kellow, Professor Richard Lindley
Location
Central, Northern and Western Clinical Schools

The Discipline of Medicine encompasses more than 15 clinical specialties in the area of medical research and education, allowing for a great diversity of staff expertise.

Teaching and research occurs predominantly in the three Clinical Schools which are based in the Central, Northern and Western areas of Sydney. Each School is located within a major teaching hospital of the University of Sydney, and has ties to other teaching hospitals in the respective regions.

Major areas of research and some of the topics being studied include:

Cardiology

• Clinical pharmacology of anti-anginal drugs
• ECG monitoring for myocardial ischaemia
• Myocardial infarction
• Myocardial viability
• Echocardiography for left ventricular function
• Intravascular ultrasound
• Arrhythmias - pathophysiology and treatment
• Hypertrophic cardiomyopathy and Marfan syndrome
• Non-invasive and laboratory assessment of endothelial function
• Ventricular and supraventricular arrhythmia, including ablation and ICD
• Cardiac Na / K pump function
• Procoagulant mechanisms in coronary disease
• Mechanisms of thrombolysis
• Coronary angioplasty and stenting
• Combined arteriosclerosis research with Heart Research Institute
• HDL and reverse cholesterol transport

Dermatology

• Protection of the immune response by physical and chemical sunscreens
• Development of a vaccine in melanoma using Langerhans cells and tumour antigens
• Molecular biological studies of progression from solar keratoses to squamous cell carcinomas
• Studies of Langerhans cell in arbovirus infections
• Studies of plasminogen activator inhibitor in psoriasis
• Studies of tea tree oil in dandruff and tinea

Endocrinology

• Diabetes mellitus and intermediary metabolism
• Insulin-like growth factors
• Andrology
• Obesity, carbohydrate and lipoprotein metabolism
• Adipose tissue metabolism
• Reproductive endocrinology
• Hormone pharmacology
• Molecular biology
• Pituitary and hypothalamic disease
• Thyroid cancer
• The pathogenesis of prostate disease
• Diabetes health care delivery and health economics
• Bone and mineral metabolism

Gastroenterology and Hepatology

• Barrett's oesophagus and adenocarcinoma
• Peptic ulcer - pathogenesis, epidemiology
• Gastrointestinal motility (health and in the functional bowel disorders - gastric, small bowel and colonic)
• Motility of the biliary tract
• Pathogenesis of the functional gastrointestinal disorders
• Psychosocial factors in the irritable bowel syndrome and functional dyspepsia
• Gastro-oesophageal reflux and respiratory symptoms
• Helicobacter pylori
• Chronic constipation
• Gastro-oesophageal reflux disease
• Diabetes and the gut
• Epidemiology of gastrointestinal disorders
• Regulation of human P450 genes in cultured hepatocytes
• Drug-induced liver disease
• Inhibition of drug metabolism
• Vitamin A metabolism
• Kupffer cells, endothelial cells and hepatotoxicity
• Hypothalamic-pituitary dysfunction in endstage cirrhosis - the effect of hepatic transplantation
• Hepatitis C
• Bone disease in endstage cirrhosis: effect of hepatic transplantation
• Non-alcoholic steatohepatitis: role of P450s, leptin, insulin resistance
• Immunopathology of hepatic allograft rejection
• Molecular basis of colorectal cancer
• Hepatic endothelial cells and liver toxicity
• Alcohol and liver cell proliferation
• Quantitative liver function tests
• Apoptosis and liver cancer
• Liver cell differentiation
• Structure / function of oligopeptidase gene family
• Differential cloning of liver disease genes
• Hepatitis C immunopathogenesis

Geriatric Medicine
The Geriatric Medicine section is mainly based at the Centre for Education and Research on Ageing (CERA) at Concord Repatriation General Hospital and conducts an active program of clinical epidemiological, biological and health service research, involving departmental and collaborative projects.

• Alzheimer's disease
• Fronto-temporal dementia
• Vascular dementia
• Parkinson's disease
• Lewy body dementias
• Gait and balance disorders
• Experimental models of ageing
• Neuropsychology of ageing
• Neuropathology of the dementias and neurodegenerative diseases
• Neuroimaging studies of the dementias and neurodegenerative disorders
• Genetic studies of familial dementias
• Public health aspects of ageing
• Neuropharmacology
• Modern information technology and education in geriatrics
• Biochemistry, cell biology and molecular biology of Alzheimer's disease
• Stroke rehabilitation

Haematology

• Biology of leukaemia
• Bone marrow stroma and interaction with normal and malignant cells
• Biology of multiple myeloma
• Clinical trials of leukaemia and lymphoma
• Bone marrow transplantation and immunotherapy of haematological malignancy

