Seattle Children’s Hospital and the Department of Pediatrics,

Transcription

2007 Academic Annual Report
Seattle Children’s Hospital
and the Department of Pediatrics,
University of Washington School of Medicine
Our Mission
We believe all children have unique
needs and should grow up without
illness or injury. With the support of
the community and through our spirit
of inquiry, we will prevent, treat and
eliminate pediatric disease.
Our Vision
We will be the best children’s hospital
We will:
> P
rovide patients and their families excellent care with
compassion and respect
> Deliver superior, accessible, cost-effective service
> Attract and retain the best talent at all levels of the organization
> Be one of the top five pediatric research institutions in the country
> Be the nation’s premier pediatric educator
> A
chieve worldwide prominence by integrating patient care,
research, education and advocacy
Contents
Message from Dr. Tom Hansen 2
Message from Dr. Paul Ramsey 3
Welcome to the 2007 Academic Annual Report 4-5
2007 Achievements 6-7
Faculty Leadership 8-9
Investing in the Future of Pediatric Medicine 10-21
The Practice of Clinical Research 10-11
Care for Medically Complex Children 12-13
Treatments for Heart Failure 14-15
Repairing Defective Genes 16
Novel Therapies to Treat Cancer 17
Preventing Preventable Diseases 18
Finding a Cause for SIDS 19
Sports Injury Prevention 20
Establishing Standards of Pediatric Care 21
For your convenience,
the department and
division reports are
identified by color bars
on the outside of each
page. Please refer to the
color key on this page
for help with locating
the correct section.
Department Reports 22
Anesthesiology and Pain Medicine 24-33
Dental Medicine 34-39
Laboratory Medicine/Pathology 40-44
Neurology 45-50
Orthopedics 51-57
Psychiatry and Behavioral Medicine 58-67
Radiology 68-75
Rehabilitation Medicine 76-79
Department of Pediatrics Division Reports 80
Adolescent Medicine 82-86
Bioethics 87-91
Cardiology 92-98
Craniofacial Medicine 99-103
Critical Care Medicine 104-107
Emergency Medicine 108-115
Endocrinology and Diabetes 116-120
Gastroenterology, Hepatology
and Nutrition 121-125
General Pediatrics 126-141
Genetics and Developmental
Medicine 142-154
Hematology/Oncology and
Bone Marrow Transplant 155-172
Hospital Medicine 173-175
Infectious Disease, Immunology
and Rheumatology 176-199
Neonatology 200-206
Nephrology 207-216
Pulmonary Medicine 217-227
Department of Surgery Division Reports 228
Cardiothoracic Surgery 230-232
Craniofacial, Plastic and
Reconstructive Surgery 233-238
General and Thoracic Surgery 239-243
Neurosurgery 244-247
Ophthalmology 248-250
Oral and Maxillofacial Surgery 251
Otolaryngology 252-255
Transplant Surgery 256-260
Urology 261-267
Centers 268
Craniofacial Center 270
Heart Center 271
Transplant Center 272
Treuman Katz Center for
Pediatric Bioethics 273
Research Institute 274-281
Fellows and Residents 282-283
Financial Summary 284-285
Seattle Children’s Hospital Seattle, Washington
1
Message from Dr. Tom Hansen
CEO of Seattle Children’s Hospital
Dea r Colleague s and Fri ends,
I am pleased to share this annual report detailing many of the outstanding achievements made at Seattle Children’s during the past year. We enjoyed a successful year
celebrating our 100-year history and envisioning a bold, bright future.
The accomplishments of our physicians, researchers and staff demonstrate our
commitment as compassionate experts in pediatric care, making significant
clinical, educational and research advances that improve the lives of children
around the world.
To address the increasing demand for our services and a need for more inpatient beds, Children’s
began working with citizens and the City of Seattle to plan for an additional 130 to 180 beds by
2012, for a total of 600 beds over the next 15 to 20 years. These efforts will ensure that we are
here for all children who look to us for a healthier future.
Research serves as the foundation of our quest to eliminate childhood disease. More than
$31 million of grant and contract revenue in 2007 supported over 500 studies. The hospital plans
to develop nearly 2 million feet of research space in downtown Seattle to support the diagnosis,
treatment, outcomes and quality of life for children with a broad range of medical conditions.
As the pediatric training site for the University of Washington School of Medicine, Children’s
provided broad clinical expertise to over 700 residents and fellows last year. This strong
relationship continues to bring the best medical professionals to the Pacific Northwest.
Thank you for taking the time to read about the significant progress we have been making at
Seattle Children’s. The work highlighted in this report and the dedicated professionals behind
it are the backbone of our institution. They make progress possible — both in our community
and in the world of pediatric medicine.
Thomas N. Hansen, MD
Chief Executive Officer
Seattle Children’s Hospital and Regional Medical Center
2
Message from Dr. Paul Ramsey
Dean, University of Washington School of Medicine
Dea r Colleague s ,
Children bring endless joy to our lives and are the hope of the future. When an
infant is born with a serious medical condition or illness strikes a young person,
the impact is immediate and profound.
Seattle Children’s Hospital has always played a key role in providing superb medical
care for the Pacific Northwest’s children and in seeking solutions for childhood diseases.
With the start of the Seattle Children’s Hospital Research Institute in October 2006,
Children’s took a huge step forward toward brighter futures for all children.
The progress made in less than two years by the research institute is remarkable. Dr. Andrew
Scharenberg, University of Washington (UW) associate professor of pediatrics, Dr. David Rawlings,
UW professor of pediatrics and chief of the Division of Pediatric Immunology, and their colleagues
recently received a $23.7 million research grant from the National Institutes of Health. The grant
will permit study of gene repair and provide support for the Northwest Genome Engineering
Consortium, a partnership of Children’s, the UW School of Medicine and Fred Hutchinson
Cancer Research Center.
The institute is addressing many areas, including global problems. It recently received a $1 million
grant from the Bill & Melinda Gates Foundation to study ways to prevent global prematurity and
stillbirth. Dr. Craig Rubens, UW professor of pediatrics, will lead the new Global Alliance for the
Prevention of Prematurity and Stillbirth in these efforts.
Training the next generation of pediatric physicians and researchers is key to finding solutions for
eradicating childhood diseases. Children’s does an outstanding job of providing pediatric training
for UW medical students and residents. In specialty training areas, the UW pediatrics program was
ranked seventh in the nation by medical school deans and senior faculty in the 2007 U.S.News &
World Report Best Hospitals rankings.
It is an honor for UW Medicine to collaborate with Children’s in teaching, research and patient
care. Through solid collaborations, there is strong hope for the future health and well-being of
the world’s children.
Paul G. Ramsey, MD
Chief Executive Officer, UW Medicine
Executive Vice President for Medical Affairs and
Dean of the School of Medicine,
University of Washington
3
Welcome to the 2007
Academic Annual Report
Dr. Douglas Hawkins betters the odds for
children and teens with cancer by developing
clinical studies that improve treatments and
lead to higher survival rates.
4
F r o m l e f t:
Seattle Children’s is hiring 85 new faculty members like pediatric
endocrinologist Dr. Angela Badaru, to expand clinical services and make
it easier for patients and families to access care.
The pioneering work of Dr. Thomas Jones has revolutionized the way
congenital heart defects are repaired.
Dr. Carol Wallace leads a $4 million NIH-sponsored clinical trial to help
children with juvenile idiopathic arthritis achieve long-lasting remission.
Investing in the Future
of Pediatric Medicine
Welcome to the 2007 Academic
Annual Report for Seattle Children’s
Hospital.
The vision of a better future for
sick and injured children has inspired
us since 1907. Our spirit of inquiry and
our clinical and research leadership
have advanced the practice of health
care, unraveled medical mysteries and
helped improve the well being of
children all over the world.
Because our sole focus is on
pediatrics, we are mindful of how the
health care we provide today affects
the physical, mental and emotional
development of the infants, children
and teens we treat. Providing the
safest, most advanced care in a
healing environment is at the heart
of everything we do.
Across the institution, we are
creating a culture of continuous
performance improvement based on
methods developed by Toyota Motor
Corporation. This hospital-wide work
helps us remove waste from our
processes as a way to create more value
for our patients and families while
reducing barriers and obstacles for
our faculty and staff.
In 2007, much of our energy
was focused on creating the facilities
our clinicians, researchers and staff
need to support their work today and
during the next 20 years.
We continued expanding our
research campus in downtown Seattle
so our researchers will have the lab
space and support services they need
as they advance our mission to prevent,
treat and eliminate pediatric disease.
We also began implementing a
plan to help us meet the increasing
clinical needs of our rapidly growing
region. Our goal is to provide more
outpatient specialty care in the
communities where our patients live,
while centralizing high-intensity
services, such as hospital care, at
our main campus in Seattle.
Recent successes include opening
a new clinic in eastern Washington’s
Tri-Cities area and acquiring a 6.6-acre
plot east of Seattle near downtown
Bellevue on which we will build a
75,000-square-foot outpatient and
day-surgery clinic slated to open in
2010. Similar facilities are planned
for communities north and south
of Seattle.
Our greatest commitment
remains to providing care to any child
in our region who needs it, regardless
of a family’s ability to pay — and to
the clinicians, researchers and staff
who make it possible to provide
these patients with the best medical
care available.
Seattle Children’s Department of Surgery
has the lowest complication rates, the
fewest repeat operations and the shortest
hospital stays of any institution doing
pediatric surgery in the region.
5
2007 Achievements
Leading Research
> A study led by Dr. James Olson showed
that tumor paint is 500 times better
than a standard MRI at helping
surgeons distinguish between cancer
cells and normal tissue. Olson and
his team developed the paint, which
is currently being studied in mice
models, from a scorpion-derived
peptide called chlorotoxin.
> Dr. David Rawlings identified a
connection between allergic diseases
and autoimmune diseases. His study
implies that allergic and inflammatory
diseases may trigger autoimmune
diseases by relaxing the controls that
normally eliminate newly produced
self-reactive B cells.
> The Damon Runyon Cancer Research
Foundation named Dr. Colleen Delaney
one of its Clinical Investigators in
2007 for the potential of her work to
create a landmark breakthrough in
cord blood transplantation.
> Dr. Dan Doherty was part of an
international team that identified
a new genetic cause for Joubert
Pediatric cancer specialist Dr. James Olson developed tumor paint to light up cancer cells
embedded in normal tissue.
syndrome (JS), a rare, often
debilitating, inherited condition.
In addition to receiving a clinical investigator award from the Damon Runyon Cancer
Their research links JS to diseases
Research Foundation, Dr. Colleen Delaney’s research in cord blood transplantation earned
her the Young Investigator of the Year Award from Genome Technology magazine.
such as nephronophthisis, the
most common genetic cause of
Administrative program assistant Kori Rothweiller works in the Department of Psychiatry and
kidney failure in children.
Behavioral Medicine as part of Seattle Children’s award-winning Project SEARCH program.
C lo c k w i s e f r o m T o p :
6
Neonatologist Dr. Sandra Juul is
investigating ways to protect infants’
developing brains from injury after
premature birth, perinatal asphyxia
or stroke.
> Dr. Sandra Juul received a $3.5
million grant from the National
Institutes of Health to study how
best to protect the developing brain
from injury due to prematurity,
perinatal asphyxia or stroke.
> Dr. Dimitri Christakis found that
playing with toy blocks may improve
language development in young
children. In a second study, Christakis
showed that while educational videos
may hinder language development
in infants, they have no positive or
negative effect on the vocabularies
of toddlers. A third study linked
aggression and antisocial behavior in
7- to 9-year-old boys with watching
violent television programs in their
preschool years.
National Rankings
> In 2007, Seattle Children’s was
ranked ninth best children’s hospital
in the nation by U.S.News & World
Report, moving up three places from
its 12th place ranking in 2006.
> In 2007, U.S.News & World Report
ranked the University of Washington
(UW) School of Medicine’s Department of Pediatrics eighth in the
country in its “America’s Best Graduate
Schools” issue. Seattle Children’s is
the primary pediatric teaching site
for the UW School of Medicine, which
was ranked number one among
medical schools for primary care for
the 14th straight year by U.S.News.
disabilities in entry-level positions
throughout the hospital. To date,
Seattle Children’s has employed 26
individuals through Project SEARCH.
Organizational Firsts
Facility Expansions
> Seattle Children’s formed the Global
Alliance for the Prevention of
Prematurity and Stillbirth (GAPPS)
to advance understanding of these
serious global health problems and
help find solutions. Seattle Children’s
will host an international conference
on prematurity and stillbirth in 2009
with support from the Bill & Melinda
Gates Foundation.
Seattle Children’s continued to grow
its research and clinical campuses. In
2007, the hospital made the following
progress toward its expansion goals:
> Leaders of Seattle Children’s,
including 16 physicians, visited
Japan to observe the Toyota Motor
Corporation’s approach to improving
quality and service. Children’s is
one of the first pediatric hospitals
in the nation to adapt Toyota’s
methods to improve quality of
care for patients.
> Seattle Children’s was named Large
Non-profit Employer of the Year by
the Washington State Governor’s
Committee on Disability Issues and
Employment. The award recognizes
the success of Project SEARCH, a
program committed to recruiting and
placing people with developmental
> Further developed its downtown
research campus by acquiring a
second city block adjacent to the two
contiguous buildings it purchased
in late October 2006. Together, these
properties give the Seattle Children’s
Hospital Research Institute the
capacity for 2 million square feet
of laboratory research.
> Announced plans to expand facilities
on its main campus beginning in
2010. The proposed expansion, which
includes increasing inpatient beds,
will meet the region’s growing demand
for pediatric specialty care services,
while ensuring the continuity of safe,
quality care in a healing environment.
> Purchased 6.6 acres in Bellevue,
Wash., to build an outpatient care
clinic and ambulatory surgery center.
The 75,000-square-foot facility is
scheduled to open in 2010.
7
Faculty Leadership
C LO C KWISE F ROM LE F T:
Drs. Catherine Karr and Sheela Sathyanarayana work to reduce children’s
exposure to environmental toxins at the University of Washington’s Pediatric
Environmental Health Specialty Unit.
Dr. Frederick Rivara is a national leader in the field of injury prevention.
Dr. Linda Quan is one of the world’s foremost experts on drowning prevention.
8
Dr. John Neff directs the
Seattle Children’s Center for
Children with Special Needs.
Endowed Chairs
Allison Eddy, MD
Dr. Robert O. Hickman Endowed
Chair in Pediatric Nephrology
Hans Ochs, MD
Jeffrey Modell Endowed Chair in
Pediatric Immunology Research
Linda Quan, MD
Appointed member, American Red Cross
Advisory Council on First Aid, Aquatics,
Safety and Preparedness
David Rawlings, MD
Elected member, Association of
American Physicians
Troy Torgerson, MD, PhD
Invited member, Society for Pediatric Research
Sandra Watkins, MD
Elected member, 14th Member Council,
International Pediatric Nephrology Association
Honors and Awards
Frederick Rivara, MD, MPH
Children’s Hospital Guild Association Endowed
Chair in Pediatric Health Outcomes Research
Gregory Redding, MD
Elected president, American Lung
Association of the Northwest
Richard A. Hopper, MD
Golden Scalpel Award, Washington
Society of Plastic Surgeons
Professional Appointments
Frederick Rivara, MD, MPH
Appointed member, Board on Children, Youth,
and Families, National Academy of Sciences;
Catherine Karr, MD, MS
Children’s Environmental Health Excellence Award,
United States Environmental Protection Agency
Appointed member, Board of Directors,
Washington State Academy of Science
Teresa L. Massagli, MD
Outstanding Service Award,
Association of Academic Physiatrists
Dimitri Christakis, MD, MPH
Appointed member, Health Services
Organization and Delivery Study Section,
Center for Scientific Review
Beth Ebel, MD, MPH
Appointed director, CDC-supported
Harborview Injury Prevention and Research
Center, University of Washington
Janet Englund, MD
Appointed member, Advisory Committee
on Immunization Practices, Centers for
Disease Control and Prevention
Lisa Frenkel, MD
Appointed advisor, HIVResNet,
World Health Organization
James Hendricks, PhD
Appointed assistant dean, Research and
Graduate Medical Education, University
of Washington School of Medicine
Brian D. Johnston, MD, MPH
Appointed editor, Injury Prevention
Carolyn McCarty, PhD
Invited member, Society for Pediatric Research
Carol Miao, PhD
Appointed member, Scientific Review Board,
NIH Gene Therapy Resource Program
Daniel Miller, MD, PhD
Invited member, Society of Pediatric Research
John Neff, MD
Appointed member, Technical Advisory Panel,
National Quality Forum Project on Establishing
Priorities, Goals and a Measurement Framework
for Assessing Value Across Episodes of Care
Andrew Scharenberg, MD
Elected member, American Society
for Clinical Investigation
Sherilyn Smith, MD
Elected member, Executive Committee, Council
on Medical Student Education in Pediatrics
Bruder Stapleton, MD
Appointed associate dean, Research and
Graduate Medical Education, University
James Stout, MD, MPH
Appointed member, National Asthma
Guidelines Implementation Panel, Agency
for Healthcare Research and Quality
Bonnie Ramsey, MD
Lifetime Achievement Award, General Clinic
Research Center, University of Washington;
Stephanie Lynn Kossoff Memorial Lectureship
in Cystic Fibrosis, Columbia University
Sheela Sathyanarayana, MD, MPH
Children’s Environmental Health Excellence Award,
United States Environmental Protection Agency
C. Ronald Scott, MD
Commissioner’s Special Citation,
United States Food and Drug Administration
Peter Tarczy-Hornoch, MD
Appointed member, Editorial Board, Journal of
the American Medical Informatics Association;
Appointed member, Editorial Board, Journal of
Biomedical Informatics
Dr. C. Ronald Scott received the
Commissioner’s Special Citation from
the Food and Drug Administration
for his efforts to get Orfadin approved
for commercial use. Before the use of
Orfadin, a majority of children with
a rare genetic liver disease called
tyrosinemia type I died of liver failure
in infancy or of cancer of the liver
in late childhood.
9
Investing in the Future of:
The Practice of Clinical Research
Accelerating Research
Advances to the Bedside
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ITHS Participating
Institutions
The Institute of Translational Health
Sciences (ITHS) is working to build local
and regional partnerships with scientists,
educational institutions, health systems
and industry members. Current local and
regional partners include:
> Benaroya Research Institute at
Virginia Mason
> Fred Hutchinson Cancer Research Center
> Group Health Cooperative Health
Care System
> Northwest Association for
Biomedical Research
> Seattle Cancer Care Alliance
> Seattle Children’s Hospital
> University of Washington
> American Indian and Alaska Native
communities and organizations
> Primary care clinical and teaching
practices in Washington, Wyoming,
Alaska, Montana and Idaho, including
the Family Medicine Research Network
10
Seattle Children’s is one of the few
pediatric institutions to receive a
new type of National Institutes of
Health (NIH) funding for clinical
and translational science. The goal
of this program is to better establish
clinical and translational research
as its own discipline, and jumpstart the career development of
investigators pursuing this area
of research.
The five-year, $62 million grant
($9.4 million directed to Children’s) —
known as a Clinical and Translational
Science Award (CTSA) — puts
Children’s at the forefront of a
national effort by the NIH. Twentyfour sites are funded thus far, and
the NIH plans to create a network
of 60 CTSA sites by 2012.
“The goal is to create an
environment that speeds up the
processes through which basic
science discoveries are turned into
clinical practice,” says Dr. Bonnie
Ramsey, a co–principal investigator
of the CTSA at Children’s. “We
want patients to receive the most
advanced care as quickly as possible.”
The NIH award combines four
existing grants from Children’s
and the University of Washington
(UW) to create a comprehensive
new entity known as the Institute of
Translational Health Sciences (ITHS).
The ITHS is based at the UW
and serves as a regional hub to unite
academic researchers, communitybased health-care providers and
patients across the Pacific Northwest.
Any researcher or individual interested
in translational research from any group
can become a member of the ITHS
through its Web site, www.iths.org.
Children’s offers the pediatric
expertise and leadership for this
research, along with access to our
Pediatric Clinical Research Center.
This provides investigators with
research facilities and resources — such
as nurses specially trained for research,
and specimen processing capabilities
— to conduct clinical and translational
research on childhood diseases.
Breaking down barriers
The NIH created the CTSA program
to ease the frustration and burnout
among clinical researchers burdened
by significant regulatory barriers and
high costs that impede initiating and
conducting research. For example,
some investigators have spent six to
12 months in the start-up phase until
their studies were opened to enroll
patients. This time loss could be
devastating to the career of a junior
faculty member.
“Under the new rules of the CTSA,
investigators now have more flexibility
to be as innovative as possible,” says
Ramsey, who also leads the Center for
Clinical and Translational Research
at Seattle Children’s Hospital Research
Institute. “The NIH has sent a clear
message that institutions need to
anticipate the needs of clinical investigators and be more service-oriented.”
Among the major initiatives
underway to improve support and
create stronger connections between
institutions are:
> Expanding biostatistical and data
management services, providing
access to UW resources and enabling
data sharing between institutions
> Making pilot funding available for
clinical and translational science
studies that involve children
> Adding cost-sharing between
investigators to allow more
flexibility in structuring personnel,
such as hiring clinical research
associates
> Developing a training program
about the federal regulations for
clinical research
“We are creating a culture of
shared knowledge and collaboration,”
says Kim Folger Bruce, PhD, the
ITHS portal manager. “We want to
create innovative partnerships and
provide the critical resources that will
advance our scientists’ translational
research to the next level.”
Folger Bruce is a “one-stop-shop”
who connects investigators, institutions
and Seattle’s burgeoning biotech
community and helps integrate
resources among research partners.
For example, executives from
Children’s, UW and Fred Hutchinson
Cancer Research Center now meet
regularly to recommend ways to make
clinical and translational research
more efficient across institutions.
“The big idea is to encourage
institutions to step out of their usual
practices and work together,” says
Ramsey. “You cannot conduct research
in a ‘silo’ anymore. These three partners
are key, but we want to go beyond that
to work with many organizations across
the entire Pacific Northwest.”
Continuously improving efficiency
“Our goal is to make it easier and more
satisfying for clinical researchers to
do the work that improves the way
Dr. Bonnie Ramsey
Need Photo for McDonald
pediatric medicine is practiced,”
says Ramsey.
Eliminating duplicate paperwork
is one area Children’s is tackling. One
example is eliminating the internal
review of studies already approved by
external funders, which cuts about
50% of the reviews needed to get a
project approved, and frees up valuable
time for investigators.
This work dovetails with a larger
initiative at Children’s to use continuous
performance improvement (CPI)
practices to eliminate duplication of
efforts from our work.
“We’ve had calls from around the
country asking how we use CPI to
eliminate inefficiencies in translational
research,” says Ramsey. “Our efforts
in this area directly relate to our goal
of eliminating barriers to conducting
the most innovative, collaborative
research possible.”
Supporting Tomorrow’s
Clinical Researchers
When Dr. Bonnie Ramsey sat down to write
her first NIH grant application, she had no
mentorship program to guide her. Young
investigators relied on informal connections
with more senior research faculty for support
as their research careers got underway.
“Frankly, if you didn’t have a strong
mentor to help you get through that period,
it was hard to make it,” she says. While
Ramsey found Dr. Arnold Smith, a wellrespected infectious disease researcher, to
mentor her early career development, she
wants to formalize that opportunity for others.
Children’s new Scholars Mentoring
Program provides mentored career
development for fellows and junior
faculty. The program gives salary support
to these investigators, for tuition to earn
their master’s in clinical research or for a
research study. It also provides a mentor
for fellows and junior faculty writing their
first NIH grant.
“Support like this award makes it easier
for talented young investigators to establish
themselves, especially in such a competitive
funding environment,” says Ramsey.
11
Care for Medically
Complex Children
Creating a New
Model of Care
Dr. Ronald Dick
The Medially Complex Child Service
hosts two interns per month on the team
— a practice requested by families and
valued by residents as an opportunity to
better understand how to care for this
special patient population.
12
Shortly after Dr. Ronald Dick joined
Seattle Children’s in 2003, he entered
the room of a boy with multiple
serious medical issues and was
greeted by a parent in a way that
would keep him awake for many
nights. The father came within an
inch of Dick’s face and shouted,
“Who are you and what are you
going to screw up?”
After the man calmed down,
Dick asked what put him over the
boiling point. The father, whose son
had been admitted a month before,
explained that he’d grown tired of
describing his son’s condition to
multiple providers as they went on
and off service. He didn’t trust that
clinicians fully understood all the
aspects of his son’s complex condition
or that they were coordinating their
efforts. The conflicting information
he’d received from doctors and nurses
made him suspicious that his son’s
care would suffer.
Dick spoke to other parents and
realized that this dad’s experience was
not an isolated incident. Many parents
with medically complex children felt
unheard and invisible. “Parents told
me, ‘we’re here all the time and you
don’t even know us,’” he remembers.
These events motivated Dick,
an attending physician in the Division
of Hospital Medicine, to develop a
new model of care for children on
the Medical Unit who have more
than one major organ system that
is compromised and who require
frequent hospital stays.
Though these “medically complex”
kids make up a small fraction of the
unit’s patient population, they require
a large portion of its health-care
resources on any given day.
Dick’s new model addresses the
unique needs of this small population.
Typically, children are admitted for
a particular procedure, stay for a few
days and are discharged for good. In
contrast, medically complex children
have a variety of high-intensity
chronic medical needs that require
continuity of care from providers
across many disciplines.
Dick’s Medically Complex Child
Service (MCCS) is one of only a few
programs of its kind on the West
Coast and puts Seattle Children’s
ahead of the national curve in
improving the inpatient experience
for families and their children
with medically complex conditions.
A unique population
A child considered medically complex
might be developmentally delayed and
nonverbal, suffer from cerebral palsy,
seizures and respiratory distress, take
close to a dozen medications, and be
dependent on a G-tube for nutrition,
a BiPAP machine for obstructive
sleep apnea, and a baclofen pump
for spasticity.
In any given year, such a child
might average four to six hospital
stays lasting two weeks each. While
most insurance companies would
categorize these children as having
“catastrophic illness,” Dick simply sees
kids who defy the medical textbooks.
Families are experts in
the care of their unique
child and are important
members of the Medically
Complex Child team.
“Each of my patients is unique.
They respond to medications and
therapies in their own way. There’s no
black-and-white answer for most of
them,” he explains. “The one thing
they all have in common is that they
are medically fragile. A common cold
can land them in the hospital for
several weeks.”
A superior model
Today, 10 beds on Seattle Children’s
inpatient Medical Unit are reserved
for children with medically complex
conditions, and approximately 200
patients have been pre-identified on
Seattle Children’s electronic medical
record system for quick admission
to the new service through the
Emergency Department.
But it’s the team of practitioners
that make the difference for the patients
and their families.
Two nurse practitioners provide
medical case management for families
and serve as liaisons for in-house
faculty and referring providers. They
know the idiosyncrasies of their
patients and advocate for the
medications and therapies that work
best for them. A social worker helps
families cope with the hospital
experience. A care coordinator ensures
that everything each patient needs
for in-home care is set up prior to
discharge, including home nursing,
TPN formula, PICC lines, medical
equipment and outpatient visits. And
eight pediatricians share the role of
attending physician, which limits the
number of physicians on the service
and improves continuity of care.
“The entire MCCS team knows
these children and their families,”
explains Dick. “Our families are much
more relaxed and trusting because
they don’t have to repeat their kids’
medical histories or spend as much
time interpreting their subtle cues
for us. We’re now viewed as a great
help instead of a hindrance.”
When a child is admitted to this
service, a care conference with all
providers is automatically scheduled
with the family every two weeks to
maximize group communication
around unresolved issues. In addition,
the MCCS team goes on morning and
evening rounds to update the family
and the rest of the care team about
the child’s plan of care. When MCCS
patients are admitted to the ICU,
team members attend ICU rounds to
improve continuity and communication.
Nationally, the topic of how best
to care for children with medically
complex conditions is just beginning
to be discussed by hospitalists. Recently,
the American Academy of Pediatrics’
Committee on Hospital Medicine
sent out an e-mail to its members
to explore models of complex care.
Dick will have a lot to share.
13
Treatments for Heart Failure
Pioneering New Uses for
Existing Technology
Dr. Howard Jeffries (pictured far
right with Dr. Mithya Lewis-Newby)
co-authored a chapter on cardiac
ECMO in pediatric cardiac care for
the 2007 edition of the Johns Hopkins
Manual of Cardiothoracic Surgery.
“Putting children on ECMO
after heart surgery gives their
weakened hearts a chance
to fully rest and increases
the probability that they will
survive and thrive.”
— Dr. Harris Baden, chief,
Cardiac Intensive Care Unit
14
When Dr. Harris Baden was a
medical student at the Shriners’ Burn
Hospital in Texas, he called his dad
in the middle of the night and told
him, “This is so tragic. I don’t think
I can do this.” His father, a retired
neonatologist, told him, “As scary as it
is for you, think about how scary it is
for the patients and their families, and
how desperately they need your help.”
Nearly two decades later, his dad’s
advice continues to guide Baden as he
and his team take pediatric cardiac
critical-care medicine to the next level.
Since joining the faculty in 2003,
Baden’s been busy shifting institutional
paradigms about the best way to care
for children and teens with congenital
heart disease, which is the most
common birth defect.
In 2003, he and Seattle Children’s
Cardiothoracic Surgery Chief
Dr. Gordon Cohen began the process
of creating a distinct intensivecare service for cardiac patients
— an innovative move undertaken
by fewer than a dozen other
pediatric hospitals in the nation.
Today, Baden and his team are
pioneering the use of mechanical
life-support devices to strengthen
weak hearts prior to surgery and
to speed recovery afterward. Early
indications show that these novel
therapeutic uses may dramatically
improve survival outcomes for children
with life-limiting heart conditions.
Powerful restorative therapy
Historically, surgeons and intensivists
used a type of heart-lung life support
called “extracorporeal membrane
oxygenation” (ECMO) as a last-ditch
effort to save the most desperately
ill children.
Now, Baden and his colleagues
are exploring the use of ECMO as
a powerful restorative therapy —
particularly after the stress of highrisk surgeries such as transplants
and single ventricle repairs.
“The plumbing can be fixed, but
aggressive surgical approaches and
cardiac medications place a lot of
stress on the heart. ECMO helps
children survive by allowing the heart
to rest and recover,” explains Dr. Rob
Mazor, medical director of Seattle
Children’s Cardiac ECMO program.
“If you strained your bicep, you
wouldn’t do curls,” says Baden. “It’s
the same principle with the heart.”
Overcoming a challenge
In the past, heart surgery was a
relative contraindication for the use
of ECMO. The anti-clotting drug
heparin — required for children on
ECMO — intensifies normal postsurgical bleeding, which can lead
to complications and even death.
The Seattle Children’s Cardiac
ICU is one of a handful in the
nation to regularly use a different
type of life-support system to
solve this problem.
For up to 24 hours after heart
surgery, the Cardiac ICU team puts
children on a centrifical pump system
(CPS) with heparin-bonded tubes
in the pump. While the heart rests,
the drug-coated tubing prevents
clotting. After the post-surgical
bleeding subsides naturally, children
are put on heparin and moved to the
ECMO system. The team also uses
this approach to get control of chest
bleeding when it continues to be
a problem more than a few days
after surgery.
Mazor says the results of this
little-used method are excellent. The
team finds that children on the CPS
circuit with heparin-bonded tubing
have less bleeding and less need for
transfusion than children who used
to be put on the conventional ECMO
circuit and given heparin right after
surgery. In fall 2008, Cohen will
present these results at the Southern
Thoracic Surgical Association meeting,
and the paper will be published in
the Annals of Thoracic Surgery.
Rigorous standards
Putting a child on ECMO is never
done in a cavalier way. Baden and
his team trade the risks associated
with the child’s heart condition for
the risks associated with mechanical
assist: infection, clotting and
mechanical failure.
Baden says the secret to a child’s
success on life support is the Cardiac
ICU team, which consists of a distinct
group of intensivists, fellows and
nurses dedicated to cardiac critical
care. “Daily repetition of practice is
the key to our record of clinical
excellence,” explains Baden.
Supporting the team’s incredible
attention to detail are rigorous
protocols instituted and tracked by
Dr. Howard Jeffries, the Cardiac
ICU’s director of quality.
In March 2005, Jeffries joined
Child Health Corporation of America’s
effort to reduce bloodstream infections
— a process that includes a checklist
for line placements and seven
standard questions asked daily about
each patient. Since then, the team
has cut bloodstream infection rates
in half and significantly decreased
the number of days children need
Foley catheters. In July 2007, Jeffries
switched to central venous catheter
lines (CVL) infused with antimicrobials; since that time, the unit
has had only one CVL infection.
Looking ahead, Baden wants to
track the long-term neurodevelop
mental outcomes of kids on ECMO and
continue training the next generation
of cardiac critical-care providers.
“We can never lose sight of the
need to take cardiac critical-care
medicine to the next level,” he says.
“But when we look toward the future,
we always consider patients and
families first.”
Drs. Rob Mazor (left) and Harris
Baden report 100% survival rates
using a combination of ECMO
and anti-arrhythmic medications
on kids with heart failure related
to arrhythmias — a technique
that allows the heart to rest while
preventing the irregular beat from
damaging the heart muscle.
15
Repairing Defective Genes
Developing New
Options for Treating
Immune Disorders
Drs. David Rawlings and Andrew
Scharenberg are leading a $23.7 million
NIH grant to find better ways to treat
single-gene immune disorders.
16
In 2007, researchers at Seattle
Children’s took a giant step in their
quest to find better ways to treat
single-gene immune disorders when
they received a $23.7 million, 5-year
grant from a special program of the
National Institutes of Health (NIH).
The Northwest Genome
Engineering Consortium (NGEC) was
one of only nine research groups in
the United States funded by the NIH’s
Roadmap for Medical Research, a
special program designed to address
complex research problems that
require expertise across multiple
scientific disciplines.
Led by Drs. Andrew Scharenberg
and David Rawlings of Seattle Children’s,
the NGEC combines 11 different
projects working to develop ways to
correct defective sequences of DNA
that cause immune disease. These
interrelated projects bring together
researchers from Seattle Children’s,
the University of Washington (UW)
and the Fred Hutchinson Cancer
Research Center.
To repair defective genes, the
research team must develop customized proteins — known as homing
endonucleases — that can bind to and
cut a defective sequence of DNA. The
team must also develop the system to
deliver the protein to the appropriate
location within the gene.
“We are trying to find the needle
in a haystack and then better design
the needle,” says Scharenberg, who
is leading the development of the
customized proteins.
Half of the team’s NIH funding will
support the engineering of homing
endonucleases and the other half will
test the application of those tools in
the laboratory and in animal models
of immune deficiency diseases.
“We hope it will be possible to
remove a patient’s existing blood stem
cells, repair defective genes in the
cells and return them to the patient
once corrected,” says Rawlings. “This
approach potentially bypasses the
complications, treatments and costs
associated with rejection of bonemarrow cells from an unrelated donor.”
He and Scharenberg are
optimistic about gene repair as a
potential cure for some primary
immune diseases because of a process
called selective advantage. If defective
genes can be repaired in a small
number of cells taken from a child’s
bone marrow, these repaired cells will
reproduce more effectively than the
other cells. If successful, this approach
could be applied to cure many other
blood and genetic disorders.
The effort requires input from
researchers with expertise in diverse
fields, including computational
protein design, biophysics, cell biology,
bioinformatics and immunology.
Scharenberg and Rawlings are joined
by UW researchers David Baker, PhD,
Dr. Ray Monnat Jr. and Nancy Maziels,
PhD, and Drs. Barry Stoddard and
Hans-Peter Kiem of the Fred Hutchinson
Cancer Research Center.
“Our NIH application was
well received because our group of
investigators was already working
together productively,” says Scharenberg.
Novel Therapies to Treat Cancer
Finding New Ways to
Inhibit Tumor Growth
TOP :
Dr. Julie Park looks for novel, less-toxic
therapies to treat relapsed or resistant tumors.
B otto m :
Research nurses Celeste Oglesby and Lauren
De Pue give families the information they
need to feel confident about their children
participating in clinical research studies.
Though refining chemotherapy has
provided tremendous improvement
in survival rates for childhood cancers
over the past several decades, Dr. Julie
Park is looking for something better —
novel, less-toxic therapies to treat
relapsed or resistant tumors.
“We may have maxed out the
options to intensify conventional
chemotherapy,” Park says. “Now it’s a
matter of finding new ways to build
on where we’ve gotten to so far.”
One line of inquiry involves
finding ways to cut off a tumor’s blood
supply. The more vascular a tumor is,
the more likely it will be aggressive,
and the more likely it will metastasize.
Park is collaborating with Children’s
colleague Dr. Douglas Hawkins on a
phase I trial of a therapy that would
block a tumor’s ability to make new
blood vessels by inhibiting one of the
proteins, vascular endothelial growth
factor (VEGF), that is essential for
blood vessel formation. Park says
early results in adult tumors are
promising. The therapy, known as
“VEGF Trap,” has demonstrated antitumor and anti-angiogenic activity
against a variety of pediatric tumor
types — including rhabdomyosarcoma,
neuroblastoma and brain tumors —
in preclinical laboratory studies,
which provides the rationale to
perform the planned clinical trial.
Park is also collaborating with
Dr. Michael Jensen of City of Hope
in Duarte, Calif., to develop new ways
to enhance the body’s ability to fight
cancer on its own. Using genetic
engineering, patients’ T cells are
reprogrammed to target the cancer
and then reintroduced into the
body. Initial phase I trials treating
neuroblastoma have been encouraging;
Park and Jensen have demonstrated
that T cells can be collected, modified
and reintroduced with limited toxicity.
“Our next task is to test ways to
increase the duration of the modified
T cells activity once they are reintroduced to the patient’s body,” says
Park. “Our hypothesis is that using
a viral-specific TCR/CAR cell product
enhanced by an in vivo stimulation
of the native TCR might enable the
cells to provide long-term protection
from disease relapse.”
Together with Drs. Russell Geyer
and Blythe Thomson, Park oversees
Children’s program of more than
40 active phase I/II clinical research
trials for pediatric hematologic and
solid tumor malignancies. “Because
Children’s is one of the few hospitals
in the nation that is a member of
all four phase I cooperative groups,
our patients have access to early
studies not available at many other
institutions. In some cases, Children’s
is the only hospital on the West Coast
where certain experimental protocols
are available,” Park says.
17
Preventing Preventable
Diseases
Protecting Children
From the Flu
Dr. Janet Englund leads the Vaccine
and Treatment Evaluation Unit at
Seattle Children’s.
Testing the Vaccines
of Tomorrow
In 2007, Seattle Children’s, Group Health
Cooperative and the University of
Washington received a $23.7 million
contract from the National Institutes of
Health to form a Vaccine and Treatment
Evaluation Unit (VTEU). There are eight
VTEUs in the country, and only one on
the West Coast.
“Research done by the VTEUs has
been instrumental in making vaccines
for diseases like meningitis and acellular
pertussis available in the United States,”
says Dr. Janet Englund, who leads the
VTEU at Seattle Children’s. “We’re
pleased to be testing vaccines that
promise to save children’s lives in
the future.”
In 2007, Seattle Children’s introduced
several initiatives to better protect
our patients from the potentially
devastating impact of the flu.
“In the past, we’d tell parents that
everyone in their household should get
vaccinated to protect their children,
especially those with chronic illnesses,
from the flu. We provided flu vaccine
to our patients, but didn’t provide it
to their family members. It became
clear that many families and their
children — including many high-risk
patients — weren’t getting immunized,”
says Dr. Danielle Zerr, the medical
director of Infection Control at
Seattle Children’s.
Barriers such as arranging
transportation or finding a public
health clinic were getting in the way.
So a team at Children’s initiated a
campaign to vaccinate patients and
the members of their households
while they were at the hospital.
The hospital opened a drop-in flu
shot clinic and adopted an approach
widely used in adult health care:
setting standing orders authorizing
nurses to screen and vaccinate
inpatients and outpatients. As a result,
Seattle Children’s vaccinated nearly
twice as many patients than the
previous year.
360 degrees of protection
Family members and others living in
patients’ homes were encouraged to
get a free flu shot at the clinic. The
idea is to create a ring of protection
around patients, which is especially
important for those who cannot be
immunized because they are too
young or they have an underlying
health condition. In its first year,
the program reached around 1,900
household contacts.
“We’ve offered vaccinations to staff
for years, and it was always frustrating
that we couldn’t offer that service to
family members when we knew they
could expose patients to the flu,” says
Zerr. “Now we’re making sure our
most vulnerable patients have that
extra protection.”
Seattle Children’s also stepped
up the staff vaccination initiative. In
2007, the program reached 84% of
the staff who provide direct care —
an exceptionally high rate for an
institution where flu vaccinations
aren’t mandatory. The American
Medical Association and the Centers
for Disease Control and Prevention
recognized the campaign’s success.
Dr. Danielle Zerr
18
Finding a Cause for SIDS
Listening to a Hunch
Playing a hunch put Dr. Daniel
Rubens on the trail of a tragic and
mysterious disease.
Sudden Infant Death Syndrome
(SIDS) claims the lives of 2,500
infants in the United States every year.
Striking without warning and leaving
scant clues about its cause, SIDS has
defied all attempts to unlock its secret,
casting a shadow of fear over every
family with a newborn.
Rubens, an anesthesiologist at
Children’s, believes the inner ear holds
the key to deciphering SIDS. In a
study published last July in Early
Human Development, Rubens
examined the posthumous medical
records of 31 Rhode Island babies
who died of SIDS and found the same
distinctive hearing difference in their
newborn hearing tests for the right
inner ear.
Although much ground remains
to be covered, the study “opens up a
whole new line of inquiry into SIDS
research,” says Rubens. It could be the
compass that finally points physicians
toward a way to screen for SIDS with a
simple hearing test and intervene
before tragedy strikes.
Rubens listened to his intuition
when he decided to look in the inner
ear for clues to SIDS. “I had the idea
that we’d missed something about the
way the body controls breathing and
that the missing piece might be in the
fine hairs of the inner ear,” he says.
These hairs are known to be
involved in both hearing and balance
functions, but Rubens suspects some
also signal the brain to adjust breathing
in response to rising carbon dioxide
levels in the blood.
If damaged, the hairs are unable
to play their normal role in hearing.
However, if Rubens is right about the
carbon dioxide connection, damage
would also prevent them from warning
the brain about rising CO2 levels. He
believes that SIDS babies suffer some
sort of trauma at birth that leads to
both the hearing abnormality and the
interrupted CO2 signal, causing death
by suffocation.
Rubens is building on his first
study with three new investigations.
One is exploring a possible cause of
damage to the fine hairs. Another is a
larger, multisite version of the Rhode
Island study that will eliminate possible
variables involving background noise
and the type of testing equipment used.
The third is using mice to test the
association between damage to the
fine hairs and the brain’s response to
CO2. “We’re in the preliminary stages,
but it does look like there is a
connection,” Rubens says.
Acting on his intuition,
Dr. Daniel Rubens opens a
new door that may reveal
a secret to SIDS.
19
Transplant
Sports Injury Prevention
Going to Bat for
Sports Safety
To p :
Dr. Ernest Conrad and Jennifer Becker
received the contract to oversee athletic
trainers in Seattle’s public high schools
beginning in fall 2008.
B otto m :
High-school athletic trainer Loka
Murphy consults with Seattle
Children’s orthopedic specialist
Dr. Thomas Jinguji.
20
Across the nation, sports-related
injuries among teens are occurring
at higher rates than ever before.
Longer sports seasons, more intense
participation at younger ages
and the focus on playing just one
sport contribute to the increase.
Seattle is no exception. In 2007,
school-district athletic trainers
evaluated about 2,600 sports injuries
sustained by the city’s 3,500 highschool athletes. Overuse injuries to
the knee from running and jumping,
such as patellar tendonitis and
tibial tubercle apophysitis, top the
list of sports traumas that teens
are seen for in the sports medicine
program at Seattle Children’s,
says Dr. Thomas Jinguji.
To drop-kick these escalating
rates, Dr. Ernest Conrad and
Jennifer Becker, the medical and
administrative leaders of Seattle
Children’s Department of Orthopedics,
partnered with the Seattle Public
School District to pilot courses in
sports medicine using seed money
from Seattle Children’s. The goal is to
give teens at two Seattle high schools
the injury-prevention knowledge they
need to keep themselves and their
peers safe at play while piquing
their interest in health-care careers.
Education and advocacy
Becker says that she and Conrad are
proud of their work to get the classes
up and running because they create
greater awareness around injury
prevention — a natural fit with
Seattle Children’s mission to prevent
childhood injury.
Nearly 50 students are taking
the sports medicine courses, which
are part of the school district’s career
and technical education track.
“Kids need to know that they are
still growing and developing, and this
puts them at higher risk for sports
injuries that could impact maturing
soft tissues and bones,” explains
Conrad. “These courses encourage
students to take sports health and
safety seriously and become advocates
among their peers.”
Historically, the 10 high schools
in the Seattle Public School District
shared only five athletic trainers.
The funding from Seattle Children’s
puts a full-time athletic trainer/sports
medicine teacher at Seattle’s Ballard
and Chief Sealth high schools.
Conrad hopes the increased
staffing and new classes will lower
sports-injury rates at the two schools —
and convince the superintendent of
public schools to fund the pilot
program at all of Seattle’s high schools.
“We see far too many kids with
ankle and knee injuries from gymnastics,
football, soccer and basketball, repetitive
motion injuries of the shoulder and
elbow from baseball and concussions
from contact sports like football,
lacrosse and rugby.”
Establishing Standards
of Pediatric Care
Closing a Critical Gap
Like a pebble that kept sneaking into
her shoe, the findings kept nagging at
Dr. Rita Mangione-Smith. Whenever
someone studied the quality of
children’s health care, the results
made her wince.
Various studies with limited scope
were revealing instance after instance
in which children weren’t receiving
recommended care for numerous
common conditions.
“We started to question whether
the quality of health care for children
in this country was really as high as
we assumed it was,” recalls MangioneSmith, a pediatrician and researcher
at Seattle Children’s.
So she led a comprehensive
study — the largest examination of
the quality of children’s health care
in the United States — that provided
a definitive answer: Children in
the United States fail to get the
recommended health care more
than half the time.
Given the scope and the stakes,
the study is a “wake-up call” that can’t
be ignored, Mangione-Smith says.
“We know from experience that when
we follow recommended standards
of care, we improve outcomes for
children,” she says.
Besides illuminating the problem,
the study also contributes to the
solution. The study’s collaborators —
Seattle Children’s, the University
and the RAND Corp. — combed
the literature to compile 175
recommended standards of care
for 12 common conditions including
Dr. Rita Mangione-Smith’s study drives home the need for more consistent use of best
practices in caring for children.
asthma, diarrhea and urinary tract
infections. Originally used as benchmarks for the study, those standards
are now a resource for physicians
seeking the latest recommendations
for those conditions studied.
Recommending change
Preventive care is more critical than
ever to keeping children healthy
and controlling health-care costs —
especially in light of the obesity
epidemic and the related rise in
conditions such as diabetes and
hypertension. Yet Mangione-Smith’s
study showed that only 41% of the
children received recommended
preventive care — including such
basics as being weighed and measured
during regular checkups. The figure
for chronic care — 53% — wasn’t
much better.
Those results suggest a need to
change the way doctors are educated,
says Mangione-Smith. “Residents
spend most of their time in hospital
settings and become very good at
managing kids with acute illnesses,
but they’re not as well trained in
providing preventive care or caring for
kids with chronic illnesses,” she says.
The study also suggests a need to
change the way doctors are reimbursed,
says Mangione-Smith. The current
system rewards them for quantity, not
quality, she says. Under pressure to
see as many patients as possible, they
don’t always have time to deliver every
element of recommended care.
The study likely reflects only the
tip of the iceberg. Nearly all of the
1,500 children involved had some
form of health insurance. “I shudder
to think of the overall population
because the kids in the study are
supposedly getting the best care
out there,” Mangione-Smith says.
21
Department Reports
22
Department and Division Reports
Faculty members from the Departments of Anesthesiology and Pain Medicine, Dental
Medicine, Laboratory Medicine, Neurology, Orthopedics, Psychiatry and Behavioral
Medicine, Radiology, and Rehabilitation Medicine have pursued opportunities to develop
innovative academic programs, strengthen state and community partnerships, and lead
improvements in the practice of pediatric medicine.
David J. Fisher, MD
Medical Director
Although regional anesthesia has demonstrated results of superior recovery in adults, it
is currently an unrecognized opportunity in pediatrics. In 2007, Anesthesiology recruited
international expert in regional anesthesia, Dr. Adrian Bosenberg, from Cape Town,
South Africa, to lead a regional anesthesiology team, create educational and research
opportunities, and ultimately develop a Center for Regional Anesthesia.
Many departments successfully expanded state and community partnerships. Psychiatry
worked with the Washington State Department of Health and Human Services to fund
two programs: one to support psychiatric consultation to primary care providers, and
a second to provide medication review for children with unusual complexity or risk. In
addition, Dr. Bryan King became the Principal Investigator for the NIH-funded University
of Washington (UW) Autism Center of Excellence. This opportunity will allow integration
of autism services for children and families.
We also continue our work to increase access to pediatric specialty services needed in
our community and region. Seattle Children’s is partnering with the UW School of Dentistry
to build a state-of-the-art Center for Early Childhood Oral Health. This joint program —
scheduled to open in August 2010 — will help meet the need of dental caries management
in our community. Chief of Neurology Dr. Sid Gospe collaborated with the UW Medical
Center Electromyography (EMG) Clinic to develop a training position for pediatric EMG.
Our faculty are also leading efforts to improve the practice of pediatric medicine. An
experienced leader in MRI and imaging sciences, Dr. Edward Weinberger, has taken the
helm as director of Pediatric Radiology. He will strengthen imaging sciences and guide
the provision of optimal care by developing image guided interventions for patients and
physicians. In fall 2007, members of the Orthopedics Department traveled with other
Children’s leaders to the Toyota plant in Japan to study methods for translating lean
principles into practice. They are now applying their new knowledge to develop clinical
care guidelines and standard work focused on making practice improvements.
23
Anesthesiology and Pain Medicine
The Department of Anesthesiology and Pain Medicine provides
safe, family-friendly care for children before, during and after
surgery. The pain medicine team also consults about, evaluates
and treats children experiencing acute or chronic pain.
Faculty
Lynn D. Martin
MD, Director
24
Lynn D. Martin, MD, Director
Corrie T. M. Anderson, MD
Sanjay M. Bhananker, MBBS, MD, DA, FRCA
Jim C. Borowiec, MD
Ursula Class, MD
Michael J. Eisses, MD
Inge Falk van Rooyen, MBChB
Sean H. Flack, MBChB
Jeremy M. Geiduschek, MD
Charles M. Haberkern, MD, MPH
Laurilyn D. Helmers, MD
David S. Jardine, MD
Nathalia Jimenez, MD, MPH
Denise C. Joffe, MD
Christer S. Jonmarker, MD, PhD
Helen W. Karl, MD
Jerry H. Kim, MD
Anjana Kundu, MBBS, MD, DA
Anne M. Lynn, MD
Jennifer L. Meyers, MD
James J. Mooney, MD
Rosemary J. Orr, MBBCh
Martha B. Pankovich, MD
Andrew J. Pittaway, BM, BS, FRCA
Sally E. Rampersad, MB, DCH, FRCA
Michael J. Richards, BM, MRCP, FRCA
Daniel D. Rubens, MBBS
Yuko Sano, MD
Nicole E. Webel, MD
Karen Wong, MBBS
Jeffrey R. Zavaleta, MD
Pain is an unpleasant sensory and emotional experience
associated with actual and potential tissue damage. It is
important to manage pain when treating a child: inadequately
controlled pain has undesirable effects on a child’s metabolic,
physiological and emotional conditions. We are dedicated
to improving infant, child and adolescent pain care and
quality of life, and we provide our patients relief from a
variety of afflictions, including pain related to surgical
procedures, cancer, sickle cell disease and other conditions.
Our team includes expert pediatric anesthesiologists,
nurse anesthetists and nurse practitioners. Each has
special experience and training with issues facing children
during anesthesia. Before surgery, a nurse practitioner
takes a complete medical history, including post-anesthetic
experiences, and provides a complete physical exam. We
provide information to the family on how children fall asleep
under anesthesia. We also discuss the surgery center routine,
recovery and criteria for home discharge. Our team includes
attending physicians and advance practice nurses who
provide pain management services 24 hours a day.
PROFESSIONAL PROFILES
Lynn D. Martin, MD, is director of the Department of
Anesthesiology and Pain Medicine at Seattle Children’s
Hospital and professor of anesthesiology and adjunct
professor of pediatrics at the University of Washington
School of Medicine. He received his MD from the
University of Washington School of Medicine. He
completed a pediatric residency at Phoenix Children’s
Hospital and an anesthesia residency and a fellowship
in pediatric anesthesia and critical care medicine at
Johns Hopkins University. He is board certified by both
the American Board of Anesthesiology and the American
Board of Pediatrics, with specialty certification in pediatric critical care medicine. His research interests have
involved conventional and nonconventional forms of
mechanical ventilation in the OR and ICU. In addition,
Martin has become involved in quality improvement
and operative outcomes research. He is involved in
the supervision of residents, fellows and CRNAs in
the OR and ICU.
Corrie T. M. Anderson, MD, is professor in the Department
of Anesthesiology and adjunct professor in the Department of Pediatrics at the University of Washington
School of Medicine. Anderson graduated from the
Stanford University School of Medicine and then
went to Boston for his postgraduate training at Boston
Children’s Hospital (pediatric residency and anesthesia
fellowship) and The Brigham and Women’s Hospital
(anesthesia residency). He is board certified in anesthesiology and holds a certificate in special competency
in pain medicine. He arrived at Seattle Children’s in
2001 after spending 13 years at the UCLA School of
Medicine. In both 2004 and 2005, he was noted as
one of Seattle’s Best Doctors.
Sanjay M. Bhananker, MBBS, MD, DA, FRCA, is attending
faculty anesthesiologist at Seattle Children’s Hospital,
Harborview Medical Center and the University of
Washington School of Medicine. He completed
residencies in anesthesiology in India and the U.K.
and a fellowship in pediatric anesthesiology in Ottawa,
Canada. Bhananker is a clinician educator and plays
a significant role in the education of anesthesiology
residents at the University of Washington. His research
interests include pediatric trauma, pediatric burns and
pediatric pharmacology. Bhananker has been active
in regional, national and international anesthesiology
societies and has presented many topics at their meetings.
Jim C. Borowiec, MD, is attending anesthesiologist
at Seattle Children’s Hospital and acting assistant
professor in the Department of Anesthesiology at the
University of Washington School of Medicine. Born in
Anaheim, Calif., in 1967, Borowiec studied medicine
at the University of Washington School of Medicine
in 1998. He completed his anesthesia residency at
the Mayo Clinic in Rochester, Minn., and a pediatric
anesthesia fellowship at Children’s in 2006. After his
fellowship, Borowiec decided to join the faculty at
Children’s, where he participates in the supervision
and training of the anesthesia residents and fellows.
Borowiec is board certified in anesthesiology.
Ursula Class, MD, is attending anesthesiologist at Seattle
Children’s Hospital and clinical assistant professor in
the Department of Anesthesiology at the University of
Washington School of Medicine. She studied medicine
at Eberhard-Karl University in Germany. She completed
a pediatrics residency at St. Louis Children’s Hospital
Spotlight on team member — Debra Ewing-Lonczak, MSN, ARNP
We now have two anesthesiologists working in Radiology so
that we can better meet the needs of children who need radiology
exams under anesthesia. Our new model decreases patient
and family wait times from up to six weeks to less than two
weeks — a dramatic improvement that lessens any anxiety
patients and families may feel while waiting for procedure day.
and an anesthesia residency at Barnes Hospital, St.
Louis. She completed a pediatric anesthesia fellowship
at Denver Children’s Hospital. Class served on the
faculty at St. Louis Children’s Hospital. At Seattle
Children’s, she participates in the supervision and
training of anesthesia residents and fellows.
Michael J. Eisses, MD, is an attending anesthesiologist
at Seattle Children’s Hospital in the Cardiac Anesthesia
Program and assistant professor in the Department
of Anesthesia at the University of Washington School
of Medicine. He earned his MD at the University of
Washington and received the John J. Bonica Award
for medical students. He completed a residency in
anesthesiology at the University of Washington, followed
by a fellowship in pediatric anesthesia at Children’s; he
completed a clinical fellowship and a one-year research
fellowship in the Department of Laboratory Medicine.
He is board certified in anesthesiology and is active
in the training of anesthesia residents and fellows.
His primary clinical responsibilities include providing
anesthesia for neonates, infants and children undergoing
procedures to treat congenital heart disease, and heart
and liver transplants. He researches mechanisms and
complications of coagulation and fibrinolytic activation
as they relate to anesthesia and surgery, in particular
cardiopulmonary bypass. He collaborates with the
University of Washington’s departments of laboratory
medicine and bioengineering in constructing computer
25
and kinetic models for hemostasis due to cardiopulmonary bypass in children. He received the B. Raymond
Fink Research Award from the university in 2004.
Inge Falk van Rooyen, MBChB, is attending anesthesiologist at Seattle Children’s Hospital and assistant
University of Washington School of Medicine. She
completed her anesthesia subspecialty training at the
University of Cambridge in the U.K. Falk van Rooyen’s
interests include management of the complex pediatric
airway, development of safe sedation techniques and
education within clinical anesthesia. As a member of
the TEE writer group, she is part of the team of specialists that creates exam practice questions for resident
education. Her published works reflect her interest in
airway surgery, respiratory pathology and physiology,
and orthopedic and neurosurgery pediatric anesthesia.
She has taught pediatric life support nationally and
directed courses locally; she is preceptor and mentor
to medical students and anesthesia residents. She is
an active member of the Washington State Society of
Anesthesiologists, the American Society of Anesthesiologists and the Society for Pediatric Anesthesia.
Sean H. Flack, MBChB, is attending anesthesiologist
professor in the Department of Anesthesiology at
the University of Washington School of Medicine. He
completed his MBChB and anesthesiology residency at
the University of Cape Town, South Africa. He completed
his fellowship at the Royal United Hospital in Bath,
U.K., and then returned to the Red Cross War Memorial
Children’s Hospital in Cape Town. He is lead anesthesiologist for general surgery. Flack’s clinical interests
include regional anesthesia and the role of ultrasound
in the practice of pediatric regional blocks. He has also
developed an interest in anesthesia for awake craniotomy
surgery. His laboratory research focuses on an animal
model for the study of intrathecal drug distribution.
Clinical research interests include ultrasound-guided
peripheral nerve blocks and the use of dexmedetomidine
as an adjunct to general anesthesia. He has presented
at a national level on a number of these topics. He is
an active member of the Washington State Society of
Anesthesiologists, American Society of Anesthesiologists,
Society for Pediatric Anesthesia and American Society
of Regional Anesthesia and Pain Medicine.
26
Jeremy M. Geiduschek, MD, is director of clinical
anesthesia services at Seattle Children’s Hospital and
clinical professor in the Department of Anesthesiology
at the University of Washington School of Medicine.
He has been at Children’s since starting his internship
in pediatrics in 1983. He completed a residency in
anesthesiology and a one-year fellowship in pediatric
anesthesiology. He did clinical research in Basel,
Switzerland, on the effects of anesthesia on laryngeal
mechanics in children. He is board certified in anesthesiology and participates in the supervision and training
of anesthesia residents and fellows. Geiduschek has
been active in establishing several clinical programs,
including the delivery of anesthesia to infants receiving
ECMO, provision of anesthesia for children with cancer
undergoing painful invasive procedures and use of
ECMO in the repair of complete laryngotracheoesophageal fistula. Geiduschek was part of the group that
established the national POCA (Pediatric Operative
Cardiac Arrest) registry. He has been involved in
improving operating room efficiency, patient safety
and timely delivery of care. Geiduschek is an active
member of the pediatric cardiac anesthesia team and
has a strong clinical interest in delivery of anesthesia
for children with complex congenital heart disease.
Charles M. Haberkern, MD, MPH, is staff anesthesiologist
at Seattle Children’s Hospital and clinical professor of
anesthesiology at the University of Washington School
of Medicine. He is board certified in anesthesiology,
pediatrics and neonatal-perinatal medicine. He has
worked at Children’s for the majority of years since he
came to the hospital as an intern in pediatrics in 1974.
He completed fellowship training in neonatology at the
University of California, San Francisco; a residency in
anesthesiology at the University of Florida, Gainesville;
and a fellowship in pediatric anesthesia at Children’s
Hospital Boston. He earned an MPH at Harvard
University. Haberkern has been active in clinical care,
resident and fellow education, operating room management and clinical research. He has maintained
research interest in perioperative care of patients with
sickle cell disease, health-care services and the POCA
(Pediatric Operative Cardiac Arrest) registry that is
directed by the University of Washington.
Laurilyn D. Helmers, MD, is attending anesthesiologist
professor in the Department of Anesthesiology at
the University of Washington School of Medicine.
She completed her internship in internal medicine at
Good Samaritan Regional Medical Center in Phoenix
and completed her anesthesia residency and pediatric
anesthesia fellowship in Iowa City. She has maintained
certification with the American Board of Anesthesiology.
She served as division director for pediatric anesthesia
and as fellowship program director in the Department
of Anesthesia at University of Iowa Hospitals and
Clinics in Iowa City. In the clinical arena, Helmers is
involved in the provision of anesthesia to all pediatric
age groups. She has an interest in acute pain management in the perioperative period, especially with the
provision of regional anesthesia alternatives. Peripheral
nerve blockade via single injections or catheters and
the safety associated with these techniques are her
special interests. In the academic arena, she is involved
in teaching anesthesia residents and fellows and has an
interest in incorporating alternative teaching methods
into the current curriculum, especially in the subspecialty
areas of pediatric anesthesia and regional anesthesia.
David S. Jardine, MD, is attending physician at Seattle
Children’s Hospital and Harborview Medical Center
and associate professor in the Department of Anesthesiology and the Department of Pediatrics at the
University of Washington Medical Center. He completed residencies in pediatrics and anesthesiology and
a fellowship in pediatric anesthesiology and intensive
care. He is board certified in anesthesiology and is
active in the supervision and training of anesthesia
residents and fellows. He has served as a reviewer for
a variety of medical journals and has published widely,
with an emphasis on hemorrhagic shock and encephalopathy syndrome. His laboratory interests are using
heat shock proteins as biomarkers and examining the
protective effect of heat shock proteins during brain
injury. He has been principal investigator on several
projects. Other interests include medical staffing
issues; he helped formulate and interpret a recent
American Academy of Pediatrics survey on pediatric
intensive care staffing. He serves on the Institutional
Review Board at Children’s and on the research committee for the Department of Anesthesiology and Pain
Medicine. He serves on the board of the SIDS Foundation
of Washington and became president in January 2006.
Nathalia Jimenez, MD, MPH, is attending physician
professor at the University of Washington School of
Medicine. She completed her residency at Pontificia
Universidad Javeriana in Colombia. She completed
her fellowship in pediatric anesthesia at Children’s
and earned an MPH in epidemiology at the University
of Washington School of Public Health. As a fellow,
she tested a new device for local anesthesia for IV
cannulation in children that is now used routinely in
clinical practice. As part of her MPH, she worked at
the injury prevention center helping educate Latino
families about traffic safety. In the American Society of
Anesthesiologists Closed Claims Project, she evaluated
trends in pediatric anesthesia liability. Her research
interests include outcomes in anesthesia and ethnic
differences in health services.
Denise C. Joffe, MD, is attending anesthesiologist at
Seattle Children’s Hospital and an associate professor
in the Department of Anesthesiology at the University
of Washington School of Medicine. Born in Suffern,
N.Y., in 1962, Joffe studied medicine at McGill University
in Montreal, Quebec, in 1981. She completed a mixed
internship at a McGill teaching hospital in Montreal,
Quebec, and an anesthesia residency at McGill University.
She then completed an adult and pediatric cardiothoracic
anesthesia fellowship at Mount Sinai Hospital in New
York in 1993. She is board certified in anesthesiology
and is active in the supervision and training of anesthesia
residents and fellows.
Christer S. Jonmarker, MD, PhD, is a pediatric anesthesiologist attending at Seattle Children’s Hospital and an
associate professor at the University of Washington
School of Medicine. He received residency training in
surgery at Virginia Mason Hospital in Seattle and in
anesthesia and intensive care at University Hospital
in Lund, Sweden. He became a specialist in anesthesia
and intensive care in Sweden in 1985 and completed a
PhD thesis in respiratory physiology the same year. He
was named docent at the University of Lund and was
awarded the European Diploma of Anesthesiology in
1989. At University Hospital in Lund, he served as
director of cardiothoracic anesthesia (1994–1996)
and director of pediatric anesthesia (1996–2000).
He was director of cardiac anesthesia at Children’s
2000–2007. Jonmarker’s primary interest is in pediatric
pulmonary and circulatory physiology and in resident
27
and fellow training. He has published articles on
pediatric respiration and ventilation, circulation
and clinical pharmacology.
Helen W. Karl, MD, has been attending anesthesiologist
at Seattle Children’s Hospital since 1990 and is associate
received her MD from the University of Virginia School
of Medicine. She completed an anesthesia residency at
Hartford Hospital, Conn., and a pediatric anesthesia
fellowship at Children’s Hospital, Philadelphia, Pa. She
is board certified in anesthesiology. She is currently
interim director of the Pain Medicine Program
and participates in the supervision and training
of anesthesia residents and fellows.
Jerry H. Kim, MD, is attending anesthesiologist at Seattle
Children’s Hospital and acting instructor/senior fellow
of anesthesiology with the University of Washington
School of Medicine. Born in Staten Island, N.Y., in
1977, Kim studied medicine at Jefferson Medical
College, Philadelphia, Pa. He completed his anesthesia
residency at Thomas Jefferson University Hospital,
Philadelphia. He then went on to complete his first
year as a pediatric anesthesia fellow at Children’s in
2007. Currently, Kim is completing his second year,
conducting research as a senior fellow. Kim is board
certified in anesthesiology.
Anjana Kundu, MBBS, MD, DA, is director of the
Complementary and Integrative Medicine Program
and associate director of the Pain Medicine Program
at Seattle Children’s Hospital. She is an assistant
Medicine. Kundu earned her MD and board certification
in anesthesiology in India. She subsequently completed
a residency training program in anesthesiology at
Medical College of Wisconsin. She completed her
fellowship training in pediatric pain medicine and
acupuncture training at Harvard Medical School and
Children’s Hospital Boston. She is board certified in
anesthesiology and pain medicine. Her main areas of
clinical and research interest include complementary
and alternative medicine and pediatric pain medicine.
Kundu established the first clinical acupuncture service
as part of the Complementary and Integrative Medicine
Program at Children’s. She provides anesthesia for
28
pediatric surgical procedures, radiological procedures
and hematology and oncology services at Children’s
and the University of Washington Medical Center.
She served as co-director for a regional pediatric pain
management conference and has developed a curriculum
for a pediatric pain medicine fellowship at Children’s.
Anne M. Lynn, MD, is attending anesthesiologist at
Seattle Children’s Hospital and professor in the Department of Anesthesiology and adjunct professor in the
Department of Pediatrics at the University of Washington School of Medicine. She received her MD from
Stanford University School of Medicine and completed
residencies in pediatrics and anesthesiology at the
University of Washington. She completed a pediatric
critical care fellowship at the Hospital for Sick Children
in Toronto. She is board certified in anesthesiology and
is active in the supervision and training of anesthesia
residents and fellows. She completed a physician medical
acupuncture training program in 2007 and is seeing
acupuncture patients at Children’s. Lynn has been
treasurer, secretary, vice president and president of the
Society for Pediatric Anesthesia, the largest pediatric
anesthesia professional group in the United States.
She is a current member of the ASA Committee on
Pediatric Anesthesia and has been an active clinical
investigator of pain management in infants, with several
studies of morphine use in postoperative infants. She
is a pediatric section reviewer for Anesthesia and
Analgesia. Lynn has been an active member of Children’s
committees, chairing the Pharmacy and Therapeutics
Committee from 1996 to 2001. She was elected to the
board of directors for Children’s University Medical
Group in 2006. She has been listed in Seattle magazine’s
“Seattle’s Top Doctors” every year since 2001 and in
“Best Doctors in America” since 2003.
Jennifer L. Meyers, MD, is attending anesthesiologist
Los Angeles, Calif., in 1973, Meyers studied medicine
at Pennsylvania State University College of Medicine,
Hershey, Pa., in 1997. She completed her anesthesia
residency at Baylor College of Medicine, Houston, Texas.
She then completed a pediatric anesthesia fellowship
at Texas Children’s Hospital, Houston, in 2007.
James J. Mooney, MD, is attending anesthesiologist
Long Island, N.Y., in 1970, Mooney studied medicine
at Boston University School of Medicine in 1997. He
completed his anesthesia residency at the University
of Massachusetts Medical Center, Worcester, Mass. He
then completed pediatric anesthesia and pediatric pain
management fellowships at Boston, Mass., in 2007.
Rosemary J. Orr, MBBCh, is associate professor at Seattle
Children’s Hospital and the University of Washington
School of Medicine. She is clinical director of remote
anesthesia services for Children’s. Orr earned her MB
from Queen’s University, Belfast, Northern Ireland, and
started a pediatrics residency in Belfast. She completed
a pediatrics residency, a pediatric cardiology fellowship
and two years as a neonatal biology fellow at the
completed an anesthesiology residency at the University
of Washington and a fellowship in pediatric anesthesia
at Children’s Hospital of Philadelphia. She joined
the University of Washington as the first academic
anesthesiologist working with the private practice of
anesthesia at Seattle Children’s. She is board certified
in pediatrics and anesthesiology, and she chairs Children’s
sedation committee. She is a clinician and an educator,
and her research has been clinically based. She has
studied several anesthetic drugs and anesthesia for
airway procedures. Other research interests involve
gathering data from anesthetics given for procedures
outside the operating room.
Martha B. Pankovich, MD, is attending anesthesiologist
Chicago, Ill., in 1970, Pankovich studied medicine at
the University of Navarra, Pamplona, Spain, in 1993.
She completed her anesthesia residency at Rush
University Medical Center in Chicago and a pediatric
anesthesia fellowship at Children’s in 2006. After her
fellowship, Pankovich decided to join the faculty at
Children’s, where she participates in the supervision
and training of anesthesia residents and fellows. She
is board certified in anesthesiology and speaks three
languages (Spanish, Serbian and English).
Andrew J. Pittaway, BM, BS, FRCA, is attending anesthesiologist at Seattle Children’s Hospital and an assistant
Yorkshire, U.K., in 1968, Pittaway studied medicine at
the University of Nottingham Medical School, graduating
in 1991. After several years of postgraduate training in
both internal and emergency medicine, he embarked
upon specialist training in anesthesiology in 1994 and
did his residency at the South West School of Anaesthesia,
based in Plymouth, U.K. He has been fortunate to
also train abroad in both Australia and Fiji. A former
member of the anesthesia faculty in 2002–2003,
Pittaway decided to return after doing locum consultant
pediatric anesthesia work in the U.K. and voluntary
consultant work in West Africa. Pittaway is anesthesia
residency coordinator at Children’s and is interested in
education, simulation, training in the developing world
and regional anesthesia.
Sally E. Rampersad, MB, DCH, FRCA, is attending anesthesiologist at Seattle Children’s Hospital and assistant
earned her MB from the University of Southampton,
England, and her diploma in child health (DCH) from
the Royal College of Physicians of London. She trained
in anesthesiology in the U.K., becoming a fellow of the
Royal College of Anaesthetists in 1994. She completed
a pediatric anesthesia fellowship at the Hospital for
Sick Children in Toronto and worked from 1996 to
1998 as a visiting attending at Seattle Children’s. She
repeated residency in anesthesiology at Virginia Mason
Medical Center in Seattle and subsequently rejoined
Children’s as an attending in 2003. Her professional
interests include pediatric anesthesia, regional anesthesia
and improving error management in the operating
room. She has served as an instructor for pediatric
advanced life support (PALS) in the United States and
Canada. She is the coordinator for the Department of
Anesthesiology QI rounds at Children’s and interim
co-director of the OR quality and safety committee.
Michael J. Richards, BM, MRCP, FRCA, is attending
anesthesiologist at Seattle Children’s Hospital and an
assistant professor in the Department of Anesthesiology
Born in Malvern, England, in 1970, Richards completed
29
his Bachelor of Medicine at Southampton University,
England, in 1993. Following his internship, he completed
18 months of junior residency in internal medicine at
Southampton University Hospitals and two years of
senior residency in internal medicine, first in Jersey,
British Isles, and then at the University of Cape Town,
South Africa. During this time, he completed his
Member of the Royal College of Physicians qualifications.
In 1998 he changed career pathways to anesthesia and
completed his two-year junior anesthesia residency at
the Royal Devon and Exeter Hospitals, England (part
of the Peninsula Medical School). He subsequently
completed a five-year senior residency in anesthesia
at the Bristol School of Anaesthesia, during which
he also completed his Fellow of the Royal College of
Anaesthetists qualifications, achieved intermediate
training in intensive care medicine and gained a
postgraduate certification in medical education. He also
completed a pediatric anesthesia fellowship at Bristol
Royal Children’s Hospital and spent a year as visiting
faculty at Children’s. Richards decided to return to
Children’s in 2006 as part of the cardiac and general
anesthesiology group and has subsequently also taken
on the role of director of the pediatric anesthesiology
fellowship program.
Daniel D. Rubens, MBBS, is assistant professor in the
Department of Anesthesiology and Pain Medicine
at Seattle Children’s Hospital and the University of
Washington School of Medicine. Rubens also serves
as director of medical simulation at Children’s. He
earned his MBBS from the University of New South
Wales, graduating with honors. He completed his
anesthesia residency training at Liverpool Hospital,
Sydney, including rotations to Prince of Wales and
Saint Vincent’s Hospitals for intensive care and
pediatric retrieval training. Rubens is board certified
in anesthesia, and his primary teaching activities
include supervising and training residents and fellows.
He helped develop SimBaby, the world’s first infant
simulator. He is researching the finding of a hearing
deficit from inner ear damage, noted at birth in SIDS
infants with newborn hearing tests, and its potential
relationship to the later mechanism of death.
30
Yuko Sano, MD, is attending anesthesiologist at Seattle
Children’s Hospital and acting instructor/senior fellow
of anesthesiology at the University of Washington
School of Medicine. Born in Manhattan, N.Y., in 1970,
Sano studied medicine at the University of Chicago
in 1998. She completed her anesthesia residency at
the University of California, San Francisco, in 2006.
She then completed her first year as a pediatric anesthesia fellow at Children’s in 2007. Currently, Sano is
completing her second year, conducting research as a
senior fellow. She is board certified in anesthesiology.
In her free time, Sano enjoys rock climbing, trail
running and sculling.
Nicole E. Webel, MD, is attending anesthesiologist
University of Washington School of Medicine. Webel
studied medicine at Southern Illinois University,
Springfield, Ill., graduating in 1994. She completed an
anesthesiology residency at the Mayo Graduate School
of Medicine in 2002 and then went on to complete a
pediatric anesthesia fellowship at Children’s in 2003.
Webel joined the faculty at Children’s in 2005 after
being on staff at the Mayo Clinic. She now participates
in the supervision and training of anesthesia residents
and fellows.
Karen Wong, MBBS, is attending anesthesiologist at
Seattle Children’s Hospital and acting assistant professor in the Department of Anesthesiology at the University
of Washington School of Medicine. She is the lead
anesthesiologist for spinal surgery at Children’s. She
completed her MBBS at the University of Melbourne,
Australia, and an anesthesiology residency at Liverpool
Hospital in Sydney. She completed a fellowship at
Princess Margaret Hospital for Children in Perth and
worked as attending anesthesiologist at Sir Charles
Gardiner Hospital in Perth. Wong’s clinical interests
include anesthesia for spinal surgery, sedation and
simulator training. She has an active interest in
anesthesia education and participates in oral board
preparation for residents and fellows. She is also
actively involved in the use of the simulator baby for
the training of pediatric residents in anesthesia and
emergency management of the sick child.
Jeffrey R. Zavaleta, MD, is attending anesthesiologist at
Seattle Children’s Hospital and acting instructor/senior
fellow of anesthesiology at the University of Washington
School of Medicine. Born in McAllen, Texas, in 1974,
Zavaleta studied medicine at the University of Texas
Southwestern Medical Center at Dallas in 1998. He
completed his anesthesia residency at Parkland Memorial Hospital in Dallas in 2006. He then went on to
complete his first year as a pediatric anesthesia fellow
at Children’s in 2007. Currently, Zavaleta is completing
his second year, conducting research as a senior fellow.
Zavaleta is board certified in anesthesiology.
AWARDS AND HONORS
Golden Seed Award. University of Washington.
June 2007.
Lynn D. Martin, MD
Listed in “Top Doctors.” Seattle magazine.
Listed in “Best Doctors in America.”
First Place. C. Ronald Stephen Resident
Essay Contest. 2007.
RESEARCH FUNDING
Continuing
Lynn D. Martin, MD
An open-label, randomized, phase IIIB, multicenter
trial to evaluate the pharmacodynamic parameters of
intubation bolus, and bolus and infusion maintenance
doses of Zemuron in pediatric and adolescent subjects.
Organon USA Inc. $73,890.
TEACHING AND PRESENTATIONS
Sanjay M. Bhananker, MBBS, MD, DA, FRCA
Anesthesia and analgesia for pediatric burns (refresher
course lecture). Winter meeting of the Society for
Pediatric Anesthesia. Phoenix, Ariz. March 2007.
SLAM (Street Level Airway Management) course
for anesthesiologists, other physicians, CRNAs and
paramedics (instructor). Dallas, Texas. June 2007.
Anesthesia and analgesia for pediatric burns
(problem-based learning discussion [PBLD]).
Postoperative ulnar neuropathy — could I have done
something to prevent it? (PBLD). Optimal effective
ratio of thiopental:propofol mixture to alleviate pain
on injection of propofol. ASA annual meeting.
San Francisco, Calif. October 2007.
Busting airway and breathing myths in pediatric
resuscitation. Southwest EMS conference. Bonneville,
Wash. December 2007.
Jim C. Borowiec, MD
ABO-mismatched heart transplantation in children.
An update on emergence delirium. Annual meeting
of the Alexandria Society of Anesthesia and Critical.
Alexandria, Egypt. September 2007.
Laurilyn D. Helmers, MD
Development of best practices proposals for
teaching/learning within participant’s program:
competency in pediatric anesthesia. Annual
meeting of the Society for Education in Anesthesia.
Anesthesia for urgent umbilical hernia repair in a twomonth-old infant with tetralogy of Fallot (problembased learning discussion [PBLD] with the Laerdal
pediatric manikin). Society for Pediatric Anesthesia.
Phoenix, Ariz. April 2007.
Anesthesia for noncardiac surgery in children with
congenital heart anomalies. Skejby University Hospital.
Aarhus, Denmark. June 2007.
Anjana Kundu, MBBS, MD, DA
Healing Touch workshop (co-director). Seattle, Wash.
February 2007.
31
Anne M. Lynn, MD
Problem-based learning (discussant). Winter meeting
of the Society for Pediatric Anesthesia. Phoenix, Ariz.
March 2007.
Parents and premeds (pediatric anesthesia panel). ASA
annual meeting. San Francisco, Calif. October 2007.
Lynn D. Martin, MD
How are we doing? Regional anesthesia database.
Regional Anesthesia in Children Conference. Seattle,
Wash. September 2007.
Andrew J. Pittaway, BM, BS, FRCA
General anesthesia for direct laryngoscopy and
bronchoscopy in a neonate with stridor (problem-based
learning discussion [PBLD]). ASA annual meeting.
Sally E. Rampersad, MB, DCH, FRCA
Cockpit resource management (co-presenter). The
effects of fatigue on medical providers. PALS survival
skills. 45th Annual Clinical Conference in Pediatric
Anesthesiology. Anaheim, Calif. Feb. 9–11, 2007.
Preparing your office and your team for emergencies.
Annual meeting of the American Dental Society of
Anesthesiology. Monterey, Calif. April 20, 2007.
From the cockpit to the OR (co-presenter). Anesthesiology Grand Rounds. Loma Linda University School of
Medicine. Loma Linda, Calif. Oct. 3, 2007.
32
PUBLICATIONS
Bhananker, SM. Asthma. In: Litman RS, ed. Pediatric
Anesthesia Practice. New York, N.Y.: Cambridge
University Press. 2007.
Bhananker SM. Asthma and perioperative bronchospasm. In: Litman RS, ed. Strategies in Pediatric
Anesthesia Practice, Palm OS edition. Marlborough,
Mass.: Skyscape Inc. 2007.
Bhananker SM, Bishop MJ. Bronchospasm. In:
Lobato EB, Gravenstein N, Kirby RR, eds. Complications in Anesthesiology, Third Edition. Philadelphia,
Pa.: Lippincott, Williams & Wilkins. 2007.
Bhananker SM, Ramamoorthy C, Geiduschek JM,
Posner KL, Domino KB, Haberkern CM, Campos J,
Morray JP. Anesthesia-related cardiac arrests in
children: update from the Pediatric Perioperative
Cardiac Arrest Registry. Anesth Analg. Aug
2007;105(2):344–350.
Do K, Bhananker SM. Exertional rhabdomyolysis
following overexertion: a possible link to creatine overconsumption. Clin J Sport Med. Jan 2007;17(1):78–79.
Eisses MJ, Geiduschek JM, Jonmarker CS,
Cohen GA, Chandler WL. Effect of polymer coating
(poly 2-methoxyethylacrylate) of the oxygenator on
hemostatic markers during cardiopulmonary bypass
in children. J Cardiothorac Vasc Anesth. Feb
2007;21(1):28–34.
Nicole E. Webel, MD
Severe obesity of the child and anesthesia. Why do we
do what we do and other anesthesia myths. 42nd Annual
Josulbra Conference. Curitiba, Brazil. April 2007.
Flack SH, Piper NA, Lynn AM. [Author reply to
comment: Is it worth the risk?] Paediatr Anaesth.
Jul 2007;17(7):707.
Halothane hepatitis solved: a scientific odyssey of
Burnell Brown Jr. Annual Meeting of the Anesthesia
History Association. Nashville, Tenn. May 2007.
Jeffries H, Martin LD. Respiratory physiology. In:
Wheeler DS, Wong HR, Shanley TP, eds. Pediatric
Critical Care Medicine: Basic Science and Clinical
Evidence. London: Springer-Verlag. 2007.
Jimenez N, Posner KL, Cheney FW, Caplan LA,
Lee LA, Domino KB. Update on pediatric anesthesia
liability: a closed claims analysis. Anesth Analg.
Jan 2007;104(1):147–153.
Rampersad SE, Lynn AM. Congenital and inherited
disease. In: Bingham R, Lloyd Thomas A, Sury M, eds.
Hatch and Sumner’s Textbook of Paediatric Anaesthesia,
Third Revised Edition. London: Hodder Arnold. 2007.
Lynn AM, Bradford H, Kantor ED, Seng KY,
Salinger DH, Chen J, Ellenbogen RG, Anderson GD.
Postoperative ketorolac tromethamine use in infants
aged 6–18 months: the effect on morphine usage,
safety assessment and stereo-specific pharmacokinetics.
Anesth Analg. May 2007;104(5):1040–1051.
Richards MJ. Postoperative nausea and vomiting.
In: Litman RS, ed. Pediatric Anesthesia Practice.
New York, N.Y.: Cambridge University Press. 2007.
Mazor R, Cohen G, Martin LD. Obstructed total
anomalous pulmonary venous drainage. In: Murphy
P, Marriage S, Davis P, eds. Problem-Based Paediatric
Critical Care. London: Taylor & Francis. 2007.
Nunn C, Uffman J, Bhananker SM. Bilateral tension
pneumothoraces following jet ventilation via an airway
exchange catheter. J Anesth. 2007;21(1):76–79.
Ross AK, Gooden CK, Golden S, Ahmed Z,
Lauro H, Flack SH, Glass N. Society of Pediatric
Anesthesia/American Academy of Pediatrics winter
meeting review. Anesth Analg. Oct 2007;105(4):967–973.
Ziegfeld S, Martin LD. Transportation of the critically
ill and injured child. In: Nichols DG, Yaster M, Lappe
DG, Haller JA, eds. The Golden Hour: The Handbook
of Advanced Pediatric Life Support, Second Edition.
Philadelphia, Pa.: Mosby-Yearbook. 2007.
Patel SI, Bhananker SM. Anesthesia and analgesia
for pediatric burns. In: Moya F, ed. Current Reviews
in Clinical Anesthesia. September 2007.
Pieters B, Johnston TA, Jones TK, Cohen G,
Jonmarker CS. Resistant hypoxemia in an infant
with a right ventricle to pulmonary artery (Sano) shunt.
J Cardiothorac Vasc Anesth. Dec 2007;21(6):880–882.
Rachel Homer J, Elwood T, Peterson D, Rampersad SE.
Risk factors for adverse events in children with colds
emerging from anesthesia: a logistic regression.
Paediatr Anaesth. Feb 2007;17(2):154–161.
Rampersad C, Rampersad SE. Can medicine really
learn anything from aviation? Or are patients and their
disease processes too complex? Seminars in Anesthesia.
2007;26(3):158–166.
Rampersad SE. Craniofacial syndromes. In: Litman
RS, ed. Pediatric Anesthesia Practice. New York, N.Y.:
Cambridge University Press. 2007.
33
Dental Medicine
The Department of Dental Medicine addresses the dental
needs of medically complex children and adolescents in the
region up to age 17. We provide high-quality specialized dental
care available only in the unique setting of a tertiary-level
Faculty
Joel H. Berg
DDS, MS, Director
34
Joel H. Berg, DDS, MS, Director
Jason Chang, DDS
Christopher Delecki, DDS, MPH, MBA
Mark A. Egbert, DDS
Geoffrey M. Greenlee, DDS, MSD
James A. Howard, DDS
Lina Kim, DDS
Cynthia L. Koudela, DDS, MSD
Seok Bee Lim, DMD
Jeffrey B. Marks, DDS
M. Lena Omnell, DDS, MSD
Andrea M. Pearson, DDS
Donna J. Quinby, DMD, MSD
Mark M. Schubert, DDS, MSD
Barbara L. Sheller, DDS, MSD
Dennis I. Sipher, DDS
Terry M. Thomas, DDS
Bryan J. Williams, DDS, MSD, MEd
Yoo-Lee Yea, DDS, MPH
Lisa H. Zimberg, DMD
pediatric medical center. The department’s professional staff
has the expertise and the resources to render care to children
referred from a variety of programs at Seattle Children’s
Hospital; we’re most closely involved with the craniofacial,
hematology/oncology, rheumatology, cardiology, rehabilitation
medicine and neurodevelopmental programs.
The Department of Dental Medicine actively pursues
clinical research, most often in collaboration with tertiarycare programs at Children’s, to further knowledge about
diagnostic and treatment techniques and ensure excellence
in clinical care. The department participates in teaching
future providers of pediatric medical and dental care,
including integration with the teaching programs of the
University of Washington, with a primary goal of ensuring
continued clinical excellence in the future care of children.
The Department of Dental Medicine acts as a strong
advocate for oral health on local, state and national levels.
We believe good oral health is critical to the well-being of
the children in our society.
Joel H. Berg, DDS, MS, is director of the Department of
Dental Medicine at Seattle Children’s Hospital; he is
also professor and Lloyd and Kay Chapman Chair for
Oral Health of the Department of Pediatric Dentistry
at the University of Washington School of Dentistry.
He is a board-certified pediatric dentist and a fellow of
the American Academy of Pediatric Dentistry. He is a
trustee of the American Academy of Pediatric Dentistry.
Berg has held positions as vice president for clinical
affairs at Philips Oral Healthcare, head of the scientific
department for ESPE Dental AG and director of the
postgraduate residency program in pediatric dentistry
at the University of Texas, Houston, where he conducted
numerous clinical trials evaluating restorative materials.
Berg is also a fellow of the Pierre Fauchard Academy
and a fellow of the American College of Dentists and
the International College of Dentists. He is the author
of many manuscripts, abstracts and book chapters
about a variety of subjects, including restorative
materials for children and other work related to
biomaterials. His current research interests include
the development of dental caries prevention programs
using risk assessment models.
Dental Medicine
Jason Chang, DDS, is dental provider at Odessa Brown
Children’s Clinic in Seattle and part-time faculty
member at the University of Washington School of
Dentistry in the Department of Restorative Dentistry.
Chang earned his DDS at the University of Detroit
Mercy. He completed a general practice residency
at the University of Texas in San Antonio and an
advanced dental practice residency at the University
of Washington. He spends most of his clinical time in
private practice in Everett, Wash., treating patients
of all ages. His interests are in advanced restorative
techniques and dental materials. He is a fellow of the
Academy of General Dentistry.
Christopher Delecki, DDS, MPH, MBA, is chief of the
dental program at Odessa Brown Children’s Clinic
in Seattle and a faculty member at the University of
Washington School of Dentistry in the Departments
of Pediatric Dentistry and Restorative Dentistry.
Delecki earned his DDS and MPH at the University of
Michigan. His received his MBA from City University
in Bellevue, Wash. As a commissioned officer in the
United States Public Health Service, he received many
honors and awards, including the Surgeon General’s
Outstanding Service Medal. He has provided dental
treatment, program management, consultation and
preventive dental services on numerous Indian
reservations throughout the western United States.
He currently serves as the National Oral Health
Consultant for American Indian and Alaska Native
Head Start Programs. His professional interests
include preventive dental care and community-based
oral health promotion and policy initiatives for
children and families in Washington. A member of
the Washington State Oral Health Coalition and the
Washington State Dental Association, Delecki is
working to ensure access to dental care for all children
in Washington. In April 2008, he was elected president
of the Seattle–King County Dental Society.
Mark A. Egbert, DDS, is chief of the Division of Oral
and Maxillofacial Surgery (OMS) at Seattle Children’s
Hospital and associate professor in the Department
of Oral and Maxillofacial Surgery at the University of
Washington School of Dentistry. He served as chief
of OMS trauma services and chair of the dental
department at Harborview Medical Center for 12 years.
Egbert received his dental and OMS training at the
University of Washington and spent one year studying
Spotlight on team member — Abigail Blendheim, RDH, BS
By introducing a dental hygienist into clinic, we’ve reduced
appointment wait times and increased our ability to see
new patients and educate them about the disease process,
nutrition and tooth care. As I clean kids’ teeth, I use the
time to talk with families, answer questions and give tips
about brushing, including using a timer and best types of
toothpaste for young mouths.
OMS at the Gemeente Ziekenhuis, Arnhem, Netherlands.
His particular interests include the biological basis
of facial growth and development, the management
of cleft lip and palate, applications of distraction
osteogenesis in the correction of facial anomalies
and the treatment of pediatric oral and maxillofacial
pathology. Egbert serves on numerous review boards
for journals, including the International Journal of
Oral and Maxillofacial Surgery, the American Journal
of OMS and Triple O. His professional society memberships include the AAOMS and ACPA, and he has served
as president of the Western Society of OMS and the
Washington State Society of OMS. He chairs and serves
on committees of the American Association of OMS.
He has served on the examining committee of the
American Board of Oral and Maxillofacial Surgery.
Geoffrey M. Greenlee, DDS, MSD, is attending dentist at
Odessa Brown Children’s Clinic and clinical assistant
professor in the Department of Orthodontics at the
University of Washington School of Dentistry. Greenlee
was a senior fellow in the Department of Dental Public
Health Sciences from 2005 to 2008. He is currently
director of predoctoral orthodontics at the School of
Dentistry, where he teaches and/or directs a number
of graduate-level courses. Greenlee earned his DDS
at the University of Michigan and received his MSD
and certificate in orthodontics from the University of
Washington. He completed a fellowship in cleft lip and
35
Dental Medicine
palate and craniofacial anomalies at Seattle Children’s
Hospital in 2001 and is finishing a public health degree
in epidemiology. Greenlee is involved with a clinical
trial looking at the impact of early orthodontic treatment
in Medicaid children, and he regularly mentors graduate
students on thesis research projects.
James A. Howard, DDS, is chief of the Temporomandibular Joint Dysfunction Clinic in the Department of
Dental Medicine at Seattle Children’s Hospital. Howard
earned his DDS from the University of Washington
School of Dentistry and did a special research and
clinical fellowship in temporomandibular dysfunction.
Howard has a strong international reputation in the
management of temporomandibular dysfunction. He
has published numerous scientific papers and lectures
widely. He is particularly interested in the management of temporomandibular function in children with
juvenile rheumatoid arthritis and in jaw problems in
vocalists and musicians.
Lina Kim, DDS, is dental provider at Odessa Brown
Children’s Clinic in Seattle and a faculty member in the
Department of Restorative Dentistry at the University
of Washington School of Dentistry. Kim earned her
DDS and completed a hospital-based general practice
residency at the University of Washington. Her professional interests include providing compassionate and
high-quality care to all of her patients while focusing
on prevention.
Cynthia L. Koudela, DDS, MSD, is pediatric orthodontist
at Seattle Children’s Hospital and affiliate associate
professor in the Department of Orthodontics at the
University of Washington School of Dentistry. Koudela
cares for children in the outpatient Dental Clinic and
in the Craniofacial Center at Children’s. She received
her DDS from the University of California, Los Angeles,
School of Dentistry and completed postdoctoral training
in orthodontics at the University of Washington School
of Dentistry. Koudela attended at Rhode Island Hospital
in Providence and is a diplomate of the American Board
of Orthodontics. She has expertise and training in
craniofacial and surgical orthodontics and oral appliance
treatment for obstructive sleep apnea. Specific areas
of clinical and research interest include nasoalveolar
molding, nonsurgical correction of congenital auricular
deformities and dental treatment for obstructive
sleep apnea.
36
Seok Bee Lim, DMD, is attending dentist at Odessa
Brown Children’s Clinic and is on the clinical faculty of
the Department of Pediatric Dentistry at the University
of Washington School of Dentistry. Lim earned her
DMD at Harvard University School of Dental Medicine
and received training in hospital dentistry through
the general practice residency at the University of
Washington. She also holds a certificate in management from the University of Washington’s Foster
School of Business. Lim provides direct patient care
and mentors residents at the University of Washington.
Jeffrey B. Marks, DDS, is clinical assistant professor
in the Department of Dental Medicine at Seattle
Children’s Hospital and holds an affiliate faculty
appointment in the Department of Pediatric Dentistry
Marks supervises postgraduate anesthesia and sedation
training at Odessa Brown Children’s Clinic. He served
as a residency coordinator in the Division of Pediatric
Dentistry at Primary Children’s Medical Center in Salt
Lake City. Marks has lectured to many groups, including
the United States Turner Syndrome Society. He has
submitted his research on the effects of myelomeningocele on intracranial structures to the Journal of Child
Neurology and presented the results to the International
Association of Dental Research. His current clinical
and research interests include craniofacial anomalies,
special needs, dental trauma/emergency care and
anticipatory guidance for infants and toddlers. He
has private practices in the Ballard and Magnolia
neighborhoods of Seattle.
M. Lena Omnell, DDS, MSD, retired as chief of orthodontics
at Seattle Children’s Hospital in December 2006. She
is affiliate professor in the Department of Orthodontics
She received dental and orthodontic specialty training
in Lund/Malmö, Sweden, and worked as regional chief
orthodontist for nine years for the Trellborg District in
Sweden. Omnell did research on growth and development at the National Institute of Dental Research in
Bethesda, Md., and received her MSD in Washington
state. She is involved in team care of children with
craniofacial anomalies and provides orthodontic care
to children at Odessa Brown Children’s Clinic. Her
main research interests are access to orthodontic care
and growth and development in children with craniofacial anomalies. She has presented at national and
international meetings and authored and co-authored
Dental Medicine
many articles on these topics in peer-reviewed
publications. Omnell is listed in “Best of the U.S.”; she
has been involved in the Washington State Society of
Orthodontists and serves on the review board for the
American Journal of Orthodontics and Dentofacial
Orthopedics and the Cleft Palate–Craniofacial Journal.
Andrea M. Pearson, DDS, is dentist at Odessa Brown
Children’s Clinic and affiliate faculty member at the
University of Washington School of Dentistry. She
earned her DDS with honors from the University of
the Pacific School of Dentistry in San Francisco. She
completed a general practice residency at the University of Washington and became certified in intravenous
conscious sedation and advanced cardiac life support.
Her clinical duties at Odessa Brown Children’s Clinic
include infant, toddler and adolescent dentistry and
dental resident supervision. Pearson is a member of
the American Dental Association, Washington State
Dental Association, Seattle–King County Dental
Society, American Academy of Cosmetic Dentistry
and Academy of General Dentistry. She has published
several articles advising predental students in national
newsletters and has served on committees to help
young dentists. Her interests in dentistry include
pediatrics, oral surgery and sedation dentistry.
Donna J. Quinby, DMD, MSD, is staff dentist at Seattle
Children’s Hospital and affiliate clinical assistant
professor in the Department of Pediatric Dentistry
Quinby graduated from the New Jersey Dental School,
University of Medicine and Dentistry of New Jersey.
She completed a residency in hospital dentistry at the
University of Washington Medical Center. She earned
a certificate in pediatric dentistry and her MSD from
the University of Washington School of Dentistry.
She is board certified in pediatric dentistry. Quinby
has interests and expertise in the dental management
of children with complex medical problems and is a
member of the regional hemophilia team.
Mark M. Schubert, DDS, MSD, is attending dentist
at Seattle Children’s Hospital and professor in the
Department of Oral Medicine at the University of
Washington School of Dentistry. He has an adjunct
appointment in the Department of Otolaryngology–
Head and Neck Surgery at the University of Washington Medical Center and is an associate member in the
clinical division at Fred Hutchinson Cancer Research
Center. He is director of oral medicine at the Seattle
Cancer Care Alliance and clinical director of the
University of Washington’s undergraduate Dental
Education for the Care of the Disabled Program.
Schubert received his DDS from the University of
Washington and completed a hospital dental residency
at the University of Washington Medical Center. He is a
diplomate of the American Board of Oral Medicine and
has published more than 85 articles and numerous book
chapters on oral complications of cancer and cancer
therapy. He was a founder of the International Society
for Oral Oncology and has served as its vice president
and president. He is actively involved with the Multinational Association for Supportive Care in Cancer and
is dental director for the Northwest AIDS Education
and Training program. He has lectured internationally
on oral cancer, HIV/AIDS and general oral medicine.
He has served on mucositis advisory boards and as
principal investigator on mucositis research.
Barbara L. Sheller, DDS, MSD, is attending pediatric
dentist and orthodontist at Seattle Children’s Hospital
and affiliate professor in the departments of Pediatric
Dentistry and Orthodontics at the University of
Washington School of Dentistry. She directs dental
education and resident training at Children’s. Sheller
received her DDS and MSD in orthodontics from the
University of Washington and a certificate in pediatric
dentistry from Children’s. Her clinical and research
interests include oral health of children with special
health care needs and dental emergencies. She is a
diplomate of the American Board of Pediatric Dentistry
and fellow of the American College of Dentists. Sheller
is past president of the Washington State Society of
Pediatric Dentistry. On a national level, sponsoring
organizations for her educational presentations include
the American Association of Orthodontists, the American
Academy of Pediatric Dentistry, the California Dental
Association Foundation and the California Dental
Association. Sheller is a reviewer for many journals,
including American Journal of Orthodontics and
Dentofacial Orthopedics, International Journal of
Pediatric Dentistry, Acta Odontologica Scandinavia,
Pediatric Dentistry and Journal of Dentistry for Children.
Dennis I. Sipher, DDS, is pediatric dentist in the
Department of Dental Medicine at Seattle Children’s
Hospital. His clinical interests include sedation in
pediatric dentistry and the dental management of
children with ectodermal dysplasia. He is a diplomate
37
Dental Medicine
of the American Board of Pediatric Dentistry and
past president of the Washington State Academy of
Pediatric Dentistry.
Terry M. Thomas, DDS, is chief of periodontics at Seattle
Children’s Hospital. Thomas earned his DDS at Loyola
University Chicago, specialized in periodontics at Boston
University and completed an internship at the University
of Washington Medical Center. He was associate at
Children’s Hospital in Denver. He is an active member
in the Academy of Osseointegration, the American
Academy of Periodontology, the American Dental
Association and the Seattle–King County Dental Society.
Bryan J. Williams, DDS, MSD, MEd, is pediatric dentist
and orthodontist in the Department of Dental Medicine
at Seattle Children’s Hospital and staff orthodontist
for the craniofacial team. He is affiliate professor at the
University of Washington School of Dentistry in the
Departments of Pediatric Dentistry and Orthodontics.
Williams received his dental training at the University
of Western Ontario and received specialty training and
his MSD and MEd from the University of Washington.
He is a diplomate of both the American Board of
Orthodontics and the American Board of Pediatric
Dentistry. He lectures internationally on pediatric
behavior management, emergency management,
cleft palate, craniofacial anomalies and the care of
children with complex medical and developmental
problems. His professional interests include dental
care for children with complex medical problems,
management of dentoalveolar trauma and orthodontic
management of children with cleft palate and other
craniofacial anomalies.
Yoo-Lee Yea, DDS, MPH, is dental provider at Odessa
Brown Children’s Clinic in Seattle. Yea earned her
DDS at the University of Michigan, Ann Arbor, and
completed a pediatric dentistry residency with a public
health degree at the University of Washington. Her
professional interests include providing compassionate
and high-quality care to all of her patients and risk
assessment of early childhood caries.
Lisa H. Zimberg, DMD, is staff dentist at Seattle Children’s
Hospital and instructor at the University of Washington
School of Dentistry. She earned her DMD at Boston
University School of Dentistry and completed her
residency at Columbia-Presbyterian Hospital in New
York. She taught dental students and residents at
Columbia College of Dentistry and Oral Surgery in
New York. Zimberg is a member of the American Dental
Association, Washington State Dental Association and
Seattle–King County Dental Society.
Joel H. Berg, DDS, MS
Research in pediatric dentistry at the University
of Washington. 2007 Pacific Northwest Dental
Conference. Seattle, Wash. July 19–20, 2007.
Caries management for children — knife doctor and
pill doctor. Cincinnati Children’s Hospital Medical
Center. Nov. 12, 2007.
Restorative dentistry for children. The Scientific
Program of the 83rd Annual Greater New York
Dental Meeting. New York, N.Y. Nov. 28, 2007.
Geoffrey M. Greenlee, DDS, MSD
Diagnosis, imaging, and temporary anchorage devices.
Pacific Coast Society of Orthodontists staff session.
Seattle, Wash. Jan. 12, 2007.
Trauma; special needs patients; behavior management;
hospital dentistry. Comprehensive review of pediatric
dentistry (course director). American Academy of
Pediatric Dentistry. Fort Worth, Texas. Jan. 12–14, 2007.
Behavior guidance for the pediatric dental patient.
California Dental Association Foundation Pediatric
Oral Health Access Program. San Francisco, Calif.
March 4, 2007.
Behavior insights for pediatric patients. California
Dental Association Spring Scientific Session. Anaheim,
Calif. May 4, 2007.
38
Dental Medicine
Understanding patients with AD/HD. American
Association of Orthodontists 107th Annual Session.
Seattle, Wash. May 21, 2007.
Marshall J, Sheller B, Williams BJ, Mancl L, Cowan
C. Cooperation predictors for autistic dental patients.
Pediatr Dent. Sep/Oct 2007;29(5):369–376.
Behavior guidance, local anesthesia, and nitrous oxide
sedation. Los Angeles Oral Health Foundation and
California Dental Association Foundation Pediatric
Oral Health Access Program. Los Angeles, Calif.
Nov. 10, 2007.
Rafferty KL, Sun Z, Egbert MA, Bakko DW, Herring
SW. Changes in growth and morphology of the
condyle following mandibular distraction in minipigs:
overloading or underloading? Arch Oral Biol. Oct
2007;52(10):967–976. Epub Jun 14 2007.
PUBLICATIONS
Berg JH. Dental caries detection and caries
management by risk assessment. J Esthet Restor Dent.
2007;19(1):49–55.
Berg JH. Minimal intervention: motivating patients
through caries risk assessment. Compend Contin Educ
Dent. Mar 2007;28(3):162–164.
Berg JH, Croll T, Donly K. Focus on preschoolers.
Dental Products Report. Sep 2007;116–117.
Berg JH, Domoto PK. The “age-one” dental visit —
preventing early childhood caries. Inside Dentistry.
Mar 2007.
Berg JH, Lin JY, Croll TP. Restorative material choices
for primary and young permanent molars. Contemporary
Esthetics. Jul 2007;24–30.
Croll TP, Berg JH. Resin-modified glass-ionomer
restoration of primary molars with proximating class
II caries lesions. Compend Contin Educ Dent. July
2007;28(7):372–377.
Schubert MM, Eduardo FP, Guthrie K, Franquine JC,
Bensadoun RJ, Lloid ME, Eduardo CP, Niccoli-Filho
W, Marques MM, Migliorati CA, Hamdi M. A phase III
randomized double-blind placebo controlled clinical
trial to determine the efficacy of low level laser therapy
for the prevention of oral mucositis in patients undergoing hematopoietic cell transplantation. Support Care
Cancer. Oct 2007;15(10):1145–1154.
Sheller B. Systems issues workshop report. Pediatr
Dent. 2007;29:150–152.
Sheller B. Chapter author. In: Nowak AJ, Casamassimo PS, eds. Handbook of Pediatric Dentistry, Third
Edition. Chicago, Ill.: American Academy of Pediatric
Dentistry. 2007.
Stapleton M, Sheller B, Williams BJ, Mancl L.
Combining procedures under general anesthesia.
Pediatr Dent. Sep/Oct 2007;29(5):397–402.
Zhang H, Somerman MJ, Berg JH, Cunningham
ML, Williams B. Dental anomalies in a child with
craniometaphysial dysplasia. Pediatr Dent. Sep/Oct
2007;29(5):415–419.
Greenlee GM. Rapid maxillary expansion results
primarily in dental, not skeletal, changes. J Evid Based
Dent Pract. Mar 2007;7(1):17–18.
Keefe DM, Schubert MM, Elting LS, Sonis ST, Epstein
JB, Raber-Durlacher JE, Migliorati CA, McGuire DB,
Hutchins RD, Peterson DE. Updated clinical practice
guidelines for the prevention and treatment of mucositis.
Cancer. Mar 2007;109(5):820–831.
39
Laboratory Medicine/Pathology
The Department of Laboratory Medicine/Pathology is a comprehensive analytical facility serving outpatients, inpatients
and regional programs and providing testing to more than
175 institutions in the country. We performed more than
900,000 clinical laboratory tests, examined 6,000 surgical
specimens, interpreted 600 bone marrow examinations and
performed more than 100 autopsies as part of the quality
control on medical care at Seattle Children’s Hospital and
for regional perinatal and neonatal programs.
Faculty
Joe C. Rutledge
MD, Director
40
Joe C. Rutledge, MD, Director
Laura S. Finn, MD
Sihoun Hahn, MD, PhD
Rhona M. Jack, PhD
Raj P. Kapur, MD, PhD
Kent E. Opheim, PhD
Kathleen Patterson, MD
Xuan Qin, PhD
Joseph R. Siebert, PhD
Karen Tsuchiya, MD
Min Xu, MD, PhD
The laboratory is staffed by 12 University of Washington
faculty members and more than 120 additional staff. In addition, the laboratory administers an extensive point-of-care
testing program in the hospital and clinics and for ground
and air transport. The laboratories are accredited by the
College of American Pathologists. Advanced instrumentation
is interfaced to the electronic medical record, and we use
techniques established by the Toyota Production System.
All organ subspecialties are covered in anatomic
pathology with a broad spectrum of techniques, including
histopathology, immunoproteomics and electron microscopy.
Technicians complement workups in holistic fashion using
in-house flow cytometry, cytogenetics, DNA arrays and
molecular pathology investigations. A strong analytical
chemistry laboratory includes a regional biochemical genetics
section. We continue to move microbiology from conventional
culture techniques to more-sensitive and more-rapid
molecular assays, both for patient care and for research
through the National Cystic Fibrosis Reference
Microbiology Laboratory.
Our major improvements in quality are achieved by
employing Lean processing through the hospital’s Continuous
Performance Improvement program. This year those efforts
have been targeted to microbiology.
Joe C. Rutledge, MD, is medical director of the Department of Laboratory Medicine/Pathology at Seattle
Children’s Hospital and professor in the Department of
Laboratory Medicine at the University of Washington
School of Medicine. Rutledge participates in all aspects
of the clinical laboratory but spends most of his time in
the area of clinical pathology. His research interest in
early mammalian development and teratology has been
supplanted by research in the area of laboratory operations and the Toyota Production System. He is former
president of the Society for Pediatric Pathology, and
he and members of his department continue to have
major leadership roles in that professional organization.
He is a consultant to the National Toxicology Program,
CHILDx, the FDA and various medical centers in
China and serves on several editorial boards. He is
a member of many national organizations.
Laura S. Finn, MD, is staff pathologist at Seattle Children’s
Hospital and associate professor in the Department of
Pathology at the University of Washington School of
Medicine. In addition to general surgical pathology,
Finn has a special interest in pediatric renal pathology.
Finn has a background in solid organ transplant
pathology and serves as the liaison to transplant teams
at Children’s. She directs the flow cytometry laboratory,
which provides a wide range of diagnostic testing in
immunodeficiency and hematopoietic disorders. She
serves as education coordinator for the Department
of Laboratory Medicine/Pathology and is director of
the pediatric pathology fellowship program.
Sihoun Hahn, MD, PhD, joined the faculty at the
University of Washington and Seattle Children’s
Hospital as professor in the Department of Pediatrics,
head of the Biochemical Genetics Program and
director of the Biochemical and Molecular Genetics
Laboratory. Hahn recently moved from the Mayo Clinic
in Rochester, Minn. After receiving his MD/PhD from
Korea University College of Medicine in Seoul, Korea,
he enrolled in a medical genetics fellowship at the
National Institutes of Health, Bethesda, Md., where
he was the recipient of a National Research Service
Award Fellowship. He is board certified in pediatrics
and medical genetics. Hahn’s research has focused on
copper metabolism, population screening for Wilson
disease and mitochondrial disease. His work focused
on developing a test for Wilson disease, a genetic disease
in which the body cannot excrete copper properly,
leading to its accumulation in various organs including
the liver and brain. He serves as a member of the medical
advisory committee of the Wilson’s Disease Association.
Other research focuses on mitochondrial diseases
and peptide fingerprinting analysis by tandem mass
spectrometry for various disorders. He serves on the
newborn screening advisory committee for Washington
state. He hopes to improve clinical practice through
integrated laboratory testing — true translational
research — and remains a great believer in prevention.
Rhona M. Jack, PhD, is director of chemistry and
co-director of the biochemical genetics lab at Seattle
Children’s Hospital and clinical associate professor in
the Department of Laboratory Medicine at the University of Washington School of Medicine. Jack’s teaching
responsibilities include the university medical technology program, postdoctoral clinical chemistry fellowship
program and medical students. She is co-director of the
Spotlight on team member — Christine Clarke, BS
I’m excited to be part of the Cytogenetics Lab. We are using
advanced microarray technology to diagnose conditions that
have gone undiagnosed with other types of genetic testing.
Some of our families are finally receiving definitive diagnoses
about their child’s condition, allowing specific treatments to
become a reality.
clinical chemistry training program in laboratory
medicine. Her clinical interests include newborn
screening, diagnosis and follow-up of children with
genetic metabolic diseases, and lysosomal storage
diseases.
Raj P. Kapur, MD, PhD, is staff pathologist at Seattle
Children’s Hospital and professor in the Department
of Pathology at the University of Washington School
of Medicine. He co-directs the Fetal Pathology Service
at Children’s, which serves as a diagnostic reference
laboratory to multiple hospitals throughout Washington
state. He has authored numerous papers related to
pathology of the fetus and infant and is an associate
editor of Potter’s Pathology of the Fetus, Infant and
Child, the authoritative text on this topic. Kapur is an
international authority on the pathology of pediatric
intestinal dysmotility and has been the principal
investigator for a research program related to murine
models of Hirschsprung disease and other forms of
intestinal pseudo-obstruction. Kapur’s primary research
interests involve the molecular and cellular events that
underlie normal and abnormal development of the
intestinal nervous system. His laboratory pioneered
some of the first transgenic mouse models for manipulating gene expression in enteric neural precursors, and
his most recent work concerns immunohistochemical
approaches to the diagnosis of Hirschsprung disease in
humans. Kapur is council member for the Society for
Pediatric Pathology and associate editor for Pediatric
and Developmental Pathology.
41
Kent E. Opheim, PhD, is clinical cytogeneticist at Seattle
Children’s Hospital and associate professor in the
Department of Laboratory Medicine at the University
of Washington School of Medicine. He is board certified
in clinical chemistry and in clinical cytogenetics, and
he is co-director of the clinical cytogenetics laboratory
at Children’s. His clinical interests include molecular
cytogenetic testing and translational research related to
new molecular diagnostic testing, such as microarrays.
Kathleen Patterson, MD, is director of anatomic pathology
at Seattle Children’s Hospital and associate professor
at the University of Washington. Her clinical duties
encompass the full range of anatomic pathology,
including surgical and autopsy pathology, with special
interests in neuromuscular disorder, pediatric cardiovascular disease and pediatric tumors. Patterson serves
as chair of the hospital Tissue Committee and as
pathology representation on the Cancer Committee,
for which she chairs a subcommittee overseeing the
use of tissue for cancer research purposes. She also
oversees the pathology aspects of the many ongoing
Children’s Oncology Group (COG) research studies
at Children’s and actively participates in the review of
lung biopsy material with ChILD, a national consortium
studying interstitial lung disease in children. Her
teaching activities at Children’s center on training
University of Washington pathology residents and the
Children’s pediatric pathology fellow. She is an active
member of the Society for Pediatric Pathology; she
chairs the Publications Committee, which oversees
publication of the journal Pediatric and Developmental
Pathology. Patterson is also interested in teaching
pediatric pathology internationally, for which she
has spent time in Bulgaria and Romania.
Xuan Qin, PhD, is director of the Microbiology Laboratory
at Seattle Children’s Hospital and assistant professor
in the Department of Laboratory Medicine at the
serves as microbiology consultant to the core laboratory
for cystic fibrosis microbiology, Cystic Fibrosis Therapeutic Development Network. She is a member of the
faculty of the university postdoctoral training program
42
in medical and public health laboratory microbiology
and of Children’s Infection Control Committee. She is
also microbiology laboratory adviser to the infectious
disease fellowship program in the Department of
Pediatrics at the University of Washington School of
Medicine. Her teaching and research interests include
molecular diagnosis of infectious diseases, antimicrobial
drug resistance and laboratory quality assurance.
Joseph R. Siebert, PhD, is program director of autopsy
services at Seattle Children’s Hospital. His chief clinical
teaching responsibility is training pathology residents
and fellows at autopsy, introducing them to a wide
variety of fetal and pediatric autopsy techniques and
relevant literature. This orientation may also involve
laboratory and other technologists, medical students
and pediatrics residents and fellows. His research
interests center around congenital malformations,
particularly of the craniofacial complex.
Karen Tsuchiya, MD, is co-director of cytogenetics and
molecular diagnostics at Seattle Children’s Hospital,
assistant professor in the Department of Laboratory
Medicine at the University of Washington School of
Medicine and staff scientist at the Fred Hutchinson
Cancer Research Center. Her clinical interests include
cytogenetics and molecular diagnostics of pediatric
neoplasms. She is a member of the College of American
Pathologists Cytogenetic Resource Committee. Tsuchiya’s
primary research interest lies in the characterization
of chromosome and molecular abnormalities in
neoplasia. She is studying genomic abnormalities
in mouse models of prostate cancer.
Min Xu, MD, PhD, is staff clinical pathologist and director
of core laboratory in the Department of Laboratory
Medicine/Pathology at Seattle Children’s Hospital and
assistant professor in the Department of Laboratory
Medicine at the University of Washington School of
Medicine. She is board certified in clinical pathology.
Her clinical interests include hematopathology,
coagulation, chemistry and immunoassays. She
serves as a voting member of the Pediatric Clinical
Research Committee.
AWARDS AND HONORS
PUBLICATIONS
Academic Enrichment Fund. Children’s Hospital.
August 2007.
Adams KM, Lucas J, Kapur RP, Eschenbach DA,
Stevens AM. Changes in amniotic epithelial TLR4
expression with gestational age and LPS stimulation.
Placenta. 2007;Epub.
RESEARCH FUNDING
Anderson SW, Stapp JR, Jane JL, Qin X. Characterization of small colony variant Stenotrophomonas
maltophilia isolated from the sputum specimens of
five patients with cystic fibrosis. J Clin Microbiol.
Feb 2007;45(2):529–535.
Continuing
Rhoda Morrow
Clinical epidemiology and pathogenesis of asymptomatic
HSV: core B — lab core. NIH/DHHS. $70,079.
Herpevac trial for women. NIAID/NIH/DHHS.
$91,707.
Borinstein SC, Xu M, Hawkins DS. Methemoglobinemia and hemolytic anemia caused by rasburicase
administration in a newly diagnosed child with
Burkitt lymphoma/leukemia. Pediatr Blood Cancer.
2007;50(1):189.
Introduction to fetal pathology. Seattle Midwifery
School. Seattle, Wash. March 2007.
Cyclopia, aprosencephaly and acardiac twinning.
Festschrift for M. Michael Cohen Jr. Salt Lake City,
Utah. March 2007.
Fetal Pathology Conference. Swedish Medical Center.
Seattle, Wash. Monthly.
Fetal Pathology Conference. Evergreen Hospital and
Medical Center. Kirkland, Wash. Monthly.
Xuan Qin, PhD
Molecular mechanisms in multiresistant gram-negative bacilli (organizer and moderator). Seattle–King
County Clinical Microbiology Show & Tell. Seattle,
Wash. Jan. 16, 2007.
Karen Tsuchiya, MD
Quality preparations in pediatric acute lymphoblastic
leukemias. Children’s Oncology Group Cytogenetics
Workshop. St. Louis, Mo. March 2007.
Bouldin AA, Parisi MA, Laing N, Patterson K, Gospe
SM Jr. Variable presentation of nemaline myopathy:
novel mutation of alpha actin gene. Muscle Nerve.
Feb 2007;35:254–258.
Carmean N, Kosman JW, Leaf EM, Hudson AE,
Opheim KE, Bassuk JA. Immortalization of human
urothelial cells by human papillomavirus type 16
E6 and E7 genes in a defined serum-free system.
Cell Prolif. 2007;40:166–184.
Charleston JS, Thyer AC, Hansen KR, Charleston LB,
Gougeon A, Siebert JR. Estimating human ovarian
non-growing follicle number: the application of
modern stereology techniques to an old problem.
Hum Reprod. Aug 2007;22(8):2103–2110.
Deutsch GH, Young LR, Deterding RR, Fan LL, Dell
SD, Bean JA, Brody AS, Nogee LM, Trapnell BC,
Langston C; Pathology Cooperative Group, Albright
EA, Askin FB, Baker P, Chou PM, Cool CM, Coventry SC, Cutz E, Davis MM, Dishop MK, Galambos C,
Patterson K, Travis WD, Wert SE, White FV; ChILD
Research Co-operative. Diffuse lung disease in young
children: application of a novel classification scheme.
Am J Respir Crit Care Med. 2007;176:1120–1128.
43
Duesterhoeft SM, Ernst L, Siebert JR, Kapur RP.
Five cases of caudal regression with an aberrant
abdominal umbilical artery: further support for a
caudal regression-sirenomelia spectrum. Am J Med
Genet. 2007;143A:3175–3184.
Finn LS. Confusion about C4d and humoral rejection:
see 4 yourself. Pediatr Dev Pathol. Sep 2007;19(1):Epub.
Gilbert-Barness E, Oligny L, Kapur RP, Siebert JR,
eds. Potter’s Pathology of the Fetus, Infant and Child,
Second Edition. Philadelphia, Pa.: Elsevier. 2007.
Nelson JL, Gillespie KM, Lambert NC, Stevens AM,
Loubiere LS, Rutledge JC, Leisenring WM, Erickson
TD, Yan Z, Mullarkey ME, Boespflug ND, Bingley PJ,
Gale EAM. Maternal microchimerism in peripheral
blood in type 1 diabetes and pancreatic islet beta
cell microchimerism. Proc Natl Acad Sci USA. Jan
2007;104(5):1637–1642.
Parisi MA, Ramsdell LA, Burns MW, Carr MC, Grady
RE, Gunther DF, Kletter GB, McCauley E, Mitchell
ME, Opheim KE, Pihoker C, Richards GE, Soules
MR, Pagon RA. A gender assessment team: experience
with 250 patients over a period of 25 years. Genet Med.
2007;9:348–357.
Patterson K. Mitochondrial muscle pathology.
Perspect Pediatr Pathol. 2007;26:171–174.
Qin X, Galankis E, Martin ET, Englund JA. Multitarget
PCR for diagnosis of pertussis and its clinical implications. J Clin Microbiol. Feb 2007;45(2):506–511.
44
Siebert JR. Cyclopia, aprosencephaly and acardiac
twinning: Is hypoxia-ischemia a unifying mechanism?
Am J Med Genet. 2007;143A:3100–3106.
Siebert JR. The perinatal, fetal, and embryonic
autopsy. In: Gilbert-Barness E, Oligny L, Kapur RP,
Siebert JR, eds. Potter’s Pathology of the Fetus,
Infant and Child, Second Edition. Philadelphia, Pa.:
Elsevier. 2007.
Siebert JR, Kapur RP. The back and perineum. In:
Gilbert-Barness E, Oligny L, Kapur RP, Siebert JR,
eds. Potter’s Pathology of the Fetus, Infant and Child,
Second Edition. Philadelphia, Pa.: Elsevier. 2007.
Xu M. New development of clinical laboratory
medicine in US. J Capital Medical University.
2007;2:182–184.
Xu M, Roberts R, Busby B, Jack RM, Finn LS, Emery
H, Rutledge JC. Evaluation of multiplex anti-nuclear
antibody assay in pediatric patients. Lab Medicine.
2007;38(11):671–675.
Neurology
The Division of Neurology provides outpatient and inpatient
consultation and management services for patients with a
variety of neurologic, neuromuscular and neurodevelopmental
disorders. Infants, children and adolescents with epilepsy,
movement disorders, cerebral palsy, developmental delay,
headache, muscular dystrophy, mitochondrial cytopathies
and other disorders of the nervous system are evaluated
by faculty pediatric neurologists who are certified by the
American Board of Psychiatry and Neurology. Patients are
also evaluated and managed by pediatric neurology midlevel
providers (pediatric nurse practitioners and physician
assistants). The clinical program is supported by pediatric
neurology nurses, dietitians, neuropsychologists and
social workers.
The division operates regular clinics at Seattle
Children’s Hospital and its regional satellites, and pediatric
neurology providers participate in outreach programs in
central Washington and Alaska. Faculty members provide
inpatient consultation for patients admitted to Seattle
Children’s and to the intensive care nursery at the University
of Washington Medical Center. The division admits children
to Seattle Children’s for evaluation of complex neurologic
disorders and administers an inpatient video-EEG telemetry
unit when children are admitted for intensive monitoring of
epilepsy and other paroxysmal disorders.
The Division of Neurology partners with several other
programs at Children’s to provide multispecialty care.
Together with the Division of Neurosurgery, the Division
of Neurology operates the only comprehensive pediatric
epilepsy program within the WWAMI region (Washington,
Wyoming, Alaska, Montana, Idaho). Management of children
in the program may include epilepsy surgery, the ketogenic
Faculty
Sidney M. Gospe Jr.
MD, PhD, Chief
Sidney M. Gospe Jr., MD, PhD, Chief
Nigel S. Bamford, MD
Heidi K. Blume, MD, MPH
Anthony A. Bouldin, MD
Raymond Ferri, MD, PhD
Laura A. Jansen, MD, PhD
John Kuratani, MD
Lauren L. Plawner, MD
Russell P. Saneto, DO, PhD
Hillary Shurtleff, PhD, ABPP/CN
Ednea Simon, MD
Mary H. Warner, PhD
diet, use of the vagus nerve stimulator and participation
in trials of new anticonvulsant medications. A monthly
diagnostic neurogenetics clinic is conducted with the
Division of Genetics and Developmental Medicine.
The department has growing basic neuroscience and
clinical research programs at Children’s and the University of
Washington. Faculty research interests include the physiology
of motor control, disorders of white matter, basic cellular
mechanisms of epileptogenesis, neurotoxicology, mitochondrial cytopathies, infantile spasms, pyridoxine-dependent
seizures and risk factors of neonatal encephalopathy.
Children’s is the primary teaching site for the University
of Washington residency training program in pediatric
neurology, a nationally recognized program that has trained
more than 40 pediatric neurologists. Several program alumni
hold faculty positions at schools of medicine throughout
the country and care for patients at other children’s hospitals,
including facilities in St. Louis, Cincinnati, Kansas City
and Stanford.
Sidney M. Gospe Jr., MD, PhD, is chief of the Division
of Neurology at Seattle Children’s Hospital. Gospe
is professor in the departments of Neurology and
Pediatrics and holds the Herman and Faye Sarkowsky
Endowed Chair in Child Neurology at the University
of Washington School of Medicine. Gospe has been at
Children’s since 2000 and previously was on the faculty
at the University of California, Davis, for 13 years. He
received his MD and PhD from Duke University and
trained in pediatrics and pediatric neurology at Baylor
College of Medicine in Houston. Gospe’s clinical interests include general pediatric neurology and pediatric
neuromuscular disorders. His research concerns the
45
Neurology
hyperactivity disorder, Parkinson’s and Huntington’s
diseases, schizophrenia and substance dependence.
Bamford serves on the University of Washington Medical
School Admissions Committee and the Planning and
Awards committees of the Child Neurology Society.
His research is supported by R01 and K02 grants from
the National Institute of Neurological Disorders and
Stroke as well as funding from Children’s, the University
of Washington Alcohol and Drug Abuse Institute and
the Child Neurology Society.
Spotlight on team member — Mary Voeller, RN, BSN
This year, we are opening a new neurology subspecialty clinic
to address pediatric multiple sclerosis. Until now, patients
diagnosed with MS at Children’s were sent to adult neurologists for follow-up care. Now, our patients and families will
receive comprehensive pediatric care in collaboration with
the Western Multiple Sclerosis Center at the University of
Washington Medical Center.
effects of maternal exposures to toxicants on the neurological development of their offspring, as well as the
clinical and genetic aspects of pyridoxine-dependent
seizures. At Children’s, he directs the division’s clinical
and teaching programs, including the University of
Washington residency training program in pediatric
neurology. Gospe is a member of the American Board
of Pediatrics, an examiner and vignette committee
member for the American Board of Psychiatry and
Neurology and a member of the editorial board of
the journal Pediatric Neurology.
Nigel S. Bamford, MD, is attending physician at Seattle
Children’s Hospital and assistant professor in the
Department of Neurology and adjunct assistant
professor in the departments of Pediatrics and Psychology
Bamford received his doctoral degree from the University
of Utah and trained in pediatrics and neurology at
Columbia College of Physicians and Surgeons in New
York. He treats patients with movement disorders and
other neurological disabilities at Children’s and seeks
answers to their problems in the laboratory. His research
focuses on synaptic plasticity in the mammalian basal
ganglia. This brain region plays an important role in
behavior, voluntary movement, learning and memory;
its dysfunction is thought to produce a multitude of
neuropsychological disorders, including attention deficit
46
Heidi K. Blume, MD, MPH, is attending physician at Seattle
Children’s Hospital and acting assistant professor in
the Division of Pediatric Neurology at the University of
Washington School of Medicine. She attended Harvard
Medical School and completed residencies in general
pediatrics and pediatric neurology at the University of
Washington. She completed a research fellowship and
earned an MPH in the Robert Wood Johnson Clinical
Scholars Program at the University of Washington. Her
primary research interests involve the epidemiology of
childhood neurological disease, and childhood headache.
Anthony A. Bouldin, MD, is an active clinician in Seattle
Children’s Hospital’s inpatient and outpatient neurology
programs and also provides outreach clinics in Yakima
and Wenatchee, Wash. He is clinical assistant professor
in the Division of Pediatric Neurology at the University
of Washington School of Medicine. He received his
MD from the University of Louisville and completed
a pediatrics residency at Tulane University. Bouldin
completed pediatric neurology fellowship training at
the University of Washington. His clinical interests
include general pediatric neurology and neurogenetics.
Raymond Ferri, MD, PhD, is attending physician at
Seattle Children’s Hospital and assistant professor
in the Department of Neurology at the University of
Washington School of Medicine. His clinical interests
are general child neurology and inherited and acquired
disorders of central nervous system myelin. Approximately half the children with abnormalities in white
matter have no identifiable etiology. Ferri’s research
program focuses on identifying factors that regulate
the development of normal myelin. In particular, his lab
is studying hemichannel function in oligodendrocyte
development. Hemichannels are similar to gap junctions
and allow for the passage of small molecules, such as
ions and amino acids, across cell membranes. They
Neurology
may play an important role in cell survival. These
studies may identify targets for pharmacological
treatments for disorders of myelin. Ferri has a pediatric
multiple sclerosis clinic for children with this and related
disorders and sees children with inherited disorders
of myelin. He is also involved in resident and medical
student teaching. He supervises pediatric neurology
residents in the Continuity Clinic and teaches pediatric
neurology residents as well as adult neurology residents,
pediatrics residents and medical students rotating on
the pediatric neurology service. He also lectures on
neural development for a graduate student course.
Laura A. Jansen, MD, PhD, is attending physician at
Seattle Children’s Hospital. She received her MD and
PhD from St. Louis University School of Medicine. She
completed pediatrics and pediatric neurology residencies
at the Washington University School of Medicine,
St. Louis. She also did a research fellowship in the
Department of Clinical and Experimental Epilepsy at
University College London. Areas of clinical interest
include general pediatric neurology, epilepsy and
migraine. Her research activities include investigation
of abnormalities in ion channel function in brain
specimens from children treated surgically for intractable
seizures, with the goals of identifying causes of pediatric
epilepsy and optimizing medical treatment of seizures.
director of the University of Washington pediatric
neurology residency program. She has strong academic
interests in the education of residents, students and
primary care providers. She is involved in writing
evidence-based practice parameters and online
resources to be used by primary care providers and
ED physicians at the initial point of patient care.
She is currently involved in a national clinical research
project on the pharmacologic treatment of spasticity
in children. Her clinical interests are in the natural
history and radiographic features of developmental
disorders of brain formation and in improvement of
delivery of medical care. Plawner is a member of the
Child Neurology Society and the American Academy
of Neurology.
John Kuratani, MD, is director of the pediatric EEG
laboratory at Seattle Children’s Hospital and associate
professor in the Department of Neurology and adjunct
associate professor in the Department of Pediatrics at
the University of Washington School of Medicine. His
clinical interests include the management of infants,
children and adolescents with epilepsy; clinical neurophysiology involving EEG; long-term monitoring and
epilepsy surgery. His research interests include epilepsy
surgery outcomes and a collaborative project with
colleagues from the Division of Neonatology on a
treatment for perinatal asphyxia. He is actively involved
in educating fellows, residents, medical students and
EEG technologists on epilepsy and EEG interpretation.
Russell P. Saneto, DO, PhD, is attending physician at
Seattle Children’s Hospital and associate professor in
the Department of Neurology and adjunct associate
professor in the Department of Pediatrics at Children’s
and the University of Washington School of Medicine.
Saneto received his DO from Des Moines University
in Des Moines, Iowa, and his PhD from the University
of Texas Medical Branch in Galveston. He trained in
pediatrics, pediatric neurology and pediatric epilepsy
at the Cleveland Clinic in Cleveland, Ohio. Saneto’s
clinical interests are in epilepsy — in particular,
difficult-to-control epilepsy. He is involved in vagus
nerve stimulation, the ketogenic diet and epilepsy
surgery to control seizures. Saneto’s other interest
is the diagnosis, treatment and care of patients with
mitochondrial disease. He is particularly interested in
patients with both mitochondrial disease and epilepsy.
Saneto is board certified by the American Board of
Pediatrics and the American Board of Psychiatry and
Neurology. He is also on the Washington Professional
Advisory Board to the Northwest Epilepsy Foundation.
He serves as secretary/treasurer and on the diagnostic
evaluation committee of the Mitochondrial Medicine
Society. Saneto is an examiner for the American Board
of EEG and EP Technologists and a member of the
editorial board of the journal Pediatric Neurology.
Lauren L. Plawner, MD, is attending physician at Seattle
Children’s Hospital and acting assistant professor
in the Department of Neurology at the University of
Washington School of Medicine. She obtained her
MD from Yale University and trained in pediatrics and
neurology at the University of California, San Francisco,
and Stanford University. She is assistant program
Hillary Shurtleff, PhD, ABPP/CN, is neuropsychologist
at Seattle Children’s Hospital and clinical assistant
professor in the Department of Neurology at the
received her training through the University of
Washington and Children’s and has more than 20
years’ experience working with children, adolescents
47
Neurology
and their families at Children’s. She is board certified
in clinical neuropsychology and is a member of the
hospital’s Psychology Credentials and Peer Review
Committee. She is past president of the Pacific Northwest
Neuropsychological Society and has been an invited
reviewer for Child Neuropsychology. Clinically, she
provides neuropsychological evaluations of children
and adolescents with epilepsy and mitochondrial
disorders. She is involved in procedures developed and
used for the purposes of lateralization and localization
of eloquent cortex, particularly language functions;
these procedures include intracarotid amobarbital
procedures, functional magnetic resonance imaging,
grid mapping and intraoperative–awake brain mapping
during surgery. Her clinical, research and teaching
interests include cognitive, social, emotional, educational
and vocational aspects of epilepsy and mitochondrial
disorders as well as the neuropsychological aspects
of epilepsy surgery, particularly the lateralization and
localization of eloquent cortex and postsurgical outcomes.
Ednea Simon, MD, is attending physician at Seattle
the Division of Pediatric Neurology at the University
of Washington School of Medicine. She completed a
pediatric neurology residency and a neurophysiology
fellowship at the University of Washington. Her clinical
interests include treatment and outcomes of children
with infantile spasms, epilepsy surgery and functional
neuroimaging investigation in patients with intractable
epilepsy.
Mary H. Warner, PhD, is a board-certified neuropsychologist at Seattle Children’s Hospital and clinical
assistant professor in the Department of Neurology at
the University of Washington School of Medicine. She
obtained her doctorate in clinical psychology from the
University of Georgia and did a postgraduate fellowship in clinical neuropsychology at the University of
Washington. She previously worked in comprehensive
epilepsy programs at Harborview Medical Center and
Swedish Medical Center in Seattle. She is the treasurer
and past president of the Pacific Northwest Neuropsychological Society. Her principal interests are in
the integration of the cognitive, social, emotional,
educational and vocational aspects of epilepsy and
other neurological disorders with children, adolescents,
48
adults and families. She has a particular interest in
neuropsychological aspects of epilepsy surgery, including
lateralization and localization of language functions
in the brain. She most recently presented at the American
Epilepsy Society an epilepsy surgery case she has
followed for 17 years.
AWARDS AND HONORS
Heidi K. Blume, MD, MPH
2007 Scholarship. American Headache Society.
Listed in America’s Top Pediatricians.
Listed in Who’s Who in Medicine and Health Care.
Ednea Simon, MD
Best Teaching Award. Division of Pediatric Neurology,
Department of Neurology. University of Washington.
RESEARCH FUNDING
New
Dopamine-induced striatal synaptic plasticity. NINDS.
$196,875.
Gestational cocaine exposure mediates long-term
changes in striatal function. University of Washington
Alcohol and Drug Abuse Institute. $20,000.
A double-blind, placebo-controlled, dose-ranging
clinical study to evaluate the safety, tolerability and
antiepileptic activity of ganaxelone in treatment of
patients with infantile spasms. Pharmaceutical
Research Association. $237,405.
An open-label clinical study to evaluate the safety,
tolerability and antiepileptic activity of ganaxalone in
treatment of patients recently diagnosed with infantile
spasms. Pharmaceutical Research Association.
$134,191.
Neurology
Continuing
Presynaptic activity of corticostriatal terminals is
regulated by D2 dopamine receptors. Child Neurology
Society. $20,000.
Presynaptic regulation of striatal excitation. NINDS.
$179,788.
Laura A. Jansen, MD, PhD
GABA-A receptor function in pediatric focal cortical
dysplasia. NINDS/NIH/DHHS. $168,291.
Synaptic mechanisms in motor learning. North Pacific
Pediatric Neurology Colloquium. Seattle, Wash.
June 2007.
Glutamate release in the ventral striatum is mediated
by D1 and D2 receptor activity. Methamphetamine
induces locomotor changes and striatal synaptic
plasticity that are dependent on D1 dopamine
receptors. Repeated amphetamine produces locomotor
sensitization by reversing chronic corticostriatal
depression. Child Neurology Society annual meeting.
Québec City, Québec, Canada. October 2007.
Sidney M. Gospe Jr., MD, PhD
Pyridoxine-dependent seizures. Neurology Grand
Rounds, National Taiwan University College of
Medicine. Taipei, Taiwan, R.O.C. May 18, 2007.
Keynote speech. Organic solvent and inhalant abuse:
epidemiology, neurotoxicology and teratology. 11th
Scientific Meeting of the Taiwan Child Neurology
Society. Taipei, Taiwan, R.O.C. May 20, 2007.
Pyridoxine-dependent seizures. Pediatric Grand
Rounds, Chang-Gung University College of Medicine,
Kwei-Shan. Taoyuan, Taiwan, R.O.C. May 22, 2007.
Ask the mito doctor. United Mitochondrial Disease
Foundation. San Diego, Calif. June 2007.
Mitochondrial disease: a primer. Pediatric Grand
Rounds, Madigan Army Medical Center. Tacoma,
Wash. June 2007.
PUBLICATIONS
Arthur TM, Saneto RP, de Menezes MS, Devinsky O,
LaJoie J, Murphy PJ, Cook WB, Ojemann JG. Vagus
nerve stimulation in children with mitochondrial
electron transport chain deficiencies. Mitochondrion.
Jul 2007;7(4):279–283.
Bamford NS, Scarlis CA. Repeated amphetamine
produces locomotor sensitization by reversing
chronic corticostriatal depression. Ann Neurol.
2007;62(S11):S105–S107.
Blackburn L, Shurtleff H. Seizure disorders. In:
Hunter SJ, Donders J, eds. Pediatric Neuropsychological
Intervention. Cambridge, England: Cambridge University
Press. 2007.
Blume HK, Loch CM, Li CI. Neonatal encephalopathy
and socioeconomic status: a population-based
case-control study. Arch Pediatr Adolesc Med. Jul
2007;161(7):663–668.
SM Jr. Variable presentation of nemaline myopathy:
novel mutation of alpha actin gene. Muscle Nerve.
Feb 2007;35(2):254–258.
Dever D, Bamford NS. Glutamate release in the
ventral striatum is mediated by D1 and D2 receptor
activity. Ann Neurol. 2007;62(S11):S105–S107.
Gurnett CA, Dobbs MB, Keppel CR, Pincus ER,
Jansen LA, Bowcock AM. Additional evidence of
a locus for complex febrile and afebrile seizures
on chromosome 12q22-23.3. Neurogenetics. Jan
2007;8(1):61–63.
49
Neurology
Haas RH, Parikh S, Falk MJ, Saneto RP, Wolf NI,
Darin N, Cohen BH. Mitochondrial disease: a practical
approach for primary care physicians. Pediatrics.
Dec 2007;120(6):1326–1333.
Juul SE, Aylward E, Richards T, McPherson RJ,
Kuratani J, Burbacher TM. Prenatal cord clamping
in newborn Macaca nemestrina: a model of perinatal
asphyxia. Dev Neurosci. 2007;29(4–5):311–320.
Kuratani J. Pyridoxine-dependent epilepsy. In:
Panayiotopoulos CP, ed. MedLink Neurology.
San Diego, Calif.: MedLink Corporation. 2007.
Miyagawa T, Sotero M, Avellino AM, Kuratani J,
Saneto RP, Ellenbogen RG, Ojemann JG. Apnea caused
by mesial temporal lobe mass lesions in infants: report
of 3 cases. J Child Neurol. Sep 2007;22(9):1079–1083.
Pearl PL, Gospe SM Jr. Pyridoxal phosphate
dependency, a newly recognized treatable catastrophic
epileptic encephalopathy. J Inherit Metab Dis.
2007;30:2–4.
Saneto RP, Sotero de Menezes MA. Persistence of
suppression bursts in a patient with Ohtahara syndrome.
J Child Neurol. May 2007;22(5):631–634.
Scarlis CA, Hanan W, Bamford NS. Methamphetamine
induces locomotor changes and striatal synaptic
plasticity that are dependent on D1 dopamine-receptors.
Ann Neurol. 2007;62(S11):S95–S97.
50
Smyth MD, Limbrick DD, Ojemann JG, Zempel J,
Robinson S, O’Brien DF, Saneto RP, Goyal M,
Appleton RE, Mangano FT, Park TS. Outcome following
surgery for temporal lobe epilepsy with hippocampal
involvement in preadolescent children: emphasis
on mesial temporal sclerosis. Neurosurg. Mar
2007;106(3 Suppl):205–210.
Zeng LH, Ouyang Y, Gazit V, Cirrito JR, Jansen LA,
Ess KC, Yamada KA, Wozniak DF, Holtzman DM,
Gutmann DH, Wong M. Abnormal glutamate
homeostasis in a mouse model of tuberous sclerosis.
Neurobiol Dis. Nov 2007;28(2):184–196.
Orthopedics
The Department of Orthopedics specializes in providing the
highest-quality pediatric care for both general and specialized
pediatric orthopedic problems to patients in the Northwest.
Our sites of clinical care include Seattle Children’s Hospital
and locations in Bellevue, Federal Way, Olympia and Everett
as well as outreach facilities in Yakima, Wenatchee, and the
Tri-Cities in Washington and in Anchorage, Alaska. Our clinical
volumes have increased 50 percent in five years, and our
access has decreased from one month to one week. Our
quality of care has improved by patient/family surveys and
has been integrated into all aspects of care with our Value
Stream work at the hospital.
Our faculty includes some of the most accomplished
pediatric orthopedic surgeons in North America dedicated
to providing immediate access and care to all children in
our region. We treat 2,000 pediatric fractures a year in
addition to spinal deformities, pediatric foot and hand
deformities, and musculoskeletal tumors and infections.
We collaborate with our pediatric colleagues on treating
complicated neuromuscular disorders, including cerebral
palsy and myelomeningocele; congenital deformities; and
skeletal dysplasias, including achondroplasia.
Faculty
Ernest U. Conrad III
MD, Director
Ernest U. Conrad III, MD, Director
Cora C. Breuner, MD, MPH
Michael J. Goldberg, MD
Douglas P. Hanel, MD
Thomas Jinguji, MD
Brian J. Krabak, MD
Wally Krengel, MD
Vincent S. Mosca, MD
Gregory Schmale, MD
Kit M. Song, MD
Theodore A. Wagner, MD
Klane K. White, MD, MS
Our new pediatric sports program has developed a
multidisciplinary sports service dedicated to the health care
of the pediatric athlete. That service is at Children’s and
in our Bellevue and Federal Way clinics. Pediatricians,
rehabilitation specialists, pediatric cardiologists, trainers
and sports psychologists will join our pediatric orthopedic
team for managing this important patient population. We
expect to establish new guidelines of care and participation
for the active, growing athlete.
Ernest U. Conrad III, MD, is director of the Department
of Orthopedics at Seattle Children’s Hospital and
professor of orthopedic surgery in the Department of
Orthopaedics and Sports Medicine at the University of
Washington School of Medicine. He completed training
at the Hospital of Special Surgery in New York City.
He also completed a musculoskeletal tumor fellowship
at the University of Florida and a pediatric orthopedic
fellowship in Toronto. When Conrad joined Children’s
Department of Orthopedics, he instituted the Division
of Musculoskeletal Oncology and Transplantation; he
also co-founded the Bone Tumor Clinic at Children’s. He
co-founded the nonprofit Northwest Tissue Center at
the Puget Sound Blood Center and serves as its medical
director. Conrad’s research projects include multiple
clinical studies in pediatric and adult tumors with a
special interest in pediatric limb-sparing procedures,
benign pediatric tumors and soft-tissue sarcomas in
adults. His research interests include the metabolic
imaging of sarcomas, the clinical and biologic description
of hereditary multiple exostoses and the response
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Orthopedics
the adolescent. She is also interested in alternative
management and treatment of adolescents with
headaches, abdominal pain and sports-related disorders.
Her research interests include the evaluation of yoga as
an adjunctive intervention for the patient with eating
disorder and the assessment of complementary medicine
usage by the pediatric patient with diabetes and
musculoskeletal complaints. Her goal is to incorporate
complementary and alternative medicine into both the
outpatient and inpatient programs at Children’s. She
has three teenage children and a black Lab and loves
to sing, play the fiddle, kayak and ride her bike.
Spotlight on team member — Patience Peale, RN, BSN
Over the last 18 months, we’ve improved clinic flow, increased
access and decreased order errors. Our goal is to provide
patients and families with a seamless transition from clinic
to operating room to inpatient unit to home. When hiring,
I now include a family member on the interview panel —
a practice that instills the importance of family-centered
care to all staff members.
associated with musculoskeletal transplantation. He
instituted the first multidisciplinary clinics in both
pediatric and adult sarcomas at Children’s and the
University of Washington School of Medicine, and he
directed the university’s Division of Orthopaedic Surgery.
Cora C. Breuner, MD, MPH, is a board-certified adolescent
medicine specialist and board-certified pediatrician.
She received her BA from Franklin and Marshall College
in Lancaster, Pa., and her MD from Jefferson Medical
College in Philadelphia, Pa. After completing an
internship and pediatric residency at the Naval Hospital
in San Diego, Calif., she came to the University of
Washington, where she completed her adolescent
medicine fellowship in 1993. She received her master’s
degree in public health from the University of Washington
in 1998; her thesis addressed complementary and
alternative medicine use in homeless youth. Currently,
she is associate professor in the Department of Pediatrics
and director of both the outpatient Eating Disorder
Program and outpatient Biofeedback Clinic. She recently
became a member of the new Children’s Sports Medicine
Program as director of the Integrative Medicine Program
and has an additional appointment as adjunct associate
professor of orthopedics. She is president of the Northwest Society of Adolescent Medicine, co-chairperson of
the Work Life Balance Committee and a member of the
Physician Well-being Committee. Her clinical interests
include the treatment of eating disorders and obesity in
52
Michael J. Goldberg, MD, is consulting orthopedic
surgeon at Seattle Children’s Hospital and clinical
professor in the Department of Orthopaedics and
Sports Medicine at the University of Washington
School of Medicine. He was chairman of the Department
of Orthopedics at Tufts University School of Medicine
and Tufts–New England Medical Center, Boston.
His clinical interests include skeletal dysplasias and
orthopedic syndromes. Goldberg participates in clinics
focused on bone dysplasias and orthopedic syndromes
at Children’s and in outreach clinics in general pediatric
orthopedics in Olympia, Federal Way, Yakima and
Wenatchee, Wash. Goldberg’s research activities include
orthopedic aspects of syndromes and measuring the
outcomes and functional health of children with
musculoskeletal conditions. He is past president of
the Pediatric Orthopaedic Society of North America
and past chairman of the Orthopedic Section of the
American Academy of Pediatrics.
Douglas P. Hanel, MD, is chief of the Hand Clinic at
Seattle Children’s Hospital, professor at the University
of Washington School of Medicine and director of the
orthopedic residency program. He trained in orthopedic
surgery at St. Louis University and completed fellowships in hand surgery and microvascular surgery at the
University of Louisville. He has completed the teaching
scholars fellowship at the University of Washington. He
has a predominant interest in surgery of the hand and
the reconstruction of devastating limb injuries. Hanel
has published more than 50 peer-reviewed articles and
13 book chapters; he is co-editor for the second edition
of the textbook Harborview Orthopedic Trauma Protocols. He is principal investigator and co-investigator on
two projects dealing with the outcomes of distal radius
fractures. Hanel has editorial duties on The Journal of
Bone and Joint Surgery, Microsurgery, Orthopedics
Orthopedics
Today, The American Journal of Orthopedic Surgery
and Techniques in Hand and Upper Extremity Surgery.
He has been honored for his teaching efforts at St.
Louis University and Medical College of Wisconsin.
Thomas Jinguji, MD, is a pediatrician at Seattle
Children’s Hospital and clinical assistant professor in
the Department of Orthopaedics and Sports Medicine
at the University of Washington. He earned his MD
at the University of Washington and completed his
residency, chief residency and sports medicine fellowship at the University of Washington. He is a fellow
of the American Academy of Pediatrics. His specialty
interests include sports medicine and nonoperative
pediatric orthopedic care.
Brian J. Krabak, MD, is attending physician in orthopedics
and rehabilitation medicine at Seattle Children’s Hospital; he is clinical associate professor in the Department
of Orthopaedics and Sports Medicine and in the
Department of Physical Medicine and Rehabilitation
Krabak was born in New York City and attended State
University of New York at Buffalo, School of Medicine.
He completed his residency in physical medicine and
rehabilitation at New England Medical Center Hospitals,
Tufts University School of Medicine Boston, and a
fellowship in sports medicine at the Mayo Clinic,
Mayo Graduate School of Medicine, Rochester, Minn.
He joined Johns Hopkins School of Medicine as an
assistant professor of orthopedic surgery and physical
medicine and rehabilitation. He also earned an MBA
from Johns Hopkins University. His clinical interest
is in sports medicine; his research interests include
physical medicine and rehabilitation. An outdoor
enthusiast, Krabak serves as the medical doctor for
the Four Deserts Run each year, which takes him
worldwide. He is highly sought out for his expertise in
sports medicine and has been frequently interviewed.
Wally Krengel, MD, is clinical associate professor of
orthopedic surgery and spine program chief at Seattle
Children’s Hospital; he is a faculty member in the
Department of Orthopaedics and Sports Medicine at
completed an internship and residency at the University
of Washington and a fellowship in spine surgery at the
University of Washington associated hospitals in 1991.
Krengel was previously in private practice orthopedic
spine surgery with Proliance Surgeons in Bellevue, Wash.
He was a previous board member of Proliance Surgeons
and is the current Washington State Orthopedic
Association president and a member of the Industrial
Insurance Medical Advisory Committee for Washington
state. Krengel is a member of the Scoliosis Research
Society and North American Spine Society. His focus
is on evaluation, treatment and outcomes of pediatric
and adult spine problems, including deformities, arthritis
and nerve compression syndromes. In the past five years,
he was a principal investigator in an FDA Phase II trial
of recombinant human thrombonin in spine surgery
and a Phase III FDA trial on safety and effectiveness of
titanium surgical mesh and pedicle screws for lumbar
fusion. His current academic and administrative focus
is on the development of standardized clinical outpatient
and inpatient pathways and outcomes assessment for
patients with spine conditions.
Vincent S. Mosca, MD, is pediatric orthopedic surgeon
of orthopedics at the University of Washington School
of Medicine. He completed his orthopedic surgery
residency at Duke University Medical Center in North
Carolina and a fellowship in pediatric orthopedics at
The Hospital for Sick Children in Toronto, Ontario,
Canada. Approximately 70 percent of his clinical work
and most of his publications and lectures pertain to
understanding and treating deformities of the child’s
foot. Mosca has authored or co-authored 22 articles,
20 book chapters and four monographs. He has been
an invited guest speaker in more than 60 medical
centers and conferences in the United States and more
than 20 internationally. He is chairman of the Education Council for the Pediatric Orthopaedic Society of
North America and serves on the editorial board of the
Journal of Pediatric Orthopedics (United States) and
the Journal of Children’s Orthopaedics (Europe). He
is listed in 12 national and international Who’s Who
directories and has been listed in The Best Doctors
in America since 1996. Mosca was director of the
Department of Orthopedics at Children’s and chief of
pediatric orthopedics at the University of Washington
School of Medicine for 13 years. He maintains a very
busy clinical practice.
Gregory Schmale, MD, is program director of orthopedics
medical education at Seattle Children’s Hospital and
assistant professor in the Department of Orthopaedics
and Sports Medicine at the University of Washington
School of Medicine. He earned his MD at the University
53
Orthopedics
of Washington and completed fellowship training in
the Department of Orthopedics at Children’s and the
University of Colorado Health Sciences Center. His
clinical interests include general pediatric orthopedics
and sports medicine. His research activities include
anterior cruciate ligament reconstruction in the
skeletally immature. He mentors medical students
at the University of Washington.
Kit M. Song, MD, is assistant director of pediatric
orthopedic surgery, acting head of spine surgery and
head of the brachial plexus injury clinic at Seattle
Children’s Hospital; he is associate professor of
orthopedic surgery at the University of Washington
School of Medicine. He completed his fellowship
training in pediatric orthopedics at Texas Scottish
Rite Hospital and was a member of the hospital staff
there for three years. He is a member of the American
Orthopaedic Association. His clinical interests include
pediatric spinal deformities with an emphasis on
infantile deformities, musculoskeletal problems in
children with neuromuscular disease, osteogenesis
imperfecta, arthrogryposis and hip problems. His
research includes bone and joint infections, functional
activity of typically developing and disabled children,
spinal cord monitoring for scoliosis surgery, vertical
expandable prosthetic titanium rib (VEPTR) for the
treatment of thoracic dysplasia and Legg-Calvé-Perthes
disease in children.
Theodore A. Wagner, MD, is attending physician at Seattle
Children’s Hospital; he is clinical professor of spine
surgery and joint clinical professor of neurosurgery at
completed a residency at the University of Washington
and a fellowship in spine surgery in Hong Kong. He
has directed the orthopedic physician associates spine
fellowship and is a member of the international Scoliosis
Research Society. Wagner’s special interests have
been in spinal deformity and in establishing physician
exchange programs with the developing world. The
focus of his clinical energies is spinal deformity resulting
from fracture, tumor and adolescent deformities of
kyphosis and scoliosis.
Klane K. White, MD, MS, is pediatric orthopedic surgeon
at Seattle Children’s Hospital and assistant professor in
the Department of Orthopaedics and Sports Medicine
54
He also sees patients at Children’s Bellevue Orthopedics
Clinic. He earned his MD from George Washington
University School of Medicine in Washington, D.C.,
and his MS in biological oceanography from the
University of Southern California. He completed a
general surgery internship and a residency in orthopedic
surgery and served as an NIH fellow at the University
of California, San Diego. He completed a fellowship
in pediatric orthopedics and scoliosis at Texas Scottish
Rite Hospital for Children in Dallas. His specialty
interests include the treatment of pediatric hip disease,
scoliosis–spinal deformity and skeletal dysplasias. White
is a member of the Pediatric Orthopaedic Society of
North America, Washington State Medical Association
and King County Medical Society. He is active in
orthopedics research and has published in clinical
pediatric orthopedics and spine biomechanics.
AWARDS AND HONORS
Listed in “Top Doctors.” Seattle Metropolitan magazine.
Honorary membership. Società Italiana di Ortopedia e
Traumatologica Pediatrica.
Brian J. Krabak, MD
High Performance Award. USA Swimming.
Listed in Who’s Who in America.
Outstanding Physician. Puget Sound Consumers’
Checkbook.
Listed in: Who’s Who. Who’s Who in America. Who’s
Who in Medicine and Healthcare. Who’s Who in Science
and Engineering. Who’s Who in the World.
Kit Song, MD
Orthopedics
Heavy petal: top ten herbs used by teens. Effective
strategies for working with difficult adolescents.
Society for Adolescent Medicine. Denver, Colo.
March 2007.
CAM in adolescents (two seminars). American Academy
of Pediatrics. San Francisco, Calif. October 2007.
So much to read, so little time (instructor). Diagnosis
and management of skeletal dysplasias (co-instructor).
Evaluation and management of skeletal dysplasia
(co-instructor). American Academy of Orthopaedic
Surgeons annual meeting. San Diego, Calif.
February 2007.
A patient with opsismodysplasia treated with
pamidronate (co-presenter). Distal phalanx and nail
hypoplasia associated with osteopetrosis. Report of an
affect kindred (co-presenter). International Skeletal
Dysplasia Society 8th annual meeting. Albi, France.
July 2007.
Dwarfs in perspective (co-presenter). Quality of
life and outcomes studies in dwarfing disorders
(co-presenter). Little People of America national
conference. Seattle, Wash. July 2007.
Thomas Jinguji, MD
An approach to knee pain in child and adolescent
primary care. Mary Bridge Children’s Hospital
and Health Center 33rd Annual Day of Pediatrics:
Pediatrics Pearls for Office Practice. Tacoma, Wash.
September 2007.
Brian J. Krabak, MD
Cracked heel a big problem in summer. KING 5
television. Seattle, Wash. July 31, 2007.
The hip: causes of pain/limp. The foot: causes of
pain/limp (faculty). L.T. Staheli Pediatric Orthopedic
Seminar. Children’s Hospital and Regional Medical
Center. Seattle, Wash. January 2007.
Anterior tibial tendon transfer in clubfoot (lab
instructor). Ponseti method technical skills course
(moderator/instructor). American Academy of
Orthopaedic Surgeons annual meeting. San Diego,
Calif. February 2007.
Calcaneal lengthening osteotomy and soft tissue
balancing in the management of the adolescent painful
flatfoot (invited faculty). POSNA Specialty Day, American
Academy of Orthopaedic Surgeons annual meeting.
San Diego, Calif. February 2007.
Assessment of foot deformities in children. The cavus
foot. Flatfoot. University of Washington Resident
Teaching Conference. University of Washington
School of Medicine. Seattle, Wash. February 2007.
Calcaneal lengthening osteotomy for flatfoot, second
stage reconstruction for cavovarus with MC osteotomy
and tendon transfers. One-day foot surgery tutorial
(lectures and surgical demonstrations). Requested
tutor, POSNA-sponsored tutorial. Children’s Hospital.
Seattle, Wash. March 2007.
Calcaneal lengthening osteotomy for talo-calcaneal
tarsal coalition. European Pediatric Orthopedic Society
26th annual meeting and EPOS/IFPOS combined
meeting. Sorrento, Italy. April 2007.
Management of the adolescent painful flatfoot. Tarsal
coalitions: new concepts in management. Cavovarus
foot in Charcot-Marie-Tooth disease. XXI International
Congress of the Sociedad Mexicana de Ortopedia
Pediatrica. Hermosillo, Mexico. October 2007.
What happens to the body when you push yourself
too far: treating musculoskeletal issues. Patient Power
Radio with Andrew Schorr, KVI radio. Seattle, Wash.
Nov. 4, 2007.
Steroids and sports (expert speaker). KXLY radio.
Spokane, Wash. Nov. 15, 2007.
55
Orthopedics
Analyzing foot deformities. Juvenile hallux valgus.
Osteotomies for flatfoot, skewfoot and metatarsus
adductus (case-based discussion). Clubfoot surgery
— technical tips (case-based discussion. Forefoot
deformities (case-based discussion). Pes cavus
(case-based discussion). Ponseti method for clubfoot
(hands-on workshop). Hindfoot surgical procedures
(ICL workshop). 4th annual POSNA/AAOS International Pediatric Orthopedic Symposium (faculty).
Orlando, Fla. November 2007.
The limping child. Assessment and management
principles for complex deformities of the child’s foot.
The cavovarus foot deformity in CMT. Tarsal coalitions:
new and old concepts in management. Visiting
professor, Children’s Hospital Medical Center.
Akron, Ohio. November 2007.
Tendon transfers around the foot and ankle. The
symptomatic adolescent flatfoot. Updates, innovations
and controversies: a tribute to Dr. Mercer Rang. The
Ponseti technique for clubfoot (workshop moderator).
ORTHOKIDS International Pediatric Orthopedic
Symposium and Workshop. Riyadh, Saudi Arabia.
November 2007.
Gregory Schmale, MD
Early outcomes following ACL reconstruction using softtissue grafts passed across open physes (co-presenter).
American Academy of Orthopaedic Surgeons annual
meeting. San Diego, Calif. February 2007.
Differences in the presentation of septic arthritis of the
hip in children to adolescents (co-presenter). Pediatric
Orthopaedic Society of North America annual meeting.
Hollywood, Fla. May 2007.
56
Kit Song, MD
Bone and joint basics in children. Back pain. L.T.
Staheli Pediatric Orthopedic Seminar. Children’s
Hospital and Regional Medical Center. Seattle, Wash.
January 2007.
Bone and joint basics — why pediatric bones and joints
are different. Orthopedic Knowledge Update. Seattle,
Wash. January 2007.
Health-related quality of life in children with thoracic
insufficiency syndrome (co-presenter). American
Lung function asymmetry in children with congenital
and infantile scoliosis (co-presenter). European
Pediatric Orthopedic Society 26th annual meeting
and EPOS/IFPOS combined meeting. Sorrento, Italy.
April 2007.
Klane K. White, MD, MS
Ultrasonographic predictors of Pavlik harness failure
in Ortolani positive hips (co-presenter). American
Our early experiences using VEPTR as a growing rod
system. Brandon Carrell Conference, Texas Scottish
Rite Hospital for Children. Dallas, Texas. April 2007.
Bones and joints in MPS: orthopedic management.
Regional Family Conference. Miami, Fla. May 2007.
Ultrasonographic predictors of Pavlik harness failure
in Ortolani positive hips. Pediatric Orthopaedic Society
of North America annual meeting. Hollywood, Fla.
May 2007.
Orthopedics
PUBLICATIONS
Bevan WP, Hall JG, Bamshad M, Staheli LT, Jaffe KM,
Song KM. Arthrogryposis multiplex congenita (amyoplasia): an orthopaedic perspective. J Pediatr Orthop.
Jul–Aug 2007;27(5):594–600.
Bindal M, Krabak BJ. Bacterial sacroiliitis in a middle
aged patient: case report and review of literature. Am J
Phys Med Rehabil. Oct 2007;88(10):1357–1359.
de Lateur BJ, Magyar-Russell G, Bresnick MG,
Bernier FA, Ober MS, Krabak BJ, Ware L, Hayes MP,
Fauerbach JA. Augmented exercise in the treatment
of deconditioning from major burn injury. Arch Phys
Med Rehabil. Dec 2007;88(12 Suppl 2):S18–23.
Moore WJ, Krabak BJ. Chronic lateral knee pain in a
cyclist: popliteal artery entrapment. Clin J Sport Med.
Sep 2007;17(5):401–403.
Mosca VS. Cavus foot. Flatfoot. In: Staheli LT, ed.
Pediatric Orthopaedic Secrets, Third Edition.
Philadelphia, Pa.: Mosby Elsevier. 2007.
Mosca VS, Bevan WP. Calcaneal lengthening osteotomy
for talocalcaneal tarsal coalition. J Child Orthop.
2007;1(supp1):S24.
Waldhausen JHT, Redding GJ, Song KM. Vertical
expandable prosthetic titanium rib (VEPTR) for
thoracic insufficiency syndrome (TIS): a new
method to treat an old problem. J Pediatr Surg.
Jan 2007;42(1):76–80.
Grassbaugh JA, Mosca VS. Congenital ingrown
toenail of the hallux. J Pediatr Orthop. Dec
2007;27(8):886–889.
Ko AL, Song KM, Ellenbogen RG, Avellino AM.
Retrospective review of multilevel spinal fusion
combined with spinal cord transection for treatment
of kyphoscoliosis in pediatric myelomeningocele
patients. Spine. Oct 2007;32(22):2493–2501.
Krabak BJ, Baima J, Smith J. Musculoskeletal
education in physical medicine and rehabilitation
programs: graduating resident perspective. Am J
Phys Med Rehabil. June 2007;86(6):493–498.
Krabak BJ, Cosgarea A, Tucker A, McFarland E.
Recurrent concussions — Football: 995. Med Sci
Sports Exerc. May 2007;39(5 Suppl):S109.
Krabak BJ, Minkoff E. Return to competition
following prolonged injury. In: Slipman CW, Derby R,
Simeone FA, Mayer TG, eds. Interventional Spine:
An Algorithmic Approach. London, England: Elsevier
Science. 2007.
57
Psychiatry and Behavioral Medicine
The Department of Psychiatry and Behavioral Medicine
provides a continuum of behavioral health services including
inpatient, outpatient and hospital and community consultations for youth with a wide spectrum of developmental,
psychiatric and behavioral problems.
The programs at Seattle Children’s Hospital are in the
top tier of pediatric behavioral sciences services in the
Faculty
Bryan H. King
MD, Director
58
Bryan H. King, MD, Director
David Breiger, PhD
Zoran Brkanac, MD
Rosemary Calderon, PhD
L. Lee Carlisle, MD
Brent R. Collett, PhD
Cynthia A. Flynn, PhD
Amy J. Henry, MD
Robert Hilt, MD
Stefanie A. Hlastala, PhD
Ray Hsiao, MD
Jeffrey P. Kaiser, MD
Jon S. Kuniyoshi, MD
Elizabeth A. McCauley, PhD, ABPP
Jon M. McClellan, MD
Kathleen M. Myers, MD, MPH, MS
Heather Carmichael Olson, PhD
Carol M. Rockhill, MD, PhD, MPH
Kelly A. Schloredt, PhD
Matthew L. Speltz, PhD
Michael G. Storck, MD
Stephen I. Sulzbacher, PhD
Ann Vander Stoep, PhD
Christopher K. Varley, MD
William M. Womack, MD
country and are recognized as a national and regional
resource. Children’s leads in areas including mood disorders,
autism spectrum disorders, coexisting medical and psychiatric
illness, early-onset psychosis and remote consultation
using telemedicine links. Research is particularly active in
psychiatric genetics, developmental psychopathology and
health services related to understanding the origins, course
and treatment of mental illness in children and adolescents.
In conjunction with the University of Washington
Department of Psychiatry and Behavioral Sciences, Children’s
is a center of clinical training, research and pediatric mental
health care for the WAMI region (Washington, Alaska,
Montana, Idaho).
The Department of Psychiatry and Behavioral Medicine
at Children’s is proud of its tradition as a leader in advancing
knowledge of the origins and treatment of mental illnesses
in youth, training clinician scientists and improving access
to care. We are committed to growing these efforts to reach
the increasing numbers of children and families in need.
Bryan H. King, MD, is director of the Department of
Psychiatry and Behavioral Medicine at Seattle Children’s
Hospital and professor and vice chair in the Department
of Psychiatry and Behavioral Sciences at the University
of Washington School of Medicine. He joined the
university from Dartmouth Medical School, where
he served as medical director for New Hampshire’s
Division of Developmental Services. King’s clinical
and research interests focus on psychiatric aspects
of developmental disorders and on severe behavioral
disturbances, particularly in autism. He chairs a
multisite clinical trial by the National Institutes of
Health (Studies to Advance Autism Research and
Treatment) examining an antidepressant medication in
treatment of children with autism who have significant
problems with repetitive behaviors — the largest study
of its kind ever conducted. King has received lifetime
achievement awards from the American Academy of
Child and Adolescent Psychiatry and the American
Psychiatric Association for his work in developmental
and intellectual disabilities.
David Breiger, PhD, is clinical program director of the
Neuropsychological Assessment Service at Seattle
Children’s Hospital and clinical associate professor in
the Department of Psychiatry and Behavioral Sciences
Children’s Neuropsychological Assessment Service
evaluates children and adolescents with medical,
neurological, psychological and genetic conditions
that affect development, and it provides inpatient and
outpatient neuropsychological assessments. Breiger’s
interests include neuropsychological outcomes of
children with brain tumors, neuropsychological and
psychosocial adjustment of long-term survivors of
acute lymphocytic leukemia, neuropsychological
functioning in children with thought disorders or
chronic fatigue syndrome and the cultural context and
understanding of autism. He supervises psychology
residents at the university and postdoctoral fellows in
pediatric neuropsychology; he also lectures psychiatry
fellows and pediatrics residents and teaches graduate
courses in the Department of Psychology at the
University of Washington School of Medicine. Breiger
has served as president of the Pacific Northwest
Neuropsychological Society.
Zoran Brkanac, MD, is attending psychiatrist at Seattle
Department of Psychiatry and Behavioral Sciences
He is board certified in adult and child and adolescent
psychiatry. His research interests include behavioral
genetics and the genetics of dyslexia.
Rosemary Calderon, PhD, is attending psychologist at
She is clinical director for the Eating Disorders Service
in psychiatry and clinical director for Psychiatric
Services for the Deaf and Hard of Hearing Program.
She is also an attending psychologist on the Inpatient
Psychiatric Unit. Her clinical interests include longterm outcomes for adolescents with eating disorders
(anorexia nervosa, bulimia nervosa). Calderon is
adjunct associate professor in the Department of
Otolaryngology-Head and Neck Surgery and a research
affiliate in the university’s Center on Human Development and Disability and in the Virginia Merrill Bloedel
Hearing Research Center. Calderon is also coordinator
of child clinical-track training of the University of
Spotlight on team member — Lynn Vigo, MSW
Our recent move toward a multidisciplinary model of care
for children with autism should improve outcomes for our
patients and make life a little easier for our families. As a
parent of a child with autism and as a family advocate for
others, I know that our kids have complex needs best served
by a team of providers from many different specialty areas.
Washington psychology internship training program.
Calderon lectures regularly to general psychiatry
residents, child psychiatry fellows, clinical psychology
graduate students and local professionals on the diagnosis
and treatment of eating disorders in adolescents.
L. Lee Carlisle, MD, is assistant professor in the Department of Psychiatry and Behavioral Sciences at the
University of Washington School of Medicine and
attending psychiatrist at Seattle Children’s Hospital.
She is a consultant to the Foster Care Assessment
Program at Harborview Medical Center and has served
for the past four years on the University of Washington
School of Medicine Admissions Committee. Carlisle is
a member of the Autism and Intellectual Disability
Committee and the Diversity and Culture Committee
of the American Academy of Child and Adolescent
Psychiatry. Her clinical interests include child abuse,
post-traumatic stress disorder, pervasive developmental
disorders, psychopathology in early childhood and
metabolic effects of atypical antipsychotics.
Brent R. Collett, PhD, is attending psychologist at Seattle
Working in Children’s Early Childhood Clinic, he is
involved in evaluation and treatment of children from
birth to age 5 and their families, particularly children
who have complex medical conditions (e.g., craniofacial
59
anomalies) in addition to developmental, behavioral or
psychiatric problems. His research is primarily in the
area of pediatric psychology and includes studies of
children with craniofacial anomalies and survivors
of childhood cancer. Collett also maintains an active
research interest in the developmental psychopathology
of disruptive behavior disorders. His teaching activities
include supervision of child psychiatry fellows and
psychology interns in the Early Childhood Clinic
and didactic teaching related to early-onset behavior
problems and normative preschool-age development.
Cynthia A. Flynn, PhD, is attending psychologist at Seattle
Children’s Hospital and acting assistant professor at
earned her doctoral degree at Vanderbilt University in
Nashville, Tenn. She completed her clinical residency
through the University of Washington and a postdoctoral fellowship at Children’s. Flynn’s clinical interests
include treatment of child and adolescent suicidality,
depressive disorders, eating disorders and disruptive
behavioral problems. She conducts research investigating
the etiology and treatment of depression and the
assessment and treatment of adolescent suicidal
ideation and behavior. Her work includes collaboration
with school-based mental-health programs to advance
use of empirically based treatments in these settings.
Amy J. Henry, MD, is attending psychiatrist at Seattle
At Children’s she directs a clinical team in the Inpatient
Psychiatry Unit and is medical director of the outpatient
psychiatry clinic. She supervises child and adolescent
psychiatry residents, general psychiatry residents and
medical students, both on the Inpatient Psychiatry
Unit and through the outpatient clinic. Henry also
provides clinical care and supervises residents at
community psychiatry sites, including school-based
clinics, Asian Counseling and Referral Services and
a rural mental health center in Alaska. Her clinical
interests include assessing and treating adolescents
with self-harmful behaviors, depressive disorders,
developmental disorders and anxiety disorders.
60
Robert Hilt, MD, is attending psychiatrist at Seattle
His work focuses on consultation psychiatry with
primary care and hospital physicians. His clinical and
research interests include psychiatric systems of care,
improving child psychiatric emergency services and
developing and studying care systems for psychiatric
consultation to primary care. His teaching interests
include a variety of child psychiatric topics likely to
be encountered by a referring clinician, and he has
experience lecturing to medical students, residents
and attending physicians in many areas. He is a
member of the American Academy of Child and
Adolescent Psychiatry (AACAP) and sits on its Committee on Collaboration with Medical Professions.
He is a fellow of the American Academy of Pediatrics
and has experience working as a practicing pediatrician.
He was awarded membership in the Alpha Omega
Alpha honor society and has received the AACAP
Outstanding Child Psychiatric Resident Award. He
is board certified in both adult and child psychiatry.
Stefanie A. Hlastala, PhD, is attending psychologist
professor in the Department of Psychiatry and Behavioral Sciences at the University of Washington School
of Medicine. Her interests include mood and psychotic
disorders in children and adolescents. She is principal
investigator for an NIH-funded research grant aimed
at adapting an adjunctive psychotherapy (interpersonal
and social rhythm therapy) for use with adolescents
who have bipolar disorder. She is a co-investigator
on a multisite study examining the effectiveness and
safety of lithium in youth with mania; she is also a
co-investigator on a study examining the effectiveness
and safety of antipsychotic medications in youth with
schizophrenia spectrum disorders.
Ray Hsiao, MD, is attending physician at Seattle Children’s
Hospital and acting assistant professor in the Department
of Washington School of Medicine. He is co-director of
the Adolescent Center on Substance Use Intervention,
Treatment, Education and Research (SUITER) at
Children’s. He received his MD from the Feinberg
School of Medicine at Northwestern University and
completed his general psychiatry residency, child
and adolescent psychiatry fellowship and addiction
psychiatry fellowship at the University of Washington
School of Medicine. His clinical and research interests
include prevention and treatment of substance use
disorders, assessment and treatment of co-occurring
disorders and cultural psychiatry. Hsiao is very actively
involved with the Washington State Psychiatric Association and has served on the board as its treasurer, then
president-elect, while chairing the Continuing Medical
Education Committee.
Jeffrey P. Kaiser, MD, is attending psychiatrist and
medical director of the Inpatient Psychiatry Unit at
Seattle Children’s Hospital. He is acting instructor in
His work focuses on inpatient evaluation and treatment; long-term outpatient medication management
and psychotherapy; and resident, fellow, faculty and
community psychiatric education. His clinical and
research interests include treatments for mood, anxiety
and eating disorders, novel approaches to psychiatric
education and residency training and the history of
psychiatry. He is a member of the American Academy
of Child and Adolescent Psychiatry.
Elizabeth A. McCauley, PhD, ABPP, is associate director
of the Department of Psychiatry and Behavioral
Medicine at Seattle Children’s Hospital and professor
She attends on Children’s Psychiatry Consultation
and Liaison Service. She works with youth who have
medical conditions affecting their sexual development,
those with gender identity concerns and adolescents
with mood disorders. McCauley is a member of the
Research Grants Board for the American Foundation
for Suicide Prevention and serves on the editorial
boards of the Journal of Clinical Child and Adolescent
Psychology and the Journal of Abnormal Child
Psychology. She was president of the American
Psychological Association’s Society of Clinical Child
and Adolescent Psychology in 2007. She leads a
research program designed to characterize clinical
depression in young people and currently has NIH
grants exploring the development of depressive and
conduct problems, the efficacy of a school-based
program to prevent depression in young adolescents
and the efficacy of a clinical treatment program for
depression. She has also studied the psychosocial
and cognitive functioning of girls and women with
Turner syndrome. In the past year, she served on NIH
task forces to develop the Practice Guidelines for
Management of Girls and Women with Turner
Syndrome and to address the development of effective
treatment strategies for depression in young people.
Jon M. McClellan, MD, is an attending psychiatrist at
Seattle Children’s Hospital, associate professor in the
Department of Psychiatry and Behavioral Sciences at
the University of Washington School of Medicine and
medical director of Washington’s Child Study and
Treatment Center (CSTC), the state hospital for children
and adolescents. He is involved in two primary areas of
research: genomic approaches for gene discovery with
schizophrenia and other complex neuropsychiatric
disorders; and the diagnosis, phenomenology and
treatment of early-onset schizophrenia and bipolar
disorders. McClellan is involved with two NIH-funded
multicenter treatment trials, one for early-onset
schizophrenia and the other for early-onset bipolar
disorder. He develops treatment guidelines for the
American Academy of Child and Adolescent Psychiatry
and authored the academy’s practice parameters
on early-onset schizophrenia and bipolar disorder.
McClellan’s teaching responsibilities include resident
supervision, research mentoring and didactic presentations for residents and university medical students.
Kathleen M. Myers, MD, MPH, MS, is director of the
Psychiatry Consultation and Liaison Service at Seattle
the University of Washington School of Medicine. Her
interests include telepsychiatry, especially for youth
living in underserved communities of Washington and
Alaska; mood disorders, especially early-onset bipolar
disorder; and the mental health needs of medically
ill children.
Heather Carmichael Olson, PhD, is attending psychologist
at Seattle Children’s Hospital, senior lecturer in the
adjunct faculty in the Department of Speech and
Hearing Sciences at the University of Washington.
She directs the Early Childhood Clinic within Child
Psychiatry Outpatient Services at Children’s and is an
attending psychologist for the Fetal Alcohol Syndrome
Diagnostic and Prevention Network at the University
of Washington. Carmichael Olson is currently principal
investigator for a study of the Families Moving Forward
61
Program, an intervention research project for children
with fetal alcohol spectrum disorders (FASD) and their
families. Her research interests include FASD, the
impact of parental substance abuse on children’s
developmental outcomes and infant/early childhood
mental health. She is a research affiliate of both the
Alcohol and Drug Abuse Institute and the Center on
Human Development and Disability. She carries out
a wide variety of presentations to professional and
lay audiences. Carmichael Olson just completed her
tenure as a member of the National FAS Task Force,
a congressionally appointed committee designed to
advance activities related to FASD. In 2007, she was
president of the FASD Study Group, a satellite research
organization with an international membership affiliated with the Research Society on Alcoholism (RSA),
and she is currently on the RSA Program Committee.
Carol M. Rockhill, MD, PhD, MPH, is attending physician
at Seattle Children’s Hospital, with her primary clinical
location at the Bellevue site. She is an acting assistant
professor at the University of Washington. She earned her
MD and PhD at the University of Illinois, ChampaignUrbana campus, as part of the Medical Scholars
Program. She earned her MPH at the University of
Washington School of Public Health. She has completed
residency training in general psychiatry and fellowship
training in child and adolescent psychiatry, both at the
University of Washington. Her clinical interests include
major depression in children, especially when complicated by another diagnosis such as oppositional defiant
disorder. She is interested in developing new treatments
for youth with comorbid (or co-occurring) psychiatric
disorders. She was selected for participation in the
Child Health, Intervention and Prevention Services
Summer Research Institute program, funded by the
National Institutes of Mental Health, in April 2007.
Kelly A. Schloredt, PhD, is attending psychologist at
Seattle Children’s Hospital and clinical associate
professor in the Department of Psychiatry and Behavioral Sciences at the University of Washington School
of Medicine. In Children’s Inpatient Psychiatry Unit,
she supervises and clinically trains child psychiatry
fellows, general psychiatry residents, psychology
residents and medical students as well as engages in a
number of administrative activities related to clinical
care and the general milieu program on the inpatient
unit. She lectures in the didactic series for child fellows,
62
general psychiatry residents and psychology residents;
she has given a number of lectures for organizations,
including the Washington State Psychiatric Association.
With a research focus on child and adolescent depression,
she manages a multisite longitudinal research project
following children of depressed parents as their
parents undergo treatment for depression. She is also
a co-investigator on a treatment development grant
focused on adapting behavioral activation therapy for
depressed adolescents and examining the efficacy of
this treatment.
Matthew L. Speltz, PhD, is chief of outpatient services
in the Department of Psychiatry and Behavioral
Medicine at Seattle Children’s Hospital and professor
Sciences at the University of Washington School of
Medicine. Speltz’s research and clinical interests focus
on the neurobehavioral development of children with
craniofacial disorders and other chronic medical
conditions, assessment and treatment of attachment
disorders, disruptive behavior disorders, autism,
anxiety disorders and behavioral medicine.
Michael G. Storck, MD, is attending psychiatrist at
Seattle Children’s Hospital and at Washington’s Child
Study and Treatment Center (CSTC) and assistant
professor in the Department of Psychiatry and Behavioral
Medicine. He lectures on growth and development;
systems of care; narrative therapy; and cross-cultural
psychiatry, spirituality, religion and health. On the
faculty of the University of Washington School of
Medicine College Program, he mentors six medical
students each year in their second year of Introduction
to Clinical Medicine and serves as their medical-school
advisor. He also supervises child psychiatry fellows in
their three-month rotation at CSTC and is preceptor
for fourth-year medical students and students in the
University of Washington School of Nursing Psychosocial
Nurse Practitioner Program. Storck is lead investigator
in a small study assessing patient and second-year
medical student perspectives on the process of early
clinical education and is co-investigator in a study on
Southwestern youth and their experience of psychiatric
treatment. He co-chairs the American Academy
of Child and Adolescent Psychiatry’s Native American
Child Committee.
Stephen I. Sulzbacher, PhD, is attending psychologist
at Seattle Children’s Hospital and the University of
Washington Medical Center. He is on the medical staff
at Central Washington Hospital in Wenatchee, Wash.,
and is associate professor emeritus in the Department
of Washington School of Medicine. Sulzbacher’s
research focuses on early identification of central
nervous system effects of inborn errors of metabolism
and on following up on children identified through the
Washington State Newborn Screening Program with
periodic neuropsychological testing. He is also conducting research to study the effects of pesticides on
the health of children of farm workers. Additionally,
Sulzbacher does applied research to demonstrate the
use of videoconferencing as a way to provide consultation to rural school districts serving children with
special health-care needs such as autism. He provides
regular telehealth consultation to rural practitioners
and clinics throughout the state as an adjunct to
outreach clinics in which he participates.
Ann Vander Stoep, PhD, is an associate professor who is
a child psychiatric epidemiologist with joint academic
appointments in the University of Washington Department of Psychiatry and Behavioral Sciences in the School
of Medicine and the Department of Epidemiology in
the School of Public Health and Community Medicine.
Her research interests include developmental epidemiology of adolescent depression and comorbid disorders,
development and evaluation of child and adolescent
mental health interventions and transition to adulthood
for adolescents with psychiatric disorders. She is a
principal investigator for the Developmental Pathways
Research Program, a collaborative effort with the
Seattle public schools to study the etiology of childhood
depression and to develop effective prevention strategies.
She teaches epidemiology methods and psychiatric
epidemiology, mentors graduate students in the
University of Washington School of Public Health and
provides research mentorship to junior scientists in
the Department of Psychiatry and Behavioral Sciences.
Christopher K. Varley, MD, is an attending psychiatrist in
the outpatient psychiatry clinic at Seattle Children’s
Hospital, where he developed a service for complex
attention deficit hyperactivity disorder. He is professor
Medicine and is training director for the Division of
Child and Adolescent Psychiatry. He is consulting
psychiatrist for the Gateway Center for Human
Services in Ketchikan, Alaska. His clinical interests
include disruptive behavior disorders and complex
psychopathology in children and adolescents and
psychopharmacology.
AWARDS AND HONORS
Award for Excellence in Mentoring Women and
Minorities. University of Washington School of
Medicine. 2007–2008.
RESEARCH FUNDING
New
Bryan H. King, MD
Social and affective processes in autism. NIH/DHHS.
$142,881.
Continuing
Behavioral activation therapy for adolescents.
NIH/DHHS. $309,949.
Best Pharmaceuticals for Children Act pediatric
off-patient drug study: lithium for the treatment of
pediatric mania (COLT). NICHD/NIH/DHHS.
$1,615,777.
Treatment of early-onset schizophrenia spectrum.
NIMH/NIH/DHHS. $170,043.
Intervention for individuals with fetal alcohol
syndrome: transitioning science to community
projects. CDC/DHHS. $368,075.
Hemifacial microsomia: psychosocial and other
sequelae. NIDCR/NIH/DHHS. $126,372.
Neurodevelopment among infants with deformational
plagiocephaly. NICHD/NIH/DHHS. $482,341.
63
Follow-up study of psychosocial outcomes in
children with hemifacial microsomia: progress report
(co-presenter). Neurodevelopment of preschoolers
with single suture craniosynostosis (co-presenter).
Social and neuropsychological outcomes of children
with and without hemifacial microsomia (co-presenter).
Annual conference of the American Cleft Palate
Craniofacial Association. Denver, Colo. April 2007.
Ray Hsiao, MD
Managing opiate detoxification with
buprenorphine/naloxone. Component workshop.
American Psychiatric Association Annual Meeting.
San Diego, Calif. May 23, 2007.
Suicide and self-harm behaviors: update and overview
(invited presentation). Nadherny/Calciano Symposium.
Santa Cruz, Calif. March 9, 2007.
Disorders of sex development: psychological considerations. Pediatric Endocrine Nurses Society Annual
Meeting. Portland, Ore. April 20, 2007.
Developmental considerations in treating depression in
adolescents (invited address). American Psychological
Association. San Francisco, Calif. Aug. 13, 2007.
Jeffrey P. Kaiser, MD
Treating depression in children and adolescents.
Update in Practical Pediatrics: Treating Mood Disorders
(Depression). Kirkland, Wash. September 2007.
Schizophrenia: a rare allele model. NIH Early Onset
Schizophrenia Symposia. Bethesda, Md. June 2007.
Bryan H. King, MD
The promises and perils of psychopharmocotherapy.
Annual Pediatric Nursing Conference. Children’s
Hospital. Seattle, Wash. February 2007.
Treatment of early-onset schizophrenia and
schizoaffective disorder. Child Psychiatry Grand
Rounds. Northwestern University. Evanston, Ill.
September 2007.
Update on psychotropic medication: staying outside
the (black) box. Annual Madigan Pediatric Conference.
Fort Lewis, Wash. February 2007.
CBS “60 Minutes” interview examining the controversies
surrounding bipolar disorder in children. October 2007.
Theories of etiology and treatment of self-injury in
the context of intellectual disability. 3rd Annual
Developmental Disabilities Health-Care Update:
Health Promotion Across the Lifespan. Seattle, Wash.
March 2007.
Psychopharmacology update. Innovative Approaches:
Treatment for People with Developmental Disabilities
and Psychiatric Disorders 6th annual conference.
Los Angeles, Calif. June 2007.
A comprehensive approach to pharmacologic treatment
in intellectual disability and autism. AACAP annual
meeting. Boston, Mass. October 2007.
64
Integrated care: why it matters and how to accomplish
it (keynote speech). Dartmouth Conference on Autism
Spectrum Disorders: Bridging the Gaps between
Medical Care, School and Social Life. Lebanon, N.H.
October 2007.
TEOSS: maintenance therapy. Annual meeting of the
American Academy of Child and Adolescent Psychiatry.
Boston, Mass. October 2007.
Meeting the challenge of FASD intervention: the
Families Moving Forward Intervention Model for
caregivers raising children with FASD. Putting the
pieces together for children and families: the national
conference on substance abuse, child welfare and the
courts. Children and Family Futures Conference.
Anaheim, Calif. January 2007.
Families moving forward: behavioral consultation
intervention for fetal alcohol spectrum disorders and
other neurodevelopmental disabilities. Symposium
on improving educational outcomes for students with
intellectual and behavioral disabilities due to prenatal
alcohol exposure. Interagency Coordinating Committee
on Fetal Alcohol Syndrome, National Institute on
Alcohol Abuse and Alcoholism, Office of Rare Diseases,
National Institutes of Health, U.S. Department of
Education. Rockville, Md. July 2007.
Christopher K. Varley, MD
Updates on “portals” into psychiatry/child and adolescent
psychiatry, including the proposed post-pediatrics
training program (co-presenter). American Association
of Directors of Psychiatric Residency Training 36th
Annual Meeting. San Juan, Puerto Rico. March 10, 2007.
FASD intervention: multifaceted research (conference
planner and session moderator). Fetal Alcohol Spectrum
Disorders Study Group (FASDSG) Annual Meeting.
Chicago, Ill. July 2007.
Update in adolescent medicine: current issues in
gynecology and psychopharmacology. Adolescent
pharmacology — focus on ADHD and on depression.
Annual meeting of the Pediatric Academic Societies.
Toronto, Ontario, Canada. May 6, 2007.
A call to action: mapping the future of FASD
intervention. Leadership Conference on Intervention
and Treatment for Alcohol-Affected Individuals: The
Next Challenge. The Marcus Institute, University
Center of Excellence in Developmental Disabilities,
Emory University and School of Medicine. Atlanta, Ga.
October 2007.
Kelly A. Schloredt, PhD
Depression in children and adolescents. 18th Annual
Pacific Northwest Ambulatory Care Nursing Conference.
Seattle, Wash. April 25, 2007.
Michael G. Storck, MD
Patients as teachers: assessing hospitalized patients’
perspectives on clinical encounters with medical
students (co-presenter). Conference on Patient- and
Family-Centered Care: Partnerships for Enhancing
Quality and Safety. Seattle, Wash. July 2007.
Clinical perspectives presentation: bringing the community to the state hospital through teleconferencing.
American Academy of Child and Adolescent Psychiatry
annual meeting. Boston, Mass. October 2007.
Ann Vander Stoep, PhD
Transition to adulthood for adolescents with mental
illness. Network for Youth Annual Conference.
Washington, D.C. Feb. 5, 2007.
Is the newest the greatest? Autism, ADHD and Other
Developmental-Behavioral Problems. Seattle Children’s
Hospital. Seattle, Wash. April 14, 2007.
Pediatric psychopharmacology. Continuing education
program, School of Social Work, University of
Washington. Seattle, Wash. May 17, 2007.
Pediatric psychopharmacology 201: mood stabilizers
and antipsychotics. University of Washington School
of Nursing Conference on Neuropsychotropic Drug
Therapy. Shoreline, Wash. June 8, 2007.
AADPRT update. 33rd Annual Meeting of ADMSEP.
Park City, Utah. June 23, 2007.
Pediatric psychopharmacology update 2007. Grand
Rounds, Northstar Hospital. Anchorage, Alaska.
Aug. 14, 2007.
PUBLICATIONS
Bondy CA, Turner Syndrome Study Group
(McCauley EA, member). Care of girls and women
with Turner syndrome: a guideline of the Turner
Syndrome Study Group. J Clin Endocrinol Metab.
Jan 2007;92(1):10–25.
Brkanac Z, Chapman NH, Matsushita MM, Chun L,
Nielsen K, Cochrane E, Berninger VW, Wijsman EM,
Raskind WH. Evaluation of candidate genes for DYX1
and DYX2 in families with dyslexia. Am J Med Genet B
Neuropsychiatr Genet. Jun 2007;144(4):556–560.
65
Bush T, Richardson L, Katon W, Russo J, Lozano P,
McCauley EA, Oliver M. Anxiety and depressive disorders are associated with smoking in adolescents with
asthma. J Adolesc Health. May 2007;40(5):425–432.
Calderon R, Vander Stoep A, Collett BR, Garrison
MM, Toth K. Inpatients with eating disorders: demographic, diagnostic and service characteristics from a
nationwide pediatric sample. Int J Eating Disorders.
Nov 2007;40(7):622–628.
Carmichael Olson H, Jirikowic T, Kartin D, Astley S.
Responding to the challenges of early intervention for
fetal alcohol spectrum disorders. Infants Young Child.
2007;20(2):162–179.
King BH. Psychopharmacology in intellectual
disabilities. In: Bourras N, Hold G, eds. Psychiatric and
Behavioural Disorder in Intellectual and Developmental
Disabilities, Second Edition. New York, N.Y.: Cambridge
McCarty CA, Vander Stoep A, McCauley EA. Cognitive
features associated with depressive symptoms in
adolescence: directionality and specificity. J Clin
Child Adolesc Psychol. Apr–June 2007;36(2):147–158.
Carmichael Olson H, Winters M, Ward S, Hodes M.
Feeding and sleeping disorders in infancy and early
childhood. In: Tyrer P, Silk K, eds. The Cambridge
Handbook of Effective Treatments in Psychiatry.
McCauley EA, Katon W, Russo J, Richardson L,
Lozano P. Impact of anxiety and depression on
functional impairment in adolescents with asthma.
Gen Hosp Psychiatry. May–Jun 2007;29(3):214–222.
Collett BR, Speltz ML. A developmental approach to
mental health for children and adolescents with orofacial
clefts. Orthod Craniofac Res. Aug 2007;10(3):138–148.
McClellan JM. Olanzapine and pediatric bipolar
disorder: evidence for efficacy and safety concerns.
Am J Psychiatry. Oct 2007;164(10):1462–1464.
Collett BR, Speltz ML. Cleft lip and palate. In:
Ayers S, Baum A, McManus C, Newman S, Wallston K,
Weinman J, West R, eds. The Cambridge Handbook
of Psychology, Health and Medicine, Second Edition.
McClellan JM, Kowatch R, Findling R. Practice
parameter for the assessment and treatment of bipolar
disorder in children and adolescents. J Am Acad Child
Adolesc Psychiatry. Jan 2007;46(1):107–125.
Frazier JA, McClellan JM, Findling RL, Vitiello B,
Anderson R, Zablotsky B, Williams E, McNamara NK,
Jackson JA, Ritz L, Hlastala SA, Pierson L, Varley JA,
Puglia M, Maloney AE, Ambler D, Hunt-Harrison T,
Hamer RM, Noyes N, Lieberman JA, Sikich L. Treatment
of early-onset schizophrenia and schizoaffective disorder:
demographic and clinical characteristics. J Amer Acad
Child Adolesc Psychiatry. 2007;46(8):979–988.
Hsiao R, McClellan JM. Substance abuse in early-onset
psychotic disorders. J Dual Diagn. 2007;4(1):87–99.
Kapp-Simon KA, Speltz ML, Cunningham ML, Patel
PK, Tomita T. Neurodevelopment of children with
single suture craniosynostosis: a review. Childs Nerv
Syst. Mar 2007;23(3):269–281.
66
Katon W, Lozano P, Russo J, McCauley EA,
Richardson L, Bush T. The prevalence of DSM-IV
anxiety and depressive disorders in youth with
asthma compared with controls. J Adolesc Health.
Nov 2007;41(5):455–463.
McClellan JM, Sikich L, Findling RL, Frazier JA,
Vitiello B, Hlastala SA, Williams E, Ambler D,
Hunt-Harrison T, Maloney A, Ritz L, Anderson R,
Hamer RM, Koch G, Lieberman JA. Treatment of
early-onset schizophrenia spectrum disorders (TEOSS):
rationale, design and methods. J Amer Acad Child
Adolesc Psychiatry. Aug 2007;46(8):969–978.
McClellan JM, Susser E, King MC. Schizophrenia:
a common disease caused by multiple rare alleles.
Br J Psychiatry. Mar 2007;190:194–199.
Mukherjee B, McCauley EA, Hanford RB, Aalsma M,
Anderson AM. Psychopathology, psychosocial, gender
and cognitive outcomes in patients with cloacal
exstrophy. J Urol. Jun 2007;178(2):630–635.
Myers KM, Valentine JM, Melzer SM. Feasibility,
acceptability and sustainability of telepsychiatry
for children and adolescents. Psychol Serv. Nov
2007;58(11):1493–1496.
RE, Gunther DF, Kletter GB, McCauley EA, Mitchell
ME, Opheim KE, Pihoker C, Richards GE, Soules MR,
Pagon RA. A gender assessment team: experience with
250 patients over a period of 25 years. Genet Med.
Jun 2007;9(6):348–357.
Richardson LP, Lewis CW, Casey-Goldstein M,
McCauley EA, Katon W. Pediatric primary care
providers and adolescent depression: a qualitative
study of barriers to treatment and the effect of the
black box warning. J Adolesc Health. May
2007;40(5):433–439.
Rockhill CM, Fan MY, Katon WJ, McCauley EA,
Crick NR, Pleck JH. Friendship interactions in children
with and without depressive symptoms: Observation
of emotion during game-playing interactions and
post-game evaluations. J Abnorm Child Psychol.
Jun 2007;35(3):429–441.
Rockhill CM, Russo JE, McCauley EA, Katon WJ,
Richardson LP, Lozano P. Agreement between parents
and children regarding anxiety and depression diagnoses
in children with asthma. J Nerv Ment Dis. Nov
2007;195(11):897–904.
Ruiz-Correa S, Starr JR, Lin HJ, Kapp-Simon KA,
Cunningham ML, Speltz ML. Severity of skull malformation is unrelated to presurgery neurobehavioral
status of infants with sagittal synostosis. Cleft Palate
Craniofac J. Sep 2007;44(5):548–554.
Seto ML, Hing AV, Chang J, Hu M, Kapp-Simon KA,
Patel PK, Burton B, Avellino AM, Ellenbogen R,
Hopper R, Hudgins R, Kane A, Reisner A, Smyth MD,
Stevenson L, Speltz ML, Cunningham ML. TWIST
box mutations in TWIST1: a new phenotype-genotype
correlation for isolated sagittal synostosis? J Med
Genet. 2007;143A(7):678–686.
Speltz ML, Kapp-Simon K, Collett BR, Keich Y,
Gaither R, Cradock M, Buono L, Cunningham M.
Neurodevelopment of infants with single-suture
craniosynostosis: presurgery comparisons with
case-matched controls. Plast Reconstr Surg.
May 2007;119(6):1874–1881.
Starr JR, Kapp-Simon K, Cloonan YK, Collett BR,
Cradock MM, Buono L, Cunningham ML, Speltz ML.
Presurgical and postsurgical neurodevelopment of
infants with single-suture craniosynostosis: comparison
with controls. J Neurosurg. Aug 2007;107(2):103–110.
Storck MG, Vander Stoep A. Fostering ecologic
perspectives in child psychiatry. Child Adolesc Psychiatr
Clin N Am. Jan 2007;16(1):133–163, ix–x.
Thorne JC, Coggins TE, Carmichael Olson H,
Astley SJ. Exploring the utility of narrative analysis in
decision-making: picture-bound reference, elaboration
and fetal alcohol spectrum disorders. J Speech Lang
Hear Res. Apr 2007;50(2):459–474.
Toth K, Collett BR, Kapp-Simon K, Cloonan Y,
Gaither R, Cradock M, Buono L, Cunningham M,
Dawson G, Starr J, Speltz ML. Memory and response
inhibition in young children with single-suture
craniosynostosis [published online ahead of print
Sep 26 2007]. Child Neuropsychol. 2007.
Varley CK. Commentary by an academic child psychiatrist on the relationship of the pharmaceutical industry,
academia, psychiatric practice and the Food and Drug
Administration. J Child Adolesc Psychopharmacology.
Jun 2007;17(3):292–294.
Varley CK. Getting to know your head meds: administering a psychotropic med to young patients can be an
uneasy venture, but you can build your comfort level.
Contemp Pediatr. Oct 2007;24(10):85–101.
Varley CK. Preface. Child Adolesc Clin N Am.
Jan 2007;16(1):xvii-xviii.
Williams JF, Storck MG. Clinical report: inhalant
abuse. Pediatrics. May 2007;119(5):1009–1017.
67
Radiology
Seattle Children’s Hospital’s Department of Radiology has
the largest concentration of board-certified specialists in
pediatric radiology in the Northwest. Serving the needs
of hospital-based physicians and community providers, 21
full-and part-time radiologists provide the complete array
of pediatric radiology and medical imaging services. Our
dedicated technical and radiologist staff members are
uniquely trained and skilled in the care of infants, children,
adolescents and their families. Our team of technologists
obtains the best possible images in a child-friendly
environment while always keeping radiation safety in
mind. We performed and interpreted more than 85,000
examinations in 2007.
Our team’s complete range of diagnostic and therapeutic
imaging services includes radiography, computed tomography,
fluoroscopy, magnetic resonance imaging, nuclear medicine,
positron emission tomography, ultrasound, bone densitometry
and 3-D imaging data reconstruction and quantitative image
analysis. Children’s provides a complete range of diagnostic
and therapeutic vascular and interventional radiology
procedures. Therapeutic procedures include embolization,
chemoembolization, thrombolysis, aspiration, drainage (pleura,
peritoneal, biliary, nephrostomy, abscess), radiofrequency
ablation of malignant and benign lesions, enteric access
(gastrostomy, cecostomy), venous access (central line
placement, PICC), joint and tendon injections, sclerotherapy
and dilatation (angioplasty, esophageal, biliary, urinary).
Faculty members are authorities in neuroradiology,
thoracic and abdominal imaging, musculoskeletal imaging,
neonatal radiology, oncologic imaging, and vascular and
interventional procedures. We are continually enhancing
our digital information capability in such areas as speech
recognition software for rapid report turnaround, PACS
systems for soft copy reading, and teleradiology review for
off-hours consultation. Children’s provides radiation oncology
services through our affiliations with the Seattle Cancer
Care Alliance and the University of Washington Medical
Center. The Department of Radiology, in association with
the University of Washington School of Medicine, educates
radiology residents from four regional programs and trains
fellows in a nationally recognized ACGME-approved pediatric
radiology fellowship.
Faculty members are engaged in a variety of research
projects in the areas of neuro-oncology, neuroradiology,
behavioral disorders, craniofacial malformations, functional
brain imaging, oncology, medical informatics, and 3-D and
high-resolution image analysis.
Faculty
Edward Weinberger
MD, Director
68
Edward Weinberger, MD, Director
David K. Brewer, MD
Teresa Chapman, MD, MA
Stephen L. Done, MD
Eric L. Effmann, MD
C. Benjamin Graham, MD
Fredric A. Hoffer, MD
Gisele E. Ishak, MD
Paritosh C. Khanna, MD, DMRE, MBBS
David C. Moe, MD
Randolph K. Otto, MD
Angelisa M. Paladin, MD
Marguerite T. Parisi, MD, MS
Shawn E. Parnell, MD
Grace S. Phillips, MD
Sumit Pruthi, MBBS
David M. Rosenbaum, MD
Dennis W.W. Shaw, MD
Manrita K. Sidhu, MD
Mahesh M. Thapa, MD
Nghia Vo, MD
Radiology
Edward Weinberger, MD, is the director of the Department
of Radiology, division chief of magnetic resonance
imaging and division chief of informatics at Seattle
Children’s Hospital; he is vice-chair of the Department
of Radiology, professor of radiology, adjunct professor
of pediatrics and professor of neurological surgery at
completed his pediatric residency, diagnostic radiology
residency and pediatric radiology fellowship through
has a clinical interest in pediatric neuroradiology and
research interests in medical and imaging informatics.
He is a member of many local and national societies,
serving on the General and Pediatric Committee of
the American College of Radiology Commission on
Standards and Accreditation and on the Radiological
Society of North America’s Radiology Lexicon
Committee. He is a board examiner for the American
College of Radiology.
David K. Brewer, MD, is division chief of computed
tomography at Seattle Children’s Hospital and associate
professor in the Department of Radiology at the
trained as the department’s first fellow in pediatric
radiology in 1977. He completed his diagnostic radiology
residency and pediatric radiology fellowship through
Brewer performs radiologic-pathologic correlation
on many of the department cases and has served as
pediatric radiology fellowship director since 1999.
Teresa Chapman, MD, MA, is radiology residency coordinator and attending physician at Seattle Children’s
Hospital and acting assistant professor in the Department of Radiology at the University of Washington
School of Medicine. She completed her diagnostic
radiology residency and pediatric radiology fellowship
at the University of Washington. Her clinical interests
are clinical education, antenatal diagnosis and CT
dose reduction. She is an active member in national
radiological societies.
Stephen L. Done, MD, is attending physician at Seattle
Children’s Hospital and clinical associate professor
of radiology and pediatrics at the University of Washington School of Medicine. He completed his residency
in pediatrics at the Letterman Army Medical Center
Spotlight on team member — Jennifer McBroom, RT, RDMS
I am very excited about our research using ultrasound to
diagnose appendicitis. We’ve shown that ultrasound produces
excellent diagnostic results without having to do a CAT
scan, which exposes patients to radiation. I love teaching
the sonographers how to perform the exam and interpret it.
At Seattle Children’s, we are leaders in using ultrasound to
keep kids safe.
in San Francisco; his diagnostic radiology residency
at Massachusetts General Hospital, Harvard Medical
School; and a pediatric radiology fellowship at Children’s
Hospital Boston, Harvard Medical School. He was chief
of diagnostic radiology at Walter Reed Army Medical
Center and director of residency training when he
retired from the army in 1989. He has a clinical interest
in early X-ray recognition of disease, skeletal dysplasias
and child abuse. He is an active member in several
national radiology societies.
Eric L. Effmann, MD, is professor in the Department of
Radiology at the University of Washington School of
Medicine. He has served as chief of pediatric imaging
at Duke University Medical Center. Effmann has a
longtime interest in basic and clinical aspects of
pediatric chest disease, with particular interest in early
cardiopulmonary development, congenital lung lesions,
and quantitative and functional chest imaging. He is
a major contributor to the 10th and 11th editions of
Caffey’s Pediatric X-Ray Diagnosis. Effmann served
in a variety of capacities in the Society for Pediatric
Radiology, including president, and received the
society’s Gold Medal, its highest honor. He is a member
of two honorary societies: the Fleischner Society (chest
disease) and the John Caffey Society (pediatric
radiology). Effmann serves on the editorial board
of Pediatric Radiology and is a regular examiner
for the American Board of Radiology for general
boards and subspecialty board credentialing.
69
Radiology
C. Benjamin Graham, MD, is attending physician at
Seattle Children’s Hospital; he is professor emeritus
of radiology and pediatrics at the University of
Washington School of Medicine. His training included
internship, residency and pediatric radiology fellowship
through the University of Washington, Children’s
and the Karolinska Institute in Stockholm, Sweden.
Graham has served as associate director and director
of radiology. He continues to work part-time with
special interests in teaching, general diagnosis,
developmental conditions and skeletal dysplasias.
He has 47 publications and is a member of many
local, national and international societies.
Paritosh C. Khanna, MD, DMRE, MBBS, is attending
physician at Seattle Children’s Hospital and acting
assistant professor in the Department of Radiology at
completed his diagnostic radiology residency at LTM
General Hospital and LTM Medical College/University
of Mumbai (Bombay), India, and his pediatric radiology
fellowship at Children’s National Medical Center at
George Washington University. He is active in research
and in resident and fellow teaching and has a clinical
interest in pediatric neuroimaging and head and neck
radiology. He is an active member of national and
international radiological societies.
Fredric A. Hoffer, MD, is section chief of pediatric
interventional radiology at Seattle Children’s Hospital
and professor in the Department of Radiology at the
trained in pediatrics at Upstate Medical Center, in
diagnostic radiology at Yale New Haven Hospital,
in pediatric radiology at Boston Children’s Hospital
(where he spent 13 years) and in pediatric interventional
radiology. He holds certificates of added qualifications
for pediatric and interventional radiology through the
American Board of Radiology. His interest is cancer
control through radiofrequency ablation. He had
the world’s only prospective protocol for children for
thermal ablation and is applying for a phase II protocol
at Children’s to treat benign and malignant lesions in
children. He is also interested in vascular anomalies
and participates in a monthly clinic and conference
and has performed sclerotherapy at Children’s. He is
involved with the COG renal tumor committee and
receives grant funding for his participation in bilateral
Wilms tumor and nephroblastomatosis. He participates
in the Children’s solid tumor board. He was the first
radiologist to be a keynote speaker at the International
Society of Pediatric Oncology in Geneva.
David C. Moe, MD, is attending physician at Seattle
the Department of Radiology at the University of
Washington School of Medicine. He completed his
diagnostic radiology residency at the University of
Wisconsin, Madison, and his pediatric radiology
fellowship through the University of Washington.
He has a clinical interest in pediatric vascularinterventional imaging. He is an active member
in regional and national radiology societies.
Gisele E. Ishak, MD, is attending physician at Seattle
Department of Radiology at the University of Washington
School of Medicine. She completed her diagnostic
radiology residency at American University of Beirut
Medical Center. Ishak completed her neuroradiology
and pediatric radiology fellowships at the University
of Washington School of Medicine. She has a clinical
interest in pediatric neuroradiology. Ishak is an active
member of several national radiology societies.
70
Randolph K. Otto, MD, is attending physician at
in the Department of Radiology at the University of
Texas Southwestern Medical Center and his pediatric
radiology fellowship at Children’s Medical Center in
Dallas, Texas. He has a clinical interest in cardiac MR
and imaging informatics. He is an active member in
regional and national radiological societies.
Angelisa M. Paladin, MD, is attending physician at
Seattle Children’s Hospital and radiology residency
director and assistant professor in the Department
of Radiology at the University of Washington School
of Medicine. She completed her diagnostic radiology
residency at University of Texas Southwestern Medical
Center–Parkland Hospital and her pediatric radiology
fellowship through the University of Washington. She
has a clinical research interest in pediatric urological
conditions and the temporal bone. She is a member
of several local and national radiology societies.
Radiology
Marguerite T. Parisi, MD, MS, is division chief of ultrasound at Seattle Children’s Hospital and associate
professor of radiology and pediatrics at the University
of Washington School of Medicine. She completed her
pediatrics residency at Children’s Hospital of Buffalo
and trained as a radiology resident with fellowships in
pediatric radiology and nuclear medicine. She earned
her MS in medical education from the University of
Southern California. Parisi’s clinical and research
interests center around oncologic imaging, including
evaluation of new techniques, modalities, and imaging
agents and their utilization; efficacy; and clinical
outcomes in pediatric radiology and nuclear medicine.
She has special expertise in the use of metaiodobenzylguanidine to image neuroblastoma and the use of
iodine-131 radiotherapy to treat pediatric thyroid
cancer. She developed the bone densitometry (DXA)
program at Children’s. She actively participates in
many regional and national radiology societies and
in numerous national committees including the
national oncology cooperative, Children’s Cancer
Group. She is president of the Pediatric Council of
the Society of Nuclear Medicine and is also chair of
the Nuclear Medicine Committee of the Society of
Pediatric Radiology.
Shawn E. Parnell, MD, is attending physician at Seattle
Washington School of Medicine. She completed her
diagnostic radiology residency and pediatric radiology
fellowship at the University of Washington. She has
a clinical interest in musculoskeletal imaging and
skeletal dysplasias. She is an active member in
regional and national radiological societies.
Grace S. Phillips, MD, is attending physician at Seattle
Washington School of Medicine. She completed her
diagnostic radiology residency at the Mallinckrodt
Institute of Radiology and her pediatric radiology
fellowship through the University of Washington.
She has a clinical interest in pediatric genitourinary
radiology, organ transplant, body imaging and resident
education. She is an active member in regional and
national societies.
Sumit Pruthi, MBBS, is attending physician at Seattle
School of Medicine. He completed his diagnostic
radiology residency at LTM Medical College and LTM
General Hospital in Mumbai (Bombay), India, and his
neuroradiology and pediatric radiology fellowships at
the University of Washington. He has a clinical interest
in neuroradiology and molecular imaging. He is an
active member of national radiological societies.
David M. Rosenbaum, MD, is division chief of nuclear
medicine at Seattle Children’s Hospital and associate
professor in the Department of Radiology at the
completed his diagnostic radiology residency at the
Medical Center of Vermont and his pediatric radiology
fellowship at Children’s Hospital Boston. He has a
clinical interest in nuclear medicine and general
pediatric radiology. He is an active member in
regional and national radiology societies.
Dennis W.W. Shaw, MD, is division chief of pediatric
vascular/interventional radiology at Seattle Children’s
Hospital and professor in the Department of Radiology
He completed pediatrics and neuroradiology fellowships
through the University of Washington. He divides his
clinical time between pediatric interventional and
neuroradiology services. His research interests include
morphometric brain imaging and MR spectroscopy
applied to autism. He has a particular interest in neurooncologic imaging and is a member of the Radiology
Subcommittee within the Children’s Oncology Group.
He is also a member of the Neuroimaging Committee
of the Pediatric Brain Tumor Consortium.
Manrita K. Sidhu, MD, is staff radiologist at Seattle
School of Medicine. She completed her pediatric
radiology fellowship at the University of Washington
and a fellowship in vascular and interventional
radiology at Stanford University Hospital. She has
a clinical and research interest in pediatric vascular
malformations and tumors. She is an active member of
Children’s Dialysis Access Committee and Medical Staff
Nominating Committee and is part of the expert panel
71
Radiology
of the Agency for Healthcare Research and Pediatric
Quality Indicators. She is also an active member of
the Vascular/Interventional Committee and Poster
Committee of the Society for Pediatric Radiology and
a member of the Educational Evaluation Committee
of the American Roentgen Ray Society.
Mahesh M. Thapa, MD, is attending physician at Seattle
diagnostic radiology residency and pediatric radiology
fellowship at the University of Washington. He has a
clinical interest in pediatric gastroenterology and
musculoskeletal radiology. He is an active member
in national medical and radiological societies.
Nghia Vo, MD, is attending physician at Seattle Children’s
Hospital and clinical assistant professor at the University
of Washington School of Medicine. He completed his
Tennessee Medical Center in Knoxville, his pediatric
radiology fellowship at the Cincinnati Children’s
Hospital and a vascular/interventional fellowship at
the University of Washington. He has a clinical interest
in pediatric interventional radiology. He is an active
member in national medical societies.
AWARDS AND HONORS
Edward Weinberger, MD
Stephen L. Done, MD
Congenital heart disease. Hot seat: review of pediatric
radiology. University of Washington School of Medicine
review courses “Not Just for Residents.” Seattle, Wash.
April 4, 2007.
A patient with opsismodysplasia treated with
pamidronate (co-presenter). Distal phalanx and nail
hypoplasia associated with osteopetrosis: report of an
affected mother and son (co-presenter). International
Skeletal Dysplasia Society 8th annual meeting. Albi,
France. July 19–22, 2007.
72
Recognizing child abuse in the emergency setting.
Airway and chest emergencies in infants and children:
radiographic evaluation with pathologic correlation.
University of Washington CME courses on emergency
radiology. Seattle, Wash. August 2007.
Eric L. Effmann, MD
Pediatric chest. University of Washington School of
Medicine review course “Not Just for Residents.”
Difficult cases in chest: learn from the experts’ mistakes
(co-presenter). The Society for Pediatric Radiology 50th
annual meeting. Miami, Fla. April 17–21, 2007.
Fredric A. Hoffer, MD
Pleurodesis and radiofrequency ablation. Palliative care
pediatric workshop. Society of Interventional Radiology.
Diagnosis and treatment of vascular anomalies.
University of Washington Medical School review course
“Not Just for Residents.” Seattle, Wash. April 4, 2007.
IR case conference. The Society for Pediatric Radiology
50th annual meeting. Miami, Fla. April 17–21, 2007.
Percutaneous US or CT guided lung biopsy vs. needle
localization for thorascopic resection. Interventional
radiology of the lung: cooling it off for infections,
bleeding and effusions and heating it up for tumors.
European Society for Pediatric Radiology 44th annual
meeting. Barcelona, Spain. June 3–7, 2007.
Gisele E. Ishak, MD
Pediatric nasal cavity and paranasal sinuses: an online
digital interactive CT/MR teaching file of normal
anatomy, variants and disease (co-presenter). Radiological Society of North America 93rd annual meeting.
Chicago, Ill. Nov. 25–30, 2007.
Paritosh C. Khanna, MD, DMRE, MBBS
Imaging approach to childhood maladies: an overview.
CME course for pediatric nurse practitioners (invited
speaker). Washington State Chapter of National
Association of Pediatric Nurse Practitioners
(NAPNAP). Shoreline, Wash. March 5, 2007.
Radiology
JPGScroller: a PowerPoint plug-in to create scrolling
image sets (co-presenter). Radiological Society of
North America 93rd annual meeting. Chicago, Ill.
Nov. 25–30, 2007.
Shawn E. Parnell, MD
Interactive digital CT atlas of the pediatric cervical
spine (co-presenter). The Society for Pediatric Radiology
Angelisa M. Paladin, MD
University of Washington School of Medicine review
course “Not Just for Residents.” April 4, 2007.
Pediatric musculoskeletal emergencies. Emergency
Radiology Conference. Seattle, Wash. Aug. 12–15, 2007.
Grace S. Phillips, MD
Pediatric nasal cavity and paranasal sinuses: an
online digital interactive CT/MR teaching file of
normal anatomy, variants and disease (co-presenter).
Radiological Society of North America 93rd annual
meeting. Chicago, Ill. Nov. 25–30, 2007.
Pediatric nasal cavity and paranasal sinuses: an
online digital interactive CT/MR teaching file of
normal anatomy, variants and disease (co-presenter).
Radiological Society of North America 93rd annual
meeting. Chicago, Ill. Nov. 25–30, 2007.
Marguerite T. Parisi, MD, MS
I-131 MIBG therapy in children and adults (course
organizer/moderator). Therapy of bone tumors
(course organizer/moderator). Mid-Winter Educational
Symposium of the Society of Nuclear Medicine.
San Antonio, Texas. Feb. 17, 2007.
Dennis W.W. Shaw, MD
Longitudinal brain developmental abnormalities in
autism spectrum disorder. Psychiatric Research Society
annual meeting. Park City, Utah. Feb. 7–10, 2007.
Pediatric oncology. University of Washington School
of Medicine review course “Not Just for Residents.”
How I do it. Pediatric nuclear medicine: oncologic
applications. The Society for Pediatric Radiology
50th annual meeting. Miami, Fla. April 19, 2007.
Radiopharmaceutical therapy in pediatrics (moderator/course development/course organizer). I-131
therapy of pediatric thyroid cancer (part of categorical
course “Radiopharmaceutical Therapy in Pediatrics”).
Pediatrics: read with the experts (speaker/course
organizer/content development). Pediatric PET
and PET/CT (course organizer). Pediatric nuclear
medicine: how I do it (speaker/course organizer/
content development). Society of Nuclear Medicine
54th annual meeting. Washington, D.C. June 2–5, 2007.
Pediatric neuroradiology. University of Washington
School of Medicine review course “Not Just for
Residents.” Seattle, Wash. April 4, 2007.
Subcortical brain morphometric changes and behavioral
correlates in autism spectrum disorder between 3
and 7 years of age (co-presenter). European Society of
Pediatric Radiology annual meeting. Barcelona, Spain.
June 3–7, 2007.
Comparison of cortical folding patterns in two independent samples of children with autism spectrum
disorders (co-presenter). Organization for Human
Brain Mapping 13th annual meeting. Chicago, Ill.
June 10–14, 2007.
Manrita K. Sidhu, MD
Pediatric thrombosis: why treatment is different in
children. Society of Interventional Radiology 32nd
annual meeting. Seattle, Wash. March 1–6, 2007.
73
Radiology
Current challenges to pediatric interventional radiology.
Pediatric IR concurrent session. The Society for
Pediatric Radiology 50th annual meeting. Miami, Fla.
April 17–21, 2007.
Mahesh M. Thapa, MD
Pediatric radiology MSK cases. University of
Washington School of Medicine review course
“Not Just for Residents.” Seattle, Wash. April 4, 2007.
Revised ultrasound size criterion for the diagnosis
of acute appendicitis in the pediatric population
(co-presenter). JPGScroller: a PowerPoint plug-in to
create scrolling image sets (co-presenter). Radiological
Society of North America 93rd annual meeting.
Edward Weinberger, MD
spine (co-presenter). New initiatives in resident and
fellow education. The Society for Pediatric Radiology
Revised ultrasound size criterion for the diagnosis
of acute appendicitis in the pediatric population
(co-presenter). DICOM Manager: A DICOM CD
and file loader, exporter, anonymizer, decompressor
and viewer (co-presenter). Pediatric nasal cavity and
paranasal sinuses: an online digital interactive CT/MR
teaching file of normal anatomy, variants and disease
(co-presenter). JPGScroller: a PowerPoint plug-in to
create scrolling image sets (co-presenter). Radiological
Society of North America 93rd annual meeting.
PUBLICATIONS
Bittles MA, Hoffer FA. Interventional radiology and
the care of the pediatric oncology patient. Surg Oncol.
Nov 2007;16(3):229–233.
Dager SR, Wang L, Friedman S, Shaw DW, Sparks B,
Artru A, Dawson G, Csernansky J. Shape mapping
of the hippocampus in young children with autism
spectrum disorder. Am J Neuroradiol. Apr
2007;28(4):672–677.
74
Effmann EL. Hermes column. Pediatr Radiol.
2007;37(12):1310.
Gomez-Lobo V, Burch W, Khanna PC. Nonpuerperal
uterine inversion associated with an immature teratoma of the uterus in an adolescent. Obstet Gynecol.
Aug 2007;110(2 pt 2):491–493.
Gupta H, Araki Y, Davidoff AM, Rao BN, Hoffer FA,
Billups C, Wu J, Shochat SJ. Evaluation of pediatric
oncology patients with previous multiple central
catheters for vascular access: is Doppler ultrasound
needed? Pediatr Blood Cancer. May 2007;48(5):527–531.
Hoffer FA, Campos A, Xiong X, Wu S, Oigbokie N,
Proctor K. Core body temperature regulation of
pediatric patients during radiofrequency ablation.
Pediatr Radiol. Mar 2007;37(3):297–300.
Hoffer FA, Hancock ML, Hinds PS, Oigbokie N,
Rai SN, Rao B. Pleurodesis for effusions in pediatric
oncology patients at end of life. Pediatr Radiol.
Mar 2007;37(3):269–273.
Khanna PC, Merchant SA, Joshi AR. Radiological case
of the month: tuberculous omental cake. Appl Radiol.
2007;36(5):36–39.
Khanna PC, Ponsky T, Zagol B, Lukish JR, Markle
BM. Sonographic appearance of canal of Nuck hydrocele.
Pediatr Radiol. Jun 2007;37(6):603–606. E-publication
Apr 24, 2007.
Khanna PC, Rothenbach P, Guzzetta P, Bulas DI.
Lap-belt syndrome: management of aortic intimal
dissection in a 7-year-old child with a constellation
of injuries. Pediatr Radiol. 2007;37(1):87–90.
McCarville MB, Hoffer FA, Adelman S, Khoury JD,
Li C, Skapek SX. MRI and biologic behavior of
desmoid tumors in children. AJR Am J Roentgenol.
Sep 2007;189(3):633–640.
Radiology
Metzger ML, Stewart CF, Freeman III BB, Billups CA,
Hoffer FA, Wu J, Coppes MJ, Grant R, Chintagumpala
M, Mullen EA, Alvarado C, Daw NC, Dome JS.
Topotecan is active against Wilms’ tumor: results
of a multi-institutional phase II study. J Clin Oncol.
2007;25(21):3130–3136.
Moe DC, Nadel H, Parisi MT. Corner shots in pediatric
nuclear medicine: anticipating the unexpected. Pediatr
Radiol. 2007;37(S1):89.
Paladin AM, Phillips GS, Raske ME, Sie KC.
Labyrinthine dehiscence in a child. Pediatr Radiol.
E-publication Dec 8, 2007.
Parisi MT, Mankoff D. Differentiated pediatric thyroid
cancer: correlates with adult disease; controversies in
treatment. Semin Nucl Med. Sep 2007;37(5):340–356.
Vo N, Wieseler KW, Burdick TR, Goswami GK, Vaidya
SS, Torrance Andrews R. The use of paired optionally
retrievable Gunther Tulip filters in trauma patients
with anatomical variants. Semin Intervent Radiol.
2007;24:90–98.
Weiss A, Khoury JD, Hoffer FA, Wu J, Billups CA,
Heck RK, Quintana J, Poe D, Rao BN, Daw NC.
Telangiectatic osteosarcoma: the St. Jude Children’s
Research Hospital’s experience. Cancer. Apr
2007;109(8):1627–1637.
Williams [Chapman] TC, DeMartini WB, Partridge
SC, Peacock S, Lehman CD. Breast MR imaging:
computer-aided evaluation program for discriminating
benign from malignant lesions. Radiology. July
2007;244(1):94–103.
Saam T, Hatsukami TS, Yarnykh VL, Hayes CE,
Underhill H, Chu B, Takaya N, Cai J, Kerwin WS,
Xu D, Polissar NL, Neradilek B, Hamar WK, Maki J,
Shaw DW, Buck RJ, Wyman B, Yuan C. Reader and
platform reproducibility for quantitative assessment
of carotid atherosclerotic plaque using 1.5T Siemens,
Philips, and General Electric scanners. J Magn Reson
Imaging. Aug 2007;26(2):344–352.
Sidhu MK. Pediatric interventional workforce
summary. IR News. Mar 2007.
Sidhu MK, James CJ, Harned RK 2nd, Connolly BL,
Dubois J, Morello FP, Kaye R, Siddiqui NJ, Roberson PK,
Seidel KD. Pediatric interventional radiology workforce
summary. Pediatr Radiol. Jan 2007;37(1):113–115.
Skapek SX, Ferguson WS, Granowetter L, Devidas M,
Peerz-Atayde AR, Dehner LP, Hoffer FA, Speights R,
Gebhardt MC, Dahl GV, Grier HE. Vinblastine and
methotrexate for desmoid fibromatosis in children:
results of a Pediatric Oncology Group Phase II Trial.
J Clin Oncol. Feb 2007;25(5):501–506.
75
Rehabilitation Medicine
The Department of Rehabilitation Medicine helps children
and their families adapt to changes in functioning brought
on by injury, illness or congenital defect. The department
includes the divisions of Occupational Therapy, Speech and
Language Services, Physical Therapy and Rehabilitation
Psychology. As the regional leader in pediatric rehabilitation,
we receive patients from the WAMI region (Washington,
Alaska, Montana, Idaho).
Faculty
Kenneth M. Jaffe, MD, Director
Ross M. Hays, MD
Kenneth M. Jaffe
MD, Director
76
The Seattle Children’s Hospital rehabilitation program
draws on the experience and expertise of its staff of
board-certified pediatric physiatrists; nurses; occupational,
physical and recreational therapists; speech and language
pathologists; teachers; social workers; child clinical
psychologists; neuro-psychologists; and nutritionists.
These professionals perform a comprehensive assessment
of each child’s needs and abilities and develop short- and
long-term treatment plans suited to the individual child’s
medical and family circumstances.
Rehabilitation services are provided for inpatients and
outpatients at Children’s. Outpatient services are offered
through the Rehabilitation Medicine Clinic as well as through
our arthrogryposis, brachial plexus, limb deficiency and
Muscular Dystrophy Association subspecialty clinics.
Physician outreach clinics are held in Yakima and Bellingham,
Wash., and some outpatient therapy services are available
at our satellite location in Bellevue, Wash. Inpatient care is
provided in our new 12-bed unit, which is certified by the
Rehabilitation Accreditation Commission as a Pediatric
Family-Centered Program in Medical Rehabilitation and
designated by the State Department of Health as the only
Level 1 Pediatric Trauma Rehabilitation Center in Washington.
Kenneth M. Jaffe, MD, is director of the Department of
Rehabilitation Medicine at Seattle Children’s Hospital;
he is professor in the Department of Rehabilitation
Medicine and adjunct professor in the departments of
Pediatrics and Neurological Surgery at the University
of Washington School of Medicine. He is board
certified in pediatrics and physical medicine and
rehabilitation. His clinical activities include inpatient
rehabilitation and outpatient clinics at Children’s and
consultation at Harborview Medical Center. Jaffe’s
clinical interests include care of children with multiple
trauma, traumatic brain injury, spinal cord injury, limb
deficiency, arthrogryposis and other neurological and
neuromuscular disorders. His research interests include
outcomes from pediatric trauma and brain injury and
management of arthrogryposis and pediatric pain. He
has served as principal investigator and co-investigator
on numerous research grants. Jaffe completed his
six-year term as editor in chief of Archives of Physical
Medicine and Rehabilitation, the most highly cited
journal in the rehabilitation sciences, in January 2007.
He continues to serve on its editorial board as the
pediatric section editor.
Ross M. Hays, MD, is ethics consultant for the
Treuman Katz Center for Pediatric Bioethics and
medical director of the palliative care program at
Seattle Children’s Hospital. He is professor in the
Department of Rehabilitation Medicine and adjunct
School of Medicine; he is faculty associate in the
university’s Department of Medical History and Ethics.
He is medical director for the pediatric hospice and
palliative care program at Providence Hospice of
Seattle. He is board certified in pediatrics, rehabilitation
medicine, and hospice and palliative medicine. He was
the principal investigator of the Supporting Children
at the End of Life: Improving Access and Quality of
Care project sponsored by the Robert Wood Johnson
Foundation. He has been the PI on NIH-funded RO1
projects and is the pediatric clinical core leader for the
Seattle Cancer Care Alliance, which provides care to
children with severe life-limiting illness using a unique
model that is highly regarded throughout the country.
He also provides consultation on pediatric palliative
care to hospitals regionally and nationally.
Teresa L. Massagli, MD, is attending physician at Seattle
Children’s Hospital and professor in the departments
of Rehabilitation Medicine and Pediatrics at the
University of Washington School of Medicine. She is
board certified in pediatrics and in physical medicine
and rehabilitation and subspecialty certified in spinal
cord injury medicine. Her clinical activities include
inpatient rehabilitation, outpatient clinics at Children’s
and at a regional outreach clinic in Bellingham, Wash.,
and consultative rehabilitation medicine at Fircrest
School and Harborview Medical Center. She is also
residency program director for physical medicine and
rehabilitation at the University of Washington. Massagli’s
clinical interests include care of patients with spinal
cord injury, traumatic brain injury, and other neurological and neuromuscular disorders. Her research
interests are in methods of teaching and evaluation of
resident competence in graduate medical education.
Spotlight on team member — Cathy Graubert, PT
We have recently begun outpatient physical therapy services
at Seattle Children’s regional clinics in Federal Way and
Bellevue, Wash. Our sports medicine physical therapy services
have expanded on the main campus with the opening of our
new sports gym. We look forward to exploring new areas for
study and treatment in our new and continuing programs
in the upcoming year.
AWARDS AND HONORS
Kenneth M. Jaffe, MD
Listed in America’s Top Doctors.
Outstanding Service Award. Association of
Academic Physiatrists.
Ross M. Hays, MD
Embedded pediatric palliative care. National Summit
for Pediatric Palliative Care, University of Minnesota.
Minneapolis, Minn. June 2007.
Kenneth M. Jaffe, MD
Acute pediatric trauma rehabilitation. Pediatric Trauma Care: A Workshop to Develop a National Study on
Costs and Outcomes from Pediatric Trauma. Funded
by Agency for Healthcare Research and Quality and
by support from the Emergency Medical Services for
Children Program, Maternal and Child Health Bureau,
HRSA. Washington, D.C. March 8–9, 2007.
77
PUBLICATIONS
Bevan WP, Hall JG, Bamshad M, Staheli LT, Jaffe KM,
Song K. Arthrogryposis multiplex congenita (amyoplasia):
an orthopaedic perspective. J Pediatr Orthop.
Jul/Aug 2007;27(5):594–600.
Bjornson K, Hays RM, Graubert C, Price R, Won F,
McLaughlin JF, Cohen M. Botulinum toxin for spasticity
in children with cerebral palsy: a comprehensive
evaluation. Pediatrics. Jul 2007;120(1):49–58.
Hays RM. Book review of: Ethical Issues in
Chronic Pain Management. N Engl J Med. Jun
2007;356(24):2551.
Massagli TL, Carline JD. Reliability of a 360-degree
evaluation to assess resident competence. Am J Phys
Med Rehabil. Oct 2007;86(10):845–852.
Vavilala MS, Muangman S, Waitayawinyu P, Roscigno
C, Jaffe KM, Mitchell P, Kirkness C, Zimmerman JJ,
Ellenbogen R, Lam AM. Neurointensive care; impaired
cerebral autoregulation in infants and young children
early after inflicted traumatic brain injury: a preliminary
report. J Neurotrauma. Jan 2007;24(1):87–96.
78
79
Department of Pediatrics
80
Creating a better future for children and their families is central to the discipline of pediatric
medicine. This vision inspires every faculty member in the Department of Pediatrics at
Seattle Children’s Hospital and the University of Washington School of Medicine. As an
academic department, we invest with an eye on the future through our recruitment of
highly talented clinicians, scientists, and educators, and by developing innovative programs.
F. Bruder Stapleton, MD
Chief Academic Officer
In the past, farsighted leaders in our Department of Pediatrics gazed into the future and
created concepts and programs that we now consider common knowledge. Dr. Abraham
Bergman recognized the toll of injuries on the lives of children. His efforts led to the
passage of legislation mandating flame-retardant sleepwear. A subsequent collaboration
with Dr. Fred Rivara raised national awareness that bicycle helmets could avert the terrible
morbidity of head injuries. Because Dr. David Shurtleff believed that the neurodevelopmental
potential for children born with hydrocephalus was far greater than what his contemporaries believed, he advocated for more aggressive treatments — many of which remain
standard practice today. Dr. David Smith, a legend in clinical genetics, understood that
congenital malformations came in patterns and described many, now commonly known,
syndromes, including fetal alcohol syndrome. Dr. Thomas Shepard astutely noted the
relationship between the exposure during pregnancy to drugs and environmental toxins
and birth defects. He created a national hotline to assist physicians and families who
had concerns or questions about this important concept.
Our pioneering efforts continue today. Dr. Leslie Walker is creating treatment programs
for children with substance addiction. Dr. Mark Lewin recently launched a fetal diagnostic
center to provide the most advanced care of children with congenital heart disease.
Dr. Tom Jones continues to develop new devices that correct congenital heart defects
in the cardiac catheterization laboratory. Dr. Michael Bamshad is developing a DNA
core repository for future population studies. Dr. Rita Mangione-Smith’s ground-breaking
publication in the New England Journal of Medicine has sparked a national conversation
on the need to improve preventive health services for children.
Many other examples of visionary faculty and divisions are described in this report.
2007 was a most productive year and marked our move into the wonderful new Seattle
Children’s Hospital Research Institute. Dr. Andrew Scharenberg received the largest
grant ($24 million) in the department’s history, which will quite possibly lead to correcting
single gene defects in immune cells. Yesterday’s future is repeating itself today, as we
search for new horizons and a better world for children.
81
Adolescent Medicine
The Division of Adolescent Medicine provides expert
consultation, diagnosis and treatment for conditions commonly seen during adolescence, including mental health
disorders, sexually transmitted diseases such as human
papillomavirus, eating disorders, substance abuse, obesity,
chronic fatigue syndrome and general adolescent psychosocial and learning issues. After a request, members of
the division also provide medical consultation for patients
throughout Seattle Children’s Hospital with conditions such
as chronic musculoskeletal pain, gynecologic issues and
somatiform disorders.
In the inpatient setting, providers coordinate closely
with services such as nutrition and child psychiatry to
ensure a multidisciplinary approach to treatment. Patients
are seen as outpatients after referral to the Adolescent
Medicine Clinic, the Eating Disorders Clinic, the Biofeedback
Clinic, the Reflex Neurovascular Dystrophy Clinic and the
Adolescent Gynecology Clinic. When appropriate, patients
seen in the outpatient setting are seen in consultation by
Faculty
Leslie R. Walker, MD, Chief
Henry S. Berman, MD
Ann E. Giesel, MD
Rachel Katzenellenbogen, MD
Laura P. Richardson, MD, MPH
Taraneh Shafii, MD, MPH
Leslie R. Walker
MD, Chief
82
members of our multidisciplinary team, including physical
and occupational therapists, social workers and chemical
dependency professionals.
Physicians and nurse practitioners in the division provide
medical consultation for all patients with eating disorders
who are admitted to the medical and psychiatric units.
Members of Adolescent Medicine are committed to
providing treatment for underserved adolescents in the
community and also see patients at the Country Doctor
Homeless Teen Clinic, which incorporates complementary
and alternative medicine with acupuncture, massage and
naturopathy. An additional clinic at the King County Juvenile
Detention Center serves as a training site for pediatric
and family medicine residents. Division providers also see
patients at Harborview Medical Center as consultants,
and in the Children and Teens Clinic and the Public Health
Seattle & King County STD Clinic as attendings.
The Division of Adolescent Medicine is committed
to education of many levels of trainees and maintains an
accredited adolescent medicine fellowship program to help
train adolescent medicine leaders for the region and the
nation. Researchers in the Division of Adolescent Medicine
are involved in studying mental health issues, substance
abuse, ADHD and sexually transmitted diseases. They
are working to improve understanding and treatment for
conditions that disproportionately affect adolescents.
After a national search, Dr. Leslie R. Walker was
recruited to lead Adolescent Medicine starting in February
2007. In addition, Dr. Henry S. Berman joined Adolescent
Medicine in 2006 and has brought depth and clinical expertise
in behavioral problems and mental health concerns such as
ADHD and depression.
Leslie R. Walker, MD, is chief of the Division of
Adolescent Medicine at Seattle Children’s Hospital and
earned her MD from the University of Illinois School
of Medicine. She completed residency training in the
Department of Pediatrics at the University of Chicago,
Wyler Children’s Hospital, and a fellowship in the
Division of Adolescent Medicine at the University of
California, San Francisco. She developed the adolescent
program and served as director of adolescent medicine
at Georgetown University Children’s Medical Center
and also served as medical director at Woodson High
Adolescent Medicine
School’s Wellness Center in Washington, D.C. She
was elected to the board of directors for the Society for
Adolescent Medicine and has served on many national
committees and boards dedicated to the health and
well-being of adolescents. She is a member of the
National Academies of Science, Institute of Medicine
Committee on Adolescent Health Care Services, and
Models of Care for Treatment, Prevention and Healthy
Development. Her research interests and publications
are in the areas of ADHD and substance abuse, healthcare transition and teenage pregnancy prevention.
Henry S. Berman, MD, is a board-certified pediatrician
who has specialized in adolescent medicine since 1971.
He is attending physician in the Division of Adolescent
Medicine at Seattle Children’s Hospital and assistant
clinical professor in the Department of Pediatrics at
received his medical degree from New York University
School of Medicine. After completing his internship
and pediatrics residency at Lenox Hill Hospital in New
York City, and three years in the U.S. Army, Berman
began his work in adolescent medicine at Mount Sinai
School of Medicine. It was there that he developed the
HEADS evaluation, now used nationally in obtaining
a social history from teens. In his work at Children’s,
he specializes in behavioral problems of adolescents,
including ADHD, depression, poor school performance
(including school avoidance) and anxiety disorders.
Cora C. Breuner, MD, MPH, is a board-certified adolescent
medicine specialist and board-certified pediatrician.
She received her BA from Franklin and Marshall
College in Lancaster, Pa., and her MD from Jefferson
Medical College in Philadelphia, Pa. After completing
an internship and pediatric residency at the Naval
Hospital in San Diego, Calif., she came to the University
of Washington, where she completed her adolescent
medicine fellowship in 1993. She received her master’s
degree in public health from the University of Washington in 1998; her thesis addressed complementary and
alternative medicine use in homeless youth. Breuner
is associate professor in the Department of Pediatrics
at the University of Washington School of Medicine
and director of both the outpatient Eating Disorder
Program and outpatient Biofeedback Clinic. She recently
became a member of the new Children’s Hospital
Sports Medicine Program as director of the Integrative
Medicine Section and has an additional appointment
as adjunct associate professor in the Department of
Spotlight on team member — Erik Schlocker, MSW, LICSW
I’m excited about two new initiatives that will provide
teens and parents with the information they need for health
improvement. A pilot program in the Adolescent Wellness
Clinic brings together an interdisciplinary team to address
adolescent obesity in a non-diet, health improvement model.
We’re also creating an educational video about eating
disorders for parents of newly diagnosed teens.
Orthopedics. She is president of the Northwest Society
of Adolescent Medicine, co-chairperson of the Work
Life Balance Committee and a member of the Physician
Well-Being Committee. Her clinical interests include
the treatment of eating disorders and obesity in the
adolescent. She is also interested in alternative management and treatment of adolescents with headaches,
abdominal pain and sports-related disorders. Her
research interests include the evaluation of yoga as
an adjunctive intervention for the patient with eating
disorders and the assessment of complementary medicine usage by the pediatric patient with diabetes and
musculoskeletal complaints. Her goal is to incorporate
complementary and alternative medicine into both the
outpatient and inpatient programs at Children’s. She
has three teenage children and a black Lab and loves
to sing, play the fiddle, kayak and ride her bike.
Ann E. Giesel, MD, is a board-certified adolescent
medicine specialist and board-certified pediatrician
who has been with adolescent medicine at the University
of Washington since she completed her fellowship at
Seattle Children’s Hospital in 1991. She received her BA
from Yale University and MD from the University of
Louisville. After completing her pediatric residency at
the University of Washington, she was a fellow in child
sexual abuse at Harborview Medical Center before doing
her fellowship in adolescent medicine. She is clinical
associate professor in the Department of Pediatrics
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Adolescent Medicine
at the University of Washington School of Medicine,
serves as the medical director of the King County
Juvenile Detention Center Health Clinic, is chief of
pediatric and adolescent gynecology at Children’s,
and is the medical director of the evening clinics for
homeless youth at the Country Doctor Free Teen Clinic.
Rachel Katzenellenbogen, MD, is attending physician
in adolescent medicine at Seattle Children’s Hospital
and assistant professor of pediatrics at the University
of Washington School of Medicine. Her clinical
interests include adolescent gynecology and STD
management as well as general preventive medicine.
Katzenellenbogen conducts research on high-risk
human papillomavirus infection, which is the most
common sexually transmitted infection and is linked
to cervical cancer, at the Fred Hutchinson Cancer
Research Center. She has a Child Health Research
Center grant from the National Institutes of Health
and will begin career development awards through the
National Cancer Institute and the National Institute of
Allergy and Infectious Diseases to support her research.
Laura P. Richardson, MD, MPH, is associate professor
in the Department of Pediatrics at the University of
Washington School of Medicine and holds an adjunct
appointment in the Department of Psychiatry. She
earned her MD from the University of Michigan and
her MPH at the University of Washington. She completed an internal medicine and pediatrics residency
at the University of Michigan and a fellowship in
adolescent medicine at the University of Washington.
Richardson’s research focuses primarily on adolescent
mental health and somatic disorders, and on improving
detection and management of child and adolescent
depression in primary care settings. Her most recent
work involves the evaluation of quality of follow-up
care for depressed youth and designing health system
interventions to improve the delivery of evidence-based
care and health outcomes for depressed adolescents in
primary care settings.
Taraneh Shafii, MD, MPH, is attending physician at
Washington School of Medicine. Shafii is the attending
adolescent medicine specialist in the Children and
Teens Clinic at Harborview Medical Center and serves
as deputy medical director for the Public Health
84
Seattle & King County STD Clinic at Harborview.
Shafii received her MD from the University of Louisville
School of Medicine in Kentucky and her MPH from the
University of Washington School of Public Health and
Community Medicine. She completed a fellowship in
adolescent medicine and sexually transmitted diseases
(STDs) at the University of Washington School of
Medicine. She was invited to be on the faculty for the
Adolescent Health Reproductive Education Health
Project. Her clinical interests include adolescent sexuality
and reproductive health care; health manifestations of
stress, anxiety and depression; and overweight/eating
disorders in adolescents. In 2007 she was awarded
a five-year Career Development Award from the
NIH/NICHD to develop a clinician-delivered behavioral
intervention to reduce high-risk sexual behaviors in
adolescents. Shafii’s research focuses on the development
and assessment of primary and secondary behavioral
interventions to reduce sexual risk and the associated
morbidities of STDs and unintended pregnancy. Her
interests include early reproductive health education
for youth who are not yet sexually active and riskreduction interventions for adolescents engaging in
high-risk sexual behaviors.
AWARDS AND HONORS
Listed in Who’s Who in America’s Doctors.
Listed in Who’s Who in America’s Pediatricians.
Leslie R. Walker, MD
RESEARCH FUNDING
New
Improving depression screening and treatment among
Group Health adolescents. Group Health Community
Foundation. $66,808.
Brief clinician intervention for high-risk behavior in
adolescents. NIH/NICHD. $126,792.
Adolescent Medicine
Continuing
Healthcare for the homeless youth. Seattle–King
County Department of Public Health. $55,688.
Improve primary care management of adolescent
depression. NIH/NIMH. $159,268.
Complementary medicine for pediatrics. Madigan
Army Medical Center Department of Pediatrics
Winter Conference. Fort Lewis, Wash. Feb. 16, 2007.
Heavy petal: top 10 herbs used by teens. Effective
strategies for working with difficult adolescents. Society
for Adolescent Medicine. Denver, Colo. March 2007.
Biofeedback in children. Seattle Children’s Hospital
Annual Pain Meeting. Seattle, Wash. October 2007.
CAM in adolescents. American Academy of Pediatrics.
Ann E. Giesel, MD
Issues and answers in pediatric and adolescent
gynecology. NASPAG (North American Society for
Pediatric and Adolescent Gynecology) Annual
Conference. Atlanta, Ga. April 2007.
Sexuality and persons with developmental disabilities.
Center for Human Development and Disabilities.
University of Washington, Lend Core Lecture Series.
Seattle, Wash. July 17, 2007.
Taking the opportunity to talk with teens about
sexuality. Annual Ambulatory Nursing Conference.
Shoreline, Wash. April 25, 2007.
STDs in adolescents — special concerns. STD Update
Course. Portland, Ore. Oct. 17, 2007.
NFX1-123 and cytoplasmic poly(A) binding proteins
augment activation of telomerase by HPV 16E6.
International Papillomavirus Meeting. Beijing, China.
Nov. 3–8, 2007.
Regulation of telomerase by HPV 16E6 and NFX1-123.
AIDS and STD Research Symposium. Seattle, Wash.
Dec. 10, 2007.
Laura P. Richardson, MD
Musculoskeletal pain in adolescents (workshop).
Research in adolescents (special interest group
co-leader). Society for Adolescent Medicine Annual
Meeting. Denver, Colo. March 2007.
2006 STD treatment guidelines update. Pediatric Drug
Therapy, Clinical Pharmacology Series. Shoreline,
Wash. March 2007.
Sexually transmitted diseases (special interest group
chair). Society for Adolescent Medicine Annual
Meeting. Denver, Colo. March 2007.
Risk-taking behavior in adolescents. Annual WAMI
Trauma Conference. Seattle, Wash. May 2007.
Chlamydia. Taking a sexual history. STD Update
Course. Idaho State Department of Health and
Welfare. Boise, Idaho. August 2007.
HPV vaccine update. Pacific Northwest 30th Annual
National Conference, Advanced Practice in Primary &
Acute Care. Seattle, Wash. November 2007.
HPV vaccine update. 27th Annual F. Richard Dion
Pediatric Update. Seattle, Wash. December 2007.
Leslie R. Walker, MD
Secrets they may never share: PTSD from interpersonal
trauma, diagnosis, and treatment (co-presenter).
Adolescent caffeine use and its association with ADHD
and cigarette smoking (co-presenter). Simulated factors
affecting adolescent medicine providers’ recommendations for nicotine susceptibility (co-presenter). Society
for Adolescent Medicine Annual Meeting. Denver,
Colo. March 2007.
Cultural competency. Introduction Course to MCH
Public Health School of Public Health. University of
Washington. Seattle, Wash. November 2007.
Adolescent health care transition (pediatric resident
lecture). Seattle Children’s Hospital. Seattle, Wash. 2007.
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Adolescent Medicine
PUBLICATIONS
Bush T, Richardson LP, Katon W, Russo J, Lozano P,
McCauley E, Oliver M. The relationship between smoking and anxiety and depressive disorders in youth with
asthma. J Adolesc Health. May 2007;40(5):425–432.
Rockhill C, Russo JE, McCauley E, Katon WJ,
Richardson LP, Lozano P. Agreement between
parents and children regarding anxiety and depression
diagnoses in children with asthma. J Nerv Ment Dis.
Nov 2007;195(11):897–904.
Committee on Adolescent Health Care Services and
Models of Care for Treatment, Prevention, and Healthy
Development (Walker LR, member). Challenges in
Adolescent Health Care: Workshop Report. Board on
Children, Youth, and Families, Division of Behavioral
and Social Sciences and Education. National Research
Council and Institute of Medicine. Washington, D.C.:
The National Academies Press. 2007.
Rosen LD, Breuner CC. Primary care from infancy
to adolescence. Pediatr Clin North Am. Dec
2007;54(6):837–858.
Katon W, Lozano P, Russo J, McCauley E, Richardson
LP, Bush T. The prevalence of DSM-IV anxiety and
depressive disorders in youth with asthma compared
with controls. J Adolesc Health. Nov 2007;41(5):455–463.
Shafii T, Stovel K, Holmes K. Association between
condom use at sexual debut and subsequent sexual
trajectories: a longitudinal study using biomarkers.
Am J Public Health. Jun 2007;97(6):1090–1095.
Katzenellenbogen R, Egelkrout EM, Vliet-Gregg P,
Gewin LC, Gafken PR, Galloway DA. NFX1-123
and poly(A) binding proteins synergistically augment
activation of telomerase in human papillomavirus
type 16E6 expressing cells. J Virol. Apr
2007;81(8):3786–3796.
Tercyak KP, Peshkin BN, Abraham A, Wine L,
Walker LR. Interest in genetic counseling and testing
for adolescent nicotine addiction susceptibility among
a sample of adolescent medicine providers attending a
scientific conference on adolescent health. J Adolesc
Health. Jul 2007;41(1):42–50.
Kerani RP, Handsfield HH, Stenger MS, Shafii T,
Zick E, Brewer D, Golden MR. Rising rates of syphilis
in the era of syphilis elimination. Sex Transm Dis.
Mar 2007;34(3):154–161.
McCauley E, Katon W, Russo J, Richardson LP,
Lozano P. Impact of anxiety and depression on functional
impairment in adolescents with asthma. Gen Hosp
Psychiatry. May–Jun 2007;29(3):214–222.
Moreno MA, Parks M, Richardson LP. What are
adolescents showing the world about their health risk
behaviors on MySpace? MedGenMed. Oct 2007;9(4):9.
86
Katon W, McCauley E. Pediatric primary care providers
and the treatment of adolescent depression: a qualitative
study of barriers to treatment and effect of the black box
warning. J Adolesc Health. May 2007;40(5):433–439.
Bioethics
The Division of Bioethics has three primary goals: consultation with families, health-care providers, researchers and
policy makers on care practices and policies; scholarship
on ethical issues related to pediatric health care and
research; and training the next generation of pediatric
bioethicists.
The division coordinates the Clinical Bioethics Consult
Service, advising families and clinicians about ethical issues
in health-care decisions. Faculty have played a leadership
role in the development of the Research Bioethics Consult
Service, part of the Institute for Translational Health
Sciences, which provides advice to researchers, research
participants and institutional review boards. This program
serves Seattle Children’s Hospital, the University of
Washington, the Fred Hutchinson Cancer Research
Center and WAMI affiliates.
Our research focuses on the interface between
population and individual concerns, with an emphasis on
how these issues relate to parental decision making and
chronic illness. Current projects examine research recruitment, genetic testing in children, justice and global health,
adolescent decision making, treatment decisions for
vulnerable populations and quality improvement in ethics.
Ongoing educational activities include a weekly
bioethics seminar for faculty and staff of Children’s and
Faculty
Benjamin S. Wilfond, MD, Chief
Douglas S. Diekema, MD, MPH
Ross M. Hays, MD
Maureen Kelley, PhD
David E. Woodrum, MD
Benjamin S. Wilfond
MD, Chief
the University of Washington School of Medicine, a monthly
conference for pediatrics residents and an annual conference
focused on current controversies in pediatric health care.
The division hosts a case-based ethics Grand Rounds three
times a year and sponsors an annual endowed lectureship.
Our pediatric bioethics fellowship program trains
clinicians for academic careers in bioethics. The program
includes a mentored research project and training in clinical
and research ethics consultation. The first fellow will
complete training in 2009.
Benjamin S. Wilfond, MD, is director of the Treuman
Katz Center for Pediatric Bioethics at Seattle Children’s
Hospital and professor and chief of the Division of
Bioethics in the Department of Pediatrics at the
is adjunct professor in the Department of Medical
History and Ethics. Wilfond attends in the Chest Clinic
in the Division of Pulmonary Medicine at Children’s.
He is the co-director of the Regulatory Support and
Bioethics Core for the Institute of Translational Health
Sciences (ITHS) and coordinates the ITHS Research
Bioethics Consult Service. He earned his MD from the
University of Medicine and Dentistry of New JerseyNew Jersey Medical School. He completed his pediatric
residency and his fellowship in pediatric pulmonology
and medical ethics at the University of Wisconsin. He
has held faculty appointments at the University of Arizona, National Institutes of Health and Johns Hopkins
University. He conducts research on ethical and policy
87
Bioethics
Faith, Health and Medical Practice and the author of
numerous scholarly publications in medical ethics and
pediatric emergency medicine.
Spotlight on team member — Maureen Kelley, PhD
The new pediatric residency pathway in global health is
exciting, not only for the residents and those of us working
in global health, but also for the broader Seattle Children’s
community. Once you appreciate that the central problems
surrounding global health have no borders, it opens one’s
perspective to the ethical, socioeconomic and health
challenges facing all of us.
issues related to genetic testing, genetic research and
pediatrics research. He has recently worked on issues
related to newborn screening, disclosure of genetic
research results and pediatric biobanks. He is a member of the Ethics Subcommittee of the FDA Pediatric
Advisory Committee and the National Children’s
Study Federal Advisory Committee.
Douglas S. Diekema, MD, MPH, is director of education
for the Treuman Katz Center for Pediatric Bioethics
and an attending physician in the Emergency Department at Seattle Children’s Hospital. He is professor
in the Division of Bioethics in the Department of
Medicine and adjunct professor in the Department
of Medical History and Ethics. He is also an adjunct
professor in the Department of Health Services at the
University of Washington School of Public Health. He
earned his MD from the University of North Carolina
and an MPH in health services and medical ethics from
the University of Washington School of Public Health.
He has been a member of Seattle Children’s Hospital
Ethics Committee since 1991, has served as an ethics
consultant since 1993 and is chair of the Institutional
Review Board. He serves as chair of the Committee on
Bioethics of the American Academy of Pediatrics and
is a member of the Ethics Committee of the American
Board of Pediatrics. He is consulting editor of AAP
Grand Rounds. Diekema is co-author of Christian
88
Ross M. Hays, MD, is ethics consultant for the Treuman
Katz Center for Pediatric Bioethics and medical director
of the palliative care program at Seattle Children’s Hospital. He is professor in the Department of Rehabilitation
Medicine and adjunct professor in the Department of
Medicine; he is faculty associate in the Department of
Medical History and Ethics. He is the medical director
for the pediatric hospice and palliative care program
at Providence Hospice of Seattle. He is board certified
in pediatrics, rehabilitation medicine and hospice and
palliative medicine. He was the principal investigator
of the Supporting Children at the End of Life: Improving
Access and Quality of Care Project sponsored by the
Robert Wood Johnson Foundation. Hays has been the
PI on NIH-funded R01 projects and is the pediatric
clinical core leader for the Seattle Cancer Care Alliance,
which provides care to children with severe, life-limiting
illness using a unique model that is highly regarded
throughout the country. He also provides consultation
on pediatric palliative care to hospitals regionally
and nationally.
Maureen Kelley, PhD, is an ethics consultant for the
Treuman Katz Center for Pediatric Bioethics, assistant
professor in the Department of Pediatrics in the
Division of Bioethics at the University of Washington
School of Medicine and adjunct assistant professor in
the Department of Medical History and Ethics and
in the Department of Philosophy. She earned her PhD
in philosophy at Rice University. She has held faculty
appointments at Baylor College of Medicine and the
University of Alabama. She serves on the Regulatory
Support and Bioethics Core of the Institute of Translational Health Sciences (ITHS) and on the steering
committee for the Global Health Pathway in the
University of Washington School of Medicine’s pediatric
residency program. Kelley conducts research on ethical
issues in pediatric global health and international
research ethics and on moral conflict resolution. She is
involved in international research projects in Siberia
and Zambia. Current projects include supporting
adolescent decision making for runaways, street children
and orphans; improving criteria of vulnerability and
risk for orphans and street children in the context of
Bioethics
HIV/AIDS; managing the ethical dilemmas raised by
infant-feeding practices among HIV-infected mothers
in resource-poor settings; and examining the role of
moral compromise in global health practice and policy.
Ethical and policy implications of limiting growth in
profoundly disabled children (conference co-chair).
University of Washington Law School. Seattle, Wash.
May 16, 2007.
David E. Woodrum, MD, is clinical director for the
Treuman Katz Center for Pediatric Bioethics at Seattle
Children’s Hospital. He is professor in the Department
of Pediatrics at the University of Washington School of
Medicine and faculty associate in the Department of
Medical History and Ethics. Woodrum’s clinical and
teaching activities are focused on convalescing premature infants and on pediatric biomedical ethics issues
for residents, fellows and other health-care providers.
His research explores the determinative elements of
parental decision making. He is co-director of the
Pediatric Interim Care Center in Kent, Wash., a
nationally recognized program providing medically
supervised care for drug-exposed infants.
Understanding differences in conflicts over medical
care (course planning committee and participant).
Third Annual Pediatric Bioethics Conference.
Seattle, Wash. June 14, 2007.
RESEARCH FUNDING
Continuing
Promoting pediatric bioethics in health care
and research. Maternal and Child Health
Bureau/HRSA/DHHS. $337,280.
Quality craftsmanship: ethical dilemmas in health
care. Rural Hospital Association Summer Workshop.
Chelan, Wash. June 26, 2007.
Ethics consultation. Pediatric decision making.
Summer Seminar in Bioethics. University of Washington.
Seattle, Wash. Aug. 6–10, 2007.
The Ashley controversy. The Ashley treatment:
the nature of the case. Ashley in 3 minutes and 30
seconds: on the relationship of media and ethical issues
(conference participant). Severely Disabled Children
and the Limitations of Treatment. Frankfurt, Germany.
Aug. 31–Sept. 2, 2007.
Ashley revisited: is growth attenuation ever justified
in a profoundly disabled child? Ashley revisited (panel
participant). Disability and Rehabilitation Ethics Interest
Group, American Society of Bioethics and Humanities
Annual Meeting. Washington, D.C. Oct. 19, 2007.
Enhancement technologies and children. Internal
Medicine Grand Rounds and Ethics Consultation.
Scott & White/Texas A&M Health Science Center
College of Medicine. Salado, Texas. Jan. 22, 2007.
Ethical issues in pediatric emergency medicine.
Managing bites and stings in children. Washington
American College of Emergency Physicians Annual
Meeting. Vancouver, British Columbia, Canada.
April 17, 2007.
Pediatric research ethics consultation (workshop).
Pediatric Academic Societies Annual Meeting.
Toronto, Ontario, Canada. May 5–7, 2007.
Gifts, bribes or necessity: managing conflicts of
interest at the organizational and individual level.
Immunizations: issues facing pediatricians in 2008.
American Academy of Pediatrics National Conference.
San Francisco, Calif. Oct. 30, 2007.
The Ashley case revisited: reflections on health-care
decision making for children. Sixth Annual Paul S.
Pierson Memorial Lecture in Bioethics. Medical
College of Wisconsin. Milwaukee, Wis. Nov. 8, 2007.
Maureen Kelley, PhD
Autonomy’s blind spots: insights from child development
and global health. Department of Philosophy, Davidson
College. Davidson, N.C. January 2007.
89
Bioethics
Freedom as development. Institute for Philosophy and
Public Policy. University of Maryland. College Park,
Md. February 2007.
Moral compromise. Department of Philosophy,
State University of New York-Albany. Albany, N.Y.
February 2007.
Rethinking dual-use: the ethics of biodefense research.
Conference on Bioethics and Biodefense. Johns Hopkins
University. Baltimore, Md. March 2007.
Rethinking vulnerability in at-risk children in the
context of HIV/AIDS. University of Zambia School
of Medicine. Lusaka, Zambia. June 2007.
Family perspectives on returning research results
(moderator). ASCO/COG Symposium on Ethical
Considerations in Disclosing Study Results to
Research Participants. Denver, Colo. Oct. 16, 2007.
Ashley revisited: is growth attenuation ever justified in
a profoundly disabled child? (moderator). American
Society of Bioethics and Humanities Annual Meeting.
Washington, D.C. Oct. 19, 2007.
Parent-provider conflicts in the children with chronic
illness. Pediatric Pulmonary Center Seminar. University
of Arizona. Tucson, Ariz. Nov. 16, 2007.
PUBLICATIONS
Benjamin S. Wilfond, MD
Ethical issues in pediatric outcomes research. Pediatric
Trauma Care: A Workshop to Develop a National Study
on the Costs and Outcomes from Pediatric Trauma.
Washington, D.C. March 9, 2007.
Disclosing incidental findings in pediatrics. Managing
Incidental Findings in Human Subjects Research:
From Imaging to Genomics. University of Minnesota.
Minneapolis, Minn. May 1, 2007.
May 16, 2007.
Show me the money: financial considerations in
responding to parental wishes. Navigating Conflicts
when Parents and Providers Disagree about Health
Care. Third Annual Pediatric Bioethics Conference.
Treuman Katz Center for Pediatric Bioethics. Seattle,
Wash. July 13–14, 2007.
Ethical issues in pediatric research. Western IRB
Seminar. Olympia, Wash. Aug. 7, 2007.
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American Academy of Pediatrics Committee on
Bioethics, Fallat ME, Glover J (Diekema DS, chair).
Professionalism in pediatrics: statement of principles.
Pediatrics. Oct 2007;120(4):895–897.
Comeau AM, Accurso FJ, White TB, Campbell PW
3rd, Hoffman G, Parad RB, Wilfond BS, Rosenfeld M,
Sontag MK, Massie J, Farrell PM, O’Sullivan BP, Cystic
Fibrosis Foundation. Guidelines for implementation
of cystic fibrosis newborn screening programs: Cystic
Fibrosis Foundation workshop report. Pediatrics.
Feb 2007;119(2):495–518.
Committee on Ethics (Diekema DS, primary author),
American College of Obstetricians and Gynecologists.
ACOG Committee Opinion No. 362: medical futility.
Obstet Gynecol. Mar 2007;109(3):791–794.
Diekema DS. The armchair ethicist: it’s all about
location. J Clin Ethics. Fall 2007;18(3):227–232.
Diekema DS. Ethical considerations. In: Woodward
GA, Insoft RM, Kleinman ME, eds. Guidelines for
Air and Ground Transport of Neonatal and Pediatric
Patients, Third Edition. Elk Grove Village, Ill.: American
Academy of Pediatrics. 2007.
Bioethics
Fallat ME, Glover J, American Academy of Pediatrics,
Committee on Bioethics (Diekema DS, chair).
Professionalism in pediatrics. Pediatrics. Oct
2007;120(4):e1123–1133.
Gunther DF, Diekema DS. Disabling children with
disabilities [reply to 3 letters to the editor]. Arch
Pediatr Adolesc Med. Apr 2007;161(4):419–420.
Wilfond BS. The Ashley case: the public response
and policy implications. Hastings Cent Rep. Sep–Oct
2007;37(5):12–13.
Wilfond BS. Ethical considerations about
observational research in children. J Trauma.
Dec 2007;63(6 Suppl):S146–151.
Gunther DF, Diekema DS. Growth attenuation:
unjustifiable non-therapy [reply to letter to the editor].
Arch Pediatr Adolesc Med. May 2007;161(5):521–522.
Gunther DF, Diekema DS. Only half the story
[reply to letter to the editor]. Arch Pediatr Adolesc
Med. Jun 2007;161(6):616.
Henderson GE, Churchill LR, Davis AM, Easter MM,
Grady C, Joffe S, Kass N, King NM, Lidz CW, Miller
FG, Nelson DK, Peppercorn J, Rothschild BB, Sankar
P, Wilfond BS, Zimmer CR. Clinical trials and medical
care: defining the therapeutic misconception. PLoS
Med. Nov 2007;4(11):e324.
Kelley M. Casuistry naturalized. In: Cherry MJ, Iltis
AS, eds. Pluralistic Casuistry: Moral Arguments,
Economic Realities and Political Theory. Dordrecht,
Netherlands: Springer. 2007.
Kelley M, Miller S. Clinical ethics. In: Briscoe DA, ed.
Lange Q&A: USMLE Step 3, Fifth Edition. New York:
McGraw-Hill. 2007.
Myers RE, Weinberg DS, Manne SL, Sifri R, Cocroft
J, Kash K, Wilfond BS. Genetic and environmental
risk assessment for colorectal cancer risk in primary
care practice settings: a pilot study. Genet Med. Jun
2007;9(6):378–384.
Opel D, Shugerman RP, McPhillips H, Swanson WS,
Archibald S, Diekema DS. Professionalism and the
match: a pediatric residency program’s post-interview
no-call policy and its impact on applicants. Pediatrics.
Oct 2007;120(4):826–831.
91
Cardiology
The Division of Cardiology is part of Seattle Children’s Heart
Center, a specialized team of pediatric cardiologists, cardiac
surgeons, pediatric cardiac intensive care specialists, cardiac
anesthesiologists, nurses, echocardiography technicians
and caring staff. We are a comprehensive cardiac care
provider for the fetus to the adult, and our commitment to
the best possible outcome for each patient includes ongoing
research into new treatments and technologies.
We have a reputation for excellence in services
ranging from advanced therapeutic catheterization
procedures for common cardiac defects and heart rhythm
disorders to heart transplantation for infants with more
complex cardiac problems.
The Division of Cardiology is committed to achieving
greater national recognition for leadership in innovation,
collaboration and excellence. Our faculty’s intellectual
curiosity and spirit of inquiry define our culture, and our
research and clinical care partnerships provide models
for our peers.
Faculty
Mark B. Lewin
MD, Chief
Mark B. Lewin, MD, Chief
Robert J. Boucek Jr., MD
Terrence U. Chun, MD
Michelle Z. Gurvitz, MD, MS
Bruce Hardy, MD
Troy A. Johnston, MD
Thomas K. Jones, MD
Isamu Kawabori, MD
Yuk M. Law, MD
Aaron Olson, MD
Michael A. Portman, MD
Jack C. Salerno, MD
Amy H. Schultz, MD, MSCE
Stephen P. Seslar, MD, PhD
Brian D. Soriano, MD
Stanley J. Stamm, MD, FAAP, FACC
Karen Stout, MD
Margaret M. Vernon, MD
Delphine Yung, MD
Mark B. Lewin, MD, is chief in the Division of Cardiology,
director of the Prenatal Center and co-director of the
Cardiac Ultrasound Program at Seattle Children’s
Hospital. He is associate professor in the Department
of Pediatrics and adjunct associate professor in the
Department of Obstetrics and Gynecology at the
University of Washington School of Medicine. Lewin
is co-director of Children’s Heart Center. He directs
the regional fetal echocardiography service and the
statewide echocardiography telemedicine service.
Lewin’s clinical responsibilities at Children’s include
general cardiology, transesophageal echocardiograms,
echocardiography and cardiovascular genetics clinics.
Lewin is pediatric preceptor of the medical student
course, and he mentors residents in pediatrics who
have a special interest in cardiology or genetics.
Robert J. Boucek Jr., MD, is professor of pediatrics in the
Division of Cardiology of the Department of Pediatrics
He holds the Thomas Bradley Armstrong Endowed
Chair in Pediatric Cardiology. He received his MD from
Tulane University Medical School in New Orleans, La.
Boucek completed a pediatrics internship and residency
at Duke University Medical Center in Durham, N.C.,
and fellowships in biochemistry and pediatric cardiology
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Cardiology
at Vanderbilt University Medical Center in Nashville,
Tenn. Boucek was the first medical director for the
pediatric heart transplant programs at Vanderbilt and
at the University of South Florida/All Children’s Hospital. He is active in clinical care and research in heart
failure and cardiac transplantation. His basic research
includes collaboration on myocardial regeneration
strategies as applied to right ventricular failure. He is
co-investigator on American Heart Association–funded
projects to enhance the regenerative potential of heart
cells. Boucek’s vision is to bring cardiac regeneration
strategies to pediatric patients with an exciting initiative
involving recruitment of experienced investigators
and collaboration with the University of Washington’s
Institute for Stem Cell and Regenerative Medicine.
Terrence U. Chun, MD, is attending pediatric cardiologist
and pediatric electrophysiologist at Seattle Children’s
Hospital and assistant professor at the University of
Washington School of Medicine. Chun received his MD
from Hahnemann University School of Medicine in
Philadelphia, Pa., and completed his pediatrics residency
at Cedars-Sinai Medical Center in Los Angeles, Calif.
He also completed fellowships in pediatric cardiology
at Cincinnati Children’s Hospital and a joint pediatric
electrophysiology fellowship at the University of
California, San Francisco, and Stanford University
School of Medicine. Chun has expertise and training in
pediatric cardiology, pediatric electrophysiology and
implantation of pacemakers and defibrillators. Specific
areas of clinical interest include catheter ablation
of cardiac arrhythmias, postoperative arrhythmias,
implantable device therapy for treatment of arrhythmias,
heart failure and prevention of sudden cardiac death.
Michelle Z. Gurvitz, MD, MS, is attending physician at
Seattle Children’s Hospital and assistant professor of
pediatrics and adjunct assistant professor of medicine
She cares for children on an outpatient basis in
Children’s Heart Center and at Group Health Eastside
and attends and consults on the inpatient service
at Children’s. Gurvitz also participates in a unique
program with Children’s and the University of Washington that supports the transition of older children
with congenital heart disease from pediatric to adult
cardiology care. She participates in a weekly clinic at
the university for adults with congenital heart disease.
Gurvitz received her MD from the University of
California, Los Angeles, School of Medicine. She
Spotlight on team member — Mary (Libs) Schlater, ARNP
For the last several years, Seattle Children’s and the University
of Washington have provided a seamless model of medical
care that allows teenagers and young adults with congenital
heart defects to easily transition from pediatric to adult care.
Our partnership with UW ensures that Seattle Children’s
patients go on to maintain the best quality of life possible
into adulthood.
completed her internal medicine–pediatrics residency
at the Cedars-Sinai Medical Center and her pediatric
cardiology fellowship at the Mattel Children’s Hospital
at UCLA. Gurvitz earned an MS in Health Services
Research at the UCLA School of Public Health. She is
board certified in pediatrics, pediatric cardiology and
internal medicine. Gurvitz has expertise and training
in adolescent and adult congenital heart disease.
Specific areas of clinical research interest include the
transition of adolescents with congenital heart disease
to adult care and the epidemiology and long-term
outcomes of adults with congenital heart disease.
Bruce Hardy, MD, is a pediatric cardiologist who
maintains a close affiliation with Seattle Children’s
Hospital. He practices in Missoula, Mont., and in
outreach clinics throughout western Montana. Hardy
travels monthly to Children’s and participates twice a
week in cardiology conferences as part of telemedicine.
He earned his MD at the University of Washington
School of Medicine. He completed an internship at the
University of Vermont, a pediatrics residency at the
University of Utah and a pediatric cardiology fellowship at Oregon Health Sciences University. He is board
certified in pediatrics and pediatric cardiology. He is a
fellow of the American Academy of Pediatrics and the
American College of Cardiology. Hardy also teaches
in the Department of English at the University of
Montana, specializing in James Joyce.
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Cardiology
Troy A. Johnston, MD, is the fellowship director and
assistant director of the Cardiac Catheterization
Laboratories at Seattle Children’s Hospital and professor
Washington School of Medicine. He is certified by the
American Board of Pediatrics and the sub-board in
pediatric cardiology. Johnston is director of the pediatric
cardiology clerkship, a curriculum that exposes the
trainee to the basics of the subspecialty, and he works
with residents and students on a one-on-one basis. He
also supervises residents and students on the inpatient
cardiology service. Johnston has participated in many
multi-institutional clinical trials of devices used in
transcatheter treatment of congenital heart disease
and has led a research project examining the use of
technology to improve the auscultation skills of
pediatric trainees. He has been an abstract reviewer
for the annual scientific session of the Society of
Cardiovascular Angiography and Interventions.
Thomas K. Jones, MD, is a professor of pediatrics and
adjunct professor of medicine at the University of
Washington School of Medicine and has been the
director of the Cardiac Catheterization Laboratories at
Seattle Children’s Hospital since 1991. He is a graduate
of the Jefferson Medical College in Philadelphia; he
completed his pediatrics residency at the University of
Washington and his pediatric cardiology fellowship at
the University of Colorado and the Denver Children’s
Hospital. He is a fellow of the American Academy of
Pediatrics, the American College of Cardiology and the
Society for Cardiovascular Angiography and Interventions. His work focuses on congenital and structural
interventional cardiac catheterization. He has worked
to pioneer several less invasive techniques to correct
congenital heart conditions. He has participated as
an investigator for most multicenter clinical trials in
the United States, evaluating devices and procedures
designed for these patients. His research interests are
now focusing on percutaneous heart valve implantation.
He serves on numerous national committees and task
forces promoting guidelines and practice standards
for patients with congenital heart disease. Jones
collaborates with emerging technology companies
to develop and test new products designed to treat
congenital and structural heart conditions.
94
Isamu Kawabori, MD, is attending cardiologist at Seattle
Department of Pediatrics at the University of Washington
School of Medicine. He attends in Children’s Heart
Center, Children’s Bellevue Cardiology Clinic, Swedish
Medical Center and Central Washington Hospital in
Wenatchee, Wash. His teaching responsibilities at
the university include pediatric cardiology and
rehabilitation courses.
Yuk M. Law, MD, is director of Cardiac Transplant and
Heart Failure Service at Seattle Children’s Hospital and
He earned his MD at the University of California,
Los Angeles, and completed his pediatrics residency at
Yale–New Haven Hospital. He completed postgraduate
training in pediatric cardiology at The Hospital for Sick
Children, University of Toronto, Canada. He was director
of the fellowship training program and director of the
Heart Failure and Transplant Service at Doernbecher
Children’s Hospital. Law is board certified in pediatric
cardiology. He has an academic interest and clinical
expertise in cardiopulmonary failure and heart transplant, and has subspecialty expertise in heart failure,
pulmonary hypertension and thoracic organ transplant.
Aaron Olson, MD, is a general pediatric cardiologist
with a special clinical interest in Kawasaki disease
and cardiac manifestations of genetic disorders. He is
involved in clinical research projects concerning novel
treatments in Marfan syndrome and Kawasaki disease.
His basic science research concerns cardiac hypertrophy
and maintaining cardiac function in the face of
hemodynamic stressors.
Michael A. Portman, MD, is director of research in the
Division of Cardiology at Seattle Children’s Hospital
and professor in the Department of Pediatrics at the
University of Washington School of Medicine. He is
attending physician at Children’s Heart Center and
the Cardiology Clinic at Providence Everett Medical
Center. Portman’s research activities include pharmacological clinical trials, basic science research projects
focused on cardiac metabolism in animal models and
mentoring future clinical researchers. He is an editorial
board member of the American Journal of Physiology
— Heart and Circulatory Physiology and co-investigator
for a grant on cardiovascular research training.
Cardiology
Jack C. Salerno, MD, is director of the Electrophysiology
and Pacing Service at Seattle Children’s Hospital and
an assistant professor in the Department of Pediatrics
He earned his MD and completed a pediatrics residency at the University of California, San Diego. He
completed his general pediatric cardiology fellowship
followed by an advanced electrophysiology fellowship
at Baylor College of Medicine/Texas Children’s Hospital
in Houston, Texas. In 2007, Salerno was a planning
committee member for the Parent Heart Watch National
Convention on the Prevention of Sudden Cardiac
Death in Young Athletes, an event sponsored by the
University of Washington CME. Salerno has expertise
and training in pediatric cardiology, electrophysiology
studies with therapeutic ablation and implantation
of cardiac pacemakers/rhythm management devices.
Specific areas of clinical interest include long QT
syndrome and sudden death in athletes.
Amy H. Schultz, MD, MSCE, sees patients at the main
Seattle Children’s Hospital campus and at Children’s
Olympia, attends in the echocardiography laboratory
and attends on the inpatient cardiology service. Schultz
is a graduate of the University of Pennsylvania School
of Medicine. She completed her pediatric training at
Johns Hopkins Hospital and her pediatric cardiology
training at The Children’s Hospital of Philadelphia,
and earned a master’s degree in clinical epidemiology
at the University of Pennsylvania.
Stephen P. Seslar, MD, PhD, is attending physician at
Seattle Children’s Hospital and assistant professor of
pediatrics at the University of Washington School of
Medicine. He is one of three pediatric electrophysiologists in the Division of Cardiology. He earned his MD
and PhD (in cell biology) at Georgetown University.
His clinical interests include arrhythmia management
in adults with congenital heart disease, medical
informatics and database design. He conducts clinical
research on a variety of topics within pediatric and
adult congenital electrophysiology.
Brian D. Soriano, MD, is attending cardiologist at Seattle
Children’s Hospital and assistant professor of pediatrics
at the University of Washington School of Medicine. He
co-directs cardiac MRI at Children’s, where he helped
establish the program in late 2007. After completing
medical school at the University of Toledo he completed
his combined residency in pediatrics and internal
medicine at the University of Illinois in Chicago. He
finished his training in clinical cardiology at Children’s
Hospital Boston. At the same institution he spent
an additional year as a senior fellow in noninvasive
imaging, and maintained his interest in adult congenital
heart disease. He is board certified in pediatric
cardiology, general pediatrics and internal medicine.
His clinical and research interests include cardiac
MRI, echocardiography and 3-D echocardiography.
Stanley J. Stamm, MD, FAAP, FACC, is attending
cardiologist at Seattle Children’s Hospital and clinical
School of Medicine. He earned his MD at St. Louis
University. His clinical interest is general cardiology.
He is board certified in pediatric cardiology and
general pediatrics. His teaching includes 24 pediatric
residents rotating through his clinic. His special
interest is the Stanley Stamm Children’s Hospital
Camp for special-needs children.
Karen Stout, MD, directs the Adult Congenital Heart
Disease Program, a collaborative program between
Seattle Children’s Hospital and the University of Washington. Stout spends half of her time at Children’s and
half at the University of Washington, seeing adolescent
and adult congenital heart disease patients at both
institutions. She continues to teach medical students,
residents, fellows and other faculty in various settings,
including medical school courses, outpatient and
inpatient clinical arenas, conferences and CME events.
Margaret M. Vernon, MD, is attending physician at
Washington School of Medicine. Vernon sees outpatients
at Children’s Bellevue, attends and consults on inpatients
at Children’s and is part of the echocardiography and
telemedicine team at Children’s. In addition, she
participates in the Prenatal Diagnosis and Treatment
Program, a unique combined program of the University
of Washington and Children’s focusing on the prenatal
diagnosis of and management of complex anomalies.
Vernon earned her MD from the University of Rochester
School of Medicine; she completed her pediatric residency
at Seattle Children’s and her pediatric cardiology fellowship
at Children’s Hospital Boston. She is board certified in
pediatrics and pediatric cardiology. Vernon has an
academic interest and clinical expertise in the prenatal
diagnosis of congenital heart disease and arrhythmias.
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Cardiology
Delphine Yung, MD, is attending cardiologist at Seattle
Department of Pediatrics at the University of Washington School of Medicine. She cares for children in the
outpatient clinic in Children’s Heart Center and also
attends and consults on the inpatient service. Yung
received her MD from Stanford University. She
completed an internship and junior residency in
pediatrics at Children’s Hospital Boston and a senior
residency in pediatrics at Lucile Packard Children’s
Hospital at Stanford. She completed her pediatric
cardiology fellowship at Children’s Hospital of New
York, Columbia University. Yung has expertise and
training in all aspects of pediatric cardiology, particularly
pulmonary hypertension and exercise testing. Her
clinical interests include cardiomyopathy, pulmonary
hypertension, transplant and the exercise lab at Seattle
Children’s Heart Center. Her current research focuses
on exercise capacity in patients with chronic diseases.
RESEARCH FUNDING
How to transition the adult with congenital heart
disease (co-chair of “How To” session). American Heart
Association Annual Scientific Sessions. Orlando, Fla.
November 2007.
New
Etanercept in Kawasaki disease. Amgen. $78,272.
FcR mutations in Kawasaki disease.
NHLBI/NIH/DHHS. $270,739.
Continuing
Thyroid regulation in the developing heart.
Triostat in children during CPB. U.S. Food & Drug
Administration. $87,500.
Delphine Yung, MD
Registry to evaluate early and long-term pulmonary
and arterial hypertension disease management.
Cotherix, Inc. $95,185.
Myocardial regeneration: kids need it too (keynote
address). Western Society of Pediatric Cardiology
Conference. Las Vegas, Nev. April 2007.
Atrial appendage as a source of cardiac stem/progenitor
cells. Euro Stem Cell Sixth Framework Programme,
Proceedings — Stem Cells and Regenerative Medicine,
Hydra III. Hydra, Greece. September 2007.
ACHD research questions that need to be answered —
part 1. 17th Annual Course on Adult Congenital Heart
Disease. Philadelphia, Pa. June 2007.
Heart disease in adolescents. Advanced Practice in
Primary and Acute Care Conference. Seattle, Wash.
November 2007.
Bruce Hardy, MD
Are corticosteroids indicated in the initial treatment
of Kawasaki disease? Pediatric Cardiology Fellows,
OHSU. Portland, Ore. March 22, 2007.
Thomas K. Jones, MD
Congenital interventional cardiology: something old,
something new, something borrowed, something now
not so blue. SIR 2007, 32nd Annual Scientific Meeting.
Seattle, Wash. March 6, 2007.
Dr. Samuel Lau in performance of Amplatzer septal
occluder closure of atrial septal defects (visiting
proctorship). Sacred Heart Medical Center. Eugene,
Ore. March 26, 2007.
In performance of Amplatzer septal occluder closure
of atrial septal defects (visiting proctorship). Providence Alaska Medical Center. Anchorage, Alaska.
April 23, 2007.
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Cardiology
Results of the HELEX septal occluder U.S. multicenter
clinical trial (webcast presentation). Cardiology Conference. Children’s National Medical Center. Washington,
D.C. June 13, 2007.
The Gore HELEX septal occluder — an innovative tool
for atrial septal defect closure. VIVA 07. Las Vegas,
Nev. Sept. 27, 2007.
CoAptus radiofrequency PFO closure system, lessons
learned and future directions. TCT 2007. Washington,
D.C. Oct. 21, 2007.
Live case demonstrations (primary operator): several
adult patients with large ASD closed by percutaneous
technique. Procedures performed at Swedish Medical
Center (broadcast to TCT 2007). Seattle, Wash.
Oct. 23, 2007.
Mark B. Lewin, MD
Pediatric cardiology review for primary care (invited
faculty). 18th Annual Recertification Review Course
and Winter Conference. Washington Academy of
Physician Assistants. SeaTac, Wash. January 2007.
How-to track: AV canal defects: the crux of the exam
(invited faculty). Adult congenital heart disease
symposium: assessment of systemic and pulmonary
vein anomalies (invited faculty). 18th Annual Scientific
Sessions of the American Society of Echocardiography.
Seattle, Wash. June 2007.
Prenatal diagnosis of congenital heart disease and
fetal echocardiography (platform presentation).
Echo telemedicine in a regional center for the acute
evaluation of suspected congenital heart disease
(platform presentation). Live fetal echocardiographic
imaging assessment of five pregnancies with complex
congenital heart disease (case presentations). 3rd
Ukrainian Congenital Heart Disease Forum. Kiev,
Ukraine. October 2007.
Overview of Children’s Hospital prenatal diagnosis
and treatment program and fetal cardiac evaluation.
Perinatology Visiting Professor Program. Grand Rounds,
Children’s Village. Yakima, Wash. November 2007.
Karen Stout, MD
Pregnancy and congenital and valvular heart disease
(expert panelist). American College of Cardiology
Annual Scientific Session. New Orleans, La.
March 2007.
PUBLICATIONS
Buroker NE, Young ME, Wei C, Serikawa K, Ge M,
Ning XH, Portman MA. The dominant negative
thyroid hormone receptor β-mutant ∆337T alters
PPARα signaling in heart. Am J Physiol Endocrinol
Metab. Feb 2007;292(2):e453–460.
Forbes TJ, Garekar S, Amin Z, Zahn EM, Nykanen D,
Moore P, Qureshi SA, Cheatham JP, Ebeid MR,
Hijazi ZM, Sandhu S, Hagler DJ, Sievert H, Fagan TE,
Ringwald J, Du W, Tang L, Wax DF, Rhodes J,
Johnston TA, Jones TK, Turner DR, Pedra CAC,
Hellenbrand WE. Procedural results and acute
complications in stenting native and recurrent
coarctation of the aorta in patients over 4 years
of age: a multi-institutional study. Catheter
Cardiovasc Interv. Aug 2007;70(2):276–285.
Gurvitz M, Inkelas M, Lee M, Stout K, Escarce J,
Chang RK. Changes in hospitalization patterns among
patients with congenital heart disease during the
transition from adolescence to adulthood. J Am Coll
Cardiol. Feb 27 2007;49(8):875–882.
Gurvitz M, Stout K. Ebstein’s anomaly of the tricuspid
valve. Curr Cardiol Rep. Jul 2007;9(4):336–342.
Hara H, Jones TK, Ladich E, Virmani R, Auth D,
Eichinger J, Sommer RJ, Schwartz RS. Patent foramen
ovale closure by radiofrequency thermal coaptation: first
experience in the porcine model and healing mechanisms
over time. Circulation. Aug 2007;116(6):648–653.
Jones TK, Latson LA, Zahn E, Fleishman C, Jacobsen
J, Vincent R, Kanter K. Improving procedural times
during percutaneous atrial septal defect closure [reply
to letter to the editor]. J Am Coll Cardiol. Sept 25
2007;50(13):1296–1297.
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Cardiology
Jones TK, Latson LA, Zahn E, Fleishman CE, Jacobson
J, Vincent R, Kanter K, Multicenter Pivotal Study of
the HELEX Septal Occluder Investigators. Results
of the U.S. multicenter pivotal study of the HELEX
septal occluder for percutaneous closure of secundum
atrial septal defects. J Am Coll Cardiol. Jun 5
2007;49(22):2215–2221.
Lewin MB. Echocardiography in patients with
inherited connective tissue disease. In: Otto C, ed.
The Practice of Clinical Echocardiography, Third
Edition. Philadelphia, Pa.: Saunders. 2007.
Mitropoulos FA, Laks H, Kapadia N, Gurvitz M,
Levi D, Williams R, Plunkett M. Intraoperative
pulmonary artery stenting: an alternative technique
for the management of pulmonary artery stenosis.
Ann Thorac Surg. Oct 2007;84(4):1338–1341.
Ning XH, Chen SH, Buroker NE, Xu CS, Li FR, Li SP,
Song DS, Ge M, Hyyti OM, Zhang M, Portman MA.
Short-cycle hypoxia in the intact heart: hypoxia-inducible
factor 1alpha signaling and the relationship to injury
threshold. Am J Physiol Heart Circ Physiol.
Jan 2007;292(1):H333–H341.
Pieters B, Johnston TA, Jones TK, Cohen G,
Jonmarker C. Resistant hypoxemia in an infant with
a right ventricle-to-pulmonary artery (Sano) shunt.
Salerno JC. Implantable defibrillator recall:
implications for children. Journal Watch: Pediatrics
and Adolescent Medicine. Oct 31 2007;6(12).
98
Salerno JC, Chun TU, Rutledge JC. Sinus bradycardia,
Wolff Parkinson White and left ventricular noncompaction: an embryologic connection? Pediatr Cardiol.
Epub Sep 1 2007.
Salerno JC, Johnston TA, Chun TU, Jones TK.
Coronary compression by an epicardial pacing lead
within the pericardium. J Cardiovasc Electrophysiol.
Jul 2007;18(7):786.
Schaefer BM, Lewin MB, Stout KK, Byers PH, Otto
CM. Usefulness of bicuspid aortic valve phenotype
to predict elastic properties of the ascending aorta.
Am J Cardiol. Mar 1 2007;99(5):686–690.
Shaddy RE, Boucek MM, Hsu DT, Boucek RJ, Canter
CE, Mahony L, Ross RD, Pahl E, Blume ED, Dodd DA,
Rosenthal DN, Burr J, LaSalle B, Holubkov R, Lukas
MA, Tani LY, 2007 Pediatric Carvedilol Study Group.
Carvedilol for children and adolescents with heart
failure: a randomized controlled trial. JAMA. Sep 12
2007;298(10):1171–1179.
Craniofacial Medicine
The Division of Craniofacial Medicine provides the highest
quality interdisciplinary care for patients with congenital
and acquired craniofacial conditions. Our faculty’s expertise
spans the fields of epidemiology, genetics, developmental
biology and clinical research. We provide outpatient and
inpatient care at Seattle Children’s Hospital and comprehensive consultations at both Children’s and the University
of Washington Medical Center.
Pediatric craniofacial medicine faculty coordinate care
through Children’s Craniofacial Center and several specialty
clinics. Currently we have a weekly team interdisciplinary
clinic that provides comprehensive multispecialty care for
children with malformations of the head and neck. In addition
to our team clinic, we provide smaller specialized interdisciplinary clinics focused on particular patient groups. These
clinics include the Plagiocephaly Clinic, which provides
the diagnosis and management of postnatal deformational
plagiocephaly; the Prenatal Clinic, which provides prenatal
assessment, education and counseling for mothers and
families after the prenatal diagnosis of a craniofacial
condition; the Craniofacial Genetics Clinic, which provides
diagnostic evaluations, education and counseling for
families affected by craniofacial conditions; and the 22q
clinic, which provides care coordination for children born
with 22q11.2 deletion (velocardiofacial/DiGeorge syndrome).
Faculty
Michael L. Cunningham, MD, PhD, Chief
Timothy C. Cox, PhD
Carrie L. Heike, MD, MS
Anne V. Hing, MD
Charlotte W. Lewis, MD, MPH
Wendy Mouradian, MD, MS
Jacqueline R. Starr, PhD, MS, MPH
Michael L. Cunningham
MD, PhD, Chief
These clinical programs provide long-term management of
craniofacial conditions, including family education.
The chief of the Division of Craniofacial Medicine also
directs the Center for Craniofacial Research, which supports
interdisciplinary research for the division. We pursue stateof-the-art basic science and clinical research to develop
improved diagnostic, preventive and health-care delivery
strategies while discovering new information on the pathogenesis of these conditions. Our long-term goal is to develop
an interdisciplinary research program that parallels our
clinical center and to become an international leader in
craniofacial-related science.
Michael L. Cunningham, MD, PhD, is chief of the Division
of Craniofacial Medicine at Seattle Children’s Hospital
and professor in the Department of Pediatrics at
Cunningham is medical director of Children’s Craniofacial Center and holds the Jean Renny Endowed Chair
in Craniofacial Medicine. He is also adjunct associate
Medicine and School of Dentistry in the Departments
of Biological Structure, Oral Biology and Pediatric
Dentistry. Cunningham balances responsibilities in
administration, patient care and research. He does
bedside teaching of medical students, dental students
and pediatrics residents. His clinical interests focus on
the diagnosis and long-term interdisciplinary care of
children with craniofacial malformations, with a particular interest in craniosynostosis. He is co-investigator
on several clinical research projects, ranging from the
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in-house genetic technologies and state-of-the-art 3-D
imaging capabilities to investigate mouse and chick
embryo models of cleft lip and palate.
Spotlight on team member — Cam Lanier, RD, CD
The breadth and depth of the Craniofacial Center’s interdisciplinary team has recently expanded with the addition of
pediatric dentistry and additional speech therapy, nursing,
clinical nutrition and surgery practitioners. I’m excited about
this growth because it helps us provide a higher quality of
holistic care to our current patients, while being better
staffed to serve new patients and their families.
epidemiology of positional plagiocephaly to the risk
factors for obstructive sleep apnea. Cunningham’s basic
molecular and developmental biology lab has been open
since 1993 and is using mouse and tissue culture models
to investigate the molecular causes of craniosynostosis
and developmental pathogenesis of midface hypoplasia
associated with syndromic craniosynostosis. In 2008
Cunningham will lead an NIH-funded project bringing
together investigators from Children’s and the University
of Washington to identify new molecular causes of
craniosynostosis.
Timothy C. Cox, PhD, is research associate professor
Washington School of Medicine. He is also an adjunct
faculty member in the Department of Oral Biology and
an affiliate member of the Center on Human Development and Disability. He obtained his PhD from the
University of Adelaide, Australia, and has held several
leading positions in craniofacial medicine in Australia,
including director of genetic programs at the Australian
Craniofacial Unit. His primary research interests focus
on the genetic and epigenetic factors that regulate
development of the craniofacial region and how perturbations in these factors contribute to the presentation
of craniofacial malformations, in particular, cleft lip
and palate. He has also had a long interest and involvement in both X-linked and mitochondrial diseases. His
research team employs existing and newly developed
100
Carrie L. Heike, MD, MS, is attending physician at Seattle
Washington School of Medicine. Heike completed
her clinical fellowship in the Craniofacial Center at
Children’s. Her research focuses on the genetic epidemiology of craniofacial conditions. Heike has a special
interest in working with families and children with
22q11.2 deletion syndrome. She is investigating the
genetic variation in children with this syndrome and
aims to understand whether this variation contributes
to the development of craniofacial anomalies in
22q11.2 deletion syndrome. She is also using 3-D
imaging combined with anthropometry to quantify
the craniofacial variation in children with and without
conditions that affect craniofacial structures.
Anne V. Hing, MD, is attending physician at Seattle
Children’s Hospital, assistant professor in the Department
Medicine and adjunct faculty member in the Division
of Medical Genetics. Hing’s clinical interests include
the diagnosis and management of infants, children and
adolescents with craniofacial and genetic conditions.
She works in the Craniofacial and Craniofacial Genetics
Clinic and the Limb Deficiency Clinic, and also serves
as a genetics consultant in seven different outreach
genetics clinics throughout the states of Washington
and Alaska. Hing coordinates the craniofacial resident
elective course and provides bedside teaching. She has
served as Children’s principal investigator in a multicenter international study of the genetics of cleft lip
and palate for the past seven years. She is also mapping
a rare autosomal recessive craniofacial disorder and is
a co-investigator in a study looking at potential causes
of hemifacial microsomia.
Charlotte W. Lewis, MD, MPH, is attending physician
at Seattle Children’s Hospital. Dr. Lewis is an associate professor in the Department of Pediatrics at the
University of Washington School of Medicine. She is
an adjunct associate professor in the Department of
Pediatric Dentistry. Her primary research interest is
improving the oral health of children with craniofacial
conditions and other special needs. She also does
research in disparities in health and health-care access,
with a specific focus on oral health and access to dental
care. Her research has involved documenting disparities
in access to oral health services for low-income and
special-needs children as well as developing and
evaluating strategies to improve children’s oral health.
RESEARCH FUNDING
Wendy Mouradian, MD, MS, is professor of pediatric
dentistry and pediatrics at the University of Washington,
with adjunct appointments in dental public health
sciences and health services at the School of Public
Health and Community Medicine. Mouradian is faculty
associate in the Department of Medical History and
Bioethics. She is director of Regional Initiatives in Dental
Education and was recently named associate dean for
Regional Affairs; she will oversee the implementation
of the school’s new distributed, community-based model
for education of dental students in eastern Washington.
Previously, she was director of the craniofacial program
at Seattle Children’s. She earned her MD from Columbia
University and her MS from the Massachusetts Institute
of Technology. She completed a fellowship in developmental pediatrics and a certificate in health-care ethics
at the University of Washington. Mouradian has played
a national role in calling attention to the importance
of children’s oral health and in addressing oral health
training needs for medical professionals. She received
several national awards for her role organizing and
chairing The Face of a Child: Surgeon General’s Conference on Children and Oral Health, and was recognized
by the American Dental Education Association for
her efforts to advance children’s oral health. She was
elected to the University of Washington chapter of the
dental honor society, Omicron Kappa Upsilon. Her
research areas include quality of life for children with
craniofacial conditions, ethics and policy related to
children’s oral health.
Caries prevalence in orofacial clefting: a pilot study for
an oral health case management RCT. NIH/NIDCR.
$148,867.
Jacqueline R. Starr, PhD, MS, MPH, is epidemiologist
at Seattle Children’s Hospital and research associate
professor of pediatrics and epidemiology at the
University of Washington School of Public Health
and Community Medicine. Starr works full-time in
Children’s Craniofacial Center. Her primary research
interests relate to identifying genetic variants that may
contribute to the occurrence of craniofacial anomalies,
with a particular focus on craniofacial microsomia. She
also collaborates on research projects that broadly target
the causes and outcomes of craniofacial anomalies.
New
Timothy C. Cox, PhD, and Michael L. Cunningham, MD, PhD
Acquisition of image analysis equipment. M.J.
Murdock Charitable Trust. $381,500.
Craniofacial microsomia: the vascular disruption
hypothesis. NIDCR/NIH/DHHS. $105,750.
Craniofacial microsomia and genetic variation in
homeostasis and vasculogenesis. NIDCR/NIH/DHHS.
$382,079.
Continuing
Craniofacial and genetic variation in 22q11.2 deletion
syndrome. NIDCR/NIH/DHHS. $125,925.
Timothy C. Cox, PhD
Regeneration of the fetal heart in a model of mitochondrial respiratory chain deficiency. Keystone Symposium
on Molecular Pathways in Cardiac Development and
Disease. Breckenridge, Colo. January 2007.
Genetic regulation of epithelial behavior and the
control of primary palatal morphogenesis. Hardheads
Seminar Series. University of Washington. Seattle,
Wash. March 2007.
The quest to quantify craniofacial variation. Computer
Science and Engineering Seminar Series. University of
Washington. Seattle, Wash. May 2007.
Embryology of the face and the developmental basis of
common facial malformations. Queensland Institute
of Medical Research. Brisbane, Queensland, Australia.
November 2007.
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Michael L. Cunningham, MD, PhD
Craniofacial defects: state-of-the-art diagnosis and
treatments. Washington State Chapter of the National
Association of Pediatric Nurse Practitioners. Shoreline,
Wash. March 2007.
Craniofacial conditions: practical points for pediatric
providers. 33rd Annual Day of Pediatrics Conference,
MultiCare Health System. Tacoma, Wash. September
2007.
Anatomy of cleft/craniofacial service — Seattle experience. Plagiocephaly — diagnosis and management.
Molecular pathogenesis of syndromic synostosis and
historical overview. Single suture craniosynostosis,
genetics and neurocognitive outcome. (Keynote
speaker.) Cleft and Cranio-Maxillofacial Anomalies:
combined meeting of the Australasian Cleft Lip and
Palate Association and the Biennial Paediatric Plastic
and Maxillofacial Surgery Meeting. Melbourne,
Australia. September 2007.
The medical and dental home working together. Putting
Medical Homes into Practice: Washington State Medical
Home Leadership Network. Seattle, Wash. May 2007.
Case-only studies. University of Washington Child
Health Institute. Seattle, Wash. March 2007.
Genetic association studies and application to
hemifacial microsomia. Slone Epidemiology Center,
Boston University. Boston, Mass. September 2007.
Boyadjiev SA, International Craniosynostosis
Consortium (Cunningham ML, contributing author).
Genetic analysis of non-syndromic craniosynostosis.
Orthod Craniofacial Res. Aug 2007;10(3):129–137.
Cunningham ML. Book review of Perspectives on the
Face. Pediatr Dev Pathol. 2007. Epub Mar 22 2007.
Cunningham ML. Is cleft lip and palate ever isolated?
Phenotype is in the eye of the beholder [invited review].
Arch Pediatr Adolesc Med. Aug 2007;161(8):811–812.
Cunningham ML, Heike CL. Evaluation of the infant
with an abnormal skull shape. Curr Opin Pediatr.
Dec 2007;19(6):645–651.
Cunningham ML, Seto ML, Ratisoontorn C, Heike CL,
Hing AV. Syndromic craniosynostosis: from history to
hydrogen bonds [invited review]. Orthod Craniofac Res.
May 2007;10(2):67–81.
Heike CL, Avellino AM, Mirza SK, Kifle K, Perkins J,
Sze R, Egbert M, Muzaffar A, Hing AV. Sleep disturbances in 22q11.2 deletion syndrome: a case with
obstructive and central sleep apnea. Cleft Palate
Craniofac J. May 2007;44(3):340–346.
Kapp-Simon KA, Speltz ML, Cunningham ML,
Patel PK, Tomita T. Neurodevelopment of children
with single suture craniosynostosis: a review. Childs
Nerv Syst. Mar 2007;23(3):269–281.
Lewis C, Johnston BD, Linsenmeyar K, Williams AC,
Mouradian W. Preventive dental care for children in
the United States: a national perspective. Pediatrics.
Mar 2007;119(3):e544–e553.
PUBLICATIONS
Anderson, PJ, Cox TC, Roscioli T, Elakis G, Smithers
L, David DJ, Powell B. Somatic FGFR and TWIST
mutations are not a common cause of isolated
non-syndromic single suture craniosynostosis.
J Craniofac Surg. Mar 2007;18(2):312–314.
Batra M, Heike CL, Phillips R, Weiss N. Geographic
and occupational risk factors for ventricular septal
defects: Washington State, 1987–2003. Arch Pediatr
Adolesc Med. Jan 2007;161(1):89–95.
102
Lewis C, Mouradian W, Slayton RL, Williams AC.
Dental insurance and its impact on preventive dental
care visits for U.S. children. J Am Dent Assoc. Mar
2007;138(3):369–380.
Massiah MA, Matts JAB, Short KM, Simmons BN,
Singireddy S, Zou Y, Cox TC. Solution structure of the
MID1 B box2 domain: insights into an evolutionary
conserved RING fold. J Mol Biol. May 2007;369(1):1–10.
Mouradian W. Ethics and leadership in children’s oral
health. Pediatr Dent. Jan–Feb 2007;29(1):64–72.
Mouradian W, Huebner C. Future directions in leadership training of MCH professionals: cross-cutting
MCH leadership competencies. Matern Child Health J.
May 2007;11(3):211–218.
Mouradian W, Huebner C, Ramos-Gomez F,
Slavkin H. Beyond access: the role of family and
community in children’s oral health. Jr Dent Educ.
May 2007;71(5):619–631.
Toth K, Collett B, Kapp-Simon KA, Cloonan YK,
Gaither R, Cradock MM, Buono L, Cunningham ML,
Dawson G, Starr JR, Speltz ML. Memory and response
inhibition in young children with single-suture
craniosynostosis. Child Neuropsych. 2007. Epub
Sep 26 2007.
Zhang H, Somerman MJ, Berg J, Cunningham ML,
Williams B. Dental anomalies in a child with
craniometaphyseal dysplasia: a case report.
Pediatr Dent. Sep–Oct 2007;29(5):415–419.
Ruiz-Correa S, Starr JR, Lin HT, Kapp-Simon KA,
Cunningham ML, Speltz ML. Severity of skull malformation is unrelated to pre-surgery neurobehavioral
status of infants with sagittal synostosis. Cleft Palate
Craniofac J. Sep 2007;44(5):548–554.
Sanchez-Lara PA, Graham JM, Hing AV, Lee J,
Cunningham ML. The morphogenesis of wormian
bones: a study of craniosynostosis and purposeful
cranial deformation. Am J Med Genet A. Dec
2007;143(24):3243–3251.
Seto ML, Hing AV, Chang J, Hu M, Kapp-Simon
KA, Patel PK, Burton BK, Kane A, Smyth MD,
Hopper R, Ellenbogen RG, Stevenson K, Speltz ML,
Cunningham ML. Isolated sagittal and coronal
craniosynostosis associated with TWIST box mutations.
Am J Med Genet A. Apr 2007;143(7):678–686.
Speltz ML, Kapp-Simon K, Collett B, Keich Y,
Gaither R, Cradock MM, Buono L, Cunningham ML.
Neurodevelopment of infants with single-suture
craniosynostosis: presurgery comparisons with
case-matched controls. Plast Reconstr Surg. May
2007;119(6):1874–1881.
Starr JR, Kapp-Simon KA, Cloonan YK, Collett BR,
Cradock MM, Buono L, Cunningham ML, Speltz
ML. Presurgical and postsurgical assessment of the
neurodevelopment of infants with single-suture
craniosynostosis: comparison with controls.
J Neurosurg. Aug 2007;107(2):103–110.
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Critical Care Medicine
The Division of Critical Care Medicine delivers comprehensive
state-of-the-art critical care medicine focused in three
clinical arenas: cardiac intensive care at Children’s Hospital,
medical-surgical intensive care at Children’s and trauma
intensive care at Harborview Medical Center. Children’s
Pediatric Intensive Care Unit (PICU) and Cardiac Intensive
Care Unit (CICU) represent an epicenter for a number of
high-profile Children’s programs, including the Heart Center,
Seattle Cancer Care Alliance, solid organ transplant, neurosurgery, craniofacial surgery, hematology-oncology, Airlift
Northwest and a range of extracorporeal life-support
technologies. With a “right care right now” attitude,
12 Critical Care Medicine faculty and seven fellows
oversee all care in Children’s ICUs.
Several crucial concepts first evolved within Children’s
ICUs, including family-centered care, formal qualityimprovement and patient-safety initiatives, computerized
physician order entry, severity-of-illness risk-adjusted
outcomes analysis and innovative infection-control programs.
Children’s ICUs received a design award from the Society
of Critical Care Medicine and the American Institute of
Architecture and serve as a family-friendly safe haven
for critically ill children in the WAMI region.
Jerry J. Zimmerman
MD, PhD, FCCM, Chief
104
Critical Care Medicine faculty are involved in clinical,
research, teaching and service activities within the
Department of Pediatrics, Children’s, Harborview Medical
Center and the University of Washington. Despite the very
high clinical intensity involved in intensive care training,
Critical Care Medicine fellows all participate in basic,
translational-clinical or outcomes research with an
expectation of an academic career following fellowship
training. The critical care medicine fellowship program
is an ACGME-accredited three-year program with seven
hospital-funded fellowship positions. Fellows divide their
clinical time between Children’s PICU and CICU and the
Harborview Medical Center Neurosurgical ICU. Fellows
take a lead role in directing the care of all infants and
children while providing supervision and education for
pediatric and anesthesia residents on rotation.
Major areas of research for faculty include patient
safety and continuous quality improvement, Lean process,
pulmonary ventilation-perfusion matching, innate immunity
in critical illness, cardiac mechanical assist support,
applied gene therapy acute lung injury and repair, critical
asthma therapy, in vivo intracellular oxygen transport and
consumption, endogenous and exogenous corticosteroids
in pediatric sepsis, computerized decision support tools,
disaster preparedness and long-term outcome measures
following pediatric critical illness. Children’s is a charter
performance site in the NIH/NICHD Collaborative Pediatric
Critical Care Research Network.
Current administrative projects include 24/7 attending
staff in-house coverage, rapid response team development,
extracorporeal life-support implementation during cardiopulmonary resuscitation, transport extracorporeal life
support, standardized sedation/analgesia protocol, NACHRI
bloodstream reduction initiative and PICU/CICU continuous
quality improvement implementing a Lean focus valuestream methodology.
Faculty
Professional Profiles
Jerry J. Zimmerman, MD, PhD, FCCM, Chief
Harris P. Baden, MD
Thomas V. Brogan, MD
Michael P. Davis, MD
David S. Jardine, MD
Howard E. Jeffries, MD, MPH, MBA
Robert Mazor, MD
John K. McGuire, MD
Joan S. Roberts, MD
Kenneth A. Schenkman, MD, PhD
Lincoln Smith, MD
Ofer Yanay, MD
Jerry J. Zimmerman, MD, PhD, FCCM, is chief of the
Division of Critical Care Medicine and director of the
Pediatric Intensive Care Unit at Seattle Children’s Hospital. He is professor of pediatrics and anesthesiology
Zimmerman has been chair of the Scientific Advisory
Committee for Children’s Clinical Research Center
since its inception. He is a member of the Society of
Critical Care Medicine and a charter member of the
American College of Critical Care Medicine. With
Dr. Bradley Fuhrman, Zimmerman is co-editor of the
textbook for the field, Pediatric Critical Care, now in its
third edition. Additionally, Zimmerman serves on the
editorial boards for Critical Care Medicine and Pediatric
Critical Care Medicine, and is book review editor for
both journals. He provides ad hoc review for a number
of other journals and has served on a number of NIH
review panels. Zimmerman is interested in the disequilibrium between the systemic inflammatory response
syndrome and compensatory anti-inflammatory
response syndrome that occurs as an important aspect
of pathophysiology in critical illness. He is intrigued by
the integrated role of neurological, endocrinologic and
inflammatory cross talk involved in the stress response
to critical illness. Zimmerman was chosen as a charter
principal investigator for the recently established
Collaborative Pediatric Critical Care Research Network.
Recently he has undergone Lean Leadership Training
in Seattle and Japan as a novel tool for directing continuous quality improvement within the PICU/CICU.
Harris P. Baden, MD, is director of the Cardiac Intensive
Care Program at Seattle Children’s Hospital and
associate professor of pediatrics and director of the
pediatric critical care medicine fellowship program at
completed his fellowship training in the Department
of Anesthesiology at Children’s. Baden serves on the
ICU Leadership Committee and the hospital Quality
Improvement Steering Committee and is medical
director of the Point of Care Testing Program for the
hospital. His clinical, teaching and research interests
relate to pediatric cardiac intensive care, quality
improvement, professionalism and medical education.
Thomas V. Brogan, MD, is an attending physician at
Seattle Children’s Hospital and Harborview Medical
Center and associate professor of pediatrics at the
completed a residency in pediatrics and a fellowship in
pediatric critical care medicine. Brogan has published a
number of peer-reviewed articles and several chapters
with an emphasis on respiratory physiology. He has
also published a number of articles related to pediatric
critical care, including studies on mechanical ventilation,
necrotizing fasciitis and ECMO. Brogan’s laboratorybased research centers on pulmonary blood flow, the
effects of carbon dioxide on changes in pulmonary
Spotlight on team member — Ruth Barker, RRT-NPS
I am impressed with the Pediatric Intensive Care Unit’s work
to prevent hospital-acquired infections. Clinicians are using
“bundles” for catheter insertion/maintenance and mechanical
ventilation. These approaches have been shown to decrease
the number of catheter-associated bloodstream infections and
ventilator-associated pneumonias for children on the unit.
We are also involved in the multi-institution CRISIS study,
using a novel approach to decrease hospital-acquired infections.
blood flow and the matching of ventilation to pulmonary
blood flow. He has been a collaborating researcher on
several research projects. He also serves as reviewer for
a number of medical journals. In addition to his research
he has served as director of PICU extracorporeal support
services at Children’s since 2001. He also serves as a
member of the Airlift Landing Review Committee.
Michael P. Davis, MD, is assistant professor of pediatrics
at Seattle Children’s Hospital and medical director of
the PICU at Harborview Medical Center. He completed
his residency at the University of Maryland and a
fellowship in critical care at Seattle Children’s. In
addition to providing clinical care, he serves on
multiple committees including the Blood Utilization
and Transplant committees at Children’s, and on the
Trauma Council, Pediatric Council and ICU Steering
Committee at Harborview. He has special interest in
education and is responsible for resident education in
the PICU; he is responsible for quality improvement
measures in the PICU at Harborview as well. Davis is
also a member of the Governor’s Emergency Medical
Services and Trauma Care Steering Committee Technical
Advisory Committee.
105
David S. Jardine, MD, attends in anesthesiology and
critical care at Seattle Children’s Hospital and pediatric
critical care at Harborview Medical Center, and he is
associate professor of anesthesiology and pediatrics at
completed residencies in pediatrics and anesthesiology,
and a fellowship in pediatric anesthesiology and
intensive care. He has published numerous chapters
and peer-reviewed articles, with an emphasis on
hemorrhagic shock and encephalopathy syndrome,
which is a special interest of his. His laboratory-based
research interests are in using heat shock proteins as
biomarkers and in examining the protective effect of
heat shock proteins during brain injury. He has been
principal investigator on a number of grants. He serves
as the Seattle associate PI for the Collaborative Pediatric
Critical Care Research Network. He has served as a
reviewer for a variety of medical journals. He serves
on the Institutional Review Board at Children’s and
on the research committee for the Department of
Anesthesiology. He is currently the president of the
SIDS Foundation of Washington, a position he has
filled for the last two years.
Howard E. Jeffries, MD, MPH, MBA, is attending physician
at Seattle Children’s Hospital and clinical associate
School of Medicine. He completed a residency in
pediatrics and a fellowship in pediatric intensive care.
Jeffries is the director of quality improvement for
critical care services. He has published chapters and
peer-reviewed articles, with an emphasis on cardiac
intensive care, informatics and quality improvement.
He sits on the advisory board for the Virtual PICU and
the Washington State Healthcare-Associated Infections
Advisory Committee, and has played an active role in
the development of a national cardiac ICU database.
Other interests include health-care finance, billing and
compliance issues. He is the vice-chair of the Children’s
University Medical Group (CUMG) Physician Education
and Compliance Committee, and is a member of the
University of Washington CUMG Retirement & Benefits
Committee, the Children’s Hospital Pharmacy &
Therapeutics Committee and the Children’s Infection
Control Committee.
106
Robert Mazor, MD, is attending physician in the cardiac
ICU at Seattle Children’s Hospital and assistant professor
of pediatrics at the University of Washington School
of Medicine. He completed a residency in pediatrics
and fellowships in pediatric critical care medicine and
pediatric cardiology. Mazor has an interest in congenital
heart disease and mechanical circulatory support. He
also has a special interest in education, serving as the
educational coordinator for fellow and resident cardiac
critical care electives. He has completed the University
of Washington’s teaching scholars program.
John K. McGuire, MD, is attending physician in the
PICUs at Seattle Children’s Hospital and Harborview
Medical Center and assistant professor of pediatrics
McGuire earned his MD from Northwestern University,
and trained in general pediatrics and pediatric critical
care medicine at Children’s Memorial Hospital and
Northwestern University in Chicago. He is board
certified in general pediatrics and pediatric critical
care medicine and is a member of several academic
societies including the American Thoracic Society and
the American Society for Matrix Biology. McGuire is
a member of the University of Washington Center
for Lung Biology. His laboratory work is directed at
understanding how matrix metalloproteinases (MMPs)
regulate epithelial repair and contribute to tissue
fibrosis and chronic organ dysfunction in the lung and
kidney. Related projects are focused on elucidating
the role of MMPs in viral and bacterial lung infections.
McGuire serves as a member of the Accreditation
Council for Graduate Medical Education Board of
Appeals Panel for Pediatrics and serves on the Lung,
Resuscitation and Respiration study section for the
American Heart Association.
Joan S. Roberts, MD, is attending physician in the PICUs
at Seattle Children’s Hospital and Harborview Medical
Center and assistant professor of pediatrics at the
University of Washington School of Medicine. Roberts
earned her MD at the University of Nevada. She did
her pediatrics residency at Children’s and served as
chief resident; she also completed her critical care
training at Children’s. Roberts has authored more than
two dozen scientific manuscripts and abstracts. She
has been a Children’s representative to the national
Pediatric Acute Lung Injury and Sepsis Investigators
(PALISI) Network. She is interested in clinical outcomes
research and in decreasing time needed for mechanical
ventilation in sick children with lung disease and
asthma. Roberts is director of the Children’s Hospital
Mock-Code Team and also chairs the Hospital Code
Blue Committee.
Kenneth A. Schenkman, MD, PhD, is attending physician
in the PICUs at Seattle Children’s Hospital and
Harborview Medical Center; he is associate professor
of pediatrics and anesthesiology and adjunct associate
professor of bioengineering at the University of
Washington School of Medicine. He is director of
critical care medicine research at Children’s. Schenkman
received his MD from Indiana University and completed a pediatrics residency at Children’s Hospital
of Pittsburgh, where he also served as chief resident.
He trained in pediatric critical care at Seattle Children’s
and received a PhD in bioengineering from the University
of Washington. He has an active research program
developing optical spectroscopic technologies for
clinical assessment of intracellular oxygenation and
mitochondrial function. Schenkman has been awarded
a U.S. patent and has filed three additional patent
applications in the last two years for his pioneering
work on developing an intracellular oxygen monitor.
Schenkman has published dozens of manuscripts and
abstracts in the field of optical spectroscopy for
physiologic and clinical applications and has published
several book chapters on pediatric critical care topics.
He also has been an active reviewer for journals in the
fields of medicine, physiology and engineering.
Lincoln Smith, MD, is attending physician at Seattle
and acting assistant professor of pediatrics at the
earned his MD at the University of Wisconsin–Madison,
and completed his pediatrics residency at Children’s
Hospital of Buffalo and his fellowship training at
Seattle Children’s. Smith oversees a research project
at the Pulmonary Research Laboratories at Veterans
Affairs Puget Sound Health Care System Hospital
in Seattle. His research focuses on the role of age in
ventilator-induced lung injury. He is investigating the
pulmonary and systemic responses of infant and adult
mice to the combination of innate immune stimulation
and mechanical ventilation.
Ofer Yanay, MD, is attending physician at Seattle
and assistant professor of pediatrics at the University
of Washington School of Medicine. He completed a
residency in pediatrics and a fellowship in pediatric
critical care. He has published chapters and peerreviewed articles with an emphasis on gene therapy.
His laboratory-based research centers on lentivirusbased vectors and on gene therapy-based treatment
for diabetes.
RESEARCH FUNDING
Continuing
John K. McGuire, MD
Matrilysin in lung epithelial cell migration.
NIH/National Heart, Lung, and Blood Institute.
$121,972.
Jerry J. Zimmerman, MD, PhD, FCCM
1st tier drugs ± theophylline in pediatric severe asthma
— parent and various protocols. NICHD/NIH/DHHS.
$368,171.
PUBLICATIONS
Baden HP, Jeffries HE, Cohen GA. Extracorporeal
membrane oxygenation in children. In: Yuh DD,
Vricella LA, Baumgartner WA, eds. The Johns Hopkins
Manual of Cardiothoracic Surgery. New York:
McGraw-Hill. 2007.
Brezezinski M, Yanay O, Waldron L, Barry SC,
Osborne WR. G-CSF-lentivirus administration in rats
provided sustained elevated neutrophil counts and
subsequent EPO-lentivirus administration increased
hematocrits. J Gene Med. Jul 2007;9(7):571–578.
Marciniak KE, Thomas IH, Brogan TV, Roberts JS,
Czaja A, Mazor SS. Massive ibuprofen overdose
requiring extracorporeal membrane oxygenation
for cardiovascular support. Pediatr Crit Care Med.
Mar 2007;8(2):180–182.
107
Emergency Medicine
The Division of Emergency Medicine provides 24-hours-perday, 365-days-per-year care for children from birth through
age 21. We provide specialized physician, nursing, social
services and environmental expertise in management of
urgent, emergency and critical medical and surgical issues.
Emergency Medicine is dedicated to providing premier
quality, up-to-date, consistent, safe and efficient pediatric
emergency care in a family-centered environment. Our
team’s focus on excellence and process improvement has
increased patient satisfaction, decreased length of stays
and improved other metrics of emergency medical-care
delivery. We opened an additional 7-bed acute emergency
treatment area in January 2007, which increased our
total beds to 25, with an additional 8 beds available during
evenings and weekends. This and a corresponding increase
Faculty
George A. Woodward
MD, MBA, Director
108
George A. Woodward, MD, MBA, Director
Julie C. Brown, MD, MHSc, MPH
Dena R. Brownstein, MD
Mark A. Del Beccaro, MD
Brianna K. Enriquez, MD
Ron L. Kaplan, MD
Eileen J. Klein, MD, MPH
Suzan S. Mazor, MD
Russell T. Migita, MD
Carolyn A. Paris, MD, MPH
Linda Quan, MD
Jennifer R. Reid, MD
Stephanie H. Richling, MD
Richard Shugerman, MD
Kimberly P. Stone, MD, MS
Paige Wright, MD, MS
in physician, nursing and administrative time have improved
our ability to respond to our patients and community and to
ensure optimal quality and efficiency.
Emergency Medicine treats approximately 32,000
patients per year, with half of all patients who are admitted
to Children’s initially cared for in the department. Over
120 residents from the University of Washington pediatrics
training program and multiple family medicine and emergency
medicine programs train in our division each year. We are
also invested in the education of medical, nursing and
paramedic students. The division sponsors an ACGMEapproved pediatric emergency medicine fellowship
program, currently with four fellows with a background
of pediatrics or emergency medicine.
Our 17 faculty physicians and 15 clinical pediatric
physicians provide care in the department and in Urgent
Care Centers. Dr. Jennifer Reid and Dr. Kimberly Stone
joined the division in 2007. We are involved in primary
and collaborative clinical research focusing on education,
sedation, respiratory illnesses, infectious diseases, injury
management, injury prevention, informatics, quality,
resuscitation and safety.
Our physicians are world leaders in the field of injury
prevention. We are among the first to begin to evaluate the
causes of and solutions to racial disparities in drowning
and other types of injury. Dr. Linda Quan is a national leader
in addressing the most common cause of drowning —
open-water drowning. We are spearheading an international
group to develop consensus-based recommendations for
prevention of this global-health issue.
George A. Woodward, MD, MBA, is director of the
Division of Emergency Medicine at Seattle Children’s
Hospital and professor in the Division of Pediatric
Emergency Medicine, Department of Pediatrics at the
director for Transport Medicine at Children’s. He
received his MD from Temple University Medical
School and his MBA from The Wharton School at
the University of Pennsylvania. He completed an
internship and residency at St. Christopher’s Hospital
for Children in Philadelphia and a fellowship at the
Pediatric Emergency Medicine Program at Children’s
Hospital of Philadelphia. He held faculty positions at
the University of Pennsylvania School of Medicine and
Primary Children’s Medical Center in Salt Lake City,
Emergency Medicine
Utah. Woodward is a member of the Children’s
University Medical Group board of directors. He has
been awarded the Norcliffe Foundation Endowed Chair
in Pediatric Emergency Medicine and has been elected
as member of the American Pediatric Society, a society
exclusively for pediatric research. Woodward’s specialty
and board certifications include being an ACLS provider
and an ATLS provider, and being certified as a Pediatric
Education for Prehospital Professionals (PEPP) provider
and instructor. He has held several editorial positions
and authored numerous publications.
Julie C. Brown, MD, MHSc, MPH, is emergency medicine
attending physician at Seattle Children’s Hospital and
assistant professor in the Department of Pediatrics
She received her MD from McGill University, Montreal;
an MHSc from the University of British Columbia,
Vancouver; and an MPH from the University of
Washington. She completed her residency and pediatric
emergency medicine fellowship at Children’s. She
is board certified in general pediatrics and pediatric
emergency medicine by the American Board of
Pediatrics. She is a member of the American Academy
of Pediatrics and the Ambulatory Pediatric Association.
She is also a member of the Scientific Advisory
Committee for the Pediatric CRC (Clinical Research
Center) funded by the NIH. She is principal investigator
for three separate research studies, is ATLS- and
ACLS-certified and is an instructor for PALS.
Dena R. Brownstein, MD, is attending physician at Seattle
School of Medicine. She is quality improvement coordinator in the Department of Medicine at Children’s. She
received her MD from the University of Washington,
completing her residency at Children’s and a fellowship
in pediatric emergency medicine at Children’s Hospital
of Philadelphia. She is board certified in general
pediatrics and pediatric emergency medicine by the
American Board of Pediatrics, and is diplomate of the
National Board of Medical Examiners. Brownstein is
coordinator of the University of Washington’s internship
for paramedic students and director of the paramedic
course. She is co-chair of the American Academy of
Pediatrics national Pediatric Education for Prehospital
Professionals (PEPP) Steering Committee and a
member of the American Academy of Pediatrics–
Emergency Medical Services for Children Subcommittee
Spotlight on team member — Jenni Zanatta, Charge RN
I work in the ED because of its atmosphere of change. I am
surrounded by “can-do” people who embrace change for the
good of patients and their families. Our growing patient
census presented us with the opportunity to change patient
flow and add care teams — an effort that has resulted in a
safer and more timely patient-family experience.
of Quality Indicators. Brownstein is a member of
regional and national organizations and is the recipient
of numerous awards, including the University of
Washington Outstanding Public Service Award.
Brownstein was co-investigator on research for the
Developmental Center for Education and Research
in Pediatric Safety from 2001 to 2004.
Mark A. Del Beccaro, MD, is attending physician at
Seattle Children’s Hospital and professor at the
served as associate director of the Division of Emergency
Medicine and is now pediatrician-in-chief and vice
chair for clinical affairs. Del Beccaro is also the chief
medical information officer and chairs the Medical
Informatics/Medical Records Committee and Children’s
University Physician Billing Education and Compliance
Committee. He received his MD from the University of
Washington and completed his residency and was chief
pediatrics resident at Children’s and the University of
Washington Medical Center. He completed a program
in medical management at the University of Washington.
Del Beccaro is board certified in general pediatrics and
pediatric emergency medicine by the American Board
of Pediatrics, and he is certified by the American Heart
Association in PALS. He is a member of many regional
and national associations. He is sought after nationally
as a speaker on the subject of medical informatics and
has an extensive bibliography.
109
Emergency Medicine
Douglas S. Diekema, MD, MPH, is director of education
for the Treuman Katz Center for Pediatric Bioethics
and attending physician in the Division of Emergency
Medicine at Seattle Children’s Hospital. He is professor in the Division of Bioethics in the Department of
Medicine, and adjunct professor in the Department
of Medical History and Ethics. He is also adjunct
professor in the Department of Health Services at the
University of Washington School of Public Health. He
received his MD from the University of North Carolina,
and an MPH in Health Services and Medical Ethics
from the University of Washington School of Public
Health. He has been a member of Children’s Ethics
Committee since 1991, has served as an ethics consultant since 1993 and is chairperson of the Institutional
Review Board. He serves as chair of the Committee on
Bioethics of the American Academy of Pediatrics and
is a member of the Ethics Committee of the American
Board of Pediatrics. He is consulting editor of AAP
Grand Rounds. Diekema is co-author of Christian
Faith, Health and Medical Practice and the author
of numerous scholarly publications in medical ethics
and pediatric emergency medicine.
Brianna K. Enriquez, MD, is attending physician at
Washington School of Medicine. She received her MD
from the University of California in San Francisco.
She completed her residency and fellowship at UCLA
Medical Center. Enriquez has received certification
from the American Board of Emergency Medicine and
is board certified in pediatric emergency medicine. She
has written several publications during her fellowship
and will continue looking for future writing opportunities
as she begins her faculty position at Children’s.
Ron L. Kaplan, MD, is emergency attending physician
at Seattle Children’s Hospital and clinical associate
Medicine. He earned his MD with highest honors
from the University of North Carolina School of Medicine. He completed his residency at the University of
North Carolina Hospitals and a fellowship in pediatric
emergency medicine at Children’s Hospital Boston. He
is board certified in general pediatrics and pediatric
emergency medicine by the American Board of Pediatrics.
His teaching responsibilities include education in
110
the emergency department and monthly didactic
sessions with Children’s housestaff. He is involved in
the research project Clinical Decision Rule for Identifying
Children with Cerebrospinal Fluid Pleocytosis at Very
Low Risk for Bacterial Meningitis.
Eileen J. Klein, MD, MPH, is attending physician at
Seattle Children’s Hospital and associate professor
Washington School of Medicine. She is director of the
pediatric emergency medicine fellowship at Children’s
and the University of Washington. She received her
MD from Johns Hopkins School of Medicine and her
MPH in epidemiology from the University of Washington
School of Public Health. She completed her residency
in pediatrics and a fellowship in pediatric emergency
medicine at Children’s and the University of Washington.
She is a fellow of the American Academy of Pediatrics
and a member of the Ambulatory Pediatric Association.
She is board certified in general pediatrics and pediatric
emergency medicine by the American Board of
Pediatrics. She is certified by the American Heart
Association in PALS. Klein trains pediatric emergency
medicine fellows and regularly teaches locally and
regionally. Her main research interest is analgesia and
sedation. She is currently studying sedation for minor
procedures in the emergency department. She has an
extensive bibliography.
Suzan S. Mazor, MD, is emergency attending physician
at Seattle Children’s Hospital and assistant professor at
is pediatric emergency medicine fellowship director
at Children’s. She received her MD from University of
Illinois at Chicago, Ill. She completed her residency
at Children’s Hospital Medical Center in Cincinnati,
Ohio; a fellowship in pediatric emergency medicine
at Children’s Memorial Hospital, Chicago, Ill.; and a
fellowship in medical toxicology at Toxikon Consortium,
John H. Stroger Hospital of Cook County, Chicago, Ill.
Mazor is associate medical director of the Washington
Poison Control Center in Seattle, Wash. She is a member
of the American College of Medical Toxicology, American
Board of Pediatrics, Ambulatory Pediatric Association
and the Section on Emergency Medicine of the American
Academy of Pediatrics. She is diplomate of the American
Board of Medical Toxicology, Pediatric Emergency
Medicine, American Board of Pediatrics and National
Board of Medical Examiners.
Emergency Medicine
Russell T. Migita, MD, is attending physician and clinical
director of emergency services at Seattle Children’s
Hospital and assistant professor in the Department
of Pediatrics at the University of Washington School
of Medicine. He earned his MD from the University of
California, San Diego School of Medicine. He completed
his internship, residency and fellowship at the University
of Washington. Migita has received certification from
the American Board of Pediatrics and is a certified
PALS provider and instructor and ATLS provider.
His special responsibilities include membership on
Children’s Emergency Department Continuous Process
Improvement Management Guidance Team and
the Emergency Department CME Course Planning
Committee. Migita received the University of
Washington Fellow Teaching Award in 2004.
Carolyn A. Paris, MD, MPH, is emergency attending
physician at Seattle Children’s Hospital and assistant
Medicine. She received her MD from Cornell University
Medical College and her MPH in epidemiology from
She completed a residency at Harbor-UCLA Medical
Center and a fellowship at Children’s. She is board
certified and licensed through the National Board of
Medical Examiners and the American Heart Association
in pediatrics. Paris is a member of the American
Academy of Pediatrics and the Ambulatory Pediatric
Association. Her local responsibilities include Children’s
Fellowship Committee, adverse events monitoring for
JDRF Study of Autoimmunity and the University of
Washington Faculty Senate. She is ad hoc reviewer for
the journals Acta Paediatrica, Pediatrics and Pediatric
Emergency Care. Paris also has an interest in research.
Her extensive bibliography includes her latest study,
SEARCH for Diabetes in Youth.
Linda Quan, MD, is emergency attending physician
School of Medicine. She received her MD from the
University of Washington, where she trained as an
intern, resident and fellow. She was chief of emergency
services at Children’s for more than two decades. Quan
is board certified by the American Board of Pediatrics
in emergency medicine. She has served on many
committees for the American Academy of Pediatrics,
American Heart Association, National Emergency
Medical Services for Children Data Analysis Resource
Center (NEDARC), Emergency Medical Services for
Children (EMS-C) and CDC Injury Prevention Centers.
She has spent a large part of her career on research,
spearheading a long list of biomedical research grants.
She has received numerous awards and has an extensive
bibliography. Quan has recently become a member of
the Advisory Council on First Aid, Aquatics, Safety and
Preparedness sponsored by the American Red Cross.
Jennifer R. Reid, MD, is attending physician at Seattle
of Medicine. She earned her MD from the University
of Washington School of Medicine. She completed her
residency at Children’s Hospital of Philadelphia and
her fellowship at Seattle Children’s. She is a current
member of the code blue response team at Children’s.
She has received certification from the American
Board of Emergency Medicine and is a certified
PALS provider and instructor.
Stephanie H. Richling, MD, is attending physician at
Seattle Children’s Hospital and has a dual assistant
professorship with the Department of Pediatrics and
the Emergency Medicine Section of the University of
Washington School of Medicine. She earned her MD
from Brown University Medical School. She completed
her residency and fellowship at Vanderbilt University
Medical School. Richling has received certification
from the American Board of Emergency Medicine
and is a certified PALS provider and instructor and an
ATLS provider. Richling is a member of the American
College of Emergency Physicians (ACEP), Pediatric
Emergency Medicine Section.
Richard Shugerman, MD, is emergency attending
physician at Seattle Children’s Hospital and professor
Washington School of Medicine. He is director of
the pediatrics residency program at the University of
Washington. He received his MD from the University
of Alabama School of Medicine in Birmingham and
completed an internship and a residency in pediatrics
at the University of Washington. Shugerman is board
certified in pediatrics by the American Board of
Pediatrics and certified by the American Heart
Association as a PALS provider. As director of pediatrics
residency his responsibility is leading the education
of 72 pediatrics residents; he leads and participates
directly in teaching committees for every service
111
Emergency Medicine
through which residents rotate in three local hospitals
and four regional practices. Shugerman is active on
several regional and national committees and has
published extensively.
Kimberly P. Stone, MD, MS, is emergency attending
physician at Seattle Children’s Hospital and assistant
Medicine. She received her MA from Tufts University,
her MS from the University of California in Berkeley
and her MD from the University of California in San
Francisco. She completed her residency at Boston
Combined Residency Program in Pediatrics at Children’s
Hospital Boston, where she began her fellowship. She
transferred at the end of fellowship to finish it at the
University of Washington School of Medicine. She is a
certified PALS provider and instructor. Stone is a member
of the American College of Emergency Physicians
(ACEP), Pediatric Emergency Medicine Section.
Paige Wright, MD, MS, is emergency attending physician
She received her MD from Indiana University School
of Medicine and her MS in clinical investigation from
Northwestern University. She completed a residency
and a fellowship at Children’s Memorial Hospital in
Chicago, Ill. She was clinical instructor in pediatrics at
Northwestern University School of Medicine. Wright
is diplomate of the American Board of Pediatrics, and
she is certified as an ATLS provider and PALS provider
and instructor. Wright is a member of the American
Academy of Pediatrics.
RESEARCH FUNDING
Continuing
Promoting pediatric bioethics in health care and
research. HRSA. $168,640.
Improving sedation of children undergoing procedures
in the emergency department: evaluation of different
dosages and routes of administration of the sedative
midazolam. Thrasher Research Fund. $130,637.
Dena R. Brownstein, MD
Using medical errors as learning opportunities
(workshop leader). Pediatric Academic Societies
Meeting. Toronto, Ontario, Canada. May 2007.
Mark A. Del Beccaro, MD
Using Lean to improve clinical practice (co-presenter).
CHCA Chief Medical Officers Meeting. Indianapolis,
Ind. September 2007.
How to build an informatics structure to maximize
quality (co-presenter). Improving EMRs by data
standardization: making sure EMRs work for children.
Cerner Health Care Conference. Kansas City, Mo.
October 2007.
AWARDS AND HONORS
Evaluation of pediatric clinical decision support
functionality with the Leapfrog CPOE flight simulator.
CHCA Leapfrog CPOE Web Conference. November
2007.
Linda Quan, MD
Stanley Stamm Role Model in Medicine Award.
University of Washington Pediatric Residency Program.
CCHIT — What does it do for you? HIMSS Pediatric
Health Informatics and Technology SIG Web Conference.
December 2007.
Enhancement technologies and children. Internal
Medicine Grand Rounds and Ethics Consultation.
Scott & White/Texas A&M Health Science Center
College of Medicine. Salado, Texas. Jan. 22, 2007.
112
Emergency Medicine
Ethical issues in pediatric emergency medicine.
Managing bites and stings in children. Washington
American College of Emergency Physicians Annual
Meeting. Vancouver, British Columbia, Canada.
April 17, 2007.
Pediatric research ethics consultation (workshop).
Pediatric Academic Societies Annual Meeting.
profoundly disabled children: a conversation about
the Children’s Hospital case (conference co-chair).
University of Washington Law School Conference.
Understanding differences in conflicts over medical
care (course planning committee and participant).
Third Annual Pediatric Bioethics Conference.
Seattle, Wash. June 14, 2007.
Quality craftsmanship: ethical dilemmas in health
care. Rural Hospital Association Summer Workshop.
Chelan, Wash. June 26, 2007.
Ethics consultation. Pediatric decision-making.
Summer Seminar in Bioethics. University of
Washington. Seattle, Wash. Aug. 6–10, 2007.
The Ashley controversy. The Ashley treatment: the
nature of the case. Ashley in 3 minutes and 30 seconds:
on the relationship of media and ethical issues. Severely
Disabled Children and the Limitations of Treatment.
Frankfurt, Germany. Aug. 31–Sept. 2, 2007.
Ashley revisited: is growth attenuation ever justified
in a profoundly disabled child? Ashley revisited (panel
participant). Disability and Rehabilitation Ethics Interest
Group. American Society of Bioethics and Humanities
Annual Meeting. Washington, D.C. Oct. 19, 2007.
Gifts, bribes or necessity: managing conflicts of
interest at the organizational and individual level.
Immunizations: issues facing pediatricians in 2008.
American Academy of Pediatrics National Conference.
San Francisco, Calif. Oct. 30, 2007.
The Ashley case revisited: reflections on health-care
decision-making for children. Sixth Annual Paul S.
Pierson Memorial Lecture in Bioethics, Medical
College of Wisconsin. Milwaukee, Wis. Nov. 8, 2007.
Eye emergencies. National Association of Pediatric
Nurse Practitioners National Conference. Shoreline,
Wash. March 2007.
Houston, we have a problem: a practical and principled
approach to error disclosure. Pediatric Academic
Societies. Toronto, Ontario, Canada. May 7, 2007.
Suzan S. Mazor, MD
Critical pediatric poison. Emergency Medicine Without
Borders, American College of Emergency Physicians
Spring Conference. Vancouver, British Columbia,
Canada. April 2007.
Russell T. Migita, MD
Common pediatric orthopedic problems. Pharmacotherapeutics for ARNPs. Pacific Lutheran University
School of Nursing Continuing Nursing Education.
Tacoma, Wash. January 2007.
Approach to the fussy infant. WAPA 18th Annual Winter
Recertification Review Course and Winter Conference.
SeaTac, Wash. January 2007.
Suture workshop. Pediatric Emergency Medicine for
Primary Care Practitioners. Seattle, Wash. March 2007.
Fever in the young child. Minor pediatric trauma. 12th
Annual Pediatric Emergency Care in Your Hospital.
Dominican Hospital. Santa Cruz, Calif. April 2007.
Pediatric neurological emergencies: weakness. Group
Health Cooperative Pediatric Day in the Office CME
Conference. SeaTac, Wash. May 2007.
Pediatric Journal Club plenary session. 35th Annual
Advances in Family Practice and Primary Care. Seattle,
113
Emergency Medicine
George A. Woodward, MD, MBA
Altered mental status. Prehospital management of the
critically ill child: developing and optimizing emergency
medical services. Trauma management and case
presentations. 5th Curso Emergencias Pediatricas.
Santiago, Chile. April 2007.
Pediatric safety initiative in emergency medicine.
Pediatric Patient Safety Expert Panel Meeting,
Joint Commission. Chicago, Ill. May 2007.
PUBLICATIONS
Bioethics (Diekema DS, chair), Fallat ME, Glover J.
Professionalism in pediatrics: statement of principles.
Pediatrics. Oct 2007;120(4):895–897.
Committee on Ethics (Diekema DS, primary author),
American College of Obstetrics & Gynecology. ACOG
committee opinion no. 362: medical futility. Obstet
Gynecol. Mar 2007;109(3):791–794.
Davis RL, Wright J, Chalmers F, Levenson L, Brown JC,
Lozano P, Christakis DA. A cluster randomized clinical
trial to improve prescribing patterns in ambulatory
pediatrics. PLoS Clin Trials. May 18 2007;2(5):e25.
Denno DM, Klein EJ, Young VB, Fox JG, Wang D,
Tarr PI. Explaining unexplained diarrhea and associating
risks and infections. Anim Health Res Rev. Jun
2007;8(1):69–80.
Diekema DS. The armchair ethicist: it’s all about
location. J Clin Ethics. Fall 2007;18(3):22–27.
Diekema DS. Ethical considerations. In: Woodward
GA, Insoft RM, Kleinman ME, eds. Guidelines for
Air and Ground Transport of Neonatal and Pediatric
Patients, Third Edition. Elk Grove Village, Ill.:
American Academy of Pediatrics. 2007.
Fallat ME, Glover J, American Academy of Pediatrics
Committee on Bioethics (Diekema DS, chair).
Professionalism in pediatrics. Pediatrics. Oct
2007;120(4):e1123–e1133.
114
Feldman K, Mazor SS. Ecstasy ingestion causing
heatstroke-like, multi-organ injury in a toddler.
Pediatr Emerg Care. Oct 2007;23(10):725–726.
Garbutt J, Brownstein DR, Klein EJ, Waterman A,
Krauss MJ, Marcuse EK, Hazel E, Dunagan WC, Fraser
V, Gallagher TH. Reporting and disclosing medical
errors: pediatricians’ attitudes and behaviors. Arch
Pediatr Adolesc Med. Feb 2007;161(2):179–185.
Gerstle RS, Lehmann CU, American Academy of
Pediatrics Council on Clinical Information Technology
(Del Beccaro MA, member). Electronic prescribing
systems in pediatrics: the rationale and functionality
requirements. Pediatrics. Jun 2007;119(6):e1413–e1422.
Gunther DF, Diekema DS. Disabling children with
disabilities [reply to three letters to the editor]. Arch
Pediatr Adolesc Med. Apr 2007;161(4):419–420.
Gunther DF, Diekema DS. Growth attenuation:
unjustifiable non-therapy [reply to letter to the editor].
Arch Pediatr Adolesc Med. May 2007;161(5):521–522.
Gunther DF, Diekema DS. Only half the story [reply
to letter to the editor]. Arch Pediatr Adolesc Med.
Jun 2007;161(6):616.
Marciniak K, Thomas I, Czaja C, Roberts J, Brogan T,
Mazor SS. Massive ibuprofen overdose requiring
extracorporeal membrane oxygenation for cardiovascular
support: a case report. Pediatr Crit Care Med. Mar
2007;8(2):180–182.
Metzger J, Welebob, E, Del Beccaro MA, Spurr C.
Taking the measure of inpatient EHRs. J AHIMA.
Jun 2007;78(6):24–30.
Migita RT, Feldman K. Visceral injury. In: Meadow R,
ed. ABC of Child Protection, Fourth Edition. London:
BMJ Publishing House. 2007.
Migita RT, Woodward GA. Ventriculoperitoneal and
other intracranial shunts. In: Baren JM, Rothrock SG,
Brennan JA, Brown L, eds. Pediatric Emergency
Medicine. Philadelphia, Pa.: Elsevier. 2007.
Emergency Medicine
Nigrovic N, Kuppermann N, Macias C, Cannavino C,
Moro-Sutherland D, Schremmer R, Schwab S, Agarwal
D, Mansour K, Bennett J, Katsogridakis Y, Mohseni M,
Bulloch B, Steele D, Kaplan RL, Herman M, Bandyopadyay S, Dayan P, Troung U, Wang V, Bonsu B,
Chapman J, Kannegaye J, Malley R, for the Pediatric
Emergency Medicine Collaborative Research Committee
of the AAP. Clinical prediction rule for identifying
children with cerebrospinal fluid pleocytosis at
very low risk of bacterial meningitis. JAMA. Jan 3
2007;297(1):52–60.
Opel D, Shugerman R, McPhillips H, Swanson WS,
Archibald S, Diekema DS. Professionalism and the
match: a pediatric residency program’s post-interview
no-call policy and its impact on applicants. Pediatrics.
Oct 2007;120(4):e826–e831.
Stone KP, Brownstein DR. Pediatric emergencies. In:
Elling B, Pollak AN, eds. Nancy Caroline’s Emergency
Care in the Streets, Sixth Edition. Sudbury, Mass.:
Jones and Bartlett Publishers. 2007.
Taylor JA, Brownstein DR, Klein EJ, Strandjord
TP. Evaluation of an anonymous system to report
medical errors in pediatric inpatients. J Hosp Med.
Jul 2007;2(4):226–233.
Woodward GA. Transport medicine. In: Zaoutis LB,
Chiang VW, eds. Comprehensive Pediatric Hospital
Medicine. Philadelphia, Pa.: Mosby/Elsevier. 2007.
Woodward GA, Insoft RM, Kleinman ME, eds. Guidelines for Air and Ground Transport of Neonatal and
Pediatric Patients, Third Edition. Elk Grove Village, Ill.:
American Academy of Pediatrics. 2007.
Quan L, Bennett E, Branche CM. Interventions to
prevent drowning. In: Doll LS, Bonzo SE, Sleet DA,
Mercy JA, eds.; Haas EN, managing ed. Handbook
of Injury and Violence Prevention. New York, N.Y.:
Springer. 2007.
Quan L, Feldman K. Drowning case studies. In:
Alexander R, Case M, eds. Child Fatality Reviews: An
Interdisciplinary Guide and Photographic Reference.
St. Louis, Mo.: G.W. Medical Publishing. 2007.
Richling, SH. Pediatric cardiology emergencies. In:
Roppolo LP, Davis D, Kelly S, Rosen P, eds. Emergency
Medicine Handbook: Critical Concepts for Clinical
Practice. Philadelphia, Pa.: Mosby/Elsevier. 2007.
Shephard E, Woodward GA. Book review of Disaster
Medicine. Ann Emerg Med. 2007;49:388.
Solari P, Woodward GA. Book review of Principles
of EMS Systems, Third Edition. Ann Emerg Med.
2007;49:723.
Spooner SA, American Academy of Pediatrics
Council on Clinical Information Technology
(Del Beccaro MA, member). Special requirements
of electronic health record systems in pediatrics.
Pediatrics. Mar 2007;119(3):631–637.
115
Endocrinology and Diabetes
The Division of Endocrinology and Diabetes provides
consultation and long-term management for children and
adolescents with diabetes and endocrine disorders in the
Faculty
Catherine Pihoker, MD, Chief
Angela Badaru, MBBS
Helén L. Dichek, MD
Patricia Fechner, MD
Daniel F. Gunther, MD, MA (in memory)
Gail E. Richards, MD
Christian Roth, MD
Srinath Sanda, MD
Catherine Pihoker
MD, Chief
WWAMI region. The division’s approach to patient care
blends clinical practice, research and education. A multidisciplinary team of dedicated physicians, midlevel providers,
certified diabetes nurse educators, dietitians and social
workers offers family-centered care in both inpatient and
outpatient settings. Endocrinologists work with primary care
providers and other subspecialists to manage endocrine
disorders in children with complex health-care needs.
Collaborative research efforts are under way in pediatric
diabetes, disorders of gonadal function and endocrine
function in childhood cancer survivors. New faculty are
bringing additional research projects in puberty, gonadal
function and childhood obesity.
Since 2005, the division has had an ACGME-accredited
subspecialty residency program, enhancing teaching efforts
and recruitment potential for pediatric endocrine providers.
Catherine Pihoker, MD, is chief of the Division of
Endocrinology and Diabetes and attending physician
School of Medicine. Her clinical focus is inpatient and
outpatient attending for endocrinology and diabetes.
Her main research interests include investigating
factors that predict the clinical course of diabetes,
diabetes typology and improving outcomes of children
with diabetes. Pihoker is also interested in the impact
on children of being overweight and living sedentary
lifestyles, and she is involved in proposals studying the
quality of life and metabolic measures in the general
population as well as in cancer survivors. Other research
interests include endocrine dysfunction in childhood
cancer survivors and hypothalamic-pituitary function
in children with tumors in the pituitary region. The
studies Pihoker has been involved with include the
SEARCH for Diabetes in Youth, TrialNet and the
Type I Diabetes Genetics Consortium. Her teaching
activities include didactic and direct teaching of resident
physicians, medical students and support staff.
Angela Badaru, MBBS, is attending physician at Seattle
Washington School of Medicine. Her clinical focus is
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inpatient and outpatient attending for endocrinology
and diabetes. She participates in didactic and direct
teaching of resident physicians and medical students.
Her research interests include disorders of puberty
and growth. She is a member of the Royal College
of Physicians, U.K.
Helén L. Dichek, MD, is attending physician at Seattle
Medical Center; she is associate professor in the Division of Endocrinology in the Department of Pediatrics
She is a board-certified endocrinologist, with unique
expertise in pediatric lipid disorders. Dichek directs
the only regional Pediatric Lipid Clinic in the WWAMI
area, which meets at Children’s and at the University of
Washington Medical Specialties Lipid/Nutrition Clinic.
Dichek’s laboratory investigations focus on genetic
modifiers of atherosclerosis and lipid metabolism.
Her laboratory has recently extended its research focus
to include development of animal models of obesity
and fatty liver.
Patricia Fechner, MD, is attending physician at Seattle
School of Medicine. She is director of the endocrine
fellowship program at Children’s. Her clinical and
research interests include Turner syndrome, androgen
insensitivity syndrome and other disorders of sex
determination as well as growth hormone and IGF-1
deficiency. She is associate editor of Sexual Development.
Daniel F. Gunther, MD, MA, passed away in September
2007. He was attending physician at Seattle Children’s
Medicine. His primary clinical and research interests
were Turner syndrome, disorders of growth and puberty
and intersex disorders. In addition to seeing general
endocrine and diabetes patients at Children’s, Gunther
attended regional clinics in Federal Way and Yakima,
Wash. He served on the Scientific Advisory Board to
the CARES foundation, a national education and
support group for individuals with congenital adrenal
hyperplasia. He was involved in research studying
long-term effects of growth hormone treatment in girls
with Turner syndrome, and was principal investigator
in a study following individuals with Turner syndrome
who were diagnosed prenatally.
Spotlight on team member — Deann Atkins, RN, CDE
I am most excited about our nurses using a group format
to start patients on insulin pumps in place of three-hour
individual appointments. Now, patients and families get
into the clinic more quickly, and, once they’re here, they find
support and connection with others who are also starting
on a new path toward greater freedom and flexibility.
Gail E. Richards, MD, is attending physician at Seattle
Children’s regional clinics in Everett and Federal
Way, Wash., and at the community outreach clinic in
Wenatchee, Wash. She is professor of pediatrics at the
University of Washington School of Medicine. Richards
is also affiliated with Seattle Children’s Research Institute
Department of Translational and Clinical Science.
Christian Roth, MD, is attending physician at Seattle
School of Medicine. He was examiner for medical
doctors in specialty pediatric endocrinology and
diabetology at the Medical Board North-Rhine,
Germany. His work focuses on childhood obesity and
disorders of puberty. His obesity research includes
metabolic factors in body weight regulation and
hypothalamic control of feeding circuits, genes involved
in childhood obesity and postcraniopharyngioma
obesity. In the field of puberty, he investigates genetic
disorders of precocious or delayed puberty, the gene
network expressed in the hypothalamus controlling
the onset of puberty and the treatment of precocious
puberty by antagonistic versus agonistic LHRHanalogues. Roth is a board member of the German
Study Group of Pediatric Endocrinology (APE).
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Srinath Sanda, MD, is attending physician at Seattle
Children’s Hospital and clinical assistant professor
Washington School of Medicine. In addition, he is
an assistant member and clinical investigator at the
Benaroya Research Institute at Virginia Mason. His
clinical focus is on general pediatric endocrinology and
type I diabetes, and he is active in teaching medical
students and residents. His primary research interest
is understanding the immune system’s role in glucose
metabolism in patients with type I diabetes. He also
manages patients enrolled in clinical intervention trials
for type I diabetes at the Benaroya Research Institute.
Research Funding
New
Increlex growth forum database-IGFD registry:
a patient registry for monitoring long-term safety
and efficacy of Increlex. Tercica. $9,000.
Deficiency among children and adolescents with
traditional short stature diagnosis. Tercica. $13,000.
Gail E. Richards, MD
Recombinant human insulin-like growth factor-1
(rhlGF-1) treatment of children and adolescents with
growth failure associated with primary IGF-1 deficiency:
an open label multicenter extension study. Tercica.
$52,668.
Christian Roth, MD
Purchase of Luminex multiplex system. 2007 Seattle
Foundation Medical Funds Program. $50,000.
Cerebral edema in pediatric diabetic ketoacidosis. NIH.
Quality of life of overweight youth: a multicultural
view. NIDDK. $8,265.
Type I diabetes genetics consortium. NIDDK.
TrialNet clinical agreement, site #307. NIDDK.
Disorders of sexual development. Turner syndrome.
Short stature. Update on type I diabetes (WWAMI
visiting professor). Pocatello, Idaho. April 23–24, 2007.
Delayed puberty (WWAMI visiting professor).
Boise, Idaho. April 25, 2007.
Turner syndrome (TS) associated with idiopathic
thrombocytopenic turpura: a patient report and review
of autoimmunity in TS (co-presenter). The Endocrine
Society’s 89th Annual Meeting. Toronto, Ontario,
Canada. June 2–5, 2007.
Update on Turner syndrome. Endocrine Days.
University of Washington. Seattle, Wash. Oct. 12, 2007.
Catherine Pihoker, MD
Pediatric diabetes update. Washington Chapter of
the American Academy of Pediatrics. Seattle, Wash.
July 14–15, 2007.
Pediatric diabetes. GCRC Third Annual Symposium:
The Obesity Epidemic and Diabetes Mellitus in Children.
Seattle, Wash. September 2007.
Continuing
Effect of early growth hormone treatment on long-term
growth and skeletal maturation in girls with Turner
syndrome. Eli Lilly and Company. $487,812.
Catherine Pihoker, MD
JDRF Center for Translational Research. Juvenile
Diabetes Foundation International. $154,775.
SEARCH for Diabetes in Youth 2: Washington site.
CDC/DHHS. $645,000.
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Christian Roth, MD
Effect of dramatic weight loss on peptide YY and
glucagon-like peptide-1 serum levels in morbidly obese
patients (co-presenter). ADA Meeting. Boston, Mass.
June 2007.
Peripheral monkey α-MSH levels are altered in
different energy states and are regulated by glucose
(co-presenter). The Endocrine Society’s 89th Annual
Meeting. Toronto, Ontario, Canada. June 2–5, 2007.
Adipocyte fatty acid-binding protein (A-FABP) in obese
children before and after weight loss (co-presenter). 45th
Annual Meeting of the European Society for Paediatric
Endocrinology. Helsinki, Finland. June 30, 2007.
Eacker SE, Agrawal N, Qian K, Dichek HL, Gong EY,
Lee K, Braun RE. Hormonal regulation of testicular
steroid and cholesterol homeostasis. Mol Endocrinol.
Epub Nov 21, 2007.
Hypothalamic obesity (co-presenter). Annual meeting
of the German Study Group of Pediatric Endocrinology
(APE). Mainz, Germany. November 2007.
Gilliam LK, Liese AD, Bloch CA, Davis C, Snively BM,
Curb D, Williams DE, Pihoker C. Family history of
diabetes, autoimmunity and risk factors for cardiovascular disease among children with diabetes in the
SEARCH for Diabetes in Youth study. Pediatr Diabetes.
Dec 2007;8(6):354–361.
PUBLICATIONS
Albers JJ, Marcovina SM, Imperatore G, Snively BM,
Stafford J, Fujimoto WY, Mayer-Davis EJ, Petitti DB,
Pihoker C, Dolan L, Dabelea DM. Prevalence and
determinants of elevated apolipoprotein B and dense
low-density lipoprotein in youths with type I and type
II diabetes. J Clin Endocrinol Metab. Epub Dec 18 2007.
Bondy CA, Gunther DF, for the Turner Syndrome
Consensus Group. Care of girls and women with Turner
syndrome: a guideline of the Turner Syndrome Study
Group. J Clin Endocrinol Metab. Jan 2007;92(1):10–25.
Buderus S, Hübner A, Utsch B, Lentze M, Roth C.
Dysphagia due to triple A syndrome: successful
treatment of achalasia by balloon dilatation. Exp
Clin Endocrinol Diabetes. Sep 2007;115(8):533–536.
Chow EJ, Pihoker C, Hunt K, Wilkinson K, Friedman
DL. Obesity and hypertension among children after
treatment for acute lymphoblastic leukemia. Cancer.
Nov 2007;110(10):2313–2320.
Davenport ML, Crowe BJ, Travers SH, Rubin K,
Ross JL, Fechner P, Gunther DF, Liu C, Geffner
ME, Thrailkill K, Huseman C, Zagar AJ, Quigley CA.
Growth hormone treatment of early growth failure
in toddlers with Turner syndrome: a randomized,
controlled, multicenter trial. J Clin Endocrinol Metab.
Sep 2007:92(9):3406–3416.
Dost A, Herbst A, Kintzel K, Haberland H, Roth C,
Gortner L, Holl RW. Shorter remission period in young
versus older children with diabetes mellitus type I.
Exp Clin Endocrinol Diabetes. Jan 2007;115(1):33–37.
Heger S, Mastronardi C, Dissen GA, Lomniczi A,
Cabrera R, Roth C, Jung H, Galimi F, Sippell W,
Ojeda SR. EAP1, a new transcriptional regulator of
the mammalian neuroendocrine reproductive axis.
J Clin Invest. Aug 2007;117(8):2145–2154.
Neely EK, Fechner P, Rosenfeld R. Turner Syndrome.
In: Lifshitz F, ed. Pediatric Endocrinology. New York,
N.Y.: Informa Healthcare. 2007.
ME, Opheim KE, Pihoker C, Richards GE, Soules
MR, Pagon RA. A gender assessment team: experience
Jun 2007;9(6):348–357.
Petitti DB, Imperatore G, Palla SL, Daniels SR, Dolan
LM, Kershnar AK, Marcovina S, Pettitt DJ, Pihoker C.
Serum lipids and glucose control: the SEARCH for
Diabetes in Youth study. Arch Pediatr Adolesc Med.
Feb 2007:161(2):159–165.
Qian K, Agrawal N, Dichek HL. Reduced atherosclerosis
in chow-fed mice expressing high levels of a catalytically
inactive human hepatic lipase. Atherosclerosis. Nov
2007;195(1):66–74.
Reinehr T, de Sousa G, Niklowitz P, Roth C.
Amylin and its relation to insulin and lipids in obese
children before and after weight loss. Obesity. Aug
2007;15(8):2006–2011.
Reinehr T, de Sousa G, Roth C. Fasting glucagon-like
peptide-1 and its relation to insulin in obese children
before and after weight loss. J Pediatr Gastroenterol
Nutr. May 2007;44(5):608–612.
119
Reinehr T, Roth C, Andler W. 43rd Workshop for
Paediatric Research: Adipocytokines and GI-hormones
before and after weight loss in obese children. Eur J
Pediatr. Mar 2007;166(3):274.
Reinehr T, Roth C, Schernthaner GH, Kopp HP,
Kriwanek S, Schernthaner G. Peptide YY and
glucagon-like peptide-1 in extremely obese patients
before and after weight loss. Obes Surg. Dec
2007;17(12):1571–1577.
Reinehr T, Stoffel-Wagner B, Roth C. Adipocyte
fatty acid-binding protein (A-FABP) in obese children
before and after weight loss. Metabolism. Dec
2007;56(12):1735–1741.
Rewers M, Pihoker C, Donaghue K, Hanas R, Swift P,
Klingensmith GJ. International Society for Pediatric
and Adolescent Diabetes (ISPAD). Assessment and
monitoring of glycemic control in children and
adolescents with diabetes. Pediatr Diabetes. Dec
2007;8(6):408–418.
Roth C, Hunneman DH, Gebhardt U, Stoffel-Wagner B,
Reinehr T, Muller HL. Reduced sympathetic metabolites
in urine of obese patients with craniopharyngioma.
Pediatr Res. 2007;61(4):496–501.
Roth C, Mastronardi C, Lomniczi A, Wright H,
Cabrera R, Mungenast AE, Heger S, Jung H, Dubay
C, Ojeda SR. Expression of a tumor-related gene
network increases in the mammalian hypothalamus
at the time of female puberty. Endocrinology. Nov
2007;148(11):5147–5161.
120
Roth C, Reinehr T. Adipocyte fatty acid-binding
protein (A-FABP) in obese children before and after
weight loss. Horm Res. July 2007;68(Suppl 1):131.
Sanda S, Newfield RS. A child with pericardial
effusion and cardiac tamponade due to previously
unrecognized hypothyroidism. J Natl Med Assoc.
Dec 2007;99(12):1411–1413.
Tontisirin N, Muangman SL, Suz P, Pihoker C, Fisk D,
Moore A, Lam AM, Vavilala M. Early childhood gender
differences in anterior and posterior cerebral blood
flow velocity and autoregulation. Pediatrics. Mar
2007;119(3):e610–e615.
Von Herrath M, Sanda S, Herold K. Type I diabetes
as a relapsing-remitting disease? [review]. Nat Rev
Immunol. Dec 2007;7(12):988–994.
Woelfle JF, Harz K, Roth C. Modulation of circulating
IGF-1 and IGFBP-3 levels by hormonal regulators
of energy homeostasis in obese children. Exp Clin
Endocrinol Diabetes. Jan 2007;115(1):17–23.
Gastroenterology,
Hepatology and Nutrition
The Division of Gastroenterology, Hepatology and Nutrition
provides expertise in consultative gastroenterology for a
broad range of gastrointestinal, liver and nutritional diseases.
Our division provides comprehensive care for a number
of children with complex gastrointestinal illnesses. The
division is particularly skilled in the care of patients with
intestinal failure, inflammatory bowel disease and acute
and chronic liver disease. We have the region’s only small
bowel transplant program, as well as intestinal care and
inflammatory bowel disease programs. We also provide
ongoing consultation and treatment for patients with
chronic recurrent abdominal pain, gastroesophageal
reflux and malabsorptive syndromes.
Technological advances in pediatric gastroenterology
have enabled us to apply diagnostic and therapeutic
endeavors to the upper intestinal digestive tract and colon.
Use of capsule endoscopy has enhanced our ability to
care for children with unusual small intestinal diseases.
Esophageal motility and anorectal manometry are available
to study selected patients. We work in close consultation
with our colleagues in general surgery, radiology and
pathology in the diagnosis and therapy of patients with
gastrointestinal disease. Our emphasis on a team approach
from a diagnostic and therapeutic perspective has enhanced
our quality of care and provided our patients the most
advanced expertise available in the WAMI region
(Washington, Alaska, Montana, Idaho).
Faculty
Dennis L. Christie, MD, Chief
Simon Horslen, MBChB
Mary K. Len, MD
Karen F. Murray, MD
David Suskind, MD
Ghassan Wahbeh, MD
Jiang Zheng, PhD
Dennis L. Christie
MD, Chief
The division has a long history of contributions to basic
science and clinical research, and continues to be a leader
in clinical and basic research in gastroenterology. Some
of the division’s research investigations include treatment
of hepatitis B, hepatitis C and acute liver failure; use of
mesalamine in pediatric inflammatory bowel disease;
maternal microchimerism in inflammatory bowel disease;
and a controlled trial of managing recurrent abdominal
pain. The division also participates in the western regional
pediatric inflammatory bowel disease registry.
Dennis L. Christie, MD, is chief of the Division of
Gastroenterology, Hepatology and Nutrition at Seattle
Children’s Hospital and professor of pediatrics at the
board certified in pediatric gastroenterology. Christie
was instrumental in establishing the specialty of
pediatric gastroenterology in the Pacific Northwest.
He collaborated in the establishment of the safety,
efficacy and practicality of using flexible fiber-optic
endoscopy in the diagnosis and therapy of children
with gastrointestinal diseases. Two of his early
publications demonstrated the association between
gastroesophageal reflux and recurrent respiratory
disease. His research interests relate to inflammation
in the intestine. He is actively involved with the
Inflammatory Bowel Disease Treatment Center and
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Gastroenterology, Hepatology and Nutrition
Committee and member of the Nominating Committee
for the International Pediatric Transplant Association.
He is the incoming chairman of the UNOS Pediatric
Transplant Committee.
Spotlight on team memberS —
Jean McGinnis, ARNP
Nancy Nelson, ARNP
We are currently standardizing our gastroenterology-related
patient education material so that our patients and families
consistently get the best available information at all sites
of care. We are also changing our follow-up process for
patients who have had endoscopic tests and procedures to
deliver quicker diagnostic results and begin the appropriate
treatment regimen faster and more efficiently.
the Autism Treatment Network. He serves as vice
chairman of clinical affairs for the University of
Washington Department of Pediatrics and is a member
of the Children’s University Medical Group (CUMG)
Advisory Board. He is past president of the pediatric
committee for the American College of Gastroenterology,
is an active member of the North American Society for
Pediatric Gastroenterology and belongs to the American
Gastroenterological Association.
Simon Horslen, MBChB, is medical director for liver and
intestine transplant at Seattle Children’s Hospital and
School of Medicine. He is helping lead the expansion
of Children’s transplant program. Horslen earned his
medical degree from the University of Bristol, England.
He is a founding member and fellow of the Royal
College of Paediatrics and Child Health, is a member
of the Royal College of Physicians and is accredited
in general pediatrics and pediatric gastroenterology.
He was medical director of the pediatric transplant
program at the University of Nebraska Medical Center.
His clinical and research interests include metabolic
liver disease, intestinal failure and liver and intestine
transplant. Horslen serves as chair of the Education
122
Mary K. Len, MD, is attending physician at Seattle
She was trained in pediatric gastroenterology at the
University of California-Los Angeles School of Medicine
and is board certified in pediatric gastroenterology.
Len has been a member of the outreach pediatric
gastroenterology division, attending clinics in Olympia
and Federal Way, Wash., and is a member of the North
American Society for Pediatric Gastroenterology,
Hepatology and Nutrition. Her research interests
include celiac sprue and inflammatory bowel disease.
Karen F. Murray, MD, is director of the Hepatobiliary
Program at Seattle Children’s Hospital and program
director of gastroenterology education; she is professor
Washington School of Medicine. She received her
MD from Johns Hopkins School of Medicine and
did a pediatrics residency and a chief resident year
at Children’s. She completed a clinical and research
fellowship in gastroenterology and nutrition in the
combined program at Children’s Hospital Boston and
Massachusetts General Hospital, Harvard Medical
School. Murray has done research and work in
Bangladesh and Tanzania. In addition to clinical care
in gastroenterology and transplantation, she has an
active clinical research program in hepatology. Her
main focus is in the treatment and pathophysiology
of hepatitis C viral infection, but her studies also
include the treatment of hepatitis B viral infection and
nonalcoholic fatty liver disease. Murray is president
of Children’s medical staff. She is a member of the
Gastroenterology Sub-board Credentialing Committee
and the Transplant Hepatology Certificate of Added
Qualifications Standard-Setting Committee of the
American Board of Pediatrics, and is on the steering
committees of three National Institute of Diabetes and
Digestive and Kidney Diseases clinical research networks
related to her research. She mentors pediatrics residents
and speaks at the noon conferences at Children’s.
David Suskind, MD, is attending physician at Seattle
An expert in intestinal diseases, Suskind has focused
much of his energies into clinical care and research for
inflammatory bowel disease. He has been co-chair of
the Nutrition Committee at Children’s since 2004,
focusing his attention on both enteral and parenteral
nutritional needs of children and pediatric patients at
Children’s. He is also director of quality assurance and
quality improvement in the Division of Gastroenterology
at Children’s. He was also named to the medical staff
honor roll at Children’s. Suskind earned his medical
degree at Louisiana State Medical in New Orleans, La.
He currently conducts research in inflammatory bowel
disease with research projects in maternal microchimerism in inflammatory bowel disease as well as in the
effects of herbal medication in inflammatory bowel
disease. On a national level, Suskind has been involved
in the Nutrition Committee for the North American
Society for Pediatric Gastroenterology, Hepatology and
Nutrition. Suskind’s philosophy in health care centers
on patient and family empowerment through education.
Ghassan Wahbeh, MD, is attending physician at Seattle
and gastroenterology at the University of Washington
School of Medicine. He is the director of the Inflammatory Bowel Disease Program. His clinical and research
interests include early diagnostic tools in pediatric
IBD, causes of Crohn disease and ulcerative colitis,
advanced therapies for Crohn disease, advanced
imaging with magnetic resonance enterography in
complicated IBD, quality-of-life assessment in children
in the first year after diagnosis and children’s perception
of their disease expressed in artwork. He also has
clinical interests in upper gastrointestinal inflammatory
conditions in children, capsule endoscopy use in small
bowel imaging, gastrointestinal complications following
cardiac transplantation and interventional endoscopy.
Jiang Zheng, PhD, is principal investigator at Seattle
Children’s Hospital Research Institute and associate
Medicine. Zheng is a faculty member of the Center
for Developmental Therapeutics at the institute. He
received his PhD at the University of Kansas and
postdoctoral training at the University of CaliforniaDavis, where he was trained in medicinal chemistry
and toxicology. His research interests include: investigation of the biochemical reactions of electrophilic
metabolites of xenobiotics with biomacromolecules,
and the toxicological consequence of the chemical
reactions; and development of biomarkers as a measure
to confirm and assess the exposure of individuals or
populations to dietary, environmental or occupational
chemical substances, providing a link between external
exposures and internal dosimetry.
RESEARCH FUNDING
Continuing
Karen F. Murray, MD
Pegylated interferon +/- ribavirin for children with
HCV. NIDDK/NIH/DHHS. $53,397.
Dennis L. Christie, MD
Wenatchee Outreach, GERD (visiting professor
and outreach clinic). Central Washington Hospital.
Wenatchee, Wash. June 8, 2007.
Simon Horslen, MBChB
Liver and intestine transplantation (speaker and
workshop director). UNOS Pediatric Summit on
Pediatric Organ Donation and Transplantation.
San Antonio, Texas. March 2007.
Acute immunologic events in organ transplantation.
Chronic allograft dysfunction. (Course organizer,
postgraduate courses.) 4th Congress of the International Pediatric Transplant Association. Cancun,
Mexico. March 17–21, 2007.
Infantile liver disease. Short bowel syndrome.
(WWAMI visiting professor.) Great Falls, Mont.
April 23–24, 2007.
The argument for induction immunosuppression.
Studies of Pediatric Liver Transplantation Annual
Meeting. Nashville, Tenn. October 2007.
123
Challenges of clinical diagnosis for the patients
presenting with liver disease: liver transplantation
outcome. Wilson’s Disease Association Regional
Meeting. Chicago, Ill. Nov. 11, 2007.
Karen F. Murray, MD
Career in academic medicine: striking a balance
(faculty leader and speaker). NASPGHAN Academic
Skills Workshop for Junior Faculty in Pediatric
Gastroenterology. New Orleans, La. January 2007.
Pediatric gastroesophageal reflux: between myth and
fact. Update in Practical Pediatrics. Kirkland, Wash.
September 2007.
Jiang Zheng, PhD
Metabolism and bioactivation of styrene. 5th
International Symposium on Pharmaceutical
Chemistry. Istanbul, Turkey. September 2007.
PUBLICATIONS
The art of mentoring (faculty organizer and leader).
NASPGHAN Annual Meeting. Salt Lake City, Utah.
Oct. 25, 2007.
Fibrocystic conditions in the liver (chairperson).
AASLD/NASPGHAN Pediatric Symposium.
Boston, Mass. Nov. 2, 2007.
NASH: it is not just a fatty liver (plenary speaker).
27th Annual F. Richard Dion Pediatric Update.
Virginia Mason Medical Center. Seattle, Wash.
December 2007.
David Suskind, MD
Maternal microchimerism in inflammatory
bowel disease. Broad Medical Research Program.
Los Angeles, Calif. February 2007.
Ghassan Wahbeh, MD
Common issues in gastroenterology (workshop).
Pediatric inflammatory bowel disease. Practical
Pediatrics. Seattle Children’s Hospital. Seattle, Wash.
February 2007.
Horslen S, Barr ML, Christensen LL, Ettenger R,
Magee JC. Pediatric transplantation in the United
States, 1996–2005. Am J Transplant. May
2007;7(5 Pt 2):1339–1358.
Hsu EK, Murray KF. Hepatitis C virus in children.
Pediatr Infect Dis J. 2007;2(1):3–9.
Lin G, Tang J, Liu X, Jiang Y, Zheng J.
Deacetylclivorine: a gender-selective metabolite
formed in female Sprague-Dawley rat liver microsomes.
Drug Metab Dispos. Apr 2007;35(4):607–613.
Celiac disease. North Pacific Pediatric Society 174th
Conference. Lynnwood, Wash. March 2007.
Malone FR, Horslen S. Medical and surgical
management of the pediatric patient with intestinal
failure. Curr Treat Options Gastroenterol. Oct
2007;10(5):379–390.
Pediatric issues in IBD. Connections, Crohn’s and
Colitis Foundation of America. Swedish Hospital.
Murray KF. Autoimmune hepatitis: are we using
the right therapy? J Pediatr Gastroenterol Nutr.
Jan 2007;44(1):18–19.
Serology and imaging in IBD. University of Washington
IBD Symposium 2007. Seattle, Wash. March 2007.
124
Dubinsky MC, Wang D, Picornell Y, Wrobel I,
Katzir L, Quiros A, Dutridge D, Wahbeh G, Silber G,
Bahar R, Mengesha E, Targan SR, Taylor KD, Rotter JI,
Western Regional Research Alliance for Pediatric
IBD. IL-23 receptor (IL-23R) gene protects against
pediatric Crohn’s disease. Inflamm Bowel Dis.
May 2007;13(5):511–515.
Murray KF, Rodrigue JR, González-Peralta RP,
Shepherd J, Barton BA, Robuck PR, Schwarz KB,
PEDS-C Clinical Research Network. Design of the
PEDS-C trial: pegylated interferon +/- ribavirin for
children with chronic hepatitis C viral infection.
Clin Trials. 2007;4(6):661–673.
Suskind D, Murray KF. Increasing the mutation
rate for Jagged1 mutations in patients with Alagille
syndrome. Hepatology. Aug 2007;46(2):598–599.
Wang W, Liu G, Zheng J. Human renal UOK130
tumor cells: a drug resistant cell line with highly
selective over-expression of glutathione S-transferase-pi
isozyme. Eur J Pharmacol. Jul 2007;568(1–3):61–67.
Yuan W, Chung JK, Gee S, Hammock BD, Zheng J.
Development of polyclonal antibodies for the detection
of styrene oxide modified proteins. Chem Res Toxicol.
Feb 2007;20(2):316–321.
125
General Pediatrics
The Division of General Pediatrics encompasses academic
general pediatrics and adolescent medicine. It is one of the
largest divisions in the Department of Pediatrics; members
of the division are involved with clinical care, teaching,
advocacy, administration and research.
Our mission statement establishes our commitment “to
improving the health of children by teaching and modeling
the practice of general pediatrics, performing clinical
research and promoting the role of the general pediatrician
as a provider of primary care and advocate for children and
their families.” Our vision is for the division to continue to
be the best division of general pediatrics in the nation.
Members of the division provide inpatient and outpatient
clinical care at several locations in Seattle: Seattle Children’s
Hospital, Harborview Medical Center, University of Washington
Medical Center, the medical center’s primary care clinics
and Odessa Brown Children’s Clinic. Our faculty are heavily
involved with running medical student programs for the
University of Washington School of Medicine, the residency
program for the Department of Pediatrics and fellowship
training programs. The division has a large research portfolio
and is a key part of the research programs at the Center
for Child Health, Behavior and Development of the Seattle
Children’s Research Institute, the Harborview Injury
Prevention and Research Center and the Child Health
Institute. The division also operates the Puget Sound
Pediatric Research Network to collaborate with primary
care pediatricians in the community to conduct important
research on common clinical problems. Our advocacy
activities are intimately linked with our clinical, teaching
and research activities.
Faculty
Frederick P. Rivara
MD, MPH, Chief
126
Frederick P. Rivara, MD, MPH, Chief
Abraham B. Bergman, MD
Julia M. Bledsoe, MD
Christine Caldwell, MD, MS
Dimitri A. Christakis, MD, MPH
Benjamin S. Danielson, MD
Julian K. Davies, MD
Donna M. Denno, MD
Beth E. Ebel, MD, MSc, MPH
Kenneth W. Feldman, MD
Elinor A. Graham, MD, MPH
Catherine J. Karr, MD, PhD
Cynthia T. Kertesz, MD
Lenna L. Liu, MD, MPH
Paula Lozano, MD, MPH
Rita M. Mangione-Smith, MD, MPH
Edgar K. Marcuse, MD, MPH
Carolyn A. McCarty, PhD
Heather A. McPhillips, MD, MPH
Sanford Melzer, MD, MBA
Wendy Mouradian, MD, MS
John M. Neff, MD
Suzinne Pak-Gorstein, MD, PhD, MPH
Brian Saelens, PhD
Sheela Sathyanarayana, MD, MPH
James W. Stout, MD, MPH
Naomi F. Sugar, MD
James A. Taylor, MD
Monica S. Vavilala, MD
Rebecca T. Wiester, MD
Jeffrey A. Wright, MD
Kyle Yasuda, MD
General Pediatrics
Frederick P. Rivara, MD, MPH, is chief of the Division
of General Pediatrics at Seattle Children’s Hospital,
School of Medicine and adjunct professor of epidemiology at the School of Public Health. He is vice
chair of the Department of Pediatrics in the School of
Medicine. Rivara received his MD from the University
of Pennsylvania and an MPH from the University of
Washington. He completed residencies at the Children’s
Hospital Medical Center in Boston and the University
of Washington and was a Robert Wood Johnson Clinical
Scholar at the University of Washington. Rivara was
director of the Harborview Injury and Research Center
in Seattle for 13 years. He was founding president of
the International Society for Child and Adolescent
Injury Prevention and serves as deputy editor of the
journal Injury Prevention. He is also editor of Archives
of Pediatrics and Adolescent Medicine. His research
interests have included the efficacy and promotion of
bicycle helmets, prevention of pedestrian injuries, youth
violence, the epidemiology of firearm injuries, intimate
partner violence, interventions for alcohol abuse in
trauma patients and the effectiveness of trauma systems
in the care of pediatric and adult trauma patients. Rivara
was elected to the Institute of Medicine in 2005.
Abraham B. Bergman, MD, is professor of pediatrics at
the University of Washington. Bergman was head of
the Division of General Pediatrics and chief of pediatrics
at Harborview Medical Center in Seattle. Bergman
practices what he calls “political medicine.” He has
been responsible for landmark legislation to improve
the health of children and families in the United States,
including the Flammable Fabrics Act to make children’s
sleepwear flame retardant, the Sudden Infant Death
Syndrome Act to provide NIH funding for research
into SIDS and legislation to create the National Health
Service Corps. Locally he has been responsible for
legislation to fluoridate water in Washington state;
improve the safety of bicyclists, pedestrians and
motorcyclists; and create the Consumer Product Safety
Commission. More recently Bergman has been a Soros
fellow for his work in foster care and is associate editor
of Archives of Pediatrics and Adolescent Medicine. For
the past five years Bergman has headed the Harborview
Foster Care Health and Early Learning Project. He also
chairs the board of directors of the Seattle Children’s
PlayGarden, a facility for children with special needs.
Spotlight on team member — Jo Montgomery, ARNP
I am very excited about Seattle Children’s Center for
Diversity — a new program that will partner with families
to help them understand their child’s health-care needs in a
way that is culturally relevant. Another exciting hospital
initiative — the medical-legal collaborative project — will
provide support to families as they work with state and
federal health-care agencies.
Julia M. Bledsoe, MD, is clinical associate professor of
Medicine. She is director of the University of Washington
Center for Adoption Medicine and staff pediatrician at
the university’s Fetal Alcohol Syndrome Clinic. Bledsoe
earned her MD at the University of Washington School
of Medicine. She has worked for the U.S. Public Health
Service on the Navajo reservation in northwestern
New Mexico and conducted a faculty practice at the
University of Washington’s Roosevelt Primary Care
Clinic. She developed a panel of families formed
through adoption and became recognized as a national
leader in understanding the unique needs of these
children over time. Through the Center for Adoption
Medicine she provides pre-adoption counseling to
families internationally. She also sees newly adopted
children in consultation and welcomes local adoptees
into her primary care practice. Bledsoe’s clinical interests
include health care for foreign and domestic adoptees,
travel medicine, strategies for managing complex
behavioral issues and the multidisciplinary approach
to diagnosing and treating children with alcoholrelated neurological disorders.
Christine Caldwell, MD, MS, is attending physician at
Seattle Children’s Hospital and pediatrician at the
University of Washington Pediatric Care Center.
Caldwell received her MD from Baylor College of
Medicine in Houston. She completed pediatrics
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residencies at Baylor Affiliated Hospitals and David
Grant USAF Medical Center/University of California,
Davis, with a fellowship in adolescent medicine at the
University of Washington Medical Center. She worked
as a community pediatrician in Seattle for 10 years.
At the Pediatric Care Center, she encourages teens to
increase responsibility for their own health.
Dimitri A. Christakis, MD, MPH, is the George Adkins
Professor of Pediatrics at the University of Washington,
director of the Center for Child Health, Behavior and
Development at Seattle Children’s Hospital Research
Institute and attending pediatrician at Children’s. He is
the author of more than 125 original research articles
and a textbook of pediatrics. He is also the author of
The Elephant in the Living Room: Make Television
Work for Your Kids. Christakis is an international
expert on children and media. His research focuses on
the effects of media on child health and development
and has been featured on Anderson Cooper 360, the
Today Show and ABC, NBC and CBS news as well as
in major national newspapers. He speaks frequently to
national and international audiences of pediatricians,
parents and educators about the effects of media on
children of all ages.
Benjamin S. Danielson, MD, is attending physician at
Seattle Children’s Hospital and clinical professor at
the University of Washington. He has been medical
director of Odessa Brown Children’s Clinic in Seattle
since 1999, and he holds the Janet and Jim Sinegal
Endowed Chair for the Odessa Brown Children’s Clinic.
The clinic has been an active part of Seattle’s multiethnic
Central District since 1970, largely serving children from
disadvantaged backgrounds. The clinic offers dental,
mental health and medical services and has special
programs for children with sickle cell disease, asthma,
school underachievement and obesity. Danielson
completed his residency training at Children’s. He
has worked in a pediatric sports medicine clinic at
Harborview Medical Center, a school-based teen
health center and a primary care clinic in West Seattle,
and was an emergency department attending at
Children’s. Danielson splits his time between clinical
care, administrative responsibilities, community
advocacy and hospital responsibilities. He serves on
several community boards, is active in mentoring efforts
and participates in a number of Children’s committees.
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Julian K. Davies, MD, is clinical associate professor of
pediatrics at the University of Washington and staff
pediatrician at the university’s Fetal Alcohol Syndrome
(FAS) Clinic, the longest-standing FAS center in the
United States. He is co-director of the Center for
Adoption Medicine, where he provides pre-adoption
consultations, post-placement evaluations and ongoing
general pediatric care for adopted children. He created
and is the primary author of the Center for Adoption
Medicine Web site, an online resource for medical and
developmental issues in adoption and pediatrics. He
has been a volunteer with Maria’s Children, an arts
rehabilitation center for Russian orphans, teaching
children’s theater and clowning and directing a summer
arts camp for children living in Moscow orphanages.
Davies is also a coordinator and presenter at Raising
Resilient Rascals, an annual regional conference on
adoption and foster care, now entering its third year.
Donna M. Denno, MD, is attending physician at Seattle
Children’s Hospital, acting assistant professor of
Medicine, clinical assistant professor at the university’s
School of Public Health and attending pediatrician at
Harborview Medical Center. She earned her MD at the
University of Michigan Medical School. Her clinical
and research areas of interest include gastrointestinal
infections in children and risk factors related to food
safety. She has a strong interest in global medicine
and lived and worked in Ghana for three years; her
interests include the impact of intermittent presumptive
treatment of malaria on anemia, the prevalence of
pneumococcal disease in children and determinants
of health. She is also interested in global medicine
education and field opportunities for physicians in
training, particularly residents at Children’s.
Beth E. Ebel, MD, MSc, MPH, is associate professor of
Medicine and director of the Injury Prevention and
Research Center at Harborview Medical Center. She
received an MSc in development economics from
Oxford University, an MD from Harvard Medical
School and the MIT Health Sciences and Technology
Program, and an MPH from the University of
Washington. Ebel’s research interests include injury
prevention, community interventions and health
behaviors with emphasis on high-risk populations.
General Pediatrics
She is principal investigator in a community intervention
to improve child passenger safety in Latino communities
and is leading a grant to improve the quality of interpreted care at Seattle Children’s Hospital. Ebel took
leadership of a Fogarty training grant to build capacity
for international injury prevention in Ghana. She is
also the principal investigator for a study of health-care
costs of unrestrained motor vehicle occupants.
Kenneth W. Feldman, MD, is attending physician at
Seattle Children’s Hospital and clinical professor in the
Department of Pediatrics at the University of Washington School of Medicine. He is the medical director of
the Children’s Protection Program at Children’s while
maintaining a half-time primary care practice at the
Odessa Brown Children’s Clinic. He also attends in the
emergency department and on the wards at Children’s.
He completed his undergraduate and medical school
training at the University of Wisconsin, Madison,
and his internship and residency at the University of
Washington and Children’s. He has conducted research
in childhood injuries, both accidental and abusive. He
is a member of the executive committee of the AAP’s
Section on Child Abuse and Neglect and a member and
past executive committee member of the Helfer Society.
He was awarded the AAP’s Practitioner Research
Award in 1991 for his work on tap water burn injuries.
Elinor A. Graham, MD, MPH, is associate professor of
pediatrics at Harborview Medical Center in Seattle.
Her medical mission is to stimulate and challenge
trainees to provide excellent health care to the world’s
children through modeling this care; educating
trainees about the impact of race, culture, family and
socioeconomic factors on the lives of children; and
creating advocacy, research and practice settings that
allow trainees to learn from their own experience.
She earned her MPH at the Johns Hopkins School of
Public Health. Graham’s work focuses on children and
teens from low-income families; she has specialized
in helping to build community support structures for
these families. She helped set up the Mud Creek Health
Project in Floyd County, Ky., to serve disadvantaged
communities. She worked for the Seattle–King County
Department of Public Health at the Children and
Teens clinic for 10 years, emphasizing the expansion of
pediatric services at health department clinics in the
county, school health, and training low-income and
immigrant parents to be more effective advocates for
their children’s education. After joining the faculty
at Harborview, she helped establish the Community
House Calls program and EthnoMed Web sites to
provide case-management and community-outreach
services to immigrant communities. She has supported
pediatrics residents in conducting health projects at
international sites and has joined them for work with
a project in El Salvador.
Brian D. Johnston, MD, MPH, is attending physician at
of Medicine. He is chief of pediatrics at Harborview
Medical Center, the only Level 1 pediatric trauma
center in the WAMI region. He directs Harborview’s
medical education programs in pediatrics and oversees
hospital resources for pediatric patients. Johnston
earned his MD at the University of California, San
Diego School of Medicine and his MPH at the University
of Washington School of Public Health. His clinical
interests include medical consultation for trauma
patients and primary care for vulnerable populations.
He conducts research on community-based injury
prevention, including programs and policy to promote
physical activity while reducing the risk of child pedestrian injury. Nationally, Johnston has been involved in
efforts to bring evidence-based injury prevention into
the work of local child-fatality review teams. He sits
on the editorial board of BMJ (British Medical Journal)
and is the editor-in-chief of Injury Prevention, an
international peer-reviewed journal.
Catherine J. Karr, MD, PhD, is assistant professor in
the Department of Pediatrics; she has an adjunct
appointment in the Department of Environmental
and Occupational Health Sciences. She is director of
the University of Washington-based Pediatric Environmental Health Specialty Unit (PEHSU); in 2007 the
unit received the Children’s Environmental Health
Excellence Award from the U.S. Environmental
Protection Agency. Karr earned an MS in environmental
health–toxicology, her MD from the University of
Washington School of Medicine and her PhD in
epidemiology from the university’s School of Public
Health. She serves on the American Academy of
Pediatrics National Committee on Environmental
Health. Her primary research interest is the adverse
effects of environmental toxicants on child health. Her
current research is in the area of respiratory health and
environmental factors with an emphasis on ambient
air pollution and pesticide exposure. She is involved in
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primary care pediatrics as attending physician at the
University of Washington Pediatric Care Center and also
sees specialty pediatric environmental medicine patients.
Liu is also co-investigator on the SEARCH for Diabetes
in Youth study that examines rates of diabetes, particularly type II diabetes, in children and adolescents.
Cynthia T. Kertesz, MD, is attending physician at Seattle
Children’s Hospital and clinical assistant professor of
pediatrics at the University of Washington. She earned
her medical degree at Northwestern University in
Evanston, Ill., and completed her pediatric residency
at the University of Washington. She is an attending
pediatrician at the Pediatric Care Center at the University
of Washington and a member of the Center for Adoption
Medicine. Her area of expertise is the evaluation of
both domestically and internationally adopted children
and their ongoing pediatric care. She also maintains a
general pediatric faculty practice.
Paula Lozano, MD, MPH, is attending physician at
Harborview Medical Center and Seattle Children’s
Hospital, associate professor of pediatrics at the University of Washington School of Medicine and adjunct
associate professor of health services at the university’s
School of Public Health and Community Medicine.
Lozano is also associate investigator at the Center for
Health Studies at Group Health Cooperative in Seattle.
She practices and teaches pediatrics at the Children
and Teens Clinic at Harborview Medical Center, as
well as attending on the general medical service at
Children’s. Lozano has conducted several randomized
trials of primary care-based interventions rooted in the
Chronic Care Model. Special populations of interest
include children with asthma, depression and obesity
as well as children with medically complex conditions
and disadvantaged populations. Lozano’s current
activities focus on developing and evaluating interventions to support families in health behavior change,
using self-management support models derived from
motivational interviewing, in primary care pediatric
settings. She has also published in the areas of quality
of care, access to care, health literacy, cultural competence
and electronic decision support and managed care. As
director of the general pediatrics fellowship (NRSA),
Lozano mentors young pediatric researchers with
diverse interests.
Charlotte W. Lewis, MD, MPH, is attending physician at
Seattle Children’s Hospital. She is associate professor
Washington School of Medicine and adjunct associate
professor in the Department of Pediatric Dentistry. Her
primary research interest is improving the oral health
of children with craniofacial conditions and other
special needs. She also does research on disparities
in health and health-care access, with a specific focus
on oral health and access to dental care. Her research
has involved documenting disparities in access to
oral health services for low-income and special needs
children as well as developing and evaluating strategies
to improve children’s oral health.
Lenna L. Liu, MD, MPH, is clinician at Odessa Brown
Children’s Clinic, associate professor of pediatrics at
investigator at the Child Health Institute. She earned
her MD from the University of Pennsylvania and her
MPH from the University of Washington. Liu is active
locally and nationally on childhood obesity prevention
and management efforts, particularly with an emphasis
on health disparities and low-income populations.
Locally, she is a member of the Children’s Obesity
Action Team (COAT) and the Seattle–King County
Department of Public Health’s Steps to a Healthier
U.S. project. She is involved in the prevention and
management of obesity in primary care settings, a family
YMCA–based healthy lifestyle program, communitybased nutrition and physical activity promotion
projects, and clinical services for overweight youth.
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Rita M. Mangione-Smith, MD, MPH, is attending physician
at Seattle Children’s Hospital, associate professor of
pediatrics at the University of Washington and adjunct
associate professor of health services at the university’s
School of Public Health. She earned her MD at Wayne
State University and her MPH at the University of
California, Los Angeles. Her primary research interests
are quality and appropriateness of care in pediatrics
and the development and evaluation of interventions
to improve care provided to children. Her currently
funded studies focus on the evaluation of quality
improvement interventions related to physician-parent
communication, antibiotic prescribing, asthma care
and the inpatient management of medically complex
children. Mangione-Smith has primarily published in
the areas of quality of care, appropriate use of antibiotics
and physician-parent communication. She serves on
the advisory committee for the Academy Health
General Pediatrics
Quality Interest Group and on the editorial board for
Annals of Family Medicine. She has also chaired the
Scientific Session at the National Initiative for Child
Healthcare Quality (NICHQ) Annual Forum for the
past two years. This past year, her New England Journal
of Medicine publication on child health-care quality in
the United States garnered national attention.
Edgar K. Marcuse, MD, MPH, is professor of pediatrics
and adjunct professor of epidemiology at the University
of Washington Schools of Medicine and Public Health,
and associate medical director at Seattle Children’s
Hospital, where his current hospital responsibilities
include leadership of the hospital’s clinical quality
improvement and patient safety activities. He received
his BA from Oberlin College, his MD from Stanford
University Medical School, did his pediatric residency
at Boston Children’s and Seattle Children’s, served as
medical epidemiologist in the CDC’s EIS and did a
fellowship in epidemiology and received his MPH from
Marcuse has authored numerous publications relating
to immunization, general pediatrics and public health
and is a founding co-editor of AAP Grand Rounds, a
monthly publication critiquing new studies relevant
to pediatric practice. Nationally, Marcuse has been a
member and chair of the United States Department
of Health and Human Services National Vaccine
Advisory Committee, a member of the Advisory
Committee on Immunization Practice, a member of
the American Academy of Pediatrics Committee on
Infectious Diseases (Red Book), associate editor
and consultant to several editions of the Red Book
and chair of the American Academy of Pediatrics
Immunization Advisory Team. He is actively involved
with numerous pediatric and public health organization activities at the local, regional, national and
international levels.
Carolyn A. McCarty, PhD, is research associate professor
in pediatrics at the University of Washington and holds
an adjunct appointment in the Department of Psychology. Trained as a clinical psychologist, she completed
her PhD at the University of California, Los Angeles.
Her research has broadly focused on family, peer and
cultural influences on children’s mental health. The
goal of her research is to use knowledge of youth development to design, implement and test programs that
will improve the lives and mental health of children.
Through a partnership with the Seattle Public Schools,
she is developing and testing a preventive intervention
for young adolescents called Positive Thoughts and
Actions, designed to reduce depression and improve
their mental health, academic success and interpersonal functioning.
Heather A. McPhillips, MD, MPH, is associate residency
director for the University of Washington pediatric
residency training program at Seattle Children’s Hospital
and associate professor of pediatrics at the University
of Washington. McPhillips earned her MD from the
University of Chicago, Pritzker School of Medicine,
and her MPH at the University of Washington. She
completed a pediatrics residency at the University
of California, San Francisco, and a fellowship at the
University of Washington. She focuses her clinical and
teaching efforts on the importance of understanding
patients and their families in terms of their development, innate and learned behaviors, and the social and
medical context in which they live. Her research focus
is on health-care quality and patient safety as well as
graduate medical education. She is a member of the
Association of Pediatric Program Directors (APPD)
and serves on the research task force and the nominating
committee for the APPD. She is also a member of the
Ambulatory Pediatric Association and the American
Academy of Pediatrics.
Sanford Melzer, MD, MBA, is pediatric hospitalist physician and senior vice president for strategic planning and
business development at Seattle Children’s Hospital;
he is professor of pediatrics and health services at the
University of Washington School of Medicine. Melzer
earned his MD from Mount Sinai School of Medicine
in New York and his MBA from the University of
Washington. He developed and now operates the
Children’s Regional Services Network, which provides
on-site pediatrics consultation and hospital, neonatal
and urgent care services in 28 communities and four
states in the Northwest. He is also responsible for new
business development and professional exchanges for
Children’s. Melzer is considered one of the national
experts in “non-face-to-face care” for children, including
the use of telemedicine and telephone to provide care
at a distance. He is actively involved with the American
Academy of Pediatrics in developing policies and
practices improving care for hospitalized children.
Melzer’s interests include strategic planning and the
application of Lean methods pioneered by the Japanese
auto manufacturer Toyota to improve quality and
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efficiency in pediatric health care. His research focus
includes hospitalist medicine, non-face-to-face care
and factors influencing the business performance of
hospital pediatrics programs.
Wendy Mouradian, MD, MS, is clinical professor of
pediatrics at the University of Washington, with
adjunct appointments in pediatric dentistry, dental
public health sciences and health services (at the
university’s School of Public Health). She is director
of regional initiatives for the university’s School of
Dentistry and has served as director of the craniofacial
program at Seattle Children’s Hospital. Mouradian
also heads the Oral-Systemic Theme Committee at the
university’s School of Medicine, charged with integrating
oral health into the curriculum of medical students.
Mouradian earned her MD from Columbia University
and her MS from the Massachusetts Institute of Technology. She completed a fellowship at the University of
Washington. Mouradian has received several national
awards for her role in organizing and chairing The Face
of a Child: Surgeon General’s Conference on Children
and Oral Health; she was recognized by the American
Dental Education Association for her efforts to advance
the importance of oral health to the overall health of
children. She is associate director of the Center for
Leadership Education in Pediatric Dentistry. Her
research areas include quality of life for children with
craniofacial conditions, ethics and educational policy
related to children’s oral health.
John M. Neff, MD, is director of the Center for Children
with Special Needs at Seattle Children’s Hospital and
School of Medicine. He received his MD from Harvard
Medical School. He was a member of the Epidemic
Intelligence Service of the Public Health Service and
trained in virology and infectious diseases at Children’s
Hospital Boston. He was instrumental in determining
the prevalence of complications associated with smallpox vaccination in the United States. Neff served on
the faculty and in the dean’s office at Johns Hopkins
Medical School. He directed the pediatrics program
at the Baltimore City Hospitals, where he developed a
prepaid practice plan for the city’s foster children. He
has worked on issues concerning children with special
needs, including identification, delivery of services and
finances. He has served as medical director and vice
president of Seattle Children’s and associate dean at the
University of Washington School of Medicine. He has
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broad interests in child health and advocacy with two
special interests — smallpox and smallpox vaccination,
and how to best serve children with special health-care
needs in our current environment. He has served on
many state and national committees and is engaged in
a project to identify the patient population admitted to
Children’s by chronic disease groups and severity, and
to analyze multiyear trends.
Suzinne Pak-Gorstein, MD, PhD, MPH, is attending
physician at Harborview Medical Center and acting
assistant professor of pediatrics at the University of
Washington School of Medicine. She earned her MD at
the Michigan State University Medical School and her
PhD and MPH in international health–epidemiology
at the University of Michigan School of Public Health.
She completed her pediatrics residency training at
Seattle Children’s Hospital. She has experience working
in Nepal, Indonesia, Bangladesh and India on micronutrient deficiency monitoring and control programs,
child survival research projects and national public
health faculty and staff training. She has also worked
with collaborative WHO technical groups to establish
guidelines for monitoring micronutrient deficiency
prevalence and control programs. Her research areas
of interest include developing culturally sensitive and
effective skills and tools for health-care providers to
promote healthy infant and child feeding practices
among immigrant and refugee families. She is working
on the Infant Feeding Cultural Support Project
at Harborview. She also works with the AAP Section
on Child Health, Children’s and the University of
Washington Department of Global Health on developing
global health educational opportunities for residents
and establishing best practices guidelines for global
health training.
Brian Saelens, PhD, is associate professor in pediatrics,
psychiatry and behavioral sciences at Seattle Children’s
Hospital Research Institute and the University of
Washington School of Medicine. Saelens earned his
PhD in clinical psychology, with a specialization in
child health psychology, from the State University of
New York at Buffalo. He completed his psychology
residency at Brown University and his postdoctoral
fellowship at San Diego State University. Saelens
focuses his research on built and social environmental
factors that affect physical activity, dietary behaviors
and weight status. In addition, he conducts research
in the behavioral treatment of pediatric obesity.
General Pediatrics
Sheela Sathyanarayana, MD, MPH, is acting assistant
professor in the Department of Pediatrics at the
University of Washington. She teaches and precepts
residents in the Harborview Children and Teens Clinic.
She specializes in pediatric environmental health and
also works in the Northwest Pediatric Environmental
Health Specialty Unit (PEHSU) at the University of
Washington doing pediatric environmental health
consults. She earned a BA from Duke University,
an MD from the University of Southern California
and an MPH from the University of Washington.
Sathyanarayana’s research focuses on the effects of prenatal and early childhood exposures to environmental
chemicals, such as phthalates and bisphenol A, and
she has a special interest in human risk, public health
and policy. Her current research is in the area of
endocrine-disrupting chemicals and their impact
on early childhood development.
James W. Stout, MD, MPH, is pediatrician at Odessa
Brown Children’s Clinic and professor of pediatrics and
adjunct professor of health services at the University
of Washington. He earned his MD at Wake Forest
University and his MPH at the University of Washington
School of Public Health. At Odessa Brown Children’s
Clinic he has a general pediatric practice, leads the
asthma clinic and provides direction for its quality
improvement programs. Stout is co-founder of the
National Initiative for Children’s Healthcare Quality
(NICHQ), a nonprofit quality improvement organization headquartered in Boston, and leads QI Partners, a
quality improvement group based at the University of
Washington Child Health Institute in Seattle. Through
these organizations, he works with practice teams on
a variety of local, state and national projects with the
common aim of improving the quality of children’s
health care. He also leads Interactive Medical Training
Resources at the Child Health Institute. The group’s
first training CD-ROM, Spirometry Fundamentals,
is licensed through the University of Washington
Office of Tech Transfer and is being evaluated in
randomized controlled trials as part of larger distancetraining programs. A training CD-ROM on pediatric
sedation is in production.
Naomi F. Sugar, MD, is attending pediatrician at Seattle
and clinical associate professor at the University of
Washington School of Medicine. She is medical
director of the Harborview Center for Sexual Assault
and Traumatic Stress and child abuse consultant at
Harborview Medical Center and Children’s. She earned
her MD at the Medical College of Wisconsin, completed
an internship and a residency in pediatrics at Children’s
Hospital of Pittsburgh, and completed a fellowship in
behavioral pediatrics. She specializes in the evaluation
of children and adolescents when there is a concern
about physical or sexual abuse, and in health care for
children in foster care. Sugar provides training to
medical, legal and social service professionals in the
medical aspects of child abuse and adolescent and
adult sexual assault. Her research interests are in
evaluation of child abuse and foster care.
James A. Taylor, MD, is attending physician at Seattle
Children’s Hospital, medical director of the newborn
nursery at the University of Washington Medical Center and director of the pediatrics residency continuity
clinic program. He earned his MD from the University
of North Carolina School of Medicine; he completed a
pediatrics residency at the University of Colorado and
a fellowship in general pediatrics at the University of
Washington School of Medicine. He is director of the
Puget Sound Pediatric Research Network, a collaborative
effort of practicing pediatricians in the community,
the university’s Division of General Pediatrics and
Children’s. Taylor’s research interests include maximizing the effectiveness of immunization delivery in
primary care practices, eliminating racial disparities
in immunization status, assessing the efficacy of
alternative therapies for children, developing and
assessing methods to promote the judicious use of
antibiotics in children and pediatric patient safety.
Monica S. Vavilala, MD, is attending physician in the
Division of Emergency Medicine at Seattle Children’s
Hospital; she is associate professor in the departments
of Pediatrics and Anesthesiology and adjunct associate
professor in the Department of Neurological Surgery at
practices anesthesiology at Harborview Medical Center
and is associate director at the Harborview Injury
Prevention and Research Center. She is also involved
in teaching anesthesiology and pediatrics trainees.
Vavilala’s research interests include hemodynamics and
outcomes in pediatric brain injury, and mechanisms
of cerebral edema in pediatric diabetic ketoacidosis.
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Rebecca T. Wiester, MD, is a member of the Child
Protection Team at Seattle Children’s Hospital and
clinical assistant professor of pediatrics at the University
of Washington School of Medicine; she is based at
Harborview Medical Center. She is also medical
consultant for DSHS in Region 4, King County, and
intermittent pediatrician for the Seattle–King County
Department of Public Health. Wiester completed her
pediatrics residency at Cincinnati Children’s Hospital,
including a second internship in family practice at
University Hospital in Cincinnati. She developed the
Federal Way Sexual Assault Clinic in conjunction with
the King County Sexual Assault Resource Center; the
clinic became part of the Harborview Sexual Assault
Center, and she continues to be consulting physician
for it.
Jeffrey A. Wright, MD, is associate professor at the
adjunct associate professor in the School of Dentistry.
He is medical director of the university’s Pediatric Care
Center and attending physician in the newborn nursery
at the University of Washington Medical Center. Wright
earned his MD at the University of Missouri–Kansas
City. His research interests include behavioral pediatrics,
children with special health-care needs and medical
informatics. He is a computer and Web programmer
working to use information technology for improving
decision support, individualized care and coordination
of care.
Kyle Yasuda, MD, is clinical professor of pediatrics at
medical director of the Pediatric Clinic at Harborview
Medical Center. He works in the new college program,
an integrated four-year curriculum to teach clinical
skills and professionalism. He has a background in
primary care practice, health policy, nonprofit organizations, and advocacy for children and pediatricians.
He is chair of the American Academy of Pediatrics
(AAP) Committee on Practice and Ambulatory Medicine,
former chair of the Washington Council for the Prevention of Child Abuse and Neglect, former member of the
Department of Social and Health Services State Advisory
Committee and former member of the Governor’s
Commission on Early Learning. He has held leadership
positions for the AAP Washington Chapter, including
nominee for the primary care health policy fellowship.
Yasuda formed and manages the 501c3 nonprofit
134
foundation of the chapter that focuses on communitybased collaborative research and education projects
involving practicing pediatricians. He received
the national 2005 Commissioner’s Award for his
contributions to the field of child abuse and neglect.
AWARDS AND HONORS
The Odessa Brown, Ken Feldman Award for
Distinguished Service in Promoting Diversity.
Inaugural Award.
Listed in Who’s Who.
John M. Neff, MD
Voices for Children Award. Children’s Alliance
Annual Meeting. Seattle.
RESEARCH FUNDING
New
AsthmaNet. NHLBI. $2.5 million.
Dental care in children with and without special
health-care needs. NIH/NIDCR. $156,000.
Oral health behavior and habits of young children with
developmental delay. NIDCR/NIH/DHHS. $227,985.
$148,867.
Improving communication during pediatric visits for
acute respiratory illness. NIH/NICHD. $292,576.
Outcomes evaluation study for medically complex
children at Children’s. Children’s. $52,900.
Frederick P. Rivara, MD, MPH
Disability from pediatric traumatic brain injury Year 2.
CDC. $677,126.
General Pediatrics
Effectiveness of designated-driver programs. CDC.
$364,750.
Last Call – Nesholm Family Foundation. Nesholm
Family Foundation. $50,000.
$148,867.
Oral health status and habits of young children with
developmental delay. Children’s. $106,955.
Paula Lozano, MD, MPH
Asthma management support training in pediatrics.
NIH/NHLBI. $189,193.
Brian Saelens, PhD
Neighborhood nutrition and physical activity
environments and weight. USDA. $129,445.
Randomized controlled trial of spirometry fundamentals
in the primary care setting. American Thoracic Society.
Practical model to transform childhood asthma
care. Agency for Healthcare Research and Quality.
$273,366.
Carolyn A. McCarty, PhD
Prevention of depression among preadolescent youth.
NIH/NIMH. $151,340.
James A. Taylor, MD
Homeopathic eardrop study. Standard Homeopathic
Company. $120,000.
Continuing
Abraham B. Bergman, MD
Child Abuse Consultation Network. Washington State
Department of Social and Health Services. $60,646.
Internet-based patient-centered asthma management
system. NIH/NHLBI. $773,028.
Parent-initiated prevention program. Agency for
Healthcare Research and Quality/DHHS. $250,000.
Cooperative agreement with HIPRC for injury control.
National Highway Traffic Safety Administration.
$50,000.
Harborview Injury Prevention and Research Center.
CDC. $1,085,078.
Speaking together: national language services network.
Robert Wood Johnson Foundation. $61,650.
Brian Saelens, PhD
Body fat and hormones in adolescent obesity treatment.
NIDDK/NIH/DHHS. $58,005.
Child weight status and neighborhood physical activity
and nutritional environment. NIEHS/NIH/DHHS.
$487,950.
Children’s Health Improvement Collaborative.
Seattle–King County Department of Public Health.
$94,042.
$101,846.
NICHQ Year 8. National Initiative for Children’s
Healthcare Quality, Washington Office. $117,444.
James A. Taylor, MD
Echinacea for preventing colds in children.
NIH/NCCAM. $493,625.
Monica S. Vavilala, MD
Cerebral edema in pediatric diabetic ketoacidosis.
NIH/DHHS. $170,570.
Northwest Pediatric Environmental Health Specialty
Unit. Association of Occupational and Environmental
Clinics. $172,784.
135
General Pediatrics
Abrocha tu vida: a community-based program for
increasing car safety for Latino families. Children’s
Mercy Hospital Grand Rounds. Kansas City, Kan.
Feb. 15, 2007.
Abrocha tu vida: a community-based program for
increasing car safety for Latino families. University
of Kansas City Grand Rounds. Kansas City, Mo.
Feb. 16, 2007.
Tailored communication and social marketing for at
risk populations. Strategic Marketing for Nonprofit
Organizations. Seattle University. Seattle, Wash.
July 26, 2007.
Injury control: progress and challenges for the future.
Washington Biotechnology and Business Association.
Seattle, Wash. Nov. 8, 2007.
Abuse of pediatric hospital patients: understanding
and avoiding physician/patient boundary issues. Pediatric condition falsification: Munchausen syndrome by
proxy. 21st Annual San Diego International Conference
on Child and Family Maltreatment. San Diego, Calif.
Jan. 22–26, 2007.
Inflicted head injuries: an overview and controversies.
Symposium on Pediatric Head Trauma. Legacy
Emmanuel Health System. Portland, Ore. Feb. 27, 2007.
Inflicted head injuries. Psychosocial precedents of child
abuse and neglect. Basic child physical abuse. Olympic
Medical Center and Children’s Protective Services.
Port Angeles, Wash. June 22, 2007.
Symptomatic cervical spinal cord injury in abused
children (co-presenter). Toward instituting a chaperone
policy in outpatient pediatric clinics (co-presenter).
Helfer Society Annual Meeting. Stevenson, Wash.
Oct. 23–25, 2007.
Promoting booster seat use in multi-ethnic urban
low-income neighborhoods (co-presenter). Pediatric
Academic Societies Annual Meeting. Toronto, Ontario,
Canada. May 2007.
136
Best papers in injury prevention 2006. American
Academy of Pediatrics, 2007 National Conference
and Exhibition. San Francisco, Calif. October 2007.
Reducing the burden of childhood asthma in farmworker children: diagnosis, environmental factors,
best management. Northwest Primary Care Association
14th Annual Western Migrant Stream Forum.
Spokane, Wash. January 2007.
Northwest USA PEHSU: examples of a pediatric
environmental health specialty unit program in action.
Fourth International Conference on Health and the
Environment. Vienna, Austria. June 2007.
Childhood asthma: diagnosis, triggers, management.
2007 Tribal Nations Children’s Environmental Health
Summit. Denver, Colo. August 2007.
Evolution of biomarkers for pesticides: examples from
the agricultural setting (co-chair). Cholinesterase testing:
clinical application in pediatric practice. NIEHS/EPA
2007 Children’s Environmental Health Workshop:
Discover, Treat, Prevent, Prepare. Washington, D.C.
October 2007.
The medical and dental home working together.
Putting medical homes into practice. Washington State
Medical Home Leadership Network. Seattle, Wash.
May 2007.
Lenna L. Liu, MD, MPH
Update on childhood obesity: office-based obesity
prevention and management. Ambulatory Care
Conference. Seattle, Wash. April 2007.
Addressing childhood obesity in low-income communities (co-presenter). National Initiative for Children’s
Healthcare Quality Q Call. November 2007.
Perspectives on the quality chasm for children.
National Health Quality Forum. Washington, D.C.
April 13, 2007.
Surviving and thriving: strategies for women in
research. Pediatric Academic Societies Annual
General Pediatrics
Ruling out the need for antibiotics: are we sending
the right message? Measuring the quality of care in
pediatrics: what are the challenges? Perspectives on the
quality chasm for children. Pharmaceutical company
sponsored research: an uneasy alliance between the
academic and corporate worlds. Visiting professorship,
Department of Pediatrics, John A. Burns School of
Medicine, University of Hawaii at Manoa. Honolulu,
Hawaii. Nov. 13–16, 2007.
Heather A. McPhillips, MD, MPH
Teach to your strengths and adapt to your learners!
Understanding individual teaching and learning
preferences to maximize your teaching potential
(workshop leader). How does resident participation in
hospital-initiated quality improvement activities affect
attitudes about quality improvement and hospital
engagement? (co-presenter). Association of Pediatric
Program Directors Annual Meeting. Toronto, Ontario,
Canada. May 4, 2007.
Sanford Melzer, MD, MBA
Patient safety initiatives and use of national data to
improve quality. Kobe Children’s Hospital–Kobe
University School of Medicine. Kobe, Japan. May 2007.
Successful strategies to improve patient safety and
quality in U.S. children’s hospitals. National Center for
Child Health and Development, National Children’s
Hospital. Tokyo, Japan. May 2007.
Telemedicine as a component of regional pediatric
care. PAS Annual Meeting. Toronto, Ontario, Canada.
May 2007.
Hospital/practice plan collaboration to support recruitment. Association of American Medical Colleges Group
on Faculty Practice Symposium. San Francisco, Calif.
July 2007.
Suzinne Pak-Gorstein, MD, PhD, MPH
Developing a curriculum for primary care providers
(PCPs) to reduce risk for childhood obesity among a
Somali population (co-presenter). Pediatric Academic
Societies Annual Meeting. Toronto, Ontario, Canada.
May 2007.
Frederick P. Rivara, MD, MPH
Intimate partner violence and its effects on children.
Cornfeld lecture. Children’s Hospital of Philadelphia.
Philadelphia, Pa. Jan. 31, 2007.
The scientific basis of injury research. Grant Gall
lecture. University of Calgary and Alberta Children’s
Hospital. Calgary, Alberta, Canada. Feb. 7, 2007.
Naomi F. Sugar, MD
Washington State Title 26 family law guardians ad
litum training. Seattle, Wash. January 2007.
James A. Taylor, MD
Vitamin D supplementation for breastfed infants.
Agency for Healthcare and Research 2007 Annual
Practice Based Research Network Meeting. Bethesda,
Md. May 2007.
PUBLICATIONS
Environmental Health (Karr CJ, member), Shea KM.
Global climate change and children’s health. Policy
statement. Pediatrics. Nov 2007;120(5):1149–1152.
Bauer NS, Lozano P, Rivara FP. The effectiveness
of the Olweus Bullying Prevention Program in public
middle schools: a controlled trial. J Adolesc Health.
Mar 2007;40(3):266–274.
Critical elements in designing a national system of
health care for children. Third Ukraine Congenital
Heart Disease Forum. Kiev, Ukraine. October 2007.
Bonomi AE, Anderson ML, Reid RJ, Carrell D,
Fishman PA, Rivara FP, Thompson RS. Intimate
partner violence in older women. Gerontologist.
Feb 2007;47(1):34–41.
Preparing for the new Telephone Care CPT codes
in 2008. American Academy of Pediatrics National
Conference and Exhibition (NCE). San Francisco,
Calif. October 2007.
Bonomi AE, Anderson ML, Rivara FP, Thompson RS.
Health outcomes in women with physical and sexual
intimate partner violence exposure. J Womens Health.
Sep 2007;16(7):987–997.
137
General Pediatrics
Brooks MA, Schiff MA, Koepsell TD, Rivara FP.
Prevalence of preseason conditioning among high
school athletes in two spring sports. Med Sci Sports
Exerc. Feb 2007;39(2):241–247.
Brown JM, Udomphorn Y, Suz P, Vavilala MS.
Antipyretic treatment of noninfectious fever in children
with severe traumatic brain injury. Childs Nerv Syst.
Apr 2008;24(4):477–483. Epub Oct 5 2007.
Bulger EM, Nathens AB, Rivara FP, MacKenzie E,
Sabath DR, Jurkovich GJ. National variability in
out-of-hospital treatment after traumatic injury.
Ann Emerg Med. Mar 2007;49(3):293–301.
Christakis DA, Zimmerman FJ. TV and kids. A
primer for pediatricians. Contemp Pediatr. Apr 2007.
Christakis DA, Zimmerman FJ. Violent television
viewing during preschool is associated with antisocial behavior during school age. Pediatrics. Nov
2007;120(5):993–999.
Christakis DA, Zimmerman FJ, Garrison MM. Effect
of block play on language acquisition and attention
in toddlers: a pilot randomized controlled trial. Arch
Pediatr Adolesc Med. Oct 2007;161(10):967–971.
Davis RL, Wright JA, Chalmers F, Levenson L, Brown
JC, Lozano P, Christakis DA. A cluster randomized
clinical trial to improve prescribing patterns in ambulatory pediatrics. PLoS Clin Trials. May 2007;2(5):e25.
138
Feldman KW, Mazor S. Ecstasy ingestion causing
heatstroke-like, multi-organ injury in a toddler.
Pediatr Emerg Care. Oct 2007;23(10):725–726.
Frank LD, Saelens B, Powell KE, Chapman JE.
Stepping towards causation: do built environments
or neighborhood and travel preferences explain
physical activity, driving and obesity? Soc Sci Med.
Nov 2007;65(9):1898–1914.
Garbutt J, Brownstein DR, Klein EJ, Waterman A,
Krauss MJ, Marcuse EK, Hazel E, Dunagan WC,
Fraser V, Gallagher TH. Reporting and disclosing
medical errors: pediatricians’ attitudes and behaviors.
Arch Pediatr Adolesc Med. Feb 2007;161(2);179–185.
Glanz K, Sallis JF, Saelens B, Frank LD. Nutrition
Environment Measures Survey in Stores (NEMS-S):
development and evaluation. Am J Prev Med. Apr
2007;32(4):282–289.
Goldin A, Sawin R, Garrison MM, Zerr DM,
Christakis DA. Aminoglycoside-based triple-antibiotic
therapy versus monotherapy for children with ruptured
appendicitis. Pediatrics. May 2007;119(5):905–911.
Greves HM, Lozano P, Liu LL, Busby K, Cole J,
Johnston BD. Immigrant families’ perceptions on
walking to school and school breakfast: a focus group
study. Int J Behav Nutr Phys Act. Dec 2007;4:64.
Feldman KW. Book review of Shaking and Other
Non-Accidental Head Injuries in Children. Arch
Pediatr Adolesc Med. Jan 2007;161(1):108–109.
Hilbert A, Saelens B, Stein RI, Mockus DS, Welch RR,
Matt GE, Wilfley DE. Pretreatment and process predictors of outcome in interpersonal and cognitive behavioral
psychotherapy for binge eating disorder. J Consult Clin
Psychol. Aug 2007;75(4):645–651.
Feldman KW. Burn injuries in child fatality review.
Burns: case studies. Drowning in child fatality review.
Drowning: case studies. In: Alexander R, ed. Child
Fatality Review: An Interdisciplinary Guide and
Photographic Reference. St. Louis, Mo.: GW Medical
Publishing. 2007.
Hollingworth W, Vavilala MS, Jarvik JG, Chaudhry S,
Johnston BD, Layman S, Tontisirin N, Muangman SL,
Wang MC. The use of repeated head computed tomography in pediatric blunt head trauma: factors predicting
new and worsening brain injury. Pediatr Crit Care Med.
Jul 2007;8(4):348–356.
Feldman KW, Feldman MD, Grady R, Burns MW,
McDonald R. Renal and urologic manifestations of
pediatric condition falsification/Munchausen by
proxy. Pediatr Nephrol. Jun 2007;22(6):849–856.
Karr CJ, Lumley T, Schreuder A, Davis R, Larson T,
Ritz B, Kaufman J. Effect of subchronic and chronic
exposure to ambient air pollutants on infant bronchiolitis.
Am J Epidemiol. Mar 2007;165(5):553–560.
General Pediatrics
Karr CJ, Solomon GM, Brock-Utne AC. Health effects
of common home, lawn and garden pesticides. Pediatr
Clin North Am. Feb 2007;54(1):63–80.
Landrigan P, Woolf A, Gitterman B, Lanphear B,
Forman J, Karr CJ, Moshier EL, Stiener JF, Godbold
J, Crain E. The Ambulatory Pediatric Association
fellowship in pediatric environmental health: a
five-year assessment. Environ Health Perspect.
Oct 2007;115(10):1383–1387.
McCarty CA, Weisz JR. Effects of psychotherapy for
depression in children and adolescents: what we can
(and can’t) learn from meta-analysis and component
profiling. J Am Acad Child Adolesc Psychiatry. Jul
2007;46(7):879–886.
Melzer S. Financial aspects of pediatric hospitalist
programs. In: Zaoutis L, Chiang V, eds. Comprehensive
Pediatric Hospital Medicine. Philadelphia, Pa.:
Elsevier. 2007.
Lewis CW, Johnston BD, Linsenmeyar KA, Williams
A, Mouradian W. Preventive dental care for children
in the United States: a national perspective. Pediatrics.
Mar 2007;119(3):e544–e553.
Mendoza JA, Drewnowski A, Christakis DA. Dietary
energy density is associated with obesity and the
metabolic syndrome in U.S. adults. Diabetes Care.
Apr 2007;30(4):974-979.
Lewis CW, Mouradian W, Slayton RL, Williams AC.
Dental insurance and its impact on preventive dental
care visits for U.S. children. J Am Dent Assoc. Mar
2007;138(3):369–380.
Mendoza JA, Zimmerman FJ, Christakis DA.
Television viewing, computer use, obesity and adiposity
in U.S. preschool children. Int J Behav Nutr Phys Act.
Sep 2007;4(1):44.
Liu, LL.The Writing Group for the SEARCH for
Diabetes in Youth Study Group. Incidence of
diabetes in youth in the United States. JAMA.
June 2007;297(24):2716–2724.
Meyers K, Valentine J, Melzer S. Feasibility,
acceptability and sustainability of telepsychiatry
for children and adolescents. Psychiatric Serv.
Nov 2007;58(11):1493–1496.
Mackenzie EJ, Rivara FP, Jurkovich GJ,
Nathens AB, Frey KP, Egleston BL, Salkever DS,
Weir S, Scharfstein DO. The national study on
costs and outcomes of trauma. J Trauma. Dec
2007;63(6 Suppl):54S–67S;discussion 81S–86S.
Migita R, Feldman KW. Visceral injury in child abuse.
In: Meadow R, Mok J, Rosenberg D, eds. ABC of Child
Protection, Fourth Edition. Oxford, England, U.K.:
Blackwell. 2007.
Mangione-Smith RM. Bridging the quality
chasm for children: need for valid, comprehensive
measurement tools. Arch Pediatr Adolesc Med.
Sep 2007;161(9):909–910.
Mangione-Smith RM, DeCristofaro AH, Setodji
CM, Keesey J, Klein D, Adams J, Schuster MA,
McGlynn EA. The quality of ambulatory care delivered
to children in the United States. New Engl J Med.
Oct 2007;357(15):1515–1523.
McCarty CA, Vander Stoep A, McCauley E. Cognitive
features associated with depressive symptoms in
adolescence: directionality and specificity. J Clin
Child Adolesc Psychol. Apr–Jun 2007;36(2):147–158.
Mouradian W. Ethics and leadership in children’s oral
health. Pediatr Dent. Jan–Feb 2007;29(1):64–72.
Mouradian W, Huebner C. Future directions in
leadership training of MCH professionals: cross-cutting
MCH leadership competencies. Matern Child Health J.
May 2007;11(3):211–218.
Mouradian W, Huebner C, Ramos-Gomez F,
Slavkin H. Beyond access: the role of family and
community in children’s oral health. Jr Dent Educ.
May 2007;71(5):619–631.
Neff JM. Finance matters: how do we pay for the care
of children with special health care needs? In: Sobo
EJ, Kutin PS, eds. Optimizing Care for Children with
Special Health Care Needs: Knowledge and Strategies
for Navigating the System. Baltimore, Md.: Brooks. 2007.
139
General Pediatrics
Owen N, Cerin E, Leslie E, duToit L, Coffee N, Frank
L, Bauman A, Hugo G, Saelens B, Sallis JF. Neighborhood walkability and the walking behavior of Australian
adults. Am J Prev Med. Nov 2007;33(5):387–395.
Rivara FP, Relyea-Chew A, Wang J, Riley S, Boisvert
D, Gomez T. Drinking behaviors in young adults: the
potential role of designated driver and safe ride home
programs. Inj Prev. Jun 2007;13(3):168–172.
Rauh MJ, Koepsell TD, Rivara FP, Rice SG, Margherita
AJ. Quadriceps angle and risk of injury among high
school cross-country runners. J Orthop Sports Phys Ther.
Dec 2007;37(12):725–733.
Roudsari BS, Nathens AB, Arreola-Risa C, Cameron
P, Civil I, Grigoriou G, Gruen RL, Koepsell TD, Lecky
FE, Lefering RL, Liberman M, Mock CN, Oestern HJ,
Petridou E, Schildhauer TA, Waydhas C, Zargar M,
Rivara FP. Emergency Medical Service (EMS) systems
in developed and developing countries. Injury. Sep
2007;38(9):1001–1013.
McCauley E, Katon W. Pediatric primary care providers
and adolescent depression: a qualitative study of
barriers to treatment and the effect of the black box
warning. J Adolesc Health. May 2007;40(5):433–439.
Rivara FP, Anderson ML, Fishman P, Bonomi AE,
Reid RJ, Carrell D, Thompson RS. Healthcare utilization
and costs for women with a history of intimate partner
violence. Am J Prev Med. Feb 2007;32(2):89–96.
Rivara FP, Anderson ML, Fishman P, Bonomi AE,
Reid RJ, Carrell D, Thompson RS. Intimate partner
violence and health care costs and utilization for
children living in the home. Pediatrics. Dec
2007;120(6):1270–1277.
Rivara FP, Christakis DA. The march of science
[editorial]. Arch Pediatr Adolesc Med. Dec
2007;161(12):1214–1215.
Rivara FP, Cummings P, Ringold S, Bergman AB,
Joffe A, Christakis DA. A comparison of reviewers
selected by editors and reviewers suggested by authors.
J Pediatr. Aug 2007;151(2):202–205.
Rivara FP, Oldham KT. Pediatric trauma care:
defining a research agenda. J Trauma. Dec
2007;63(6 Suppl):S52–S53.
Rivara FP, Oldham KT, Jurkovich GJ, Guice KS, Mackenzie EJ. Towards improving the outcomes of injured
children. J Trauma. Dec 2007;63(6 Suppl):S155–S156.
140
Roudsari BS, Nathens AB, Cameron P, Civil I, Gruen
RL, Koepsell TD, Lecky FE, Lefering RL, Liberman M,
Mock CN, Oestern HJ, Schildhauer TA, Waydhas C,
Rivara FP. International comparison of prehospital
trauma care systems. Injury. Sep 2007;38(9):993–1000.
Saelens B, Glanz K, Sallis JF, Frank LD. Nutrition
Environment Measures Study in Restaurants (NEMS-R):
development and evaluation. Am J Prev Med. Apr
2007;32(4):273–281.
Saelens B, Liu LL. Clinician’s comment on treatment
of childhood overweight meta-analysis. Health Psychol.
Sep 2007;26(5):533–536.
Saelens B, Seeley RJ, van Schaick K, Donnelly LF,
O’Brien KJ. Visceral abdominal fat is correlated with
whole-body fat and physical activity among 8-yearold children at risk of obesity. Am J Clin Nutr. Jan
2007;85(1):46–53.
Spear BA, Barlow SE, Ervin C, Ludwig DS, Saelens B,
Schetzina KE, Taveras EM. Recommendations for
treatment of child and adolescent overweight and
obesity. Pediatrics. Dec 2007;120(Suppl 4):S254–S288.
Sugar NF, Feldman KW. Perineal impalements in
children: distinguishing accident from abuse. Pediatr
Emerg Care. Sep 2007;23(9):605–616.
General Pediatrics
Tarini BA, Christakis DA, Lozano P. Toward familycentered inpatient medical care: the role of parents
as participants in medical decisions. J Pediatr. Dec
2007;151(6):690–695.
Tarini BA, Garrison MM, Christakis DA. Institutional
variation in ordering complete blood counts for children
hospitalized with bronchiolitis. J Hosp Med. Apr
2007;10(2):69–73.
Taylor JA, Brownstein D, Klein EJ, Strandjord TP.
Evaluation of an anonymous system to report medical
errors in pediatric inpatients. J Hosp Med. Jul
2007;2(4):226–233.
Thompson DA, Christakis DA. The association
of maternal mental distress with television viewing
in children under 3 years old. Ambul Pediatr.
Jan–Feb 2007;7(1):32–37.
Thompson DA, Lozano P, Christakis DA. Parent
use of touchscreen computer kiosks for child health
promotion in community settings. Pediatrics. Mar
2007;119(3):427–434.
Zatzick DF, Russo J, Rajotte E, Uehara E, Roy-Byrne P,
Ghesquiere A, Jurkovich G, Rivara FP. Strengthening
the patient-provider relationship in the aftermath of
physical trauma through an understanding of the nature
and severity of post-traumatic concerns. Psychiatry.
Fall 2007;70(3):260–273.
Zimmerman FJ, Christakis DA. Associations
between content types of early media exposure and
subsequent attentional problems. Pediatrics. Nov
2007;120(5):986–992.
Zimmerman FJ, Christakis DA, Meltzoff AN.
Associations between media viewing and language
development in children under age 2 years. J Pediatr.
Oct 2007;151(4):364–368.
Zimmerman, FJ, Christakis DA, Meltzoff AN.
Television and DVD/video viewing in children
younger than 2 years. Arch Pediatr Adolesc Med.
May 2007;161(5):473–479.
Weber W, Taylor JA, McCarty RL, Johnson-Grass A.
Frequency and characteristics of pediatric and adolescent
visits in naturopathic medical practice. Pediatrics.
Jul 2007;120(1):e142–e146.
Wilfley DE, Stein RI, Saelens B, Mockus DS, Matt GE,
Hayden-Wade HA, Welch RR, Schectman KB, Thompson PA, Epstein LH. Efficacy of maintenance treatment
approaches for childhood overweight: a randomized
controlled trial. JAMA. Oct 2007;298(14):1661–1673.
Zatzick DF, Rivara FP, Nathens AB, Jurkovich GJ,
Wang J, Fan MY, Russo J, Salkever DS, Mackenzie EJ.
A nationwide US study of post-traumatic stress after
hospitalization for physical injury. Psychol Med. Oct
2007;37(10):1469–1480.
141
Genetics and Developmental Medicine
The Division of Genetics and Developmental Medicine is
committed to providing excellence in clinical care, education
and research related to a broad spectrum of genetic disorders,
birth defects and developmental disabilities. Approximately
3% to 5% of all newborns will have one of these conditions
or some related problem that may seriously influence the
quality of the patients’ and their families’ lives.
Faculty
Phillip F. Chance
MD, Chief
142
Phillip F. Chance, MD, Chief
Michael J. Bamshad, MD
Craig L. Bennett, PhD
Forrest C. Bennett, MD
Charles A. Cowan, MD
Daniel A. Doherty, MD, PhD
Alan G. Fantel, PhD
Ian A. Glass, MD, MBChB
Sihoun Hahn, MD, PhD
Mark C. Hannibal, MD, PhD
Anne V. Hing, MD
Ronald J. Lemire, MD (in memory)
John F. (Jeff) McLaughlin, MD
J. Lawrence Merritt, MD
Daniel G. Miller, MD, PhD
William R.A. Osborne, PhD
Roberta A. Pagon, MD
Melissa A. Parisi, MD, PhD
Janine E. Polifka, PhD
Michael L. Raff, MD
C. Ronald Scott, MD
Katherine A. TeKolste, MD
Cristine M. Trahms, MS, RD
William O. Walker Jr., MD
Stephanie E. Wallace, MD
Samuel H. Zinner, MD
The division is one of the largest in the United States
and is the oldest and most recognized referral center of
its type in the Pacific Northwest. Through an extensive
network of outreach clinics we also provide outpatient care
to children in the WAMI region. Faculty in the division have
varied academic backgrounds and are drawn from many
disciplines, including human/medical genetics, neurology,
developmental/behavioral pediatrics, developmental biology
and biochemistry. Through our academic partnerships at
the University of Washington, we provide postdoctoral
training programs in developmental pediatrics and medical
genetics. Our training programs are among the oldest in the
country, and many of our alumni hold leadership positions
at other institutions.
Faculty in the division are involved in many research
areas, including research into neurodevelopmental disabilities
(e.g., Joubert syndrome), neurodegenerative disorders (e.g.,
Charcot-Marie-Tooth neuropathy, Lou Gehrig disease), limb
malformations, heart malformations, biochemical/metabolic
diseases, gene therapy and population genetics/evolution.
Phillip F. Chance, MD, is chief of the Division of
Genetics and Developmental Medicine at Seattle
Medicine, with a joint appointment as professor in the
Department of Neurology. He is the first recipient of
the Allan and Phyllis Treuer Endowed Chair in Genetics
and Development at Children’s. Chance is director of
the Neurogenetics Laboratory in the Department of
Pediatrics, which includes trainees, technical staff
and the participation of six full-time faculty. The lab
conducts research into the molecular basis of several
rare neurodevelopmental and neurodegenerative
diseases in children, focusing on four main areas:
juvenile Lou Gehrig disease (amyotrophic lateral
sclerosis or ALS4), Charcot-Marie-Tooth neuropathies,
hereditary neuralgic amyotrophy (HNA, also called
familial brachial plexus neuropathy) and Joubert
syndrome and related cerebellar malformations.
Chance has published more than 80 peer-reviewed
articles and communications and authored 40 book
chapters; he lectures frequently on his research. He is
a member of the steering committee of the University
Center for Neurogenetics and Neurotherapeutics. He
serves on the medical advisory committees for the
Muscular Dystrophy Association, the Charcot-MarieTooth Association, the Les Turner ALS Association
and the Joubert Syndrome Association.
Michael J. Bamshad, MD, is professor in the Department
of Pediatrics and adjunct professor of genome sciences
at the University of Washington. His laboratory addresses
the origins and affinities of humans, develops novel
strategies to find disease susceptibility variants and
characterizes genetic variants influencing risk for an
assortment of health-related conditions. Bamshad is
particularly interested in identifying genetic variants
that cause birth defects that alter risk for chronic
diseases of childhood, infections and preterm birth,
and that influence chemosensory perception such as
taste. His laboratory has identified genetic variants
that underlie several disorders manifested by either
limb defects or heart defects. Bamshad’s lab has
recently discovered that mutations in several genes
(e.g., TNNI2, TNNT3, TPM2, MYH3) that encode
proteins of the contractile apparatus of fast-twitch
myofibers cause several syndromes characterized by
contractures of the feet such as clubfoot. Researchers
in his lab are now trying both to understand the
mechanism by which these mutations disrupt muscle
function and also to determine whether these genes
influence susceptibility to idiopathic clubfoot.
Craig L. Bennett, PhD, is research assistant professor
in the Department of Pediatrics at the University
of Washington School of Medicine. His research is
conducted in the Neurogenetics Laboratory and is
focused in two areas. The first is the molecular basis
of a juvenile-onset form of a motor neuron disease
known as amyotrophic lateral sclerosis type 4 (ALS4)
that results from mutations of the senataxin (SETX)
gene. In recent work, Bennett and co-workers generated mammalian expression constructs of wild type
SETX and three mutant forms of SETX associated
with ALS4. They also found that the amount and
molecular weight of the SETX protein isolated from
ALS4 patient lymphoblasts is approximately equal
to that from controls. Most important, they have
produced murine ALS4 transgenic founders that will
likely prove extremely important to understanding the
mechanism leading to motor neuron death resulting
from SETX mutations. The second area of research is
Charcot-Marie-Tooth neuropathy type 1C (CMT1C).
Bennett has collaborated to show that the SIMPLE
protein (which, through mutation, causes CMT1C)
Spotlight on team member — Kathy Price, MSW, LICSW
The concepts of compassionate, comprehensive, familycentered and coordinated care are exemplified in Seattle
Children’s new Medically Complex Child Service (MCCS),
started in summer 2007. Working hand in hand with parents
and providing the gold standard regarding continuity of
care, the MCCS team is improving the hospital experience
and quality of life for our children and teens with complex
medical needs.
interacts with two proteins, NEDD4 and TSG101, that
act sequentially in the lysosomal sorting pathway. Their
results show that SIMPLE co-localizes with NEDD4
at the plasma membrane and the Golgi apparatus.
Forrest C. Bennett, MD, serves as director for the
High-Risk Infant Follow-Up Program at the Center for
Human Development and Disability at the University
of Washington School of Medicine; he is also director
of the Pediatrics WWAMI Program and director of
the Pediatric Medical Student Program. Bennett is a
member of the university Clinical Curriculum Committee
and serves on the Pediatric Residency Committee and
the Intern Selection Committee. Bennett was named
president-elect of the Western Society for Pediatric
Research in 2007 and will serve as president in 2008.
His research includes a Phase IV study looking at the
role of early developmental intervention for premature
infants. Bennett is also participating in collaborative
studies evaluating the role of nitric oxide in the
treatment of neonatal RDS and long-term outcomes,
including developmental and chronic lung disease.
Bennett lectures in rehabilitation medicine and in
public health and maternal child health courses. He
oversees the third-year pediatrics clerkship students
and approximately 20 fourth-year medical students. He
also serves as a mentor to the regional medical student
faculty and gives CME lectures in developmental
pediatrics at regional and national courses.
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Charles A. Cowan, MD, is attending physician in the
Neurodevelopmental Program and leads the Autism
Program at Seattle Children’s Hospital; he is clinical
University of Washington School of Medicine. Cowan’s
clinical interests relate to care of children with complex
developmental disabilities, especially autism. He also
has Children’s responsibilities as the clinical director
of Care Coordination Services. These duties encompass
development and supervision of the community
hospitalist programs at three regional hospitals:
Evergreen Hospital Medical Center, Providence
Everett Medical Center and Kadlec Medical Center.
His research interests also encompass standardization
of care utilizing the Pediatric Health Information
System database and development of guidelines
and clinical pathways at Children’s. In 2006, Cowan
was honored with the Duncan Award for service to
children and families with developmental disabilities.
Daniel A. Doherty, MD, PhD, is assistant professor in the
School of Medicine. He is a developmental pediatrician
working on Joubert syndrome (JS), an autosomal
recessive brain malformation syndrome involving
cerebellar vermis hypoplasia with accompanying brainstem abnormalities. Clinically, JS is characterized by
hypotonia, developmental delays, abnormal respiratory
control, abnormal eye movements and in some cases
retinal, renal and hepatic disease. Mutations in five genes
cause JS, accounting for less than 50% of patients. With
Drs. Glass and Parisi, Doherty led a collaborative effort
to identify the RPGRIP1L gene as one cause of JS and
to implicate RPGRIP1L in the function of the primary
cilium/basal body complex, a subcellular organelle
involved in a variety of genetic disorders. The JS group
continues to search for the remaining causes of JS
using SNP genotyping to identify regions of haplotype
sharing in consanguineous families. This work will
directly benefit patients with JS through diagnostic
testing and improved medical monitoring for complications. It will also shed light on the genetic mechanisms
underlying JS and normal brain development. Doherty’s
clinical interests include the care of children with brain
malformations and prenatal counseling for fetal central
nervous system malformations.
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Alan G. Fantel, PhD, is professor in the Department of
Medicine. His laboratory has two main interests. One
is the role of free radical formation and toxicity in the
genesis of limb reduction anomalies. He is studying
the involvement of nitric oxide and its metabolites in
these malformations in mice. The laboratory is also
the major NIH-funded facility for the collection and
distribution of human conceptal tissue to grant-funded
institutions.
Ian A. Glass, MD, MBChB, is director of Medical Genetics
at Seattle Children’s Hospital and co-director of the
Alaska Genetics and Birth Defects Clinic. He is associate
University of Washington School of Medicine and holds
an adjunct appointment in the Division of Medical
Genetics. He also serves on the Genetics Advisory
Committee and the Newborn Screening Committee of
the Washington State Department of Health. Children’s
programs provide virtually all of the pediatric genetic
services for the states of Washington and Alaska. Glass
serves as program leader for a focused research project
on Joubert syndrome and related disorders of brain
development. The project is a collaboration within
the Neurogenetics Laboratory that includes several
division faculty. His recent work with this group includes
two important discoveries, both of which have been
recently reported. The first is a description of the
NPNH1 gene deletions in patients with a subset of
Joubert syndrome. The second relates to a prenatal
diagnosis imaging protocol for Joubert syndrome.
Sihoun Hahn, MD, PhD, is attending physician at Seattle
of Pediatrics and adjunct professor of medicine at
He is head of the Biochemical Genetics Program and
director of the Biochemical and Molecular Genetics
Laboratory. Hahn recently moved from the Mayo Clinic
in Rochester, Minn. After receiving his MD/PhD from
Korea University College of Medicine in Seoul, Korea,
he enrolled in a medical genetics fellowship at the
National Institutes of Health, Bethesda, Md., where
he was the recipient of a National Research Service
Award Fellowship. He is board certified in pediatrics
and medical genetics. Hahn’s research has focused on
copper metabolism, population screening for Wilson
disease, and mitochondrial disease. His work focused
on developing a newborn screening test for Wilson
disease, a genetic disease in which the body cannot
excrete copper properly, leading to its accumulation in
various organs including the liver and brain. He serves
as a member of the medical advisory committee of the
Wilson’s Disease Association. Other research focuses
on mitochondrial diseases and peptide fingerprinting
analysis by tandem mass spectrometry for various
disorders. He serves on the Newborn Screening Advisory
Committee for Washington state. He hopes to improve
clinical practice through integrated laboratory testing
— true translational research — and remains a great
believer in prevention.
include the diagnosis and management of infants,
children and adolescents with craniofacial and genetic
conditions. She works in the craniofacial, craniofacial
genetics and limb deficiency clinics, and also serves
as a genetics consultant in seven different outreach
genetics clinics throughout the states of Washington
and Alaska. Hing coordinates the craniofacial resident
elective course and provides bedside teaching. She has
served as Children’s principal investigator in a multicenter international study of the genetics of cleft lip
and palate for the past seven years. She is also mapping
a rare autosomal recessive craniofacial disorder and is
a co-investigator in a study looking at potential causes
of hemifacial microsomia.
Mark C. Hannibal, MD, PhD, is attending physician at
Washington School of Medicine. He completed a
combined MD/PhD program at the University of
Michigan and a pediatrics residency and medical genetics
fellowship at the University of Washington. His clinical
work is in the medical genetics, cardiovascular genetics
and immunology clinics at Children’s. Regionally, he
provides genetics consultation throughout Washington
and Alaska. His areas of interest are Kabuki syndrome
and immunogenetics, particularly immune deficiency
associated with syndromes. Hannibal’s primary
research focus is studying the molecular basis of
hereditary neuralgic amyotrophy. This episodic
autosomal dominant disorder is characterized by
attacks of sudden, severe, nonabating pain in the
shoulder and/or the arm, and weakness with muscle
wasting. In some families, non-neurologic findings
include excessive skin folds, relatively short palpebral
fissures, hypotelorism and bifid uvula or cleft palate.
His interest is in the translational aspects of genetic
disorders, such as understanding how mutations in the
Septin-9 gene cause features of hereditary neuralgic
amyotrophy. He is a member of the faculty senate at
the University of Washington and the Professional
Advisory Board for the Kabuki Syndrome Network.
Ronald J. Lemire, MD, passed away in February 2008.
He was the director for inpatient services at Seattle
Children’s Hospital, which include the Transport Team
and the Intensive Care Unit; he was also attending
physician in the Birth Defects Clinic. He was professor
of Medicine. Lemire served as an interface between
the Harborview Medical Center Trauma System and
Seattle Children’s, and he was coordinator for the
Flight Service. Lemire also provided coverage for the
medical director of Seattle Children’s and the chair of
the Department of Pediatrics. Lemire’s main research
interest was in teratology. With Tom Shepard, he
published the 11th edition of the Catalog of Teratogenic
Agents. His research studies included anencephaly,
holoprosencephaly and other aspects related to normal
and abnormal development of the human nervous
system. Lemire’s clinical interests included neural
tube defects and spinal cord malformations.
Anne V. Hing, MD, is attending physician at Seattle
Children’s Hospital, assistant professor in the Department of Pediatrics at the University of Washington
School of Medicine and adjunct faculty member in the
Division of Medical Genetics. Hing’s clinical interests
John F. (Jeff) McLaughlin, MD, is chief of the Spasticity
Management Clinic at Seattle Children’s Hospital. He
is a professor in the Department of Pediatrics at the
University of Washington School of Medicine, where
he is the director of the Clinical Training Unit in the
Center on Human Development and Disability. His
research interests are in the treatment of spasticity
and the comprehensive care of children with disabilities
and congenital anomalies. McLaughlin is chair of the
annual Duncan Seminar, devoted to developmental
disabilities, at Children’s.
145
J. Lawrence Merritt, MD, is attending physician at
Washington School of Medicine. He joined Children’s
after completing his pediatric residency, medical
genetics residency and biochemical genetics fellowship
at the Mayo Clinic in Rochester, Minn. He provides
inpatient and outpatient clinical services in biochemical
genetics at Children’s and in Spokane travel clinics. His
clinical interests include long-term follow-up of infants
with abnormal newborn screens, urea cycle disorders
and fatty acid oxidation disorders. He is chair of the
ad-hoc Professional Development Committee of the
American Society of Human Genetics.
Daniel G. Miller, MD, PhD, is attending physician at
Seattle Children’s Hospital, assistant professor in the
Division of Genetics and Developmental Medicine
and adjunct professor in the Department of Genome
Medicine. Miller is interested in using gene therapy
strategies to treat human genetic disease. His research
is focused in three principal areas: the first focuses
on characterization of the integration sites for adenoassociated virus (AAV). Other research focuses on
gene-targeting keratinocytes for possible treatment
of epidermolysis bullosa. A third area relates to the
evaluation of DUX4 expression during myogenesis in
a transgenic animal model for facioscapulohumeral
muscular dystrophy. Miller was elected to the Society
of Pediatric Research in 2007. His clinical work is in
the pediatric Medical Genetics Clinic at Children’s.
William R.A. Osborne, PhD, is research professor in the
Department of Pediatrics and director of gene therapy
research at the Center on Human Development and
Disability (CHDD) at the University of Washington
School of Medicine. His current research is in two
areas. The first is developing gene transfer therapies to
treat cyclic neutropenia in dogs. This research entails
the in vivo lentivirus-mediated delivery of canine
granulocyte/colony stimulating factor and also its
delivery using encapsulated cells. The second area is in
gene therapy to treat type I and type II diabetes. This
work entails the development of specific cell lines to
secrete insulin and glucagon-like peptide 1 for transplantation into diabetic rats. It also involves developing
methods permitting implantation of allogeneic islet
cells for long-term survival and therapy not requiring
immunosuppression. Osborne is a member of the
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Scientific Editorial Board for Human Gene Therapy;
he is also a member of the Musculoskeletal Tissue
Engineering Study Section at the NIH and a member
of the Scientific Review Board for the National Gene
Vector Laboratories also based at the NIH. He has
trained numerous postdoctoral fellows.
Roberta A. Pagon, MD, is attending physician at Seattle
Medicine. She is principal investigator for GeneTests:
Genetic Testing Information Resource, an NIH-funded
database used by clinicians to identify genetic testing
laboratories and apply genetic testing to the diagnosis,
management and genetic counseling of patients with
inherited disorders and their families. Pagon is the
review board coordinator for the Collaboration, Education and Test Translation (CETT) Program funded by
the Office of Rare Disorders of the NIH. The CETT
Program is focused on facilitating translation of genetic
testing from research laboratories into clinical practice.
Pagon’s clinical interests are hereditary eye disorders
and disorders of sexual differentiation. In addition to
seeing patients in the genetics clinic at Children’s, she
attends in the genetics clinics in the Washington State
Regional Genetics Program and the Alaska Genetics and
Birth Defects Clinic. Pagon has served on the board of
directors of the American Society of Human Genetics,
the board of directors of the American Board of Medical
Genetics and the Board of Scientific Counselors of the
National Human Genome Research Institute at the NIH.
Melissa A. Parisi, MD, PhD, is attending physician at
Washington School of Medicine. Her clinical work is
performed primarily through the Medical Genetics
Clinic at Children’s. She also sees patients in the State
of Alaska Outreach Clinics, participates in genetics
clinics in Bellingham, Wash., and provides consultation
in genetics at Swedish Hospital in Seattle, Wash. Areas
of special interest include congenital brain disorders
and disorders of sex development. Parisi’s research is
focused on identifying the molecular basis of genetic
disorders of brain development, particularly those
involving the hindbrain or cerebellum. She is involved
in studies on the prenatal diagnosis and natural history
of cerebellar malformation syndromes. Many of her
publications focus on Joubert syndrome and related
cerebellar disorders, a group of conditions with the
shared feature of the molar tooth sign on MRI. She
and her colleagues have identified several new causative
genes for Joubert syndrome, and they are actively
seeking other genetic causes for these disorders. Parisi
is chair of the Scientific Advisory Board for the Joubert
Syndrome Foundation and Related Cerebellar Disorders
parent support group. She also serves on the steering
committee for the Puget Sound Women’s Pediatric
Society and is involved in work-life balance initiatives
at Children’s.
Janine E. Polifka, PhD, is lecturer in the University of
Washington School of Medicine and clinical instructor
in the School of Pharmacy. She is co-director of CARE
(Counseling and Advice on Reproductive Exposures)
Northwest, a teratogen information service at the
University of Washington that receives approximately
75 inquiries per month regarding pregnancy and lactation exposures. She also manages TERIS (Teratogen
Information System), a computerized database that
provides information on the effects of environmental
agents on the developing embryo/fetus. She received
her PhD in experimental psychology from the University
of Louisville and a postdoctoral training fellowship in
teratology at Thomas Jefferson University in Philadelphia, Pa. Her clinical and research interests include
clinical teratology and teratogenic risk assessment.
She serves on the Pediatric Environmental Health
Specialty Unit (PEHSU) Committee, which addresses
the concerns of health-care professionals and their
patients about exposures to environmental contaminants.
Polifka is also on the staff of the Community Outreach
and Education Core (COEC) of the Center for Ecogenetics
and Environmental Health (CEEH) at the University
of Washington. Polifka is a past president and active in
several committees of OTIS (Organization of Teratology
Information Services), which oversees 19 teratology
information services in North America. She also serves
on several committees of the Teratology Society.
Michael L. Raff, MD, is attending physician at Seattle
Children’s Hospital and assistant professor at the
provides clinical genetics services in the Medical
Genetics, Biochemical Genetics and Metabolic Bone
clinics at Children’s, in the Washington State Regional
Clinics program and in the Biochemical Genetics
Clinics for the state of Alaska. Raff ’s clinical and
research interests include disorders of energy metabolism
(including CPT1 deficiency) and metabolic disorders
of bone. Other interests include medical genetics
teaching and curricula for medical students and
medical residents, and the use of telemedicine to
provide clinical genetics services.
C. Ronald Scott, MD, is attending physician at Seattle
Children’s Hospital and professor in the departments
of Pediatrics and Medicine at the University of Washington School of Medicine. He has special clinical
expertise in the diagnosis and management of children
and adults with inborn errors of metabolism. He is
director of the Phenylketonuria and Metabolic Disease
Clinic at the University of Washington and has initiated
a program for the diagnosis and management of
children or adults with lysosomal storage diseases.
Scott’s research focuses on collaboration with the
University of Washington’s Department of Chemistry
in the development of special applications of tandem
mass spectroscopy for the diagnosis of biochemical
disorders through newborn screening programs. He
has multiple grants from federal and private agencies
in support of detecting metabolic diseases through
newborn screening and for the management of
lysosomal storage disorders. Scott is board certified
in pediatrics, biochemical genetics and molecular
genetics. He serves as an advisor on genetics for the
Washington State Legislature and Department of Health.
He serves as a consultant to companies who manufacture
special infant formulas and to pharmaceutical companies
regarding the appropriate management of individuals
with lysosomal storage diseases. He has served on the
board of directors for the Society for Inherited Metabolic
Disorders, the American Board of Medical Genetics
and the American Society of Human Genetics. Scott
recently received the FDA Commissioner’s Special
Citation for his work on hereditary tyrosinemia I and
has been listed in “Best Doctors in America” since 1992.
Katherine A. TeKolste, MD, is clinical associate professor
in the Department of Pediatrics and developmental
pediatrician at the University of Washington School
of Medicine. Since 1993, TeKolste has worked with the
Washington State Medical Home Project to improve
care for children and youth with special health-care
needs. She co-directs the UW’s Medical Home Leadership Network and is co-director of the Medical Home
Learning Collaborative of the Washington State Collaborative to Improve Health. In addition, she serves as
director of the Adolescent Health Transition Project
(AHTP) supported by the Washington State Department
147
of Health. The AHTP aims to improve the transition
of adolescents with disabilities and childhood-onset
chronic conditions from pediatric care into adult health
care. TeKolste has worked with many state and regional
projects, including the Kids Get Care/Children’s
Preventive Healthcare Initiative in King County, Wash.,
and the CHILD Profile materials review committee.
As co-primary investigator on a CATCH grant from
the AAP, she worked to improve mental health services
in the primary care pediatric practice. She has been
involved in HB1088 implementation efforts. TeKolste
served for many years as a member of the State
Interagency Coordinating Council for Birth to Three
services in Washington state. She has been active in
regional efforts to improve developmental screening
and oral health services for children, including work
with the Interdisciplinary Children’s Oral Health
Promotion (ICOHP) project. She was part of the multistate team for the Assuring Better Child Development
(ABCD-I) grant from the Commonwealth Fund and
the National Academy for State Health Policy. TeKolste
worked on the Infant Health and Development Program
(IHDP) multicenter study of premature infants and
has served as interim director of the university’s
High-Risk Infant Follow-up Clinic. She served for
six years as president of the Northwest Society for
Developmental and Behavioral Pediatrics.
Cristine M. Trahms, MS, RD, is senior nutritionist for the
Biochemical Genetics Clinic and the Metabolic Genetics
Clinic at Seattle Children’s Hospital. She is program
director and senior nutritionist for the Phenylketonuria
(PKU) Clinic at the University of Washington School of
Medicine. She coordinates cooperative educational and
support activities, including a live TV downlink to the
Spokane PKU Clinic. She serves on the editorial board
and the advisory board for the National PKU News.
She also writes a quarterly self-management column,
“Just for Kids,” and is reviewer for The Journal of the
American Dietetic Association. In addition to many
committee and board memberships, Trahms is nutrition
discipline leader for the Leadership Education in
Neurodevelopmental and Related Disabilities (LEND)
training project at the university’s Center on Human
Development and Disability (CHDD). She is a member
of the core faculty of Nutritional Sciences in the
School of Public Health and Community Medicine
and co-teaches courses and mentors students. Trahms
developed and continues to refine and update a
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regional PKU treatment protocol/manual — which
incorporates current evidence-based medical and
nutritional care — as well as the PKU Clinic Web site.
Trahms has been recognized for Excellence in the
Practice of Clinical Nutrition by the American Dietetic
Association and named Outstanding Dietitian of the
Year by the Washington State Dietetic Association.
William O. Walker Jr., MD, is director of the Neurodevelopmental/Birth Defects Clinic at Seattle Children’s
Hospital. He is associate professor in the Department
Medicine and serves as director of the developmental
behavioral pediatrics fellowship program. He is also
adjunct associate professor of pediatrics at the Uniformed
Services University of the Health Sciences, F. Edward
Herbert School of Medicine, Bethesda, Md. Walker’s
clinical interests are focused on improving coordination
of patient care across medical and surgical specialties
in the Neurodevelopmental/Birth Defects Clinic and
improving access to neurodevelopmental outpatient
services by utilizing referral pathways and pre-referral
guidelines. He is subspecialty boarded in neurodevelopmental disabilities and developmental behavioral
pediatrics. Walker has collaborative research projects
under way in the areas of continence and quality-of-life
measures for spina bifida patients. He frequently
lectures at national conferences on spina bifida as well
as conferences on intellectual and other developmental
disabilities. He is a member of the Professional Advisory
Committee, Spina Bifida Association of America; the
editorial board for DB:PREP, a subspecialty publication
of the American Academy of Pediatrics; and the
Treatment Outcomes Committee, American Academy
of Cerebral Palsy and Developmental Medicine.
Stephanie E. Wallace, MD, is attending physician at
Washington School of Medicine. Her clinical work is
performed primarily through the Medical Genetics
Clinic at Children’s. She also sees patients in genetics
clinics in Bellingham, Yakima and Wenatchee, Wash.,
and in the State of Alaska outreach clinic. She leads
the Neurofibromatosis Clinic and participates in the
Skeletal Dysplasia Clinic at Children’s and provides
an adult cancer genetics clinic at Tacoma General
Hospital. Areas of interest include skeletal dysplasias
and cancer genetics.
Samuel H. Zinner, MD, is an assistant professor and a
developmental-behavioral pediatrician (DBP) with
the University of Washington Center on Human
Development and Disability and with the Neurodevelopmental/Birth Defects Clinic at Seattle Children’s
Hospital. Zinner completed medical school at the
University of California, San Diego; a pediatrics
residency at Kaiser Permanente in Los Angeles, Calif.;
and a DBP fellowship at Children’s Hospital, Boston,
Mass. His clinical and research interests focus on
psychosocial and behavioral aspects of neurodevelopment
with particular interest in Tourette syndrome and
its associated conditions. Research and educational
activities explore quality of life (QoL) for adolescents
with Tourette syndrome and their families; enhancement
of “Medical Home” capabilities for community providers;
and participation with the Autism Treatment Network,
a network of research centers that engages in projects
to advance understanding of the disease, develop
medical treatments and establish standards of clinical
care based on research and shared clinical practice.
Recent Tourette syndrome presentations include
multiple Grand Rounds throughout the United States
and in Norway, and on Medical Home in Alabama.
QoL work was presented as posters at the annual
conference of the Society of DBP. Zinner is director
of pediatric residency training in DBP and a member
of the Medical Advisory Board of the national Tourette
Syndrome Association.
Alan G. Fantel, PhD
Laboratory of Developmental Biology. NIH/NICHD.
$417,857.
AAV vector integration frequency and associated
genome alterations. NIH/NIDDK. $234,000.
DUX4 gene expression differences in
facioscapulohumeral muscular dystrophy.
Muscular Dystrophy Association. $220,000.
Rare diseases research test translation to clinical
testing. NIH/Office of Rare Diseases. $73,738.
C. Ronald Scott, MD
An open-label extension of patients with late-onset
Pompe disease who were previously enrolled in protocol
AGLU02704. Genzyme Corporation. $71,442.
Continuing
Genetic and molecular basis of congenital contractures.
NIH/NICHD. $316,023.
Human genes shaping the response to bioterrorism
agents. Colorado State University. $266,817.
National birth defects prevention study. Utah
Department of Health. $109,214.
AWARDS AND HONORS
C. Ronald Scott, MD
Commissioner’s Special Citation. U.S. Food and
Drug Administration.
Phillip F. Chance, MD
Identification and characterization of the ALS4 gene.
NIH/NINDS. $86,233.
Molecular basis of hereditary neuralgic amyotrophy.
NIH/NINDS. $307,850.
RESEARCH FUNDING
New
Genetic modifier C.F.-DNA collection. Seattle
Children’s Hospital. $150,179.
Senataxin mutations and neurodegeneration in
amyotrophic lateral sclerosis type 4. Muscular
Dystrophy Association. $128,415.
Genetic analyses of cerebellar malformations.
NICHD/NIH/DHHS. $74,534.
Improving measurement of pain and fatigue in children
and adults with disabilities, University of Washington
Center for Outcomes Research in Rehabilitation. NIH.
$787,501.
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Infusion system performance registry. Medtronic, Inc.
$30,000.
Use of oral baclofen for treatment of spasticity of cerebral
palsy in children. NICHD/NIH/DHHS. $59,764.
FSHMD related defects in human myogenesis.
Pacific Northwest Friends of FSH Research. $50,000.
William R.A. Osborne, PhD
Canine G-CSF gene transfer. NIH/NIDDK. $235,741.
GeneTests. NIH/National Library of Medicine.
$1,523,731.
Molecular basis of Joubert syndrome and related
diseases. NIH/NINDS. $166,271.
C. Ronald Scott, MD
Novel technologies in newborn screening.
Phenylketonuria Clinic 2005–2008. Washington State
Department of Health. $535,819.
Study of Gaucher disease. Genzyme Corporation.
$185,000.
5th Annual Structural Birth Defects Meeting, National
Institute of Child Health and Development. Baltimore,
Md. 2007.
M.H. Gluck Equine Research Center. University of
Kentucky. Lexington, Ky. 2007.
Genetic influences on health: does race matter? Grand
Rounds Seminar Series, New York University Department of Medicine. New York, N.Y. March 7, 2007.
150
Genetic and molecular basis of congenital contractures
(invited plenary session). International Clubfoot
Symposium. University of Iowa. Iowa City, Iowa.
September 2007.
Genetic influences on health: does race matter?
(invited plenary session). American Society of Human
Genetics 57th Annual Meeting. San Diego, Calif.
October 2007.
Senataxin, a role in ataxia (OA2) and familial ALS
(ALS4). Pacific Northwest Neurogenetics Retreat.
Seattle Children’s Hospital. Seattle, Wash. March 2007.
Charles A. Cowan, MD
Understanding behavior problems in children with
developmental disabilities: a non-categorical approach.
North Pacific Pediatric Society Annual Meeting.
Lynnwood, Wash. March 18, 2007.
Autism spectrum disorders. Advanced Practice in
Primary and Acute Care Conference, University of
Washington School of Nursing. Seattle, Wash.
Nov. 8, 2007.
Daniel A. Doherty, MD, PhD
Prenatal diagnosis in pregnancies at risk for Joubert
syndrome utilizing ultrasound and MRI: review and
proposed screening protocol (co-presenter). American
College of Medical Genetics Annual Meeting. Nashville,
Tenn. March 24, 2007.
Joubert syndrome: the new ciliopathy (co-presenter).
North Pacific Pediatric Neurology Colloquium. Seattle,
Wash. June 22, 2007.
Joubert syndrome: the new ciliopathy (co-presenter).
Second Annual Seattle Children’s Hospital Research
Institute Symposium. Seattle, Wash. Aug. 9, 2007.
Mutations in the gene encoding the basal body protein
RPGRIP1L, a novel nephrocystin-4 interactor, cause
Joubert syndrome (co-presenter). American Society
of Human Genetics 57th Annual Meeting. San Diego,
Calif. Oct. 27, 2007.
The geneticist’s approach to mental retardation.
Pediatrics Grand Rounds, Alaska Native Medical
Center. Anchorage, Alaska. Nov. 27, 2007.
To grow tall or stay small. Point/counterpoint. American
Academy for Cerebral Palsy and Developmental Medicine.
Vancouver, British Columbia, Canada. October 2007.
Gordon Conference on Myogenesis. Italy. March 2007.
AAV vector integration sites associated with
hepatocellular carcinoma. American Society of Gene
Therapy Annual Meeting. Seattle, Wash. May 2007.
Mayo genomics education. Distinguished Speakers
Series. Mayo Clinic. Rochester, Minn. April 2007.
Genetic testing in clinical neurology course. American
Academy of Neurology. Boston, Mass. May 2007.
Role of registries in health care: the GeneTests experience.
Genetic Testing Quality Meeting. Genetics and Public
Policy Center, Johns Hopkins University. Washington,
D.C. July 2007.
Genetic testing in the U.S.: the GeneTests perspective.
Third International Conference on Rare Diseases
(ICORD). Brussels, Belgium. September 2007.
Genetic testing: the clinician’s perspective. Third
Hangzhou International Symposium and Annual
Short Course on Medical and Laboratory Applications
of Genetics and Genomics. Zhejiang University.
Hangzhou, China. October 2007.
An approach to infants and adolescents with disorders
of sex development (DSD). Pediatric Grand Rounds,
Alaska Regional Hospital. Anchorage, Alaska.
Jan. 24, 2007.
Prenatal diagnosis in pregnancies at risk for Joubert
syndrome utilizing ultrasound and MRI: review and
proposed screening protocol (co-presenter). American
College of Medical Genetics Annual Meeting. Nashville,
Tenn. March 24, 2007.
Malformations of the posterior fossa. Neurogenetics
Symposium. Alberta Children’s Hospital. Calgary,
Alberta, Canada. April 20, 2007.
Identification of a novel gene for Joubert syndrome
and related disorders: further support for a ciliary
mechanism for cerebello-oculo-renal syndromes.
David W. Smith Annual Workshop on Malformations
and Morphogenesis. Kingsmill, Va. Aug. 8–12, 2007.
Joubert syndrome and related cerebello-oculo-renal
syndromes: the primary cilium and beyond. Ondokuz
Mayis University. Samsun, Turkey. Oct. 31, 2007.
The genetics of nephronophthisis and related
cerebello-oculo-renal syndromes. Grand Rounds,
Northwest Kidney Center. Seattle, Wash. Dec. 6, 2007.
Janine E. Polifka, PhD
Human teratogens in relationship to craniofacial
anomalies. Orthodontic lecture series, Seattle Children’s
Hospital. Seattle, Wash. Nov. 29, 2007.
C. Ronald Scott, MD
The potential for newborn screening of lysosomal
storage diseases by tandem mass spectroscopy.
American College of Medical Genetics. San Diego,
Calif. March 26, 2007.
Significant milestones in the treatment of PKU. PKU
Science Night. Shoreline, Wash., simulcast in Spokane,
Wash. Oct. 5, 2007.
The technologies for using newborn blood spots to
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American Society of Human Genetics. San Diego, Calif.
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Technologies for performing newborn screening for
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Health/American College of Medical Genetics.
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Katherine A. TeKolste, MD
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CHDD and the LEND program — resources for children
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Cristine M. Trahms, MS, RD
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The role of the low-sodium diet in the management
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William O. Walker Jr., MD
Mental retardation — what do all these numbers
mean? (invited lecturer). Le developpement de
l’enfant: nouveaux enjeux! CHU Sainte-Justine.
Montreal, Quebec, Canada. October 2007.
Mental retardation — what do we do with all of these
numbers? (instructional course). 61st Annual Meeting,
American Academy for Cerebral Palsy and Developmental Medicine. Vancouver, British Columbia,
Canada. October 2007.
Samuel H. Zinner, MD
Tourette disorder and comorbid conditions. Cardinal
Glennon Children’s Hospital and Washington University.
St, Louis, Mo. January 2007.
Tourette disorder and comorbid conditions. University
of Wyoming–Cheyenne Regional Medical Center.
Cheyenne, Wyo. February 2007.
Tourette disorder and comorbid conditions. University
of Nevada, Las Vegas. Las Vegas, Nev. March 2007.
Tourette disorder and comorbid conditions. Cottage
Hospital. Santa Barbara, Calif. March 2007.
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Borozdin W, Graham JM, Bohm D, Bamshad MJ,
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SM Jr. Case of the month: variable presentation of
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Brzezinski M, Yanay O, Waldron L, Barry SC,
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Donsante A, Miller DG, Li Y, Vogler C, Brunt EM,
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Hematology/Oncology
and Bone Marrow Transplant
Seattle Children’s Hospital, Fred Hutchinson Cancer
Research Center (FHCRC) and the University of Washington
Medical Center bring together their adult and pediatric
oncology programs in the Seattle Cancer Care Alliance
(SCCA). Children’s is a nationally recognized leader in
pediatric cancer diagnosis and treatment, and the Division
of Hematology/Oncology and Bone Marrow Transplant
provides the pediatric cancer care for the SCCA. The dedicated pediatric specialists in our 33-bed SCCA inpatient
unit care for more than 240 new patients each year.
Our multidisciplinary approach to treatment offers real
advantages to our patients. A diverse group of experienced
pediatric specialists, present in one location and focused
on the care of children, is able to deliver the best possible
treatments. Members of our team include oncologists,
surgeons, midlevel practitioners, nurses, nutritionists, social
workers and child life specialists working in inpatient and
outpatient settings.
The Hematology/Oncology Clinic offers multiple specialty
services, including a bone tumor clinic, bone marrow
transplant services, hematologic and sickle cell disease
clinics, a multidisciplinary solid tumor oncology clinic, a
neuro-oncology clinic, surgical oncology care, palliative
care and radiation therapy. Whenever possible, we treat
our patients with the Children’s Oncology Group protocols
approved by our review board, which include investigational
therapy or drugs when there are no effective standard
therapies for a given diagnosis.
We offer long-term follow-up through the ACCESS
(After Cancer Care Ends, Survivorship Starts) Program,
which helps pediatric cancer survivors live healthy lives,
and through the Long-Term Follow-up Program, which
evaluates effects after hematopoietic cell transplant.
Based on our overall dedication to improving survival rates
for children with brain tumors, the depth of our program,
the clinical resources of our institution and our ability to
perform innovative research, Children’s was one of nine
institutions in the United States selected for membership
in the Pediatric Brain Tumor Consortium.
Our research activities to improve cancer treatment
encompass internationally recognized programs at
Children’s, the University of Washington and FHCRC. These
activities have been responsible for the development of
widely used clinical treatments, including hematopoietic
stem cell transplantation and a novel targeted therapy for
treating acute myelogenous leukemia.
Faculty
Irwin D. Bernstein, MD, Chief
Tina M. Albertson, MD
Robert G. Andrews, MD
Michael A. Bender, MD, PhD
Marie Bleakley, MD, MMSc
Lauri M. Burroughs, MD
Paul Carpenter, MBBS
Eric Chow, MD, MPH
Mari Dallas, MD
Colleen Delaney, MD, MSc
Debra L. Friedman, MD
J. Russell Geyer, MD
Douglas S. Hawkins, MD
Rebecca H. Johnson, MD
Thomas J. Manley, MD
Dana C. Matthews, MD
Soheil Meshinchi, MD, PhD
James M. Olson, MD, PhD
Julie R. Park, MD
Thomas W. Pendergrass, MD, MSPH
Jessica Pollard, MD
Jean E. Sanders, MD
Akiko Shimamura, MD, PhD
Barbara Small, MD
Blythe G. Thomson, MD
Ann E. Woolfrey, MD
Irwin D. Bernstein
MD, Chief
155
Hematology/Oncology and Bone Marrow Transplant
Irwin D. Bernstein, MD, is chief of the Division of
Department of Pediatrics at the University of Washington School of Medicine. He is director of the Division
of Pediatric Hematology/Oncology in the university’s
Department of Pediatrics and head of the Pediatric
Oncology Program at the Fred Hutchinson Cancer
Research Center (FHCRC). Bernstein holds the
John R. Hartmann Endowed Chair in Pediatric
Oncology/Hematology at Children’s and is an American
Cancer Society clinical research professor. He has been
a board member for the Leukemia & Lymphoma Society,
is chairman of the society’s Professional Education
Committee and is a member of the Scientific Advisory
Board for the University of Minnesota Cancer Center.
Bernstein’s research interests include hematopoietic
stem cells, antibody targeted therapies for lymphoma
and leukemia, and the biology of acute myeloid
leukemia. He is principal investigator on a Leukemia &
Lymphoma Society SCOR program in immunotherapy
of hematologic malignancies; on multiple grants,
including those that support his studies of acute myeloid
leukemia cells, which have led to the development
of Mylotarg, a drug widely used for treating acute
myelogenous leukemia; and his current studies of
hematopoietic stem cells. These studies led to a novel
approach for expanding stem cell numbers in cord
blood that is being tested in a clinical trial, supported
by an NIH grant, to improve cord blood transplantation.
Other NIH grants support the Children’s Oncology
Group AML reference laboratory. Bernstein also
heads NIH-supported grants for career development
in pediatric and medical oncology and for pediatric
oncology research training.
Tina M. Albertson, MD, is attending physician at
Seattle Children’s Hospital and acting instructor in
the Division of Pediatric Hematology/Oncology at
She received the Seattle Children’s Young Investigator
Award. Her research investigates the pathways of
genetic instability that drive cancer initiation and
progression to metastatic disease.
156
Robert G. Andrews, MD, is attending physician at
the Division of Pediatric Hematology/Oncology at the
an associate member of the Fred Hutchinson Cancer
Research Center (FHCRC) in the Clinical Research
Division, and head of stem cell and transplant biology
at the Washington National Primate Research Center.
Andrews has research interest in hematopoietic stem
cell and transplant biology, including gene therapy and
expansion of hematopoietic stem cells as well as fetal
stem cell transplant and embryonic stem cell–based
therapies. His laboratory is studying novel nonhuman
primate embryonic stem cell (ESC) lines to characterize
the differentiation to hematopoietic stem cells (HSC)
and to develop strategies for the use of ESC-derived
HSCs for transplant in these preclinical models. His
work also includes examining the role of natural killer
and mesenchymal stem cells in hematopoietic stem
cell transplant.
Michael A. Bender, MD, PhD, is attending physician at
Seattle Children’s Hospital and director of the Odessa
Brown Comprehensive Sickle Cell Clinic; he is associate
Medicine. Clinically, Bender has a long-standing
commitment to hemoglobinopathies with an emphasis
on sickle cell disease, and special emphasis on patient
education, community outreach and access to health
care. He acts as a consultant to the state newborn
screening program regarding hemoglobinopathies,
providing advice to the state, community physicians
and families. Bender has worked with the Puget Sound
Blood Center’s Rare Blood Groups program to increase
the number of minority donors by overcoming cultural
barriers and improving education and information
services, and he received the American Society of
Hematology’s Champion for Advocacy award. He has
served as session leader and abstract reviewer for the
American Society of Hematology. Bender is on the
NHLBI Special Emphasis Panel for Comprehensive
Sickle Cell Centers, the NIH Sickle Cell Advisory
Committee, and the National Coordination and
Evaluation Center Steering Committee. He is also a
reviewer for the Cooley’s Anemia Foundation RFA and
Fellowship Programs and a member of the Sickle Cell
Disease Association of America. His research focuses
on two main areas: regulation of the chromatin
structure in vivo, using the beta-globin locus as a
model; and the manipulation of the oxidation/reduction
state in vivo to affect sickle cell disease. Bender is
working on multiple research projects, ranging from
developing new techniques to analyze chromatin
structure, to establishing a statewide collaborative to
provide better support for patients, families, practitioners
and community members affected by sickle cell disease.
He has used several strategies to delete multiple DNaseI
hypersensitive sites (HSs) of the beta-globin locus
control region (LCR). The LCR is essential for the
activation of the locus. Loss of the LCR decreases but
does not eliminate expression, but does not lead to
a major change in chromatin structure. As this is
different than predicted from analysis of a human with
an LCR deletion, two approaches were pursued. The
first was to extend the deletion further upstream of the
LCR. The second was to identify and delete additional
candidate regulatory regions from the endogenous
locus in mice. Data from several systems has implicated
HSs flanking the locus as being important in the
regulation of chromatin structure and expression of
the locus. Several models have been generated about
the role of these regions. Bender has recently published
the results of these studies, which demonstrate the
inaccuracy of several prior models for globin gene
regulation. He is using long-range DNase sensitivity
and chromatin immunoprecipitation studies to further
characterize the region through erythroid development
and generate new models.
Marie Bleakley, MD, MMSc, is attending physician at
Seattle Children’s Hospital and in the Clinical Research
Division of the Fred Hutchinson Cancer Research
Center (FHCRC) and acting instructor in the Department
of Medicine. She is an associate in clinical research in
immunology at FHCRC and attending physician on
the bone marrow transplant service. Bleakley’s primary
research focus is the discovery of novel minor histocompatibility antigens expressed on leukemic stem
cells. The ability to cure leukemia with allogeneic
hematopoietic stem cell transplant requires a type
of donor immune cell called a T cell that recognizes
and destroys leukemic cells. Some of these T cells
can also damage normal cells and cause a condition
called graft-versus-host disease (GVHD). Bleakley is
conducting research to discover the target molecules
on leukemic cells that the immune system recognizes,
in order to develop immunotherapy for transplant
patients that selectively kills leukemic cells without
Spotlight on team members — Chelsea Ward, RN, BSN
A large component of delivering holistic care is patient
and family education. Having patients and their families
understand the care they are receiving and having them
take ownership of their care whenever possible is crucial.
I am grateful for the addition of transition nurses to our
unit, as their role has helped to better facilitate this teaching
process while providing consistency among educators.
damaging normal cells. In the past year she has
completed the identification of three new target
molecules and is continuing to find additional targets.
Immunotherapy administered in the form of vaccines
or T cell infusions could improve the cure rate of
patients with advanced leukemia. Bleakley is also
developing a protocol for a clinical trial of selective
depletion of specific T cell subsets from donor cells
for allogeneic hematopoietic stem cell transplant to
prevent GVHD.
Lauri M. Burroughs, MD, is acting assistant professor at
associate in clinical research at the Fred Hutchinson
Cancer Research Center (FHCRC). Her research
interests include hematopoietic cell transplantation
(HCT) for patients with primary immunodeficiencies
and other nonmalignant disorders. She is conducting
a clinical trial to evaluate whether the addition of the
T cell–depleting agent Campath can decrease the
incidence of graft-versus-host disease (GVHD) and
improve donor chimerism following HCT. In addition,
to increase the number of patients who may benefit from
HCT, Burroughs developed a clinical trial for patients
who do not have HLA-matched related or unrelated
donors. Patients will receive cyclophosphamide before
and after HCT followed by HLA-haploidentical grafts
to remove alloreactive T cells with the goal of improving
engraftment and decreasing GVHD. In an effort to
157
continue to develop the HCT program for patients
with nonmalignant disorders, Burroughs is developing
two additional protocols. Protocol 2256 is a reducedintensity conditioning regimen (treosulfan and
fludarabine) that will replace our current standard
myeloablative treatment plan. In addition, she has
developed Protocol 2214, which uses HLA-matched
related and unrelated marrow grafts following
nonmyeloablative conditioning for patients with
bone marrow failure syndromes.
of Clinical Oncology/Lance Armstrong Foundation.
Chow’s research interests focus on pediatric cancer
survivors, particularly on neuroendocrine complications following leukemia therapy. At present, he is
examining the prevalence and risk factors for obesity
and the metabolic syndrome following leukemia
therapy and hematopoietic cell transplantation. His
ultimate goal is to incorporate these findings into
clinical trials that attempt to minimize these types
of problems in future pediatric cancer patients.
Paul Carpenter, MBBS, is attending physician at Seattle
Children’s Hospital and the Fred Hutchinson Cancer
Research Center (FHCRC) and associate professor
with a focus on graft-versus-host disease (GVHD).
He supervises junior attending staff on the pediatric
hematopoietic cell transplant service at FHCRC. His
local responsibilities include acting clinical director of
HCT. He has made long-standing contributions to the
FHCRC Standard Practice Committee and Standard
Practice Manual. He chairs a data safety monitoring
board for multiple FHCRC protocols and serves on
the FHCRC Scientific Review Committee and one of
the two institutional review boards. His clinical and
research interests focus on GVHD, which is the major
and potentially lethal complication of hematopoietic
cell transplant. His research continues to explore
new therapies for the treatment of acute and chronic
GVHD, and he is an active member in both the Bone
Marrow Transplant Clinical Trials Network and NIH
Consensus Development Project to advance the field
of chronic GVHD treatment. He is also researching
therapies to prevent relapse after transplant and to
ameliorate key morbidities associated with chronic
immunosuppressive therapies, such as bisphosphonate
therapy for glucocorticoid-induced bone disease and
the use of statins to treat hyperlipidemia. He recently
completed a multicenter pilot study to evaluate the
safety and efficacy of nilotinib as post-transplant
therapy for high-risk Philadelphia chromosome–
positive leukemias.
Mari Dallas, MD, is attending physician at Seattle
Children’s Hospital, associate in the Clinical Research
Division at the Fred Hutchinson Cancer Research
Center (FHCRC) and acting instructor in the Division
of Pediatric Hematology/Oncology at the University
of Washington School of Medicine. She received the
Aliana J. Enlow Scholar award from the National
Marrow Donor Program and the New Investigator
Award from the University of Washington Child Health
Research Center. She was also named special fellow
in clinical research by the Leukemia & Lymphoma
Society. Dallas’ research interests center around
bone marrow transplant and immune reconstitution
afterward, with the goal of improving immune recovery.
Her research focuses on the effects of Notch signaling
in regulating multiple cell fate decisions by hematopoietic
precursors, including the role of Notch in T cell
development. Her work in the mouse model demonstrated that murine hematopoietic stem cells cultured
on Delta1 reconstituted the T cell compartment more
rapidly than noncultured cells. She is translating her
findings using human umbilical cord blood progenitors.
When applied in a clinical setting, augmentation of
transplanted umbilical cord blood cells with Delta1
cultured cells may improve clinical outcomes of patients
undergoing transplantation by decreasing the transplantrelated mortality secondary to infection.
Eric Chow, MD, MPH, is acting instructor in
hematology/oncology at Seattle Children’s Hospital
and at the University of Washington School of
Medicine. He is also a research associate at the Fred
Hutchinson Cancer Research Center. He received the
Young Investigator Award from the American Society
158
Colleen Delaney, MD, MSc, is attending physician at
Seattle Children’s Hospital, an assistant member of
the Clinical Research Division of the Fred Hutchinson
Cancer Research Center (FHCRC) and assistant
professor at the University of Washington School
of Medicine. She is the director of the Cord Blood
Transplant Program at FHCRC–Seattle Cancer Care
Alliance. She received the Clinical Investigator Award
from the Damon Runyon Cancer Research Foundation
and “Tomorrow’s PI” Young Investigator of the Year
Award from Genome Technology Magazine. Delaney’s
research interests include hematopoietic stem cell
regulation and the development of novel and clinically
feasible ex vivo expansion systems for hematopoietic
progenitor cells using the Notch ligand, Delta1, which
is a known regulator of cell fate determination. Her
goal is to improve the outcome of patients in need of a
cord blood transplant. Delaney’s research on the role of
Notch signaling in hematopoietic stem cell regulation
has resulted in the development of a pilot study
investigating the use of ex vivo expanded cord blood
progenitors to augment conventional cord blood
transplantation. She is the lead investigator in this
trial, which began accrual in summer 2006. Delaney
is principal investigator on four additional FHCRC
clinical trials investigating the use of single or double
unrelated-donor umbilical cord blood grafts as an
alternative source of stem cells for hematopoietic cell
transplant, including a multicenter protocol investigating
the use of single versus double unrelated-donor
umbilical cord blood grafts as the source of stem
cells for hematopoietic cell transplantation.
Debra L. Friedman, MD, is attending physician at Seattle
Children’s Hospital, associate professor at the University
of Washington School of Medicine, associate member
of the Clinical Research Division at the Fred Hutchinson
Cancer Research Center (FHCRC) and affiliate
investigator in the Division of Public Health Sciences.
She is director of the FHCRC Survivorship Program,
one of only eight institutions in the nation that are
part of the LIVESTRONG Survivorship Center of
Excellence Network, funded by the Lance Armstrong
Foundation. She also directs the After Cancer Care
Ends, Survivorship Starts (ACCESS) Program at
Children’s and the Medical Oncology Survivor Team
(MOST) Program at the Seattle Cancer Care Alliance.
She is the vice chair of the Cancer Control and Survivorship Committee and is on the steering committee
of the Hodgkin lymphoma and retinoblastoma committees of the Children’s Oncology Group (COG) and
heads a study in each of these areas. For retinoblastoma
and Hodgkin lymphoma, she has developed novel
therapeutic protocols designed to decrease adverse
long-term effects of therapy. She is also a nationally
recognized expert in cancer survivorship, participating
in projects evaluating best practices and models of
care. Friedman is principal investigator on seven
projects and supporting investigator on six additional
projects. She is conducting studies on the interaction
between environmental exposures and genetic predisposition toward several types of childhood cancer,
neuroblastoma, retinoblastoma and Wilms tumor,
as well as second malignant neoplasms (SMNs). She
is investigating a diverse group of physiologic and
psychosocial outcomes, including health-related quality
of life, SMNs, exercise and fitness, endocrinopathies,
pulmonary and cardiac dysfunction among survivors
of pediatric cancer, hematopoietic stem cell transplant
and medical oncology.
J. Russell Geyer, MD, is clinical director of the
Hematology/Oncology Clinic at Seattle Children’s
Hospital and professor in the Department of Pediatrics
and adjunct professor in the Department of Neurological
Surgery at the University of Washington School of
Medicine. Geyer holds the Evans Family Endowed
Chair in Pediatric Cancer at Children’s. He received the
University of Washington Junior Faculty Mentor Award.
Nationally, Geyer is a member of the COG-CNS Brain
Tumors Committee and the CNS Steering Committee
of the Children’s Oncology Group (COG), the Brain
Tumor Strategy Group of the Children’s Cancer Group,
and the Steering Committee and Quality Assurance
Committee of the Pediatric Brain Tumor Consortium
(PBTC). Geyer also serves as chairman of the Seattle
Cancer Care Alliance Pediatric Cancer Committee
and of the Fred Hutchinson Cancer Research Center
Consortium Pediatric Scientific Review Committee.
He is also COG co-chairman of the Infant Brain Tumor
Committee and chairman of the PBTC Phase II
brainstem glioma study of Iressa and radiotherapy.
Douglas S. Hawkins, MD, is a clinician at Seattle
Children’s Hospital, associate professor at the University
of Washington School of Medicine and associate division
chief for the Division of Pediatric Hematology/Oncology.
Hawkins is the principal investigator for Children’s
Oncology Group (COG) activity at Children’s and vice
chair of the COG Soft Tissue Sarcoma Committee. He
is a member of several COG committees, including the
Soft Tissue Sarcoma, Bone Tumor and Voting Body
steering committees. Hawkins has focused on clinical
research, particularly in the treatment of pediatric
sarcomas. He is the COG chair of two clinical trials, one
for Ewing sarcoma and another for rhabdomyosarcoma,
and the vice chair of three other COG clinical trials.
He is working collaboratively on a pharmacogenomic
study investigating cyclophospharmide metabolism
and toxicity, both locally and as part of two COG
159
studies. He collaborates on the use of FDG PET to
assess response and guide treatment in pediatric
sarcomas. He is the associate director of the Children’s
Center of Clinical and Translational Research.
Rebecca H. Johnson, MD, is director of the Adolescent
and Young Adult (AYA) Cancer Program at Seattle
Children’s Hospital; she is assistant professor at the
University of Washington School of Medicine. Her
research interests include quality of life and clinical
outcomes in adolescents and young adults with cancer.
She is a member of the Lance Armstrong Foundation
LIVESTRONG Young Adult Alliance.
Thomas J. Manley, MD, is attending physician at Seattle
Children’s Hospital. Manley has developed a strategy
to identify novel CMV antigens targeted by cytotoxic
T cells using a CMV cDNA library in an expressioncloning assay. Using this technique he has identified 10
genes that encode CMV antigens, and he is mapping
the epitopes recognized by cytotoxic T cell clones.
His planned studies of the function of these cytotoxic
T cells using an in vitro reactivation model may provide
insight into their role in suppressing viral replication,
and may support the inclusion of a more diverse
repertoire of CMV-specific cytotoxic T cells into
adoptive immunotherapy trials. He will be using the
mutant strain of CMV to study CMV-specific immune
reconstitution of patients undergoing T cell–depleted
haploidentical stem cell transplantation, a group of
patients at high risk for CMV reactivation and disease.
These efforts will provide the basis for future protocols
to examine the biology and therapeutic efficacy of
adoptively transferred CMV-specific T cell clones.
Dana C. Matthews, MD, is director of clinical hematology
at Seattle Children’s Hospital and head of the Pediatric
Hemophilia Program; she is associate professor at the
University of Washington School of Medicine. Her
research interests include risk-based optimization of
the treatment of pediatric thrombosis, and clinical
outcomes in patients with hemophilia. In particular,
she is participating in projects including an effort to
characterize immune responses to factor VIII that
result in inhibiting antibodies that significantly complicate the management of hemophilia A, and a prospective
study of the development of inhibitors in young
patients with hemophilia. Additionally, she is interested
in improving the outcome for pediatric patients with
160
thrombosis by developing clinical trials for subgroups
of patients with thrombosis. She served on the
board of directors for the American Thrombosis and
Hemostasis Network, a national organization with the
mission to “provide stewardship in the development
and support of an accessible national database to
support excellence in patient care, research, professional mentorship and public health translation.” She
is chair of the hematology-oncology sub-board of the
American Board of Pediatrics and has been appointed
to be medical editor for this sub-board after completion
of her term as member in 2010.
Soheil Meshinchi, MD, PhD, is attending physician at
Seattle Children’s Hospital, assistant professor at the
assistant member of the Fred Hutchinson Cancer
Research Center (FHCRC). He attends on the
Hematopoietic Stem Cell Transplant Service. He is
co-director of the Children’s Oncology Group (COG)
Myeloid Resource Laboratory, vice chair of the COG
acute myeloid leukemia (AML) Phase III trial, member
of the COG Myeloid Disease Steering Committee and
the chairman of the COG committee on the role of
RTK activating mutations in pediatric AML. In addition,
he serves on several COG committees, including the
committee for development of new APL therapy,
Phase III AML Committee, Phase II trial of STI571 for
Philadelphia chromosome leukemias and the Infant
Leukemia Steering Committee. Meshinchi’s clinical
and research interests center around the treatment of
pediatric myeloid leukemia. He is principal investigator
on six research projects at FHCRC and Children’s,
including a study on the biology of the alterations of
the signal transduction pathway in pediatric cancers,
the biology and prognostic implications of FLT3
mutations in AML and the evaluation of minimal
residual disease by multiparameter flow cytometry
for risk identification. He supervises the treatment
and management of all patients with myeloid diseases
(AML, MDS, etc.) in the Seattle Cancer Care Alliance,
and he is working to identify novel therapies in AML.
James M. Olson, MD, PhD, is attending physician at
Seattle Children’s Hospital and associate member
of the Fred Hutchinson Cancer Research Center
(FHCRC). He is associate professor in the Division of
Pediatric Hematology/Oncology at the University of
Washington School of Medicine, where he also holds
affiliate appointments in four graduate training
programs. He has mentored more than 30 graduate
students and postdoctoral research fellows. He has
received the President’s Award from the Jordyn Dukelow
Memorial Guild. He is chair of a national Phase III
clinical trial for high-risk medulloblastoma/PNET
patients and a national brain tumor biology protocol.
Olson is principal investigator on six projects that
focus on developing effective new therapies for pediatric
brain tumors, methods that allow surgeons to better
visualize the border of brain cancer and normal brain,
the molecular mechanisms of cerebellar development
and genetic-based endpoints for neuro-degenerative
diseases.
Julie R. Park, MD, is attending physician at Seattle
Children’s Hospital, associate professor in the Department of Pediatrics at the University of Washington
School of Medicine and associate in clinical research at
the Fred Hutchinson Cancer Research Center (FHCRC).
She is director of the pediatric hematology/oncology
fellowship at the University of Washington. Park is an
active member of the Children’s Oncology Group (COG)
Consortium, coordinating the center’s participation
in clinical trials for treatment of neuroblastoma and
non-Hodgkin lymphoma. Park is the oncology division
director of Advanced Developmental Therapeutics,
overseeing participation in national NIH-funded
Phase I clinical research consortia, including the
COG Phase I Consortium and the New Approaches
to Neuroblastoma Therapy (NANT) Consortium.
Park’s primary research focus is to discover novel
therapies for the treatment of high-risk neuroblastoma,
a rare but aggressive form of childhood cancer. As
vice chair of the COG Neuroblastoma discipline, she
provides national leadership for future development
of neuroblastoma clinical research. She is the principal
investigator for a national randomized Phase III trial
within COG for treatment of newly diagnosed high-risk
neuroblastoma. She is also leading the development
of novel therapies for neuroblastoma using both
adoptive immunotherapy and novel molecularly
targeted approaches.
Thomas W. Pendergrass, MD, MSPH, is director of
medical education at Seattle Children’s Hospital; he
is professor in the Department of Pediatrics at the
University of Washington School of Medicine, adjunct
professor in the Department of Epidemiology at the
University of Washington School of Public Health
and associate in the Clinical Research Division at the
Fred Hutchinson Cancer Research Center (FHCRC).
He is vice chair for education in the Department
of Pediatrics at the University of Washington. For
Children’s, he serves as chair for the GME Council,
member of the Medical Records/Medical Informatics
Committee, member of the Hospital Steering Committee
and member of the Children’s Protection Program
Quality Advisory Committee. Pendergrass is a member
of the Committee on Continuing Medical Education
and of the Provisional Committee on Development
for the American Academy of Pediatrics. Pendergrass’
clinical and research interests center around general
pediatric hematology and oncology, retinoblastoma,
medical education and faculty development. He is
interested in the epidemiology and treatment of
pediatric thromboses, management of iron overload
in chronically transfused patients and treatment of
retinoblastoma. His educational focus includes the
administration and improvement of residency and
fellowship programs, moving curricula toward
meeting competency criteria, evaluation processes
and continuing medical education.
Jessica Pollard, MD, is acting instructor in the Division
of Pediatric Hematology/Oncology and Bone Marrow
Transplant at Seattle Children’s Hospital and at the
is also a research associate at the Fred Hutchinson
Cancer Research Center. Pollard’s research interests
include the biology of acute myeloid leukemia (AML)
and the impact of disease biology on clinical response.
At present she is better defining the maturational
states of hematopoietic precursors in which molecular
events contributing to leukemogenesis arise, and has
demonstrated that pediatric AML patients with an
internal tandem duplication of the FLT3 gene do
poorly if the mutation is detected in an immature
hematopoietic progenitor population. Her ultimate
goal is to improve clinical outcomes in AML by
enhancing understanding of the biologic events that
contribute to leukemogenesis and by determining
whether heterogeneity of such events affects clinical
response to conventional chemotherapeutics and/or
targeted agents like gemtuzumab ozogamicin (GO).
She is also exploring methods for enhancing GO
efficacy in patients with GO-resistant disease.
161
Jean E. Sanders, MD, is director of the Clinical Pediatric
Hematopoietic Transplant Program at Seattle Children’s
Hospital and the University of Washington School
of Medicine and a member of the Clinical Research
Division at the Fred Hutchinson Cancer Research
Center (FHCRC). She is Gerald and Gloria Swanson
Endowed Chair in Pediatric Bone Marrow Transplantation. She also received the FACT Inspector Award.
For more than 31 years, Sanders’ work has centered
around pediatric hematopoietic stem cell transplant,
including the design of transplant preparative regimens
for children with acute lymphoblastic leukemia, acute
myelogenous leukemia, chronic myelogenous leukemia
and other hematologic malignancies, and pediatric
solid tumors including neuroblastoma, Ewing’s sarcoma
and aplastic anemia, and other nonmalignant hematologic disorders. She has also been very involved in donor
selection from a matched family member, an unrelated
marrow or peripheral blood stem cell donor or an
umbilical cord blood donor. Sanders’ major research
focus is in the long-term follow-up issues of children
surviving after hematopoietic stem cell transplant, such
as chronic graft-versus-host disease (GVHD), recurrent
leukemia, growth and development problems, and
other late effects. Her studies have demonstrated that
some patients who relapse after their first transplant
may have a successful second transplant, particularly
when the first transplant preparative regimen was
chemotherapy-based and the second transplant uses a
total body irradiation-based preparative regimen. She
is involved in research projects to improve the outcome
of allogeneic hematopoietic stem cell transplant in the
treatment of hematologic malignancies, to improve
ambulatory care of the stem cell transplant recipient
and to improve the long-term quality of life for children
after marrow transplantation. Her research goals
include developing interventions to minimize or treat
some of the delayed effects of hematopoietic stem cell
transplant, such as using a nonmyeloablative preparative
regimen for second transplant.
Akiko Shimamura, MD, PhD, is associate professor in the
School of Medicine. Before coming to Seattle, she
served as director of the Bone Marrow Failure Clinic
at Children’s Hospital Boston. She is a member of the
scientific advisory board for the Shwachman-Diamond
Syndrome Foundation and served as co-chair of
162
the Fourth International Scientific Congress on
Shwachman-Diamond Syndrome. She is the principal
investigator for the North American ShwachmanDiamond Syndrome Registry currently under development. She is a member of the editorial board for the
American Journal of Hematology. Shimamura’s research
interests focus on hematopoiesis and leukemogenesis
in the inherited marrow failure syndrome. Her current
studies investigate the role of ribosomal dysfunction
in marrow failure and malignant transformation.
Shimamura is also pursuing studies on translational
control of gene expression in hematopoietic stem cells.
Her laboratory recently reported a role for mitotic
spindle stabilization in genomic instability.
Barbara Small, MD, is attending physician at Seattle
Children’s Hospital and assistant professor at the
has presented nationally and internationally on issues
surrounding end-of-life and quality-of-life decisions.
Small has also taught medical ethics for pediatrics
residents and has been a pediatric life support instructor.
Blythe G. Thomson, MD, is clinical associate professor
at Seattle Children’s Hospital. She earned her MD
magna cum laude from Ohio State University College
of Medicine. Locally, she serves on the Human Subjects
Protection Advisory Committee, the Department
of Pediatrics Recognition Committee, the Scientific
Advisory Committee of the General Clinical Research
Center, the Ambulatory Oversight Committee and the
Institutional Biosafety Committee of the Seattle Cancer
Care Alliance. Thomson is a member of the Children’s
Oncology Group (COG) Stem Cell Transplant Steering
Committee, the Institutional Performance Monitoring
Committee and the Accreditation Committee of the
Foundation for Accreditation of Cellular Therapies.
Her clinical and research interests include bone
marrow transplant and leukemia research. She is
taking a leading local role on several research projects
for the treatment of leukemia. These projects include
the INTERFANT study for infant ALL and research
studies for newly diagnosed pre-B-cell leukemia. She
is a participating member of the Therapeutic Advances
in Childhood Leukemia Consortium to investigate
novel therapies for relapsed and refractory leukemia.
Additionally, Thomson is the local investigator for
industry-sponsored trials for relapsed leukemia.
Ann E. Woolfrey, MD, is attending physician at Seattle
Children’s Hospital and associate member of the
Clinical Research Division at the Fred Hutchinson
Cancer Research Center (FHCRC). She is director of
the Unrelated Marrow Donor Program for the Seattle
Cancer Care Alliance. Nationally, she is co-chair of the
Center for International Blood and Marrow Transplant
Research of the Chronic Leukemia Working Committee,
serves on National Marrow Donor Program committees
for histocompatibility and for transplant center
contingency response planning, and is on the board of
medical advisers of the Immunodeficiency Foundation.
Woolfrey’s research interests involve pediatric oncology,
particularly leukemia, and processes of stem cell, blood
and marrow transplant. She is involved in several
studies on overcoming genetic barriers in hematopoietic
stem cell transplant, identifying nonmyeloablative
transplants for nonmalignant disorders and investigating the use of blood stem cell and marrow transplant
from HLA-compatible related and unrelated donors.
Woolfrey’s goals include researching nonablative
treatments for pediatric diseases, the T cell depletion
of peripheral blood stem cells in HLA identical and
nonidentical transplants, and the effectiveness of
high-dose therapy for autoimmune diseases.
RESEARCH FUNDING
A multicenter phase I/II study of the prophylactic
inhibition of BCR/ABL tyrosine kinase by Tasigna
(nilotinib) after hematopoietic cell transplantation
for Philadelphia chromosome–positive leukemias.
Novartis Commercial Research Agreement. $300,000.
Mari Dallas, MD
Enhanced T cell reconstitution by umbilical cord
blood progenitors expanded ex vivo using the Notch
ligand Delta1. Amy Strezler Manasevit Research
Program/The Marrow Foundation/National Marrow
Donor Program. $74,074.
Enhanced T cell reconstitution by umbilical cord blood
progenitors expanded ex vivo using the Notch ligand
Delta1. The Leukemia & Lymphoma Society. $60,000.
Delta1. Ronald McDonald House Charities. $50,000.
Delta1. University of Washington. $75,000.
Blood & Marrow Transplant Clinical Research
Center (single vs. double cord blood transplantation).
NCI/NHLBI. $5,043.
New
Molecular control of hematopoietic stem cell fate.
Irwin D. Bernstein, MD
Molecular control of hematopoietic stem cell fate.
NIH/NHLBI. $1,121,086.
Nonmyeloablative allografting for immunodeficiency
and other nonmalignant disorders. NIH/NHLBI.
$124,500.
Adult Leukemia Research Center, project 3.
NIH/NCI. $159,431.
Core Center of Excellence in Hematology pilot grant.
NIH/NIDDK. $20,000.
Ex vivo expansion of cord blood progenitor cells.
Damon Runyon Clinical Investigator Award, Damon
Runyon Cancer Research Foundation. $150,000.
Specialized Center for Cell Based Therapy (PTH study).
NIH. $41,995.
Umbilical cord blood transplantation. Cuyamaca
Community outreach for cancer survivors. Amgen
Family-based physical activity intervention for
preschool-age cancer survivors. NIH/NCI. $24,878.
163
Native People for Cancer Control Telehealth Network.
HRSA. $68,697.
Needs assessment for cancer survivors in transition.
Lance Armstrong Foundation. $66,000.
Patterns of Care Study. NIH/NCI. $75,544.
Children’s Oncology Group chair grant.
NCI/NIH/DHHS. $77,848.
CTX:Cy5.5 imaging for early detection of melanoma.
FHCRC Synergy Funds. $50,000.
Multifunctional nanovector for diagnosis and treatment
of pediatric brain cancer. NIH. $40,470.
Nanovectors for brain tumor diagnosis and treatment.
NIH/NCI. $25,549.
Preclinical evaluation of cyclopamine derivative(s) in
medulloblastoma mice. Infinity Pharmaceuticals Inc.
$9,059.
Tumor paint: a molecular probe for intraoperative
visualization of cancer foci. Royalty Research Fund.
$50,000.
Julie R. Park, MD
Phase I/II safety & exploratory pharmacodynamic
study of intravenous temsirolimus (CCI-779) in
pediatric subjects with relapsed refractory solid
tumors. Wyeth. $206,823.
Blythe G. Thomson, MD
A phase I/II dose escalation study of Clolar
(clofarabline) plus etoposide and cyclophosphamide
in pediatric patients with refractory or relapsed acute
leukemia. Genzyme. $279,363.
Continuing
In utero transplantation in primates. NIH/NHLBI.
$629,387.
Consultant to the Washington State Newborn Screening
Program. Washington State Department of Health.
$5,000.
Function of human and mouse ß-globin locus control
regions. NIDDK. $460,000.
Northwest Sickle Cell Collaborative. HRSA. $183,000.
Quantitating chromatin dynamics during erythropoiesis.
NIDDK. $175,000.
Washington State Sickle Cell Contract. Washington
State Department of Health. $56,094.
Career development in pediatric and medical oncology.
NCI. $498,000.
Clinical Research Professorship Award. American
Cancer Society. $60,000.
Human specimen banking. National Center for
Children and Families/NIH/NCI. $87,955.
Immunotherapy of hematological malignancies.
The Leukemia & Lymphoma Society. $1,042,000.
Myeloid disease reference laboratory. National Center
for Children and Families/NIH/NCI. $296,606.
Notch effects on hematopoietic repopulating cells.
Notch mediated expansion of hematopoietic precursors.
Pediatric Oncology Training Program. NIH/NCI.
$192,682.
164
Marie Bleakley, MD, MMSc
Adult Leukemia Research Center, project 6: Targeting
alloreactivity for leukemia eradication. NIH/NCI.
$618,681.
The Leukemia & Lymphoma Society Fellowship.
$45,000.
Nonmyeloablative allografting for immunodeficiency
and other nonmalignant disorders. Fighting Children’s
Cancer Foundation. $1,500.
Stem cell transplantation: basic/clinical research,
subproject 1: allogeneic hematopoietic cell transplantation
for nonmalignant diseases. NIH/NHLBI. $163,735.
Eric Chow, MD, MPH
A pilot study to determine the prevalence and risk
factors associated with the metabolic syndrome in
childhood acute lymphoblastic leukemia survivors.
American Society of Clinical Oncology/Lance
Armstrong Foundation. $50,000.
Arnold Smith Research Faculty Development Award.
$35,000.
Amgen. $60,000.
Notch mediated expansion of hematopoietic precursors.
NIH/NHLBI. $1,016,676.
Environmental influences in retinoblastoma.
NIH/NCI. $22,005.
Health outcomes for Hodgkin disease survivors.
NIH/NCI. $317,418.
Hodgkin Lymphoma and Retinoblastoma Study chair.
NCCF/NIH/NCI. $236,989.
Late effects in Wilms tumor survivors and offspring.
NIH/NCI. $136,775.
Radiation sensitivity, DNA repair and second cancers.
NIH/NCI. $319,185.
Social and physical activity of childhood cancer
survivors. NIH/NCI. $185,975.
core D: long-term follow-up and chronic GVHD.
Survivorship Center grant. Lance Armstrong Foundation.
$266,915.
J. Russell Geyer, MD
Pediatric Brain Tumor Consortium. St. Jude/NIH.
$96,415.
Children’s Oncology Group. NIH/NCCF. $43,851.
Preclinical studies to assess the SCID (severe combined
immunodeficiency) repopulating cell activity of
primitive human hematopoietic cells from HPUCB
(human placental umbilical cord blood). Celgene.
$82,806.
Childhood Cancer Survivor Study. NIH/NCI.
Thomas J. Manley, MD
CD8+ T cell immunity to cytomegalovirus.
NIH/NIAID. $250,000.
Specificity and function of CMV-specific CD8+ cells
T cells. NIH/NCI. $133,650.
165
Dana C. Matthews, MD
B cell responses to clotting factor VIII. NIH/NHLBI.
$250,000.
Biologic and clinical implications of an s-SHIP
expression in pediatric leukemias. Children’s. $47,230.
Biology and prognostic implications of FLt3 mutations
in AML. NIH/NCI. $246,478.
Leukemia signatures for risk classification and targeting.
NIH. $1,113,255.
Myeloid Leukemia Reference Laboratory. National
Center for Children and Families/NIH/NCI. $181,788.
bHLH factors in medulloblastoma genesis and
maintenance. NIH/NCI. $323,310.
Evaluation of gamma-secretase inhibitors in animal
and ex vivo culture preclinical models. Merck & Co.
Inc. $231,695.
Genomics based therapy for Huntington’s disease.
High Q Foundation. $176,007.
Genomics based therapy for Huntington’s disease:
nanotechnology platform for pediatric brain cancer
imaging and therapy. High Q Foundation. $81,202.
Study chair: Efficacy of carboplatin administered
concomitantly with radiation and 13-cis retinoic acid
as a pro-apoptotic agent in other than average risk
medulloblastoma/PNET patients. National Childhood
Cancer Foundation. $11,010.
Targeted therapy in ex vivo medulloblastoma/PNET.
NIH/NCI. $223,417.
Julie R. Park, MD
ALS Translational Research Grant for neuroblastoma.
Alex’s Lemonade Stand Foundation. $100,000.
Novel therapies for high-risk neuroblastoma.
NIH/DHHS. $131,220.
Jessica Pollard, MD
Career Development in Pediatric and Medical Oncology
Award. NIH/NCI. $134,460.
Jean E. Sanders, MD
Adult Leukemia Research Center, project F: long-term
follow-up. NIH/NCI. $214,463.
Shwachman-Diamond syndrome: molecular
pathogenesis. NIH/NHLBI. $200,000.
Mechanisms of gene dysregulation in Huntington’s
disease. NIH. $432,500.
Ann E. Woolfrey, MD
Adult Leukemia Research Center, project 1. NIH/NCI.
$242,509.
Molecular imaging, diagnosis and treatment of
medulloblastoma. NIH/NCI. $134,770.
Blood & Marrow Transplant Clinical Research Center,
Project BMT020. $6,000.
Molecular imaging of neurons in brain. The Dana
Commercial research agreement. Miltenyi Biotech.
$13,000.
Muscle gene expression biomarkers of Huntington’s
disease. NIH/NINDS. $195,330.
Gene therapy for Fanconi anemia. NIH/NHLBI.
$483,172.
Nanotechnology platform for pediatric brain cancer
imaging and therapy. NIH/NCI. $87,000.
project 1. NIH/NHLBI. $93,800.
Pediatric Brain Tumor Clinical Trials Consortium.
Children’s/NIH/NCI. $96,415.
166
The role of NMYC in medulloblastoma genesis.
Children’s Brain Tumor Foundation. $75,000.
Sickle cell: medical and social interactions. Evergreen
State College. Olympia, Wash. January 2007.
Roles of the locus control region? Red Cell Gordon
Conference. Ausois, France. May 2007.
Neurocognitive issues in sickle cell. NW Sickle Cell
Collaborative Provider Meeting. Tacoma, Wash.
July 2007.
Combined Comprehensive Sickle Cell Centers/Sickle
Cell Disease Association of America Meeting.
Washington, D.C. September 2007.
Celebrating a century of partnerships for child health.
Seattle Children’s Hospital. Seattle, Wash. October 2007.
Notch signaling modulates hematopoietic
stem/progenitor cell self-renewal (organizer and
presenter). The Notch Meeting. Athens, Greece.
Sept. 23–27, 2007.
Biology and Clinical Applications of Cord Blood Cells
Conference. Paris, France. Oct. 19–21, 2007.
Allogeneic transplantation for patients with
nonmalignant inherited disorders. Work in Progress
Meeting. Fred Hutchinson Cancer Research Center.
Seattle, Wash. 2007.
Allogeneic transplantation for patients with bone
marrow failure syndromes. Comparison of outcomes
following hematopoietic cell transplantation using
nonmyeloablative conditioning followed by HLAmatched related, unrelated or HLA-haploidentical
grafts for patients with Hodgkin lymphoma. Mixed
Chimerism Meeting. Fred Hutchinson Cancer
Research Center. Seattle, Wash. 2007.
Advances in chronic graft-versus-host disease.
Transplantation Nursing Conference. Keystone, Colo.
February 2007.
Do bisphosphonates strengthen bones in children after
hematopoietic cell transplantation? Pediatric Blood
and Marrow Transplantation Meeting. Keystone, Colo.
February 2007.
Advances in chronic graft-versus-host disease. Dao Pei
Lu Hospital. Beijing, China. April 24, 2007.
Eric Chow, MD, MPH
ALL grown up — understanding and preventing
chronic illness among ALL survivors. University of
Washington Pediatric Hematology/Oncology Seminar.
Seattle, Wash. July 2007.
Mari Dallas, MD
Strategies to improve post-transplant care. Scientific
Advances in Hematopoietic Stem Cell Transplantation.
American Association of Blood Banks Annual Meeting.
Anaheim, Calif. Oct. 22, 2007.
LIVESTRONG Survivorship Center of Excellence.
Seattle Cancer Care Alliance Outreach Presentation.
Richland, Wash. January 2007.
History and overview of cord blood transplantation.
Mavin Foundation. Seattle, Wash. Jan. 17, 2007.
Cord blood transplantation: current clinical practice,
future trends and protocols update. Seattle Cancer
Care Alliance HSCT Infusion Room Nurse In-Service.
Umbilical cord blood: expanding access to hematopoietic
cell transplantation. Seattle Cancer Care Alliance
Laboratory Quarterly Continuing Education Series.
Seattle, Wash. April 2007.
The use of umbilical cord blood for hematopoietic cell
transplantation. Seattle Cancer Care Alliance Volunteer
In-Service. Seattle, Wash. April 2007.
Cord blood expansion. Seattle Cancer Care Alliance
CTL In-Service. Seattle, Wash. May 2007.
Cord blood transplant program. Seattle Cancer Care
Alliance Nutrition In-Service. Seattle, Wash. May 2007.
167
Care Alliance PA Education In-Service. Seattle, Wash.
May 2007.
Reduced intensity cord blood transplantation. Mixed
Chimerism Meeting. Fred Hutchinson Cancer Research
Center. Seattle, Wash. May 2007.
Delta1: a notch-up on cord blood transplantation.
Fifth Annual International Umbilical Cord Blood
Transplantation Symposium. Los Angeles, Calif.
May 10–12, 2007.
Cord blood transplantation. Puget Sound Blood Bank
Hemostasis/Transfusion Medicine Course for 2007.
Care Alliance Transplant Nurse Education. Seattle,
Rapid neutrophil engraftment in patients receiving
cord blood progenitor cells expanded ex vivo with the
Notch ligand, Delta1. National Marrow Donor Program
20th Annual Council Meeting. Minneapolis, Minn.
Nov. 2–4, 2007.
Survivors of childhood cancer: views from both sides
of the bed. Association of Pediatric Oncology Social
Workers Annual Meeting. Seattle, Wash. May 2007.
Models of cancer for cancer survivors. The FHCRC
Survivorship Program. University of Calgary Cancer
Center Survivorship Retreat. June 2007.
Moving past cancer to wellness: late effects of cancer
and its treatment. Fred Hutchinson Cancer Research
Center. Seattle, Wash. June 2007.
Childhood cancer: future directions for survivorship
research. University of North Carolina Chapel Hill
Cancer Center Survivorship Retreat. Chapel Hill, N.C.
September 2007.
Survivorship at the interface of research and clinical
care. Grand Rounds, Alaska Native Medical Center.
Anchorage, Alaska. September 2007.
Biologic basis and staging for pediatric sarcomas.
Orthopedic Pathology Review. Seattle, Wash.
Oct. 12, 2007.
Umbilical cord blood: expanding access to hematopoietic
cell transplantation. The Division of Pediatric Hematology/Oncology at Doernbecher Children’s Hospital
and OHSU Cancer Institute. Portland, Ore. Nov. 9, 2007.
Lecture on molecular alterations in AML. COG
National Meeting. Dallas, Texas. 2007.
Notch mediated expansion of cord blood progenitors:
from bench to bedside. Benaroya Research Institute,
Puget Sound Blood Bank. Seattle, Wash. Nov. 13, 2007.
Molecular alterations in pediatric AML. Grand
Rounds, University of Minnesota Medical Center.
Minneapolis, Minn. Jan. 24, 2007.
LIVESTRONG Survivorship Center of Excellence.
Seattle Cancer Care Alliance Physician Outreach
Presentations: Wenatchee Community Medical Center,
Olympic Medical Center, Providence Alaska Medical
Center, Deaconess Medical Center.
Invited speaker. New Horizons in the Characterization
and Treatment of Leukemia International Meeting.
Amsterdam, Netherlands. July 6, 2007.
Moving past cancer to wellness: late effects of cancer
and its treatment. The Leukemia & Lymphoma Society.
March 2007.
168
Radiation sensitivity, DNA repair and second cancers
following total body irradiation. CURED II. Rochester
University Cancer Center. May 2007.
Julie R. Park, MD
Neuroblastoma: new advances. Stem Cell Transplantation in Children, Current Results and Controversies,
Meeting No. 9. Cincinnati Children’s Hospital. San
Diego, Calif. January 2007.
New directions for treatment of high risk neuroblastoma:
a Children’s Oncology Group perspective. Educational
Session, American Society of Clinical Oncology.
Chicago, Ill. June 2007.
Jessica Pollard, MD
Methods in Clinical Cancer Research Workshop.
American Society of Clinical Oncology/American
Association of Cancer Research. July 2007.
Gemtuzumab ozogamicin and cyclosporine for multiple
relapsed/refractory AML. AML Subcommittee Session
at Children’s Oncology Group National Meeting.
Denver, Colo. October 2007.
Jean E. Sanders, MD
Invited speaker. Oregon Health & Science University.
Portland, Ore. Aug. 8, 2007.
Invited speaker. Oocytes, Ovary and Transplantation:
New Discoveries Applied to Fertility Preservation
Meeting. Boston, Mass. Sept. 27–29, 2007.
Invited speaker. Second International Symposium on
Bone Marrow Transplantation. São Paulo, Brazil.
Nov. 23–25, 2007.
Invited speaker. Hematology Grand Rounds, Johns
Hopkins Hospital. Baltimore, Md. 2007.
Hematologic abnormalities. Functional studies of the
SBDS protein. Workshop on diagnosis (discussion
leader). Fourth International Scientific Congress on
Shwachman-Diamond Syndrome. Boston, Mass.
June 10–12, 2007.
FA101. Fanconi Anemia Scientific Conference.
Chicago, Ill. Oct. 11, 2007.
Ribosomal dysfunction in bone marrow failure
syndromes. Hot Topics in Paediatric and Adolescent
Cancer and Blood Diseases Conference. Dublin,
Ireland. Nov. 1–2, 2007.
PUBLICATIONS
Alvarez JA, Scully RE, Miller TL, Armstrong FD,
Constine LS, Friedman DL, Lipshultz SE. Long-term
effects of treatments for childhood cancers. Curr Opin
Pediatr. Feb 2007;19(1):23–31.
Aoyama K, Delaney C, Varnum-Finney B, Kohn AD,
Moon RT, Bernstein ID. The interaction of the
Wnt and Notch pathways modulates natural killer
versus T cell differentiation. Stem Cells. Oct
2007;25(10):2488–2497.
Barbaric D, Alonzo TA, Gerbing RB, Meshinchi S,
Heerema NA, Barnard DR, Lange BJ, Woods WG,
Arceci RJ, Smith FO. Minimally differentiated acute
myeloid leukemia (FAB AML-M0) is associated with
an adverse outcome in children: a report from the
Children’s Oncology Group studies CCG-2891 and
CCG-2961. Blood. Mar 2007;109(6):2314–2321.
Baron F, Sandmaier BM, Storer BE, Maris MB, Langston
AA, Lange T, Petersdorf E, Bethge W, Maziarz RT,
McSweeney PA, Pulsipher MA, Wade JC, Chauncey TR,
Shizuru JA, Sorror ML, Woolfrey AE, Maloney DG,
Storb R. Extended mycophenolate mofetil and shortened
cyclosporine failed to reduce graft-versus-host disease
after unrelated hematopoietic cell transplantation with
nonmyeloablative conditioning. Biol Blood Marrow
Transplant. Sep 2007;13(9):1041–1048.
Bonfim CM, de Medeiros CR, Bitencourt MA, Zanis-Neto
J, Funke VA, Setubal DC, Ruiz J, Sanders JE, Flowers
ME, Kiem HP, Storb R, Pasquini R. HLA-matched
related donor hematopoietic cell transplantation in
43 patients with Fanconi anemia conditioned with
60 mg/kg of cyclophosphamide. Biol Blood Marrow
Transplant. Dec 2007;13(12):1455–1460.
Brown P, McIntyre E, Rau R, Meshinchi S, Lacayo N,
Dahl G, Alonzo TA, Chang M, Arceci RJ, Small D. The
incidence and clinical significance of nucleophosmin
mutations in childhood AML. Blood. Aug
2007;110(3):979–985.
Ann E. Woolfrey, MD
Innovative approaches in transplant for autoimmune
diseases. Stem Cell Transplantation in Children.
San Diego, Calif. January 2007.
169
Burroughs LM, Storb R, Leisenring W, Pulsipher M,
Loken M, Torgerson T, Ochs H, Woolfrey AE. Intensive
postgrafting immune suppression combined with
nonmyeloablative conditioning for transplantation of
HLA-identical hematopoietic cell grafts: results of a
pilot study for treatment of primary immunodeficiency
disorders. Bone Marrow Transplant. Oct
2007;40(7):633–642.
Cantor AB, Shimamura A. Cellular basis of
hematopoiesis and marrow failure syndromes.
In: Kahn MJ, Gregory SA, eds. American Society of
Hematology Self-Assessment Program (ASH-SAP),
Third Edition. Washington, D.C.: American Society
of Hematology. 2007.
Carpenter P, Hoffmeister P, Chesnut CH III, Storer B,
Charuhas PM, Woolfrey AE, Sanders JE. Bisphosphonate therapy for reduced bone mineral density in
children with chronic graft-versus-host disease. Biol
Blood Marrow Transplant. Jun 2007;13(6):683–690.
Carpenter P, Snyder DS, Flowers MED, Sanders JE,
Gooley TA, Martin PJ, Appelbaum FR, Radich JP.
Prophylactic administration of imatinib after
hematopoietic cell transplantation for high-risk
Philadelphia chromosome–positive leukemia. Blood.
Apr 2007;109(7):2791–2793.
Chang CK, Storer BE, Scott BL, Bryant EM, Shulman
HM, Flowers ME, Sandmaier BM, Witherspoon
RP, Nash RA, Sanders JE, Bedalov A, Hansen JA,
Clurman BE, Storb R, Appelbaum FR, Deeg HJ.
Hematopoietic cell transplantation in patients with
myelodysplastic syndrome or acute myeloid leukemia
arising from myelodysplastic syndrome: similar
outcomes in patients with de novo disease and disease
following prior therapy or antecedent hematologic
disorders. Blood. Aug 2007;110(4):1379–1387.
Chow E, Friedman DL, Mueller BA. Maternal and
perinatal characteristics in relation to neuroblastoma.
Cancer. Mar 2007;109(5):983–992.
170
Chow E, Friedman DL, Yasui Y, Whitton JA, Stovall
M, Robison LL, Sklar CA. Decreased adult height in
survivors of childhood acute lymphoblastic leukemia:
a report from the Childhood Cancer Survivor Study.
J Pediatr. Apr 2007;150(4):370–375.
Chow E, Pihoker C, Hunt K, Wilkinson K,
Friedman DL. Obesity and hypertension among
children after treatment for acute lymphoblastic
leukemia. Cancer. Nov 2007;110(10):2313–2320.
Cohen JM, Cooper N, Chakrabarti S, Thomson K,
Samarasinghe S, Cubitt D, Lloyd C, Woolfrey AE,
Veys P, Amrolia PJ. EBV-related disease following
hematopoietic stem cell transplantation with
reduced intensity conditioning. Leuk Lymphoma.
Feb 2007;48(2):256–269.
Dallas M, Varnum-Finney B, Martin PJ,
Bernstein ID. Enhanced T-cell reconstitution
by hematopoietic progenitors expanded ex-vivo
using the Notch ligand Delta1. Blood. Apr
2007;109(8):3579–3587.
Douglas JG, Arndt CA, Hawkins DS. Delayed radiotherapy following dose intensive chemotherapy for
parameningeal rhabdomyosarcoma (PM-RMS) of
childhood. Eur J Cancer. Apr 2007;43(6):1045–1050.
Eggleston B, Patience M, Edwards S, Adamkiewicz T,
Buchanan GR, Davies SC, Dickerhoff R, Donfield S,
Feig SA, Giller RH, Haight A, Horan J, Hsu LL,
Kamani N, Lane P, Levine JE, Margolis D, Moore TB,
Ohene-Frempong K, Redding-Lallinger R, Roberts IA,
Rogers ZR, Sanders JE, Scott JP, Sleight B, Thompson
AA, Sullivan KM, Walters MC, Multicenter Study of
HCT for SCA. Effect of myeloablative bone marrow
transplantation on growth in children with sickle
cell anaemia: results of the multicenter study of
haematopoietic cell transplantation for sickle cell
anaemia. Br J Haematol. Feb 2007;136(4):673–676.
Frangoul H, Nemecek E, Billheimer D, Pulsipher M,
Khan S, Woolfrey AE, Levine J, Cole C, Walters M,
Ayas M, Ravindranath Y, Manes B, Grupp S.
A prospective study of G-CSF primed bone marrow
as a stem cell course for allogeneic bone marrow
transplant in children: a Pediatric Blood and Marrow
Transplant Consortium (PBMTC) study. Blood.
Dec 2007;110(13):4584–4587.
Friedman DL, Rovo A, Leisenring W, Locasciulli A,
Flowers ME, Tichelli A, Sanders JE, Deeg HJ, Socie G,
FHCRC; EBMT-Late Effect Working Party. Increased
risk of breast cancer among survivors of allogeneic
hematopoietic cell transplantation: a report from the
FHCRC and the EBMT-Late Effect Working Party.
Blood. Oct 2007;111(2):e939–944.
Ganapathi KA, Austin KM, Lee CS, Dias A, Malsch
MM, Reed R, Shimamura A. The human ShwachmanDiamond syndrome protein, SBDS, associates with
ribosomal RNA. Blood. Sept 2007;110(5):1458–1465.
Henderson TO, Whitton J, Stovall M, Mertens AC,
Mitby P, Friedman DL, Strong LC, Hammond S,
Neglia JP, Meadows AT, Robison L, Diller L. Secondary
sarcomas in childhood cancer survivors: a report from
the Childhood Cancer Survivor Study. J Natl Cancer
Inst. Feb 2007;99(4):300–308.
Kaltenbach LS, Romero E, Becklin RR, Chettier R,
Bell R, Phansalkar A, Strand A, Torcassi C, Savage J,
Hurlburt A, Cha GH, Ukani L, Chepanoske CL,
Zhen Y, Sahasrabudhe S, Olson JM, Kurschner C,
Ellerby LM, Peltier JM, Botas J, Hughes RE.
Huntingtin interacting proteins are genetic modifiers
of neurodegeneration. PLoS Genet. May 2007;3(5):e82.
Kennedy RD, Chen CC, Stuckert P, Archila EM, De la
Vega MA, Moreau L, Shimamura A, D’Andrea AD.
Fanconi anemia pathway-deficient tumor cells are
hypersensitive to inhibition of ataxia telangiectasia
mutated. J Clin Invest. May 2007;117(5):1440–1449.
Kuhn A, Goldstein DR, Hodges A, Strand AD,
Sengstag T, Kooperberg C, Becanovic K, Pouladi MA,
Sathasivam K, Cha JH, Hannan AJ, Hayden MR,
Leavitt BR, Dunnett SB, Ferrante RJ, Albin R,
Shelbourne P, Delorenzi M, Augood SJ, Faull RL,
Olson JM, Bates GP, Jones L, Luthi-Carter R. Mutant
huntingtin’s effects on striatal gene expression in mice
recapitulate changes observed in human Huntington’s
disease brain and do not differ with mutant huntingtin
length or wild-type huntingtin dosage. Hum Mol Genet.
Aug 2007;16(15):1845–1861.
Linenberger M, McCrae K, Matthews DC. Consultative
hematology. In: Kahn MJ, Gregory SA, eds. American
Society of Hematology Self-Assessment Program
(ASH-SAP), Third Edition. Washington, D.C.:
American Society of Hematology. 2007.
Meshinchi S, Arceci RJ. Prognostic factors and
risk-based therapy in pediatric acute myeloid leukemia.
Oncologist. Mar 2007;12(3):341–355.
Oliansky DM, Rizzo JD, Aplan PD, Arceci RJ, Leone L,
Ravindranath Y, Sanders JE, Smith FO III, Wilmot F,
McCarthy PL Jr., Hahn T. The role of cytotoxic therapy
with hematopoietic stem cell transplantation in the
therapy of acute myeloid leukemia in children: an
evidence-based review. Biol Blood Marrow Transplant.
Jan 2007;13(1):1–25.
Park JR, Digiusto DL, Slovak M, Wright C, Naranjo
A, Wagner J, Meechovet HB, Bautista C, Chang WC,
Ostberg JR, Jensen MC. Adoptive transfer of chimeric
antigen receptor re-directed cytolytic T lymphocyte
clones in patients with neuroblastoma. Mol Ther.
Apr 2007;15(4):825–833.
Prakash A, Piening B, Whiteaker J, Zhang H, Shaffer
SA, Martin D, Hohmann L, Cooke K, Olson JM,
Hansen S, Flory MR, Lee H, Watts J, Goodlett DR,
Aebersold R, Paulovich A, Schwikowski B. Assessing
bias in experiment design for large-scale mass
spectrometry-based quantitative proteomics.
Mol Cell Proteomics. Oct 2007;6(10):1741–1748.
171
Sanders JE. Growth and development after
hematopoietic cell transplant in children. Bone
Marrow Transplant. Oct 2007;41(2)e223–227.
Satwani P, Sather H, Ozkaynak F, Heerema NA,
Schultz KR, Sanders JE, Kersey J, Davenport V, Trigg
M, Cairo MS. Allogeneic bone marrow transplantation
in first remission for children with ultra-high-risk
features of acute lymphoblastic leukemia: a Children’s
Oncology Group study report. Biol Blood Marrow
Transplant. Feb 2007;13(2):218–227.
Strand AD, Aragaki AK, Baquet ZC, Hodges A,
Cunningham P, Holmans P, Jones KR, Jones L,
Kooperberg C, Olson JM. Conservation of regional
gene expression in mouse and human brain.
PLoS Genet. Apr 2007;3(4):e59.
Strand AD, Baquet ZC, Aragaki AK, Holmans P,
Yang L, Cleren C, Beal MF, Jones L, Kooperberg C,
Olson JM, Jones KR. Expression profiling of
Huntington’s disease models suggests that
brain-derived neurotrophic factor depletion plays
a major role in striatal degeneration. J Neurosci.
Oct 2007;27(43):11758–11768.
Syrjala KL, Kurland BF, Abrams JR, Sanders JE,
Heiman JR. Sexual function changes during the 5
years after high-dose treatment and hematopoietic
cell transplantation for malignancy, with case-matched
controls at 5 years. Blood. Sep 2007;111(3):e989–996.
Takahide K, Parker PM, Wu M, Hwang WYK,
Carpenter P, Moravec C, Stehr B, Martin PJ, Rosenthal
P, Forman SJ, Flowers ME. Use of fluid-ventilated,
gas-permeable scleral lens for management of severe
keratoconjunctivitis sicca secondary to chronic graftversus-host disease. Biol Blood Marrow Transplant.
Sep 2007;13(9):1016–1021.
Tebbi CK, London WB, Friedman DL, Villaluna D,
De Alarcon PA, Constine LS, Mendenhall NP, Sposto
R, Chauvenet A, Schwartz CL. Dexrazoxane-associated
risk for acute myeloid leukemia/myelodysplastic
syndrome and other secondary malignancies in
pediatric Hodgkin disease. J Clin Oncol. Feb
2007;25(5):493–500.
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Upton A, Kirby KA, Carpenter P, Boeckh M, Marr
KA. Invasive aspergillosis following hematopoietic
cell transplantation: outcomes and prognostic factors
associated with mortality. Clin Infect Dis. Feb
2007;44(4):531–540.
Veiseh M, Gabikian P, Bahrami SB, Veiseh O, Zhang M,
Hackman RC, Ravanpay AC, Stroud MR, Kusuma Y,
Hansen SJ, Kwok D, Muñoz NM, Sze RW, Grady
WM, Greenberg NM, Ellenbogen RG, Olson JM.
Tumor paint: a chlorotoxin:Cy5.5 bioconjugate for
intraoperative visualization of cancer foci. Cancer Res.
Jul 2007;67(14):6882–6888.
Walter RB, Gooley TA, van der Velden VH, Loken MR,
van Dongen JJ, Flowers DA, Bernstein ID, Appelbaum
FR. CD33 expression and P-glycoprotein-mediated
drug efflux inversely correlate and predict clinical
outcome in patients with acute myeloid leukemia
treated with gemtuzumab ozogamicin monotherapy.
Blood. May 2007;109(10):4168–4170.
Wise RP, Bonhoeffer J, Beeler J, Donato H, Downie P,
Matthews DC, Pool V, Riise-Bergsaker M, Tapiainen T,
Verricchio F, The Brighton Collaboration Thrombocytopenia Working Group. Thrombocytopenia: case
definition and guidelines for collection, analysis and
presentation of immunization safety data. Vaccine.
Aug 2007;25(31):5717–5724.
Wolfl M, Kuball J, Ho W, Nguyen H, Manley TJ,
Bleakley M, Greenberg PD. Activation-induced
expression of CD137 permits detection, isolation and
expansion of the entire repertoire of CD8+ T-cells
responding to antigen without requiring knowledge of
epitope specificities. Blood. Jul 2007;110(1):201–210.
Hospital Medicine
The Division of Hospital Medicine consists of pediatricians
who serve as attending physicians for inpatients at Seattle
Children’s Hospital. Division physicians attend on patients
whose primary care physicians prefer a hospital-based
physician.
Our physicians ensure that the medical team keeps in
close contact with primary care physicians to coordinate
inpatient and outpatient care. We provide care using a
family-centered model and meet daily with parents, nurses
and resident physicians to develop a plan of care and
update families on the child’s condition. As hospitalists
with particular expertise in caring for pediatric inpatients,
division members also take a lead role in treating patients
with complex medical needs, and in undertaking quality
improvement projects for the inpatient medical service.
Division physicians also participate extensively in medical
education, providing formal lectures, bedside teaching and
mentoring for medical students and resident physicians.
Faculty
Glen S. Tamura, MD, PhD, Director
Julianne K.J. Bishop, MD
Ronald L. Dick, MD
Janie G. Hallstrand, MD
Michael Leu, MD, MS, MHS
Darren Migita, MD
Anne E. Phalen, MD
Joel S. Tieder, MD, MPH
Glen S. Tamura
MD, PhD, Director
Glen S. Tamura, MD, PhD, is medical director of the
Inpatient Medical Service at Seattle Children’s Hospital
and assistant professor in the Department of Pediatrics
Tamura received his MD and PhD from Stanford
University, and trained in pediatrics and pediatric
infectious diseases at the University of Washington.
His clinical interests are focused on general inpatient
pediatric medicine and infectious diseases. He is
director of the pediatric infectious diseases fellowship
program at the University of Washington. He teaches
clinical skills to second-year medical students and
mentors approximately 40 students throughout their
medical school careers. Tamura’s research interests
include clinical research into quality improvement
and patient-centered care.
Julianne K.J. Bishop, MD, is attending physician on
the inpatient ward at Seattle Children’s Hospital and
clinical instructor in the Department of Pediatrics
Bishop earned her MD from the University of
Kansas and completed her residency in pediatrics at
Children’s. She is a fellow of the American Academy
of Pediatrics. Bishop’s clinical interests include ethics
and palliative care.
173
Hospital Medicine
Janie G. Hallstrand, MD, is attending physician at Seattle
Washington School of Medicine. She works with
medically complex children with prolonged hospital
stays. She earned her MD at the University of Vermont
School of Medicine and completed residency training
at Maine Medical Center. Hallstrand is involved
with resident and medical student education through
bedside and didactic teaching. She is interested in
quality improvement and participates in rapid
process improvement.
Spotlight on team members — Jessalynn Jones, RN, BSN
I’m excited to be part of Seattle Children’s effort to obtain
Magnet Recognition for our excellence in nursing. Magnet
Recognition will help us retain and attract gifted staff
members and broaden our reputation for quality patient
care, research, education and advocacy. As our national
reputation grows, so will our ability to provide holistic,
accessible care for all children.
Ronald L. Dick, MD, is clinical assistant professor in the
School of Medicine and medical director of the Medically
Complex Child Service. Dick earned his MD from
the University of Massachusetts Medical School and
completed his pediatrics residency at the University
of Washington. From 1989 to 1999 he was a general
pediatrician at The Everett Clinic in Everett, Wash.
In 1999, he started the inpatient pediatric hospitalist
service for The Everett Clinic, which he ran from 1999
to 2003. He served as the medical director for the
Pediatric Inpatient Services Program at Providence
Everett Medical Center from 2002 to 2003. Dick joined
Children’s hospital medicine team in 2003. In addition
to caring for general medicine patients on the inpatient
service, a significant focus of his work has been the care
of medically complex children with prolonged hospital
stays. He is involved in resident and medical student
education through bedside and didactic teaching. He is
interested in quality improvement and is a member of
the Quality Improvement Steering Committee. He is
especially interested in quality improvement issues
related to the care of medically complex children.
174
Michael Leu, MD, MS, MHS, is hospitalist and pediatric
informaticist at Seattle Children’s Hospital. A Seattle
native, he trained in computer science and worked in
that industry for several years before attending medical
school. He received his MD with Thesis Honors from
the University of Washington, completed pediatric
residency training at Harbor-UCLA Medical Center
and was a Robert Wood Johnson Clinical Scholar at
Yale University. Leu is interested in using technology
to improve the practice of pediatrics in both the
ambulatory and hospital settings. He is currently
the applications chair for the American Academy of
Pediatrics Council on Clinical Information Technology.
Darren Migita, MD, is pediatric hospitalist at Seattle
Children’s Hospital and assistant clinical professor
Washington School of Medicine. Migita serves as the
director of line management and is involved in efforts
to decrease bloodstream infection rates. He is also
chief of the pediatric hospitalist section at Evergreen
Hospital Medical Center in Kirkland, Wash., a
Children’s-sponsored program founded in 1999.
Migita has contributed to the Children’s Continuous
Performance Improvement (CPI) initiative. Project
themes have included improving the inpatient
experience for families and providers, maximizing
pediatric inpatient and ED throughput efficiency and
standardizing the care of pediatric inpatients through
the use of evidence-based clinical guidelines. He was
also instrumental in creating a single-care-provider
hospitalist service at Children’s. With Dr. Dimitri
Christakis he co-authored a pediatric handbook,
The Saint-Frances Guide to Pediatrics.
Hospital Medicine
Anne E. Phalen, MD, is pediatric hospitalist at Seattle
MD from Georgetown University Medical School and
completed her residency at the Children’s Hospital
National Medical Center in Washington, D.C. Phalen
works with medically complex children having prolonged
medical stays. She also provides didactic and bedside
teaching for residents and medical students on the
wards. Her interests also include patient care qualityimprovement projects.
Joel S. Tieder, MD, MPH, is attending physician and
clinical instructor at Seattle Children’s Hospital’s
hospitalist program for the Department of Pediatrics
He provides specialized care for hospitalized children
and serves as an educator for residents and medical
students. He is also a pediatric hospitalist at Evergreen
Hospital Medical Center in Kirkland, Wash. He
obtained his MPH in epidemiology from the University
of Washington and specializes in inpatient outcomes
research. He is studying how standardization of practice
affects quality care for inpatients, nationally and
at Children’s, for such conditions as apparent lifethreatening events (ALTEs) and acute gastroenteritis.
He serves on the Children’s Clinical Effectiveness
Team and has recently developed and implemented a
guideline and pathway for acute gastroenteritis for use
at Children’s. He is an active member of the American
Academy of Pediatrics Section of Hospital Medicine
and serves as chair of a national expert panel on ALTEs.
RESEARCH FUNDING
New
Ronald L. Dick, MD
Outcomes evaluation study for medically complex
children. Continuous Performance Improvement
Office at Children’s Hospital.
Glen S. Tamura, MD, PhD
Including families on rounds at a pediatric teaching
hospital. National Family-Centered Care Conference.
Joel S. Tieder, MD, MPH
Variation in inpatient resource utilization and
management of apparent life-threatening events.
Pediatric Academic Society Annual Conference.
Toronto, Ontario, Canada. May 2007.
Variation in inpatient resource utilization and
management of apparent life-threatening events.
AAP’s Society of Hospital Medicine Annual Conference.
Denver, Colo. July 2007.
PUBLICATIONS
Hull JR, Tamura GS, Castner DG. Structure and
reactivity of adsorbed fibronectin films on mica.
Biophys J. Oct 2007;93(8):2852–2860.
AWARDS AND HONORS
Darren Migita, MD
175
Infectious Disease, Immunology
and Rheumatology
The Division of Infectious Disease, Immunology and
Rheumatology contains three subspecialty sections. All
three have internationally recognized faculty and clinical,
educational and research programs. Each section is
described separately.
The Section of Infectious Disease offers consultation
and diagnostic services in the management of suspected
and proven infectious diseases in children, in the hospital
and in outpatient settings. We treat complicated, chronic
and recurrent infections that arise from exposure to
infectious diseases and immunosuppressive therapy,
and infections that follow hematopoietic cell and organ
transplantation and other surgical procedures.
The Infectious Diseases Service provides laboratory
assistance in the diagnosis of complex infections and
assistance in the selection, dosage and monitoring of
antibiotics, antivirals and other forms of therapy. The
Virology Clinic provides specialized treatment for difficult
viral infections such as herpes and for exposure to and
diagnosis with HIV or AIDS.
Our outpatient Infectious Disease Clinic cares for
children referred by health-care providers for a wide variety
of infectious disease problems. The clinic works closely
with Seattle Children’s home care services to support
patients on home IV antimicrobial therapy. Children’s infection
control program is one of the best in the United States in
preventing the spread of infections in the hospital. Our
physicians provide one of the largest telephone information
consultation services for the hospital, serving community
physicians in the WWAMI region. We also provide services
related to international travel, including education and
recommendations for managing children returning from
a foreign country with symptoms of infection.
Our research programs investigate the natural history
of infections in children, the specific traits of microbes
that infect humans and the molecules that help microbes
establish infections, such as pneumonia and bloodstream
and brain infections. The section has developed new
programs to understand how infections result in premature
birth or infection of the fetus. We also investigate the immune
mechanisms that thwart infection by human pathogens.
These studies include basic science experimentation at the
molecular and cellular level and the use of relevant models
of human infections. Results from this research are used
to identify new drugs for treatment and new vaccines for
prevention. Clinical studies investigate how microbes cause
disease in childhood and in children with immune-related
problems from chemotherapy and transplantation. Clinical
studies also test the efficacy of new drugs that may treat
and improve the outcome from severe infections, and of
new vaccines aimed at preventing infections in children.
Faculty
Craig E. Rubens, MD, PhD, Chief
Jane L. Burns, MD
Angela J.P. Campbell, MD
Janet A. Englund, MD
Lisa M. Frenkel, MD
Soren M. Gantt, MD, PhD
Tina Guina, PhD
Amanda L. Jones, PhD
Ann J. Melvin, MD, MPH
Tamara C. Pozos, MD, PhD
Lakshmi Rajagopal, PhD
Lynn M. Rose, PhD
Craig E. Rubens
MD, PhD, Chief
176
Sherilyn Smith, MD
Glen S. Tamura, MD, PhD
Kevin B. Urdahl, MD, PhD
Scott Weissman, MD
Danielle M. Zerr, MD, MPH
Section of Infectious Disease
in Infectious Disease, Immunology and Rheumatology
Craig E. Rubens, MD, PhD, is chief of the Division of
Infectious Disease, Immunology and Rheumatology
at Seattle Children’s Hospital and the division in the
Department of Pediatrics at the University of Washington School of Medicine. Rubens is adjunct professor of
microbiology and holds the Children’s Hospital Guild
Association Endowed Chair in Pediatric Infectious
Disease Research. He completed his MD, his pediatrics
residency and his pediatric infectious disease subspecialty certification at the University of Washington.
Rubens is investigating the biologic mechanisms
involved in newborn infections and bacterial pneumonia.
His work has identified important virulence traits of
bacteria that are critical to interaction with the host
and for escaping innate immunity. His laboratory has
also identified the genetic and biosynthetic basis for
production of these virulent traits. His current research
has expanded to include how infections with group B
streptococci lead to premature births. Rubens has been
selected to head a research center that will investigate
pediatric infections and premature birth at Children’s
Research Institute. His society memberships include
the American Society of Clinical Investigation and
the American Pediatric Society, and he has served as
consultant and grant reviewer for the FDA and the
NIH/NIAID. He oversees the program for pediatric
infectious disease subspecialty training, participates
in graduate student education and training and has
served on several university committees to improve
faculty and graduate education. Rubens is also
regional affiliate investigator for the Center on
Human Development and Disability.
Jane L. Burns, MD, is attending physician at Seattle
Medicine. She is the clinical director of the Section of
Infectious Disease and director of the infectious disease
clinic at Children’s. She earned her MD and also did
her training in pediatrics and infectious diseases at the
University of Washington. Her research interest is in
cystic fibrosis microbiology antibiotic resistance, and
she directs the Therapeutics Development Network
Core Laboratory for Cystic Fibrosis Microbiology. Her
work includes both clinical and translational research,
and she has been involved in developing and testing
Spotlight on team member — Joan Heath, RN, BSN, CIC
I’m most excited about the work we’re doing to prevent surgical
site infections at Seattle Children’s. After implementing a
strong and successful program of prevention strategies in our
cardiac surgery population, we’re spreading the measures to
other services and populations. Adopting standard work
based on best practices will lower our infection rates and
improve outcomes for patients.
new antibiotic medications for use in cystic fibrosis.
Burns is nationally and internationally known for her
work in cystic fibrosis and is a founding member of the
International Burkholderia Cepacia Working Group.
Angela J.P. Campbell, MD, is attending physician at
the Department of Pediatrics at the University of
at Vanderbilt University and completed training in
pediatrics and pediatric infectious diseases at the
University of Washington. She received the travel
award at the Infectious Diseases Society of America’s
annual meeting and the poster presentation award
from the Pediatric Infectious Diseases Society. Campbell
attends the University of Washington School of Public
Health. Her clinical and teaching interests include
viral infections, particularly respiratory viruses and
domestic and international arthropod-borne viral
illnesses. Campbell’s research focuses on factors that
influence the acquisition of respiratory virus infection
and disease progression among immuno-compromised
children and adults, with the goal of facilitating new
diagnostic, preventive and treatment strategies for
respiratory virus infections.
177
Janet A. Englund, MD, is attending physician at Seattle
Children’s Hospital, associate professor in the Department of Pediatrics at the University of Washington
School of Medicine and clinical associate at Fred
Hutchinson Cancer Research Center (FHCRC). She
serves as co-chair of the Pharmacy and Therapeutics
Committee at Children’s, director of the Pediatric
Infectious Disease Transplant Service and pediatric
infectious disease representative with the Seattle
Cancer Care Alliance and at FHCRC. She serves on
the Advisory Committee on Immunization Practices
(ACIP) at the Centers for Disease Control, the ID
Sub-board of the American Academy of Pediatrics and
as pediatric representative on the Seasonal Influenza
Planning Committee for the Infectious Disease Society
of America. Her clinical interests include the diagnosis,
prevention and treatment of respiratory diseases in
children and immuno-compromised patients. Englund’s
research involves the study of live and inactivated
influenza vaccines in pediatric populations, including
infants, toddlers, school-age children and immunocompromised patients, and the evaluation of molecularbased methods for the diagnosis of new and emerging
respiratory virus pathogens in these populations. She
conducts clinical trials for other vaccine-preventable
diseases, including pertussis (whooping cough), and
has interests in the field of maternal immunization.
Her ongoing research involves the study of respiratory
syncytial virus (RSV), human metapneumovirus and
human coronaviruses in special pediatric populations,
including children with cystic fibrosis, Inuit children
and children attending day care. Englund has conducted
clinical studies with the assistance of practicing
pediatricians around Washington state.
Lisa M. Frenkel, MD, is attending physician at Seattle
Medicine. Frenkel trained in pediatrics and pediatric
infectious diseases at the University of California,
Los Angeles. She is director of the HIV Program at
Children’s. She has studied herpes simplex virus (HSV)
and human immunodeficiency virus type 1 (HIV-1),
and has led and participated in multicenter international trials. Her studies have found that antiviral
drugs can prevent most HIV-1 transmissions from
mothers to their babies, have improved the treatment
of HIV-1–infected children and have elucidated the role
of drug-resistant virus in HIV-1 disease progression.
178
Frenkel’s laboratory focuses on the development and
transfer of practical and economical assays for early
HIV-1 diagnosis and monitoring of drug-resistant
mutants in resource-strapped communities; it also
serves as a developmental laboratory for the International Maternal Pediatric Adolescent AIDS Clinical
Trials (IMPAACT) Network. Frenkel directs research
projects aimed at understanding the evolution and
treatment of drug-resistant viruses in children and
adults with colleagues in India, Mozambique, Peru,
Thailand, the United States and Zimbabwe. She is
adviser to WHO HIVResNet for use of dried blood
spot specimens and genotyping, a member of the
NIH-NIAID AIDS research review committee and a
reviewer on the NIH-NIAID special emphasis panel.
Soren M. Gantt, MD, PhD, is attending physician at
Seattle Children’s Hospital and acting assistant
Medicine. He earned a combined MD/PhD at New
York University School of Medicine. He completed
his pediatrics residency and a fellowship in infectious
diseases at Children’s. His clinical interests include
infectious disease consultation as well as general
pediatric inpatient medicine. Gantt has developed
projects focused on mother-to-child transmission
of HIV-1 through breast-feeding in Zimbabwe and
Mozambique. He also directs studies in Uganda on
human herpes virus 8 infection and Kaposi’s sarcoma.
Gantt is a K12 Clinical Research Scholar and Center for
AIDS Research New Investigator, and he attends the
University of Washington School of Public Health.
Tina Guina, PhD, is research assistant professor in
the Department of Pediatrics, Division of Infectious
Diseases. Guina is one of the principal investigators
of the Northwest Regional Center of Excellence for
Biodefense and Emerging Infectious Diseases Research.
She received her PhD in molecular biology and
biochemistry at Wesleyan University in Middletown,
Conn. She is an ad-hoc grant reviewer for the NIH
and Dutch Cystic Fibrosis Foundation, and an ad-hoc
reviewer for international science journals PLoS
Pathogens, Molecular Microbiology, Cellular Microbiology, Infection and Immunity, Molecular and Cellular
Proteomics, FEMS Immunology and Microbiology
and the Journal of Medical Microbiology. She studies
pathogenesis of highly infectious Gram-negative
bacteria that cause severe pulmonary infections. Her
goal is to understand the causes and outcomes of
infectious diseases by studying the interaction of
microbial pathogens with human and animal immune
systems. To address these questions, she uses state-ofthe-art proteomics approaches, animal and cellular
infection models and immunological assays.
Amanda L. Jones, PhD, is research assistant professor
Washington School of Medicine and adjunct research
assistant professor in the Department of Pathobiology
at the University of Washington School of Public Health.
She earned her PhD in microbial pathogenesis from
the University of Calgary in Canada. Research in her
laboratory focuses on immune evasion strategies used
by group B streptococcus and the molecular pathogenesis
of neonatal infections. Jones regularly teaches classes
in medical bacteriology and on critical thinking and
research design at the University of Washington schools
of Medicine and Public Health. She has been a member
of the University of Washington Medical School Admissions Committee since 2005 and is the co-director of
the Seattle Children’s Hospital Fellows’ College. She is
principal investigator on an NIH-funded research grant.
Ann J. Melvin, MD, MPH, is co-director of the HIV
Program at Seattle Children’s Hospital and associate
School of Medicine. She is the primary physician
responsible for HIV-infected and HIV-exposed
children at Children’s and medical director of the
HIV early diagnosis program at Harborview Medical
Center. She completed an internship in pediatrics
at the University of California, San Francisco; she
completed a pediatrics residency and a fellowship in
pediatric infectious disease at Children’s. Melvin’s
research interests are in the antiretroviral management
of HIV disease in children and prevention and management of complications of HIV treatment. She is an
investigator in the International Maternal Pediatric
Adolescent AIDS Clinical Trials unit at the University
of Washington, through which she is co-chair of several
national and international research trials. She is also
co-director of the Regulatory Support and Bioethics
core of the Institute of Translational Health Sciences
of the University of Washington. Melvin mentors
physicians in India as part of the Puget Sound
Partners Program.
Tamara C. Pozos, MD, PhD, is attending physician at
Washington School of Medicine. She earned a combined
MD/PhD at Stanford University. She completed a
pediatrics residency at the University of California,
San Francisco, and a fellowship in pediatric infectious
diseases at Children’s. Pozos’ research goal is to
understand innate immune responses to mycobacterial
infection by investigating the interconnected roles of
immune cell migrations, matrix metalloproteinase
activity and early granuloma formation. Her clinical
and teaching interests are pediatric tuberculosis and
other infections in children of the developing world,
particularly Latin America. Pozos mentors and encourages trainees, particularly women and minorities, to
consider careers in academic medicine.
Lakshmi Rajagopal, PhD, is assistant professor in the
departments of Pediatrics and Microbiology at the
earned her PhD from Jawaharlal Nehru University in
India and completed her postdoctoral fellowship in the
Department of Pediatrics at the University of Washington. Rajagopal’s research interests center on the role
of eukaryotic-type signaling in prokaryotic organisms.
Her research focuses on elucidating the link between
a eukaryotic-type serine/threonine kinase and a twocomponent regulator in the human neonatal pathogen,
group B streptococci. A number of peer-reviewed
articles have resulted from her research. In 2007,
Rajagopal was awarded an NIH/NIAID RO1 grant to
establish the link between eukaryotic-type and twocomponent signaling in the regulation of GBS toxins.
Lynn M. Rose, PhD, is the director of Clinical Operations
and Regulatory Affairs at the Cystic Fibrosis Therapeutics
Development Network Coordinating Center (CF-TDNCC)
at Seattle Children’s Hospital Research Institute. In
that capacity, Rose oversees the implementation of
several multicenter clinical trials each year. Rose is also
a research associate professor in the Department of
Pediatrics at the University of Washington and faculty
director of the Development of Novel Clinical and
Translational Methodologies (DNCTM) Core at the
Institute of Translational Health Sciences (ITHS)
in Seattle. She directs the DNCTM consulting and
educational programs for preclinical development of
179
novel therapeutics. She earned her PhD at the University
of Geneva, Switzerland, and her BS at the University
of California, San Diego. Before joining the CF-TDNCC,
she was a senior pharmaceutical executive with extensive
experience in biomedical research and product development. Rose has more than 15 years of therapeutics
development experience, including management of
manufacturing, preclinical and clinical programs. This
experience includes seven years of direct regulatory
experience with both small molecule products (oral
and aerosol delivery) and biologics. Her primary
clinical research expertise is in the areas of infectious
disease, cystic fibrosis, autoimmune disease, thrombosis
and hemostasis. On a national level, Rose is involved in
efforts to develop resources for therapeutics development
in an academic setting.
Sherilyn Smith, MD, is co-director of the Infectious
Disease Clinic, attending physician at Seattle Children’s
Medicine. She completed residency training in pediatrics
and served as chief resident at the University of
California, San Diego. She completed a fellowship
in pediatric infectious diseases at the University of
Washington. Her clinical responsibilities include the
Infectious Disease Clinic, Inpatient Infectious Disease
Consult Service and General Pediatrics Ward Service.
She is also associate director of the pediatric clerkship
at Children’s and head of the Big Sky College at the
University of Washington School of Medicine. Smith is
on the editorial board for the Computerized Learning
in Pediatrics Project (CLIPP), a national computerized
curriculum of pediatric cases for medical students.
Glen S. Tamura, MD, PhD, is medical director of the
Inpatient Medical Service at Seattle Children’s Hospital
He is director of the pediatric infectious diseases
fellowship program. Tamura received his MD and
PhD from Stanford University and trained in pediatrics
and pediatric infectious diseases at the University of
Washington. His clinical interests are focused on
general inpatient pediatric medicine and infectious
diseases with clinical research interests in quality
improvement and patient-centered care. He has a
strong interest in both graduate and undergraduate
medical education, and is developing a research
program in the feedback and evaluation of trainees.
180
Kevin B. Urdahl, MD, PhD, is attending physician in
infectious diseases and pediatrics at Seattle Children’s
Hospital and assistant professor at the University of
Washington School of Medicine. He earned his MD and
his PhD in microbiology/immunology at the University
of Minnesota. He completed both his pediatric residency
and his infectious diseases fellowship at Children’s and
the University of Washington. His clinical interests
include the diagnosis and management of infants,
children and adolescents with infectious diseases,
especially tuberculosis and diseases associated with
robust immune cell activation (e.g., Kawasaki disease
and toxic shock syndrome). He conducts research that
characterizes immunity in tuberculosis with the goal
of identifying strategies that could lead to the development of an effective vaccine. Recently, he defined a
role for a suppressive subset of T lymphocytes that
dampens immunity and prevents the immune system
from effectively eradicating the bacteria that causes
tuberculosis. Urdahl is the recipient of a Burroughs
Wellcome Fund Career Award in the Biological Sciences.
Scott Weissman, MD, is attending physician at Seattle
Children’s Hospital and acting instructor in the
School of Medicine. He earned his MD from the
University of California-Irvine College of Medicine. He
completed a pediatrics residency at Kaiser Foundation
Hospital, Los Angeles, and a fellowship in pediatric
infectious disease at Children’s. His research concerns
the evolution of virulence properties in Escherichia
coli strains associated with newborn meningitis and
urinary tract infection. Specifically, the work focuses
on the study of allelic variation in fimbrial adhesion
genes to delineate fine phylogenetic relationships
between strains grouped together by conventional
molecular footprinting techniques such as multiple
locus sequence typing. This improved resolution allows
the identification of key genetic adaptations, including
point mutation, recombination and pathogenicity
island acquisition/deletion that promote adaptation
to novel niches. Fimbrial adhesion sequence typing
(FAST) should provide an important tool in the
understanding of genomic plasticity in E. coli evolution,
with application in bacterial pathogenesis, population
biology and epidemiology. This work has been published
and presented at national conferences. Weissman’s
clinical interests include the treatment of recurrent
urinary tract infections, as well as infections of
skin/soft tissue and bone by Staph aureus.
Danielle M. Zerr, MD, MPH, is medical director of
infection control at Seattle Children’s Hospital,
affiliate investigator at the Fred Hutchinson Cancer
Research Center. Zerr’s research has focused on
the epidemiology of human herpes virus 6 (HHV-6)
infections in healthy children and immuno-compromised
hosts. Zerr is principal investigator on a study of HHV-6
reactivation in hematopoietic stem cell transplant
recipients. She is also interested in the epidemiology,
viral pathogens and prognosis of nonfebrile seizures
occurring in the setting of mild illness as well as the
epidemiology and prevention of infections associated
with health care.
AWARDS AND HONORS
Jane L. Burns, MD
New Investigator Award. Center for AIDS Research.
Craig E. Rubens, MD, PhD
Listed in America’s Top Physicians.
New model of ascending infection related premature
birth. March of Dimes. $399,967.
Continuing
Jane L. Burns, MD
Therapeutics Development Center microbiology core.
Cystic Fibrosis Foundation. $272,496.
Therapeutics Development Center microbiology core
toolkit. Cystic Fibrosis Foundation. $68,972.
Role of viruses in CF airway infections. Cystic Fibrosis
Lisa M. Frenkel, MD
Children’s IMPAACT clinical trials site. NIH/DHHS.
$127,773.
Etiology of mastitis in HIV-1 infected women.
NIAID/NIH/DHHS. $225,001.
Immunization by HIV exposure during
chemoprophylaxis. NIH/DHHS. $292,132.
Mechanism/predictors of genital/rectal HIV
shedding during ART with plasma <50c/mL.
NIGMS/NIH/DHHS. $395,101.
RESEARCH FUNDING
Pediatric HIV clinical trials network. NIH/DHHS.
$450,000.
New
Jane L. Burns, MD
Multidose safety and tolerability study of dose escalation
of liposome amikacin for inhalation in cystic fibrosis
patients with chronic infections due to Pseudomonas
aeruginosa. Transave Corporation. $294,402.
Reservoirs of drug-resistant HIV-1.
Lisa M. Frenkel, MD
IMPAACT Network Virology Specialty Laboratory.
Tina Guina, PhD
NW RCE-Project 3: bacterial proteome. NIH/NIAID.
$234,140.
Eukaryotic-type signaling mediates two-component
regulation of GBS virulence. NIAID/NIH/DHHS.
$396,380.
Academic pediatric infectious disease.
Women’s HIV Pathogenesis Program. NIH/DHHS.
$89,787.
181
Early host: microbial interactions in S. aureus pneumonia
— SCCOR. NIH/DHHS. $173,697.
Role of a novel signal transduction pathway in GBS.
Scott Weissman, MD
Type 1 fimbrial variation in E. coli 018:K1:H7
virulence. NIAID/NIH/DHHS. $120,420.
HHV-6 and CNS disease following stem cell
transplant. NIAID/NIH/DHHS. $313,116.
Pediatric influenza. Grand Rounds, Madigan Army
Medical Center Department of Pediatrics. Tacoma,
Wash. Jan. 19, 2007.
Preventing influenza in children. National Immunization
Conference Satellite Symposium. Kansas City, Kan.
March 6, 2007.
Recruitment and retention of patients in clinical trials.
Clinical Investigator Speaker Series, University of
Washington. Seattle, Wash. April 25, 2007.
New respiratory viruses. 27th Annual ID Symposium,
University of Nebraska/Creighton University. Omaha,
Neb. April 27, 2007.
Jane L. Burns, MD
Microbiology of CF airways. Center of Excellence
Education Seminar. Seattle, Wash. January 2007.
Antibiotic resistance in Burkholderia cepacia complex:
is there a magic bullet? International Burkholderia
cepacia Working Group. Ann Arbor, Mich. April 2007.
New therapies for targeting CF lung pathogens.
American Society for Microbiology. Toronto, Ontario,
Canada. May 2007.
Recurrent fevers. Update in Practical Pediatrics.
Kirkland, Wash. September 2007.
Current antibiotic resistance patterns in CF and PCR
diagnosis of respiratory viruses in children with CF.
NACFC. Anaheim, Calif. October 2007.
Interesting pediatric infections: they aren’t just little
adults. Recurrent fevers in kids: when is it not just
another virus? 23rd Annual ID Conference. Seattle,
Wash. December 2007.
Prevention of influenza. University of British Columbia
Vaccine Center. Vancouver, British Columbia, Canada.
Jan. 11, 2007.
Respiratory viral diseases in the immuno-compromised
host. Grand Rounds, Children’s Hospital, University of
British Columbia. Vancouver, British Columbia,
Canada. Jan. 12, 2007.
182
Pandemic influenza in pregnant women and infants.
Perinatal Action Committee of Washington. Renton,
Wash. May 20, 2007.
New findings in influenza. Puget Sound Association
for Professionals in Infection Control. SeaTac, Wash.
June 1, 2007.
Influenza in daycare (invited speaker). Infectious
Diseases Society of America. Chicago, Ill. Sept. 18, 2007.
Pandemic influenza. AAP annual meeting. San Francisco,
Calif. Oct. 29–30, 2007.
Lisa M. Frenkel, MD
Preventing HIV via breast-feeding (invited faculty).
Harare, Zimbabwe. 2007.
African International Conference on Immunity
(invited speaker). Victoria Falls, Zimbabwe. 2007.
Fifth Annual Western Regional International Health
Conference (invited speaker). University of Washington.
Seattle, Wash. 2007.
International course: HIV, pathogenesis, prevention
and treatment (invited speaker). Peru. 2007.
HIV transmission through breast-feeding. Department
of Paediatrics Grand Rounds, Makerere University.
Kampala, Uganda. March 21, 2007.
Targeting breast inflammation to reduce mother to
child transmission of HIV through breast-feeding.
HIV Breast-feeding Summit. Harare, Zimbabwe.
May 21–23, 2007.
Human herpes virus 8 transmission and primary
infection. Paediatric Infectious Disease Continuing
Medical Education, Mulago Hospital. Kampala,
Uganda. Oct. 31, 2007.
Secretion mechanisms of bacteria relevant to virulence.
Antimicrobial defenses in the lungs. Severe sepsis:
pathogenesis and treatment. 47th Interscience
Conference on Antimicrobial Agents and Chemotherapy.
Chicago, Ill. September 2007.
Initial host:bacterial responses in Staphylococcus
aureus pneumonia, and host and bacterial factors in
invasive group B streptococcal infections. Dartmouth
Medical School. Hanover, N.H. October 2007.
Tina Guina, PhD
Secreted protease is a Francisella anti-virulence factor.
ASM Biodefense. Washington, D.C. February 2007.
Infectious diseases and microbiology. Lake Washington
Technical College. Kirkland, Wash. November 2007.
Role of MglA in Francisella tularensis stress response
and virulence. Third National Meeting of the RCEs
for Biodefense and Emerging Infectious Diseases.
St. Louis, Mo. May 2007.
Sherilyn Smith, MD
Scholarship of teaching: highlighting the talents of
educators. COMSEP meeting. San Antonio, Texas.
March 2007.
Cord blood LDL cholesterol is higher in infants
exposed to protease inhibitor (PI) therapy in utero
versus those not exposed to PIs (co-presenter).
Pediatric Academic Societies annual meeting.
Kevin B. Urdahl, MD, PhD
Pathogen-specific T regulatory cells and suppression of
protective immunity against Mycobacterium tuberculosis
(co-presenter). Burroughs Wellcome Fund Career
Awardees’ Summer Conference. Dana Point, Calif. 2007.
Tamara C. Pozos, MD, PhD
Gordon Conference on Matrix Metalloproteinases.
Il Ciocco, Italy. June 2007.
Expansion and function of T regulatory cells in
tuberculosis (co-presenter). Keystone Symposia,
From Lab Research to Field Trials. Keystone, Colo.
March 2007.
Eukaryotic signaling by a bacterial pathogen. Department
of Microbiology and Immunology, University of Illinois.
Chicago, Ill. March 22, 2007.
A eukaryotic-type kinase and a two-component
system regulate toxin expression in the human pathogen.
Streptococcus agalactiae, Phosphorylation, Signaling
and Disease Meeting. Cold Spring Harbor, N.Y.
May 16–20, 2007.
Staphylococcal gene expression during the early stages
of pneumonia. Wyeth Research Lecture. Newark, N.J.
February 2007.
Strategy and tactics in building your research career.
St. Jude/PIDS Pediatric Infectious Diseases Research
Conference. Memphis, Tenn. February 2007.
Scott Weissman, MD
The ongoing evolution of extraintestinal pathogenic
Escherichia coli. Postgraduate Institute of Medical
Education and Research. Chandigarh, India.
March 1, 2007.
HHV-6: what does a positive PCR mean? (invited
speaker). Stem Cell Transplantation in Children:
Current Results and Controversies. San Diego, Calif.
January 2007.
Human herpes virus 6 infection: a system to identify
primary infection. Institute of Translational Health
Sciences Symposia: Utilizing Saliva in Translational
Research. University of Washington. Seattle, Wash.
Sept. 11, 2007.
183
PUBLICATIONS
Anderson SW, Stapp JR, Burns JL, Qin X. Characterization of small colony variant Stenotrophomonas
maltophilia isolated from the sputum specimens of
five patients with cystic fibrosis. J Clin Microbiol.
Feb 2007;45(2):529–535.
Baggett HC, Duchin JS, Shelton W, Zerr DM, Heath J,
Ortega-Sanchez IR, Tiwari T. Two nosocomial pertussis
outbreaks and their associated costs — King County,
Washington, 2004. Infect Control Hosp Epidemiol.
May 2007;28(5):537–543.
Boeckh M, Englund JA, Li Y, Miller C, Cross A,
Fernandez H, Kuypers J, Kim H, Gnann J, Whitley R.
Randomized controlled multicenter trial of aerosolized
ribavirin for respiratory syncytial virus upper respiratory
tract infection in hematopoietic cell transplant recipients.
Clin Infect Dis. Jan 2007;44(2):245–249.
Braff MH, Jones AL, Skerrett SJ, Rubens CE.
Staphylococcus aureus exploits cathelicidin antimicrobial
peptides produced during early pneumonia to promote
staphylokinase-dependent fibrinolysis. J Infect Dis.
May 1 2007;195(9):1365–1372.
Burns, JL. Antibiotic resistance of Burkholderia spp.
In: Long SS, Prober CG, Pickering LK, eds. Burkholderia:
Molecular Microbiology and Genomics. Norwich, U.K.:
Horizon Scientific Press. 2007.
Chattopadhyay S, Feldgarden M, Weissman S,
Dykhuizen DE, Van Belle G, Sokurenko EV. Haplotype
diversity in “source-sink” dynamics of Escherichia coli
urovirulence. J Mol Evol. Feb 2007;64(2):204–214.
Cheung K, Li G, Urban TA, Goldberg JB, Griffith A,
Lu F, Burns JL. Pilus-mediated epithelial cell death in
response to infection with Burkholderia cenocepacia.
Microbes Infect. Jun 2007;9(7):829–837.
D’Argenio DA, Wu M, Hoffman LR, Kulasekara HD,
Deziel E, Smith EE, Nguyen H, Ernst RK, Larson
Freeman TJ, Spencer DH, Brittnacher M, Hayden
HS, Selgrade S, Klausen M, Goodlett DR, Burns JL,
Ramsey BW, Miller SI. Growth phenotypes of
Pseudomonas aeruginosa lasR mutants adapted to
the airways of cystic fibrosis patients. Mol Microbiol.
Apr 2007;64(2):512–533.
184
Ernst RK, Moskowitz SM, Emerson JC, Kraig GM,
Adams KN, Harvey MD, Ramsey B, Speert D,
Burns JL, Miller SI. Unique lipid A modifications in
Pseudomonas aeruginosa isolated from the airways
of patients with cystic fibrosis. J Infect Dis. Oct
2007;196(7):1088–1092.
Forsberg A, Guina T. Francisella type II secretion and
type IV pili. Ann N Y Acad Sci. Jun 2007;1105:187–201.
Galankas E, Englund JA, Abe P, Qin X. Antimicrobial
susceptibility of Bordetella pertussis isolates in the
state of Washington. Int J Antimicrob Agents. May
2007;29(5):609–611.
Gantt SM, Shetty AK, Seidel KD, Matasa K,
Musingwini G, Woelk G, Zijenah LS, Katzenstein DA,
Frenkel LM. Laboratory indicators of mastitis are not
associated with elevated HIV-1 DNA or predictive of
HIV-1 RNA concentrations in breast milk. J Infect Dis.
Aug 15 2007;196(4):570–576.
Gibson RL, Emerson J, Mayer-Hamblett N, Burns JL,
McNamara S, Accurso FJ, Konstan MW, Chatfield BA,
Retsch-Bogart G, Waltz DA, Acton J, Zeitlin P, Hiatt P,
Moss R, Williams J, Ramsey BW. Duration of treatment
effect after tobramycin solution for inhalation in young
children with cystic fibrosis. Pediatr Pulmonol. Jul
2007;42(7):610–623.
Goldin AB, Sawin RS, Garrison MM, Zerr DM,
Christakis DA. Aminoglycoside-based triple antibiotic
versus monotherapy in children with ruptured
Gomez-Duarte OG, Chattopadhyay S, Weissman S,
Giron JA, Kaper JB, Sokurenko EV. Genetic diversity
of the gene cluster encoding longus, a type IV pilus
of enterotoxigenic Escherichia coli. J Bacteriol. Dec
2007;189(24):9145–9149.
Gray GC, McCarthy T, Lebeck MG, Schnurr DP,
Russell KL, Kajon AE, Landry ML, Leland DS,
Storch GA, Ginocchio CC, Robinson CC, Demmler GJ,
Saubolle MA, Kehl SC, Selvarangan R, Miller MB,
Chappell JD, Zerr DM, Kiska DL, Halstead DC,
Capuano AW, Setterquist SF, Chorazy ML, Dawson JD,
Erdman DD. Genotype prevalence and risk factors for
clinical adenovirus infections, United States 2004–2006.
Clin Infect Dis. Nov 1 2007;45(9):1120–1131.
Guina T, Radulovic D, Bahrami AJ, Bolton DL,
Rohmer L, Jones-Isaac KA, Chen J, Gallagher LA,
Gallis B, Ryu S, Taylor GK, Brittnacher MJ, Manoil C,
Goodlett DR. MglA regulates Francisella tularensis
subsp. novicida response to starvation and oxidative
stress. J Bacteriol. Sep 2007;189(18):6580–6586.
Gupta D, Lhewa D, Viswanath R, Jacob SM, Parameshwari S, Radhakrishnan R, Seidel K, Frenkel LM,
Samuel NM, Melvin AJ. Effectiveness of antenatal
group HIV voluntary counseling and testing services in
rural India. AIDS Educ Prev. Jun 2007;19(3):187–197.
Gutman JA, Peck [Campbell] AJ, Kuypers J, Boeckh
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infection in adult stem cell transplantation patients:
a report of two cases. Bone Marrow Transplant. Oct
2007:40(8):809–811.
Heugel J, Kuypers J, Martin E, Englund JA. Coronavirusassociated pneumonia in previously healthy children.
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Hitti J, Andersen J, McCompsey G, Liu T, Melvin AJ,
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Watts DH, Livingston E, AIDS Clinical Trials Group
5084 Study Team. Protease inhibitor-based antiretroviral
therapy and glucose tolerance in pregnancy: AIDS
Clinical Trials Group A5084. Am J Obstet Gynecol.
Apr 2007;196(4):331.e1–7.
Hull JR, Tamura GS, Castner DG. Structure and
reactivity of adsorbed fibronectin films on mica.
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Kuypers J, Martin ET, Heugel J, Wright N, Morrow R,
Englund JA. Clinical disease in children associated
with newly described coronavirus subtypes. Pediatrics.
Jan 2007;119(1):e70–76.
Li ST, Smith S. Abstracts from the 2006 COMSEP
meeting: national survey of pediatric clerkship
directors response to LCME ED-2. Teach Learn Med.
2007;19:83–89.
Li ST, Smith S, Gigante J. A national survey of pediatric
clerkship directors’ response approaches to meeting
the LCME ED-2 requirement for quantified patient
criteria for medical students. Teach Learn Med.
Fall 2007;19(4):352–356.
Mayer-Hamblett N, Aitken ML, Accurso FJ, Kronmal
RA, Konstan MW, Burns JL, Sagel SD, Ramsey BW.
Association between pulmonary function and sputum
biomarkers in cystic fibrosis. Am J Respir Crit Care
Med. Apr 15 2007;175(8):822–828.
Murata T, Tseng W, Guina T, Miller SI, Nikaido H.
PhoPQ-mediated regulation produces a more robust
permeability barrier in the outer membrane of Salmonella
typhimurium. J Bacteriol. Oct 2007;189(20):7213–7222.
Nguyen D, Emond MJ, Mayer-Hamblett N, Saiman L,
Marshall BC, Burns JL. Clinical response to azithromycin in cystic fibrosis correlates with in-vitro effects
on Pseudomonas aeruginosa phenotypes. Pediatr
Pulmonol. Jun 2007;42(6):533–541.
Jones AL, Mertz RH, Carl DJ, Rubens CE. A streptococcal penicillin-binding protein is critical for resisting
innate airway defenses in the neonatal lung. J Immunol.
Sep 1 2007;179(5):3196–3202.
Peck [Campbell] AJ, Englund JA, Kuypers J,
Guthrie KA, Corey L, Morrow R, Hackman RC,
Cent A, Boeckh M. Respiratory virus infection among
hematopoietic cell transplantation recipients: evidence
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Sep 2007;110(5):1681–1688.
Jones AL, Rubens CE. Molecular pathogenesis of
group B streptococcal infections. In: Siongh Chhatwal,
ed. Molecular Biology of Streptococi. Wymondham,
UK: Horizon Scientific Press. 2007.
Qin X, Galanakis E, Martin ET, Englund JA. Multitarget
polymerase chain reaction for diagnosis of pertussis
and its clinical implications. J Clin Microbiol. Feb
2007;45(2):506–511.
Kronman MP, Baden HP, Jeffries HE, Heath J, Cohen
GA, Zerr DM. An investigation of Aspergillus cardiac
surgical site infections in three pediatric patients.
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Rantanen MK, Lehtio L, Rajagopal L, Rubens CE,
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of oseltamivir prophlylaxis in hematopoietic cell
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Rhoads MP, Magaret AS, Zerr DM. Family saliva
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Scott-Browne JP, Shafiani S, Tucker Heard G,
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Section of
Immunology
Immunology is the study of the immune system, the body’s
natural defense against infection. Our team diagnoses
and treats children and adults with any of the more than
140 complex conditions that together are called primary
immune deficiency disorders (PIDD). Because the immune
systems of patients born with these inherited disorders
are not working properly or are missing essential parts,
these people are particularly vulnerable to serious infection
and illness.
Seattle Children’s Hospital is one of the few hospitals
in the world where doctors both carry out cutting-edge
research and provide treatment for immune deficiencies
in children. We are the only center in the Northwest that
cares specifically for pediatric and adult patients with
PIDD. We also evaluate and treat PIDD patients referred
from throughout the world.
We offer the most current and extensive testing to
identify these disorders and their causes, and are at the
forefront of research to find ways to treat and cure PIDD.
Because PIDDs represent some of the best candidate
disorders for treatment via hematopoietic stem cell gene
therapy, our translational research programs include modeling
of novel gene and cellular therapies. Working closely with
the Fred Hutchinson Cancer Research Center and the
Seattle Cancer Care Alliance, we also coordinate care for
our patients who are undergoing bone marrow transplants.
We also carry out clinical trials related to optimization
of immunoglobulin replacement and for nonmyeloablative
Faculty
David J. Rawlings, MD, Chief
Carol H. Miao, PhD
Hans D. Ochs, MD
Andrew M. Scharenberg, MD
Troy R. Torgerson, MD, PhD
David J. Rawlings
MD, Chief
hematopoietic stem cell transplant in PIDD. Drs. Rawlings
and Scharenberg co-direct the Northwest Genome
Engineering Consortium, a group of interdisciplinary
investigators in the Seattle area who are developing a
new approach to the treatment of inherited diseases using
genetic repair in bone marrow stem cells. Members of the
Immunology faculty also hold key international leadership
positions in advocacy and research related to PIDD.
The Section of Immunology provides inpatient and
outpatient training experience for adult and pediatric
allergy/immunology fellows and co-directs the University of
Washington-based allergy/immunology fellowship program.
David J. Rawlings, MD, is chief of the Section of
Immunology, overseeing the Immunodeficiency Clinic
at Seattle’s Children’s Hospital. He is also director
of the Center for Immunity and Immunotherapies,
leading the research programs at Seattle Children’s
Hospital Research Institute, and is professor in the
Department of Pediatrics and adjunct professor in
the Department of Immunology at the University of
Washington School of Medicine. He earned his MD
with honors from the University of North Carolina
School of Medicine and completed a residency and
chief residency in pediatrics at the University of
California, San Francisco. He was an intramural
research fellow at the NIH and a senior fellow at
the Howard Hughes Medical Institute, UCLA. He
completed specialty training in pediatric rheumatology
187
Section of Immunology
Spotlight on team member — Kathey Mohan, MN, ARNP
With our research program attracting local and national
attention, demand for our clinical services has increased. I
am very excited for the opportunity to expand our clinical
services with the addition of a new clinical immunologist.
We plan to add another clinic day, which will decrease
appointment wait times and provide better service to
patients and families in our region.
and immunology at Children’s Hospital Los Angeles
and directed the pediatric rheumatology program
at UCLA. Rawlings has received numerous awards
and was elected to the American Society for Clinical
Investigation in 2001 and the Association of American
Physicians in 2007. His primary research interests
include dysregulated B cell development and signaling
leading to immunodeficiency, autoimmunity or
lymphoid malignancies and the development of gene
therapy for primary immune deficiency diseases.
His laboratory uses expertise in basic and clinical
immunology, signal transduction and lymphocyte
developmental biology to understand how altered
signals can lead to immunologic disease, with the
ultimate goal of developing translational therapies
capable of specifically modulating these disorders.
Rawlings is a member of multiple regional and national
organizations, an NIH study section member, chairman
for the USIDNET XLA patient registry and ad hoc
reviewer for various grant programs and immunology
journals. He also co-directs the Northwest Genome
Engineering Consortium, a research program funded
as part of the NIH Roadmap for Medical Research and
comprising seven collaborative projects focused on
developing enzymatic reagents and delivery methods
for site-specific gene repair in hematopoietic stem cells.
188
Mark C. Hannibal, MD, PhD, is attending physician at
Washington School of Medicine. He completed a
combined MD/PhD program at the University of
Michigan and his pediatrics residency and a medical
genetics fellowship at the University of Washington.
His clinical work is in medical genetics, cardiovascular
genetics and immunology clinics at Children’s. Regionally,
he provides genetics consultation throughout Washington
and Alaska. His areas of interest are Kabuki syndrome
and immunogenetics, particularly immune deficiency
associated with syndromes. Hannibal’s primary research
focus is studying the molecular basis of hereditary
neuralgic amyotrophy. This episodic autosomal dominant
disorder is characterized by attacks of sudden, severe,
nonabating pain in the shoulder and/or the arm and
weakness with muscle wasting. In some families,
non-neurologic findings include excessive skin folds,
relatively short palpebral fissures, hypotelorism
and bifid uvula or cleft palate. His interest is in the
translational aspects of genetic disorders, such as
understanding how mutations in the Septin-9 gene
cause features of hereditary neuralgic amyotrophy. He
is a member of the faculty senate at the University of
Washington and the Professional Advisory Board for
the Kabuki Syndrome Network.
Carol H. Miao, PhD, is principal investigator in the
Section of Immunology at Seattle Children’s Hospital
and associate professor in the Department of Pediatrics
The major focus of Miao’s research is to develop gene
therapy strategies for treating genetic diseases. Her
primary interest is to expand and to investigate two
prominent gene therapy model systems: hemophilia
and primary immunodeficiency disease (PIDD). In
hemophilia gene therapy, she pioneered the use of
nonviral naked DNA delivery to achieve full correction
in both hemophilia A and hemophilia B mouse models.
Her research laboratory is pursuing two important
projects: development of safer and more efficient
nonviral vectors and delivery methods suitable for
clinical applications; and immunomodulation strategies
involving immunosuppressive regimens and regulatory
T cells. These latter studies are crucial to eliminating
antibody responses in hemophilia patients that block
the benefits of clotting factor treatment. Miao also
participates in the gene therapy program for PIDD.
A major current focus for these collaborative studies
is lentiviral-based gene transfer in animal and cellular
models of Wiskott-Aldrich syndrome (WAS). Miao is
active in many regional, national and international
scientific societies; she is a member of the Genetic
Diseases Committee of the American Society of Gene
Therapy and of the Scientific Review Board for the
Gene Therapy Resource Program of the NIH’s
National Heart, Lung and Blood Institute.
Hans D. Ochs, MD, is co-director of the Immunodeficiency
Molecular Diagnostic Laboratory at Seattle Children’s
Hospital. He earned his MD summa cum laude from
the University of Freiburg, Germany, in 1961. He
completed his residency in pediatrics at the University
of Washington in 1969. The focus of his research is
the molecular definition of primary immunodeficiency
diseases and the investigation of new techniques to
confirm the diagnosis. He and his collaborators contributed significantly to the identification of a number
of genes associated with PIDD on the X chromosome
(CD40L, Wiskott-Aldrich syndrome protein [WASP],
FOXP3, gp91phox) or on autosomes (uracil-DNA
glycosulase; Rag1, syndrome). Ochs started the
Immunodeficiency Clinic at Children’s in 1985, providing
evaluation and care for both pediatric and adult patients
with immunodeficiency disorders. He has initiated
clinical trials for new immunoglobulin preparations
for intravenous and subcutaneous infusions and has
collaborated with the bone marrow transplant team
in the design of new protocols for stem cell transplant
and gene therapy. Ochs is principal investigator for
the U.S. Immune Deficiency Network and co-founder
and a member of the summer school faculty devoted
to primary immune deficiencies. He was elected to the
Henry Kunkel Society and holds the Jeffrey Modell
Chair of Pediatric Immunology Research. He is also
principal editor for the medical textbook Primary
Immunodeficiency Diseases: A Molecular and Genetic
Approach and co-editor for Immunological Disorders
in Infants and Children.
Andrew M. Scharenberg, MD, is attending physician at
the Department of Pediatrics and adjunct associate
professor in the Department of Immunology at
Scharenberg received his medical degree with distinction
from the University of North Carolina School of
Medicine and completed his residency training in
pediatrics at the University of North Carolina Children’s
Hospital in 1993. He underwent postdoctoral training
in immunology in Dr. Jean-Pierre Kinet’s lab at the
National Institutes of Health and at the Division of
Experimental Pathology, Beth Israel Deaconess Medical
Center, before joining the faculty of Harvard Medical
School as an assistant professor in 1998. Scharenberg
joined the faculty at the University of Washington and
the attending staff at Children’s in 2000. At Children’s,
he participates in the Immunodeficiency Clinic and the
inpatient immunology consult service, and operates a
six-member laboratory at the Seattle Children’s Hospital
Research Institute focused on lymphocyte physiology
and gene repair. He was chosen as winner of the
American Pediatric Society/Society for Pediatric
Research National Young Investigator Award in 2002.
He is co-director of the Northwest Genome Engineering
Consortium, a group of interdisciplinary investigators
in the Seattle area who are working on a new approach
to the treatment of inherited diseases. Scharenberg is
a member of the Transplantation Biology Program of
the Fred Hutchinson Cancer Research Center Cancer
Consortium and was elected to the American Society
for Clinical Investigation. His bench research interests
include ion channel functions in immune cell biology,
application of the immune mechanism of somatic
hypermutation to protein engineering and homing
endonuclease engineering for gene repair application
and animal models for gene repair.
Troy R. Torgerson, MD, PhD, is attending physician at
Washington School of Medicine. He is co-director
of the Immunodeficiency Molecular Diagnostics
Laboratory. He obtained his MD and PhD from
Vanderbilt University School of Medicine and completed
residency training in pediatrics and a fellowship in
pediatric rheumatology and immunology at the
University of Washington. He is an elected member
of the Society for Pediatric Research. He participates
in clinical care of patients with immune deficiency
and autoimmune disorders at Children’s and coordinates care for immunodeficient patients treated by
hematopoietic stem cell transplant (HSCT). His clinical
interests include the diagnosis and management of
children and adults with primary immunodeficiency
diseases (PIDDs) and children with autoimmune
disorders. His research interests relate to the identification of basic cellular mechanisms that jointly
189
promote autoimmunity and immunodeficiency. His
research is focused on studies of the molecular basis
of immune dysregulation present in patients with
immune dysregulation, polyendocrinopathy, enteropathy,
X-linked (IPEX). The genetic defect present in this
syndrome alters the development and function of
regulatory T cells, which are required for controlling
immune responses. Torgerson coordinates several joint
clinical research protocols designed to optimize HSCT
treatment in PIDD.
Model for gene therapy in X-linked
agammaglobulenemia. NCI/NIH/DHHS. $297,611.
RESEARCH FUNDING
TSLP receptor in the regulation of B cell development.
New
David J. Rawlings, MD
Cell and virus core. NHLBI/NIH/DHHS. $827,340.
Gene repair in murine hematopoietic stem cells.
Lentiviral gene therapy for Wiskott-Aldrich syndrome.
Directed protein evolution for design of LAGLIDADGs
with novel recognition specifications. NCI/NIH/DHHS.
$455,000.
Homing endonuclease genes: new tools for mosquito
population engineering and control. Foundation for
NIH. $150,000.
Northwest Genome Engineering Consortium
component 1. NCRR/NIH/DHHS. $557,662.
Continuing
Carol H. Miao, PhD
Modulation of immune responses for hemophilia
following replacement therapy. NHLBI/NIH/DHHS.
$428,084.
Hans D. Ochs, MD
Developmental and genetic defect of immunity.
Lentiviral gene therapy of X-linked
agammaglobulinemia. NHLBI/NIH/DHHS.
$367,420.
190
PKD2 involvement in the Btk-KDCB-NFkB pathway in
B lymphocyte development. NIH/DHHS. $59,630.
Regulation of B cell development and signaling by
BTK. NICHD/NIH/DHHS. $330,679.
Stem cell transplantation: basic/clinical research: core
A, immune function studies. NIH/DHHS. $96,614.
Bpl phase Iii study to evaluate gammaplex in Pidd.
Bio Products Laboratory, Inc./Research, Inc. $139,381.
Molecular mechanisms of vertebrate Mg2+ homeostasis.
Regulation of metal ion homeostasis by channel.
The geneticist’s approach to mental retardation.
Pediatrics Grand Rounds, Alaska Native Medical
Center. Anchorage, Alaska. Nov. 27, 2007.
Carol H. Miao, PhD
Modulation of immune responses for hemophilia
following replacement therapy. Grantees’ Meeting
for RFA Improved Therapy for Hemophilia and
Hereditary Bleeding Disorders. National Institutes
of Health. Bethesda, Md. April 26, 2007.
Gene therapy and immunomodulation for hemophilia.
Fifth Annual International Conference on Transposition
and Animal Biotechnology. University of Minnesota.
Minneapolis, Minn. June 21–24, 2007.
Regulation of factor VIII-specific immune responses
in a plasmid DNA treated hemophilia A mouse model
by transgenic FOXP3+CD4+ regulatory T cells. 59th
Annual Meeting, National Hemophilia Foundation.
Orlando, Fla. Nov. 1–3, 2007.
Hans D. Ochs, MD
IPEX and Scurfy, prototypes of FOXP3/Treg deficiency.
Published Symposium on Immunomodulation. Medellin,
Colombia. March 20–23, 2007.
The clinical presentation and molecular basis of IPEX.
Seventh Annual FOCIS Meeting. San Diego, Calif.
June 7–11, 2007.
New developments in the understanding of PIDD.
Immune Deficiency Foundation Annual Patient Meeting.
St. Louis, Mo. June 28–29, 2007.
Autoimmune polyendocrinopathy candidiasis ectodermal
dystrophy: a defect of AIRE gene. IPEX syndrome:
clinical aspects and mechanisms of autoimmunity.
Autoimmune manifestations of Wiskott-Aldrich syndrome. Autoimmunity in Primary Immunodeficiencies
Conference. Sao Paulo, Brazil. Aug. 16–18, 2007.
Chair of proceedings. 13th Annual Congress of
Immunology. Rio de Janeiro, Brazil. Aug. 21–25, 2007.
Immune dysregulation, polyendocrinopathy, enteropathy,
X-linked inheritance: model for autoaggression.
International Immunology Congress. Moscow, Russia.
Sept. 11–15, 2007.
Primary immunodeficiency: single gene defects and
autoimmunity. Grand Rounds, University of Munich.
Munich, Germany. Oct. 15, 2007.
Immune dysregulation syndromes and autoimmunity.
Spectrum of paediatric immunology: from immunodeficiency to autoimmunity. Montreal, Quebec,
Canada. Oct. 30–Nov. 1, 2007.
Intense 4-day course on the clinical presentation
and molecular basis of primary immune deficiency.
Clinical Immunology Society (CIS) Summer School.
Miami, Fla. Nov. 1–5, 2007.
WAS genotype-phenotype relationship (roundtable
discussion). Second Robert A. Good Immunology
Society Conference. Boston, Mass. Nov. 17–18, 2007.
Molecular mechanism(s) controlling PKC-dependent,
immunoreceptor-induced signals. Keystone Symposia,
Biology of B Cells in Health and Disease. Banff,
Alberta, Canada. Feb. 6–11, 2007.
Role of PKC signals in B cell activation, survival and
malignancy (invited speaker). Division of Cell Pathology
Seminar Series, Children’s Hospital of Philadelphia.
Philadelphia, Pa. March 28, 2007.
Role of PKC signals in B cell activation, survival and
malignancy (invited speaker). Harvard Medical School
Program in Immunology Seminar Series. Boston, Mass.
May 23, 2007.
Meeting on primary immunodeficiencies (invited
delegate). International Union of Immunological
Societies (IUIS)/WHO. Jackson Hole, Wyo.
June 6–10, 2007.
NIAID outcome measures meeting (invited delegate).
Division of Allergy and Transplantation (DAIT/NIAID),
Harvard Medical School. Boston, Mass. Nov. 16, 2007.
Immune reconstitution in Wiskott-Aldrich syndrome
(moderator for roundtable discussion). Second Robert
A. Good Immunology Society Conference — Immune
Reconstitution of Primary Immunodeficiencies.
Boston, Mass. Nov. 16–18, 2007.
Use of multiparameter B cell subset analysis for
diagnosis and evaluation of humoral immunodeficiencies. The Molecular Diagnostic Center at
Seattle Children’s Inauguration Seminar Series.
Channel/protein kinase: dual regulation of TRPM
channel. FASEB Summer Research Conference
on Channel Regulation. Snowmass Village, Colo.
June 9–14, 2007.
Regulation of lymphocyte biosynthetic metabolism by
TRPM7 (invited speaker). University of Washington 18th
Annual Immunology Department Retreat Workshop
No. 3: Immune Regulation. Port Townsend, Wash.
Sept. 10–11, 2007.
191
The Northwest Genome Engineering Consortium.
Davis Wright Tremaine Venture Series, Rainier Club.
Seattle, Wash. Oct. 23, 2007.
Design of novel LAGLIDADG homing endonucleases
for genome engineering applications. Institute for Stem
Cell and Regenerative Medicine: Stem Cell Meeting.
University of Washington. Seattle, Wash. Nov. 5, 2007.
New tools for manipulating genomes; new treatments
for inherited disease. Frontiers in Children’s Health,
Children’s Campaign. Washington Biotechnology and
Biomedical Association. Seattle, Wash. Nov. 8, 2007.
Lessons in autoimmunity taught by patients with
primary immunodeficiency. Medical College of
Wisconsin and Milwaukee Children’s Hospital
Molecular Medicine Conference. Milwaukee, Wis.
January 2007.
Regulatory T cells. American Academy of Allergy,
Asthma and Immunology Annual Meeting. San Diego,
Calif. Feb. 23, 2007.
Update on IPEX and immune dysregulation syndromes.
University Medical Center Utrecht, Utrecht Children’s
Hospital. Utrecht, Netherlands. March 11, 2007.
IPEX: Taking FOXP3 from bench to bedside.
Penn Center for Clinical Immunology Symposium.
Philadelphia, Pa. June 29, 2007.
PIDDs that primarily affect immune tolerance.
Clinical Immunology Society Summer School in
Primary Immunodeficiency Diseases. Miami, Fla.
Nov. 1–5, 2007.
Immune deficiency syndromes. American College
of Rheumatology 71st Annual Scientific Meeting.
192
PUBLICATIONS
Astrakhan A, Omori M, Nguyen T, Becker-Herman
S, Iseki M, Aye T, Hudkins-Loya K, Dooley J, Farr A,
Alpers CE, Ziegler S, Rawlings DJ. Local increase in
thymic stromal lymphopoietin induces systemic alterations in B cell. Nat Immunol. May 2007;8(5):522–531.
Baker NL, Morgelin M, Pace RA, Peat RA, Adams
NE, Gardner RJ, Rowland LP, Miller G, De Jonghe P,
Ceulemans B, Hannibal MC, Edwards M, Thompson
EM, Jacobson R, Quinlivan RC, Aftimos S, Kornberg
AJ, North KN, Bateman JF, Lamande SR. Molecular
consequences of dominant Bethlem myopathy collagen
VI mutations. Ann Neurol. Oct 2007;62(4):390–405.
Burroughs LM, Storb R, Leisenring WM, Pulsipher
MA, Loken MR, Torgerson TR, Ochs HD, Woolfrey AE.
Intensive postgrafting immune suppression combined
with nonmyeloablative conditioning for transplantation
of HLA-identical hematopoietic cell grafts: results
of a pilot study for treatment of primary immunodeficiency disorders. Bone Marrow Transplant.
Oct 2007;40(7):633–642.
Carman CV, Sage PT, Sciuto TE, de la Fuente MA,
Geha RS, Ochs HD, Dvorak HF, Dvorak AM, Springer
TA. Transcellular diapedesis is initiated by invasive
podosomes. Immunity. Jun 2007;26(6):784–797.
Chen S, Ye P, Chen A, Davie EW, Miao CH. Specific
amino acid modifications to increase safety and efficacy
of nonviral gene therapy of factor VII for hemophilia
A with inhibitors. Mol Ther. May 2007:15(Suppl 1):S366.
De la Fuente MA, Sasahara Y, Calamito M, Anton
IM, Elkhal A, Gallego MD, Suresh K, Siminovitch K,
Ochs HD, Anderson KC, Rosen FS, Geha RS, Ramesh
N. WIP is a chaperone for Wiskott-Aldrich syndrome
protein (WASP). Proc Natl Acad Sci U S A. Jan 16
2007;104(3):926–931.
Evans JG, Chavez-Rueda KA, Eddaoudi A, MeyerBahlburg A, Rawlings DJ, Ehrenstein MR, Mauri
C. Novel suppressive function of transitional 2 B
cells in experimental arthritis. J Immunol. Jun
2007;178(12):7868–7878.
Herve M, Isnardi I, Ng YS, Bussel JB, Ochs HD,
Cunningham-Rundles C, Meffre E. CD40 ligand
and MHC class II expression are essential for
human peripheral B cell tolerance. J Exp Med.
Jul 9 2007;204(7):1583–1593.
Fuchizawa T, Adachi Y, Ito Y, Higashiyama H,
Kanegane H, Futatani T, Kobayashi I, Kamachi Y,
Sakamoto T, Tsuge I, Tanaka H, Banham AH, Ochs HD,
Miyawaki T. Developmental changes of FOXP3expressing CD4+CD25+ regulatory T cells and their
impairment in patients with FOXP3 gene mutations.
Clin Immunol. Dec 2007;125(3):237–246.
Humblet-Baron S, Sather B, Anover S, Becker-Herman
S, Kasprowicz DJ, Khm S, Nguyen T, Hudkins-Loya
K, Alpers CD, Ziegler SF, Ochs HD, Torgerson TR,
Campbell DJ, Rawlings DJ. Wiskott-Aldrich syndrome
protein is required for regulatory T cell homeostasis.
J Clin Invest. Feb 2007;117(2):407–418.
Geha RS, Notarangelo LD, Casanova JL, Chapel H,
Conley ME, Fischer A, Hammarstrom L, Nonoyama S,
Ochs HD, Puck JM, Roifman C, Seger R, Wedgwood
J, International Union of Immunological Societies
Primary Immunodeficiency Diseases Classification
Committee. Primary immunodeficiency diseases: an
update from the International Union of Immunological
Societies Primary Immunodeficiency Diseases
Classification Committee. J Allergy Clin Immunol.
Oct 2007;120(4):776–794.
Habib T, Park H, Tsang M, de Alborán IM, Nicks A,
Wilson L, Knoepfler PS, Andrews S, Rawlings DJ,
Eisenman RN, Iritani BM. Myc stimulates B lymphocyte
differentiation and amplifies calcium signaling. J Cell
Biol. Nov 2007;179(4):717–731.
Harmeling BR, Ziegler S, Torgerson TR, Chen L,
Peng B, Ochs HD, Rawlings DJ, Miao CH. Regulation
of Factor VIII-specific immune responses in a plasmid
DNA treated Hemophilia A mouse model by transgenic
FOXP3+CD4+ regulatory T cells. Mol Ther. May
2007:15(Suppl 1):S97.
Heltzer ML, Choi JK, Ochs HD, Sullivan KE,
Torgerson TR, Ernst LM. A potential screening
tool for IPEX syndrome. Pediatr Dev Pathol.
Mar–Apr 2007;10(2):98–105.
Liu P, Scharenberg AM, Cantrell DA, Matthews
SA. Protein kinase D enzymes are dispensable for
proliferation, survival and antigen receptor-regulated
NFkappaB activity in vertebrate B-cells. FEBS Lett.
Apr 2007;581(7):1377–1382.
Meyer-Bahlburg A, Khim S, Rawlings DJ.
B cell intrinsic TLR signals amplify but are not
required for humoral immunity. J Exp Med.
Dec 2007;204(13):3095–3101.
Miao CH. Recent advances in immune modulation.
Curr Gene Ther. Oct 2007;7(5):391–402.
Notarangelo LD, Rawlings DJ, Sullivan KE. An
exemplum of XLA. Clin Immunol. Epub Oct 31 2007.
Ochs HD, Gambineri E, Torgerson TR. IPEX, FOXP3
and regulatory T-cells: a model for autoimmunity.
Immunol Res. 2007;38(1–3):112–121.
Ochs HD, Rosen FS. Wiskott-Aldrich syndrome.
In: Ochs HD, Schmidt CE, Puck JM, eds. Primary
Approach, Second Edition. New York, N.Y.: Oxford
Ochs HD, Smith CIE, Puck JM, eds. Primary
Approach, Second Edition. New York, N.Y.: Oxford
193
Ochs HD, Torgerson TR. Immune dysregulation,
polyendocrinopathy, enteropathy, X-linked inheritance:
model for autoaggression. In: Shurin MR, Smolkin
YS, eds. Immune-Mediated Diseases: From Theory
to Therapy. New York, N.Y.: Springer. 2007.
Ochs HD, Torgerson TR. Immune dysregulation,
polyendocrinopathy, enteropathy, X-linked inheritance: model for autoaggression. Adv Exp Med Biol.
2007;60:27–36.
Peng B, Ye P, Blazar BR, Ochs HD, Miao CH.
Transient blockade of ICOS co-stimulatory pathways
induces long-term tolerance to Factor VIII following
nonviral gene transfer of Factor VIII into Hemophilia
A mice. Mol Ther. May 2007:15(Suppl 1):S415.
Perkins JA, Tempero RM, Hannibal MC,
Manning SC. Clinical outcomes in lymphocytopenic
lymphatic malformation patients. Lymphat Res Biol.
2007;5(3):169–174.
Puck JM, SCID Newborn Screening Working Group
(Torgerson TR, member). Population-based newborn
screening for severe combined immunodeficiency: steps
toward implementation. J Allergy Clin Immunol. Oct
2007;120(4):760–768.
Renner ED, Torgerson TR, Rylaarsdam S, AnoverSombke S, Golob K, LaFlam T, Zhu Q, Ochs HD.
STAT3 mutation in the original patient with Job’s
syndrome. N Engl J Med. Oct 2007;357(16):1667–1668.
Sahni J, Nelson B, Scharenberg AM. SLC41A2
encodes a plasma-membrane Mg2+ transporter.
Biochem J. Jan 2007;401(2):505–513.
Scharenberg AM, Humphries LA, Rawlings DJ.
Calcium signalling and cell-fate choice in B cells.
Nat Rev Immunol. Oct 2007;7(10):778–789.
Sediva A, Smith CI, Asplund AC, Hadac J, Janda A,
Zeman J, Hansíková H, Dvořáková L, Mrázová L,
Velbri S, Koehler C, Roesch K, Sullivan KE, Futatani T,
Ochs HD. Contiguous X-chromosome deletion
syndrome encompassing the BTK, TIMM8A,
TAF7L and DRP2 genes. J Clin Immunol. Nov
2007;27(6):640–666.
194
Shearer WT, Cunningham-Rundles C, Ballow M,
Ochs HD, Geha RS. Images in immunodeficiency.
J Allergy Clin Immunol. Oct 2007;120(4):982–984.
Shen Z, Brayman AA, Chen L, Peng B, Miao CH.
Optimization of definity microbubble concentrations
and acoustic pressure increases ultrasound-mediated
gene transfer efficiency while reduces tissue damage.
Mol Ther. May 2007:15(Suppl 1):S9.
Torgerson TR, Gambineri E, Ziegler SF, Ochs HD.
Immune dysregulation, polyendocrinopathy, enteropathy,
X-linked inheritance. In: Ochs HD, Schmidt CE,
Puck JM, eds. Primary Immunodeficiency Diseases:
a Molecular and Genetic Approach, Second Edition.
New York, N.Y.: Oxford University Press. 2007.
Torgerson TR, Linane A, Moes N, Anover S, Mateo
V, Rieux-Laucat F, Hermine O, Vijay S, Gambineri E,
Cerf-Bensussan N, Fischer A, Ochs HD, Goulet O,
Ruemmele FM. Severe food allergy as a variant of
IPEX syndrome caused by a deletion in a noncoding
region of the FOXP3 gene. Gastroenterology.
May 2007;132(5):1705–1717.
Torgerson TR, Ochs HD. Immune dysregulation,
polyendocrinopathy, enteropathy, X-linked: forkhead
box protein 3 mutations and lack of regulatory T cells.
J Allergy Clin Immunol. Oct 2007;120(4):744–750.
Torgerson TR, Ochs HD. Regulatory T cells in primary
immunodeficiency diseases. Curr Opin Allergy Clin
Immunol. Dec 2007;7(6):515–521.
Volna P, Jarjour J, Baxter S, Roffler SR, Monnat RJ,
Stoddard BL, Scharenberg AM. Flow cytometric
analysis of DNA binding and cleavage by cell surfacedisplayed homing endonucleases. Nucleic Acids Res.
2007;35(8):2748–2758.
Section of
Rheumatology
The Section of Rheumatology under the Division of
Infectious Disease, Immunology and Rheumatology is the
only pediatric rheumatology center in the WWAMI area and
plays a major role in providing clinical care, education and
leadership in research for our region and beyond. We offer
telephone consultation and triage for physicians in our
area, as well as an outreach clinic in Anchorage, Alaska.
Our large clinical service facilitates interactions with our
clinical and basic research endeavors.
Our outpatient service conducts about 4,000 outpatient
visits each year, provides inpatient care and responds to
consultation requests for patients from other services.
Our focus is the diagnosis and management of possible
inflammatory, musculoskeletal and autoimmune problems,
and comprehensive ongoing management for children who
have confirmed rheumatic diseases such as juvenile onset
arthritis, spondyloarthropathies, dermatomyositis, systemic
lupus erythematosus and vasculitis. Our team includes
clinical nurse specialists, a nurse practitioner, a social
worker, and physical and occupational therapists to provide
comprehensive multidisciplinary care. Because many of
our children have multisystem diseases, we work closely
with health professionals in other specialties, such as
ophthalmology, nephrology and orthopedics, and also with
the Pacific Northwest Chapter of the Arthritis Foundation
for parent support and advocacy.
Pediatric rheumatology is an underserved field with
only 200 board-certified pediatric rheumatologists for the
estimated 385,000 children in the United States who have
rheumatic diseases. About one-third of medical schools do
not have a pediatric rheumatologist, and many practicing
pediatricians and family physicians have had no training in
these conditions. Our goal is to meet the needs of patients
and families with rheumatic diseases, educate present and
future physicians about these conditions, advance the understanding of these diseases and provide optimal treatments.
Faculty
Helen M. Emery, MD, Chief
Anne M. Stevens, MD, PhD
Jennifer K. Turner, MD
Carol A. Wallace, MD
Jennifer Wargula, MD, MSc
Helen M. Emery
MD, Chief
All our physicians are involved with basic or clinical
investigation into the mechanisms, management or outcomes
of childhood rheumatic diseases. In the arena of clinical
investigation, our center holds a leadership role in the
Childhood Arthritis and Rheumatology Research Alliance,
a national network of pediatric rheumatology centers
undertaking collaborative studies to improve understanding
and treatment of rheumatic diseases in children. We offer
the opportunity for patients to participate in a number of
clinical studies.
In the area of basic science, our section has a special
interest in mechanisms that may initiate the onset of
autoimmune diseases.
Our faculty is involved with the education of a variety
of trainees at different levels. We participate in the medical
school curriculum, precept pediatric residents, offer rotations
in pediatric rheumatology to adult rheumatology trainees,
teach community physicians and allied health professionals,
and train new pediatric rheumatologists and investigators
in our fellowship programs.
Helen M. Emery, MD, is chief of the Section of Rheumatology, program director of Rheumatology Education
and attending physician at Seattle Children’s Hospital.
She completed a pediatrics residency and a fellowship
in pediatric rheumatology at Children’s. She established
pediatric rheumatology programs at the University of
Chicago and the University of California, San Francisco.
Her clinical interests involve care of children with
rheumatic diseases, with a special emphasis on
195
Section of Rheumatology
Spotlight on team member — Deborah King, MSW, LICSW
I’m excited about helping teens take charge of their own health
care so that they have the skills to partner with an adult
rheumatologist in the management of their chronic illness.
We begin helping our teens transition in early adolescence
by using developmentally appropriate communication and
anticipatory guidance. Our goal is a seamless transition
from pediatric to adult care.
rehabilitation of children with juvenile arthritis and
dermatomyositis, for which she has an international
reputation. Her educational activities have been focused
on community physicians, including a project to
present educational seminars to primary care physicians,
adult rheumatologists and orthopedists about the
diagnosis and management of childhood rheumatic
diseases; the project also tracks whether children are
referred earlier and more appropriately, and their level
of impairment. Emery regards training of new investigators and clinicians as a top priority and has graduated
many trainees, all of whom hold academic positions.
She has received an American College of Rheumatology
Clinician Educator Award, which enabled the expansion
of educational efforts into the medical school musculoskeletal curriculum. She is an executive board member
of the Pacific Northwest Arthritis Foundation Chapter
and has been very involved with the chapter’s professional
education and parent group activities.
Anne M. Stevens, MD, PhD, is attending physician at
She completed her residency in pediatrics at the
Children’s Hospital Medical Center in Cincinnati
and a fellowship in pediatric rheumatology at the
University of Washington. In the Rheumatology Clinic
196
and inpatient service at Children’s, Stevens cares for
children with chronic inflammatory diseases and
teaches residents and students. Her research interest
is in the role that maternal cells, passing into the fetus
during pregnancy and persisting for years in the child,
play in the pathogenesis of autoimmune diseases. She
demonstrated that maternal cells can differentiate into
myocardial cells in the hearts of infants with neonatal
lupus syndrome, where these foreign cells may act as
targets for the child’s immune system. Alternatively,
maternal cells may respond to tissue injury and aid
in repair. Stevens is studying the immune response to
chimeric maternal cells in children with lupus, and a
mouse model investigating the role of maternal cells
in renal injury. Stevens is a co-investigator on studies
of Lipitor (atorvastatin), etanercept and the long-term
outcome of juvenile rheumatoid arthritis.
Troy R. Torgerson, MD, PhD, is attending physician at
Washington School of Medicine. He is co-director of
the Immunodeficiency Molecular Diagnostics Laboratory. He obtained his MD and PhD from Vanderbilt
University School of Medicine and completed residency
training in pediatrics and a fellowship in pediatric
rheumatology and immunology at the University of
Washington. He participates in clinical care of patients
with immune deficiency and autoimmune disorders at
Children’s and coordinates care for immunodeficient
patients treated by hematopoietic stem cell transplant
(HSCT). His clinical interests include the diagnosis
and management of children and adults with primary
immunodeficiency diseases (PIDDs) and autoimmune
disorders in children. His research interests relate to
the identification of basic cellular mechanisms that
jointly promote autoimmunity and immunodeficiency.
His research is focused on studies of the molecular
basis of immune dysregulation present in patients
with immune dysregulation, polyendocrinopathy,
enteropathy, X-linked (IPEX). The genetic defect
present in this syndrome alters the development and
function of regulatory T cells, which are required for
controlling immune responses. Torgerson is a member
of the Society for Pediatric Research and coordinates
several joint clinical research protocols designed to
optimize HSCT treatment in PIDD.
Jennifer K. Turner, MD, is attending physician at Seattle
Washington. She earned her MD at the University
of Washington School of Medicine, and completed
her pediatric residency training and fellowship in
pediatric rheumatology at Children’s and the University of Washington. She is completing a master of
epidemiology degree at the University of Washington,
with research investigating the maternal and infant
outcomes of pregnancies to women with systemic
lupus erythematosus. Her clinical interests include
auto-inflammatory diseases/periodic fever syndromes
such as TNF receptor-associated periodic fever
syndrome and familial Mediterranean fever, as well
as pediatric sarcoidosis and the overlap between
immunodeficiency and autoimmunity.
Carol A. Wallace, MD, is attending physician at Seattle
School of Medicine. She received her MD from the
University of Michigan. She completed a pediatrics
residency and a fellowship in pediatric rheumatology
at the University of Washington. Wallace’s main focus
has been the aggressive treatment of juvenile idiopathic
arthritis (JIA) and other pediatric rheumatic diseases.
She has published many of the sentinel studies of the
use of methotrexate in the treatment of JIA. She is
principal investigator for a multicenter clinical trial
of early aggressive therapy in JIA and co-principal
investigator for a national collaborative study of
autologous stem cell transplantation for severe
pediatric rheumatologic diseases. Wallace also
participates in many multicenter clinical trials of
new biologic agents for the treatment of JIA. She
led an international consensus effort to define
remission of JIA. Wallace has served on the pediatric
rheumatology sub-board for the American Board of
Pediatrics and subcommittees of the American College
of Rheumatology. She is on the Advisory Committee
of the Pediatric Rheumatology Collaborative Study
Group and is vice chair of the Childhood Arthritis
and Rheumatology Research Alliance.
Jennifer Wargula, MD, MSc, is attending physician at
Seattle Children’s Hospital and assistant professor in
the Department of Pediatrics and Rheumatology at
Her clinical and research interests include juvenile
dermatomyositis, localized scleroderma and autoinflammatory diseases, as well as providing
rheumatology care to Alaska native children with
rheumatic diseases. Wargula is a fellow of the
American Academy of Pediatrics and a member of
the AAP Section on Pediatric Rheumatology. She is
also a fellow of the American College of Rheumatology
and a member of the Childhood Arthritis and
Rheumatology Research Alliance.
RESEARCH FUNDING
New
Colony PDL1 as a marker of disease activity in pediatric
systemic lupus erythematosus. Lupus Foundation of
America, Inc. $66,500.
Mechanisms of PD-L1 dysregulation in pediatric lupus.
Lupus Foundation of America, Inc. $100,000.
Mechanisms of PD-L1 dysregulation in pediatric lupus.
Lupus Foundation of America, Inc. $411,511.
A cell intrinsic role for FOXP3 in the human immune
system. NIAID/NIH/DHHS. $237,500.
FoxP3 structure, function and regulatory activity in
T cells. NIAID/NIH/DHHS. $119,340.
CARRA drug safety surveillance project. Pfizer
Corporation. $289,050.
Continuing
Maternal microchimerism in pediatric systemic lupus
erythematosus. Arthritis National Research Foundation.
$60,000.
197
Childhood Arthritis and Rheumatology Research
Alliance Project. Arthritis Foundation. $50,836.
PIDDs that primarily affect immune tolerance. Clinical
Immunology Society Summer School in Primary
Immunodeficiency Diseases. Miami, Fla. Nov. 1–5, 2007.
Early aggressive therapy in juvenile idiopathic arthritis
(TREAT-JIA). NIH/DHHS. $1,220,807.
Immune deficiency syndromes. American College
of Rheumatology 71st Annual Scientific Meeting.
Jennifer K. Turner, MD
Risk of pregnancy complications, adverse maternal
and infant birth outcomes and maternal post-partum
rehospitalizations among women with systemic lupus
erythematosus in Washington state. American Academy
of Pediatrics Section on Rheumatology Second Annual
Fellows Meeting. Hershey, Pa. June 30–July 1, 2007.
Biologic therapy for autoimmune diseases. North
Pacific Pediatric Society Scientific Conference.
Lynnwood, Wash. March 2007.
Fetal-maternal chimeric cells in autoimmune disease.
The European League Against Rheumatism Annual
European Congress of Rheumatology. Barcelona,
Spain. June 2007.
Microchimerism: can’t we all just get along? Northwest
Medical Laboratory Symposium. Seattle, Wash.
October 2007.
Lessons in autoimmunity taught by patients with
primary immunodeficiency. Medical College of
Wisconsin and Milwaukee Children’s Hospital
Molecular Medicine Conference. Milwaukee, Wis.
January 2007.
Regulatory T cells. American Association of Allergy,
Asthma and Immunology annual meeting. San Diego,
Calif. Feb. 23, 2007.
Update on IPEX and immune dysregulation syndromes.
University Medical Center Utrecht, Utrecht Children’s
Hospital. Utrecht, Netherlands. March 11, 2007.
IPEX: Taking FOXP3 from bench to bedside.
Penn Center for Clinical Immunology Symposium.
Philadelphia, Pa. June 29, 2007.
198
Biologic therapy of inflammatory arthritis. Pediatric
Rheumatology Grand Rounds, Children’s Hospital
Boston. Boston, Mass. Jan. 19, 2007.
Achieving remission in juvenile idiopathic arthritis.
Pediatric Rheumatology Grand Rounds, Children’s
Hospital of Pittsburgh. Pittsburgh, Pa. March 2, 2007.
Difference between treating physician and PI site
responsibilities. Essentials for Successful Clinical
Research for CARRA Members. Denver, Colo.
May 31, 2007.
PUBLICATIONS
Adams KM, Lucas J, Kapur RP, Stevens AM. LPS
induces translocation of TLR4 in amniotic epithelium.
Placenta. May–Jun 2007;28(5–6):477–481.
Burroughs LM, Storb R, Leisenring WM, Pulsipher
MA, Loken MR, Torgerson TR, Ochs HD, Woolfrey
AE. Intensive postgrafting immune suppression
combined with nonmyeloablative conditioning for
transplantation of HLA-identical hematopoietic cell
grafts: results of a pilot study for treatment of primary
immunodeficiency disorders. Bone Marrow Transplant.
Oct 2007;40(7):633–642.
Graham EA, Wallace CA, Stapleton FB. Developing
women leaders in medicine at the grass roots level:
evolution from skills training to institutional change.
J Pediatr. Jul 2007;151(1):1–2.
Humblet-Baron S, Sather B, Anover S, Becker-Herman
S, Kasprowicz DJ, Khm S, Nguyen T, Hudkins-Loya
K, Alpers CD, Ziegler SF, Ochs HD, Torgerson TR,
Campbell DJ, Rawlings DJ. Wiskott-Aldrich syndrome
protein is required for regulatory T cell homeostasis.
J Clin Invest. Feb 2007;117(2):407–418.
Torgerson TR, Ochs HD. Immune dysregulation,
polyendocrinopathy, enteropathy, X-linked: forkhead
box protein 3 mutations and lack of regulatory T cells.
J Allergy Clin Immunol. Oct 2007;120(4):744–750;
quiz 751–752.
Torgerson TR, Ochs HD. Regulatory T cells in
primary immunodeficiency diseases. Curr Opin
Allergy Clin Immunol. Dec 2007;7(6):515–521.
Nelson JL, Gillespie KM, Lambert NC, Stevens AM,
Loubiere LS, Rutledge JC, Leisenring WM, Erickson
TD, Yan Z, Mullarkey ME, Boespflug ND, Bingley PJ,
Gale EA. Maternal microchimerism in peripheral
blood in type 1 diabetes and pancreatic islet beta
cell microchimerism. Proc Natl Acad Sci USA.
Jan 30 2007;104(5):1637–1642.
Renner ED, Torgerson TR, Rylaarsdam S,
Anover-Sombke S, Golob K, LaFlam T, Zhu Q, Ochs
HD. STAT3 mutation in the original patient with Job’s
syndrome. N Engl J Med. Oct 2007;357(16):1667–1668.
Stevens AM, Nelson JL. The chimeric self. The
Rheumatologist. Feb 2007;1(2):16–19.
Torgerson TR, Gambineri E, Ziegler SF, Ochs
HD. Immune dysregulation, polyendocrinopathy,
enteropathy, X-linked inheritance. In: Ochs HD,
Schmidt CE, Puck JM, eds. Primary Immunodeficiency
Diseases, a Molecular and Genetic Approach, Second
Edition. New York, N.Y.: Oxford University Press. 2007.
Torgerson TR, Linane A, Moes N, Anover S, Mateo V,
Rieux-Laucat F, Hermine O, Vijay S, Gambineri E,
Cerf-Bensussan N, Fischer A, Ochs HD, Goulet O,
Ruemmele FM. Severe