Infectious Diseases and Immunology
Central Clinical School

• Hepatitis C
• Duck hepatitis
• Papilloma virus
• Cancer of the cervix
• Cystic fibrosis microbiology
• Fungal actives
• Biofilms on endoscopes
• Parvovirus
• Staphylococcus aureus hospital cross-infections
• Endotoxaemia
• Immune responses to mycobacteria
• Bacterial and viral vaccine vectors
• Genetic control of human allergic responses
• Characterisation of allergens
• Dietary control of food intolerance
• Immune mechanisms in rheumatoid arthritis and systemic lupus erythematosus
• Reproductive immunology
• HIV, trials of chemotherapy and immunotherapy
• Cytokine regulation of HIV
• Immune mechanisms in allergic disease
• B cell responses in allergy
• Genetics of autoimmune disease

Infectious Diseases and Microbiology
Western Clinical School

The Centre for Infectious Diseases and Microbiology and the linked Centre for Virus Research, Westmead Institutes of Health Research are located at Westmead Hospital and the ICPMR (Institute of Clinical Pathology and Medical Research). Areas of interest include the following:

Clinical Microbiology

• Epidemiology of infectious organisms in the gut, surgical wounds and blood
• Epidemiology and virulence of factors of Ureaplasma urealyticum
• Intrauterine and perinatal infections
• Molecular diagnosis and epidemiology of tuberculosis
• Molecular methods of bacterial typing
• Bacterial pathogenesis
• Bartonella and the human host
• Virulence factors of Legionella species

Infectious Diseases

• Lipids in the inflammatory response
• Magnetic resonance spectroscopy of infective lesions
• Interaction of Cryptococcus neoformans with respiratory epithelial cells and neutrophils

Medical Entomology

• Arbovirus / vector surveillance
• Mosquito biology and control
• Studies of Ross River and Bahmah Forest virus in mosquitoes
• Mosquitoes at Homebush Bay

Mycology

• Molecular epidemiology of Cryptococcus neoformans
• Molecular taxonomy of yeasts of medical importance
• Virulence factors of Cryptococcus neoformans
• World wide study of genetic relatedness of Cryptococcus neoformans
• Fungal phospholipases

Parasitology

• Molecular techniques for parasite detection
• Seroepidemiology of zoonotic helminth infections
• Molecular epidemiology of malaria

Virology

• Antivirals and vaccines for herpes viruses
• Clinical studies in HIV and other STDs
• HIV molecular biology
• Pathogenesis of HIV infection
• Pathogenesis of HSV reactivation – immunology and neuronal infection

Molecular Genetics
Royal Prince Alfred Hospital

• Molecular basis of genetic disease
• Thalassaemia
• Cystic fibrosis
• Genomic imprinting (e.g. Prader Willi and Angelman syndromes)
• Familial hypertrophic cardiomyopathy
• Genetic diagnosis e.g. prenatal diagnosis of disease
• Genes and the elite athlete

Molecular Medicine
ANZAC Research Institute, Concord Repatriation General Hospital

• Finding genes causing diseases of nerve and brain, including peripheral nerve disorders and motor neurone disorders
• Clinical and molecular studies
• Gene mapping and screening
• Gene expression
• Cell biology of disease

Neurology

Royal Prince Alfred Hospital

• Inflammatory demyelinating neuropathies
• Epidemiology, pathophysiology and treatment of multiple sclerosis
• Hearing and balance disorders
• Behavioural neurology
• Autonomic disorders
• Therapeutic strategies in stroke
• Movement disorders
• Application of Positron Emission Tomography (PET) scanning to neurology
• Application of DNA technology to inherited neurological diseases
• Peripheral neuropathy
• Investigation and management of epilepsy

ANZAC Research Institute Concord Hospital

• Finding genes causing diseases of nerve and brain, including peripheral nerve disorders and motor neurone disorders
• Clinical and molecular studies
• Gene mapping and screening
• Gene expression
• Cell biology of disease

Nuclear Medicine

• Thyroid cancer
• Drug resistance in tumours
• Myocardial perfusion assessment
• Pulmonary embolism detection
• Brain tumour assessment
• GI motility in functional disease
• Palliation of bony metastases
• Renal transplant evaluation
• Positron emission tomography (PET)

Oncology and Palliative Care
Royal Prince Alfred Hospital and Royal North Shore Hospital

• Magnetic resonance spectroscopy and tumour pathology / biology
• Magnetic resonance imaging
• Biochemical modulation of anticancer drug action in vitro and in vivo
• Clinical aspects of human tumour resistance to anticancer drug treatment
• Apoptosis
• Quality of life in cancer patients
• Communication in cancer care
• Evaluation of new drugs

Westmead Hospital

• DNA repair and chemotherapy resistance
• Hormonal regulation of breast cancer
• Molecular genetics of melanoma
• Molecular cytogenetics of ovarian cancer
• Genetics of hereditary cancers
• Cell cycle regulation
• Gene expression and nucleo-cytoplasmic transport

Rehabilitation Medicine
The Rehabilitation Studies Unit is a multi-disciplinary group that is conducting research and education within the theme of injury related disability. It is largely based at its Ryde headquarters (Royal Rehabilitation Centre, Sydney). The Unit is well equipped with its own computer network and is also linked to the University of Sydney Medical Program's Medical Education Network. Modern audiovisual facilities for teaching and lecturing are available and there is access to an excellent specialised small library. The Unit has developed strong links with the Faculty of Health Sciences, and Centre for Developmental Disability Studies. Present activities include projects focusing on:

• Evidence based rehabilitation
• Mobility after spinal cord injury
• Health outcomes research in medical rehabilitation
• Recovery after hip fracture
• Home-based rehabilitation
• Curriculum development in rehabilitation
• Brain injury rehabilitation
• Behavioural science in rehabilitation
• Hip protectors
• Physiotherapy treatment after ankle fracture

Renal Medicine

• Mechanisms in the initiation of diabetic renal disease
• Response of renal tubule cells to growth factors
• Mechanisms of compensatory renal hypertrophy
• Renal function in subjects with one kidney
• Enzymuria and renal function as a predictor of early renal damage
• Kidney stone metabolic investigations
• Endogenous diuretic-like substances and natriuretic factors
• Erythrocyte electrolyte transport
• Cytotrophoblast invasiveness and function
• Treatment of pregnancy-associated hypertension
• Conduit artery function in pregnancy
• Platelet and monocyte function in pre-eclampsia
• Endothelial function in pregnancy and pre-eclampsia
• Mechanisms of urine concentration
• Management of intractable oedema
• Altered kidney metabolic activity in renal failure
• Pathogenesis of proteinuric renal injury
• Pathogenesis of paraquot nephrotoxicity
• Nephrotoxic renal disease
• Mutation analysis of Alport's syndrome
• Nutrition in renal disease
• Assessment of adequacy of dialysis
• Management of diabetic nephropathy by pancreatic transplantation; islet cell transplantation
• Histocompatibility in renal transplantation
• Cellular mechanisms in xenograft rejection
• Prognostic factors in IgA disease
• Natural history and progression of focal sclerosing glomerulonephritis
  Hyperlipidaemia and vascular disease in dialysis and transplantation

Respiratory Medicine
Respiratory Medicine insists on students taking units of study in statistics and sometimes epidemiology or other related subjects.

• Epidemiology of asthma
• Pathology of asthma and CAL
• Treatment of asthma
• Causes of bronchial hyperresponsiveness
• Cystic fibrosis
• Gas exchange abnormalities in CAL
• Exercise physiology
• Treatment of adult respiratory distress syndrome (ARDS)
• Cost of major respiratory disease
• Respiratory failure
• Role of infection in COPD
• Bone marrow transplantation and lung function
• Immuno-system for measuring allergens
• Identification of allergens
• Measurement of allergen exposure

Rheumatology
The rheumatology section continues to develop a broad spectrum of research activities including studies on basic mechanisms of inflammation and studies of the immunogenetic predisposition to bone and joint disorders.

• Mechanisms of tissue damage in arthritis
• Angiogenesis in arthritis
• Cytokine production in rheumatoid arthritis
• Epidemiological studies of arthritis and hip fractures in the elderly
• Studies of the molecular basis of T-cell antigen receptor assembly and ways in which this process may be inhibited
• Immunogenetic studies in rheumatoid arthritis
• Family and twin studies in systemic lupus erythematosus, osteoporosis and osteoarthritis
• Osteoporosis and metabolic bone disease
• Clinical trials of new agents in rheumatic disease

Sleep Disorders Medicine

• Sleep apnoea - mechanisms and treatment
• Endocrine, cardiovascular, metabolic and neurologic complications of sleep apnoea
• Epidemiology and public health aspects of sleep apnoea
• Respiratory failure and sleep
• Paediatric sleep disorders
• Control of breathing
• Upper airway - physiology and pathophysiology
• Non-invasive cardiorespiratory monitoring during sleep
• Foetal neurophysiologic state and breathing movements
• SIDS
• Autonomic function in sleep
• Asthma and sleep
• Stroke and sleep
• Heart failure and sleep

Centre for Advanced Medical Technology

• Medical device technology development
• Medical engineering and bioengineering

Heads of Discipline contact details:

Professor Warwick J Britton
Head of Discipline (Central Clinical School)

Blackburn Building
University of Sydney, NSW, 2006

Phone: +61 2 9515 5210
Fax: +61 2 9351 3968
E-mail:

Associate Professor John E Kellow
Head of Discipline (Northern Clinical School)

Discipline of Medicine
Royal North Shore Hospital
Pacific Highway, St Leonards, NSW, 2065

Phone: +61 2 9926 7355
Fax; +612 9436 3719
E-mail:

Professor Richard I Lindley
Head of Discipline (Western Clinical School)

Westmead Hospital
Darcy Road, Westmead, NSW, 2145

Phone: +61 2 9845 5080
Fax: +61 2 9687 1429
E-mail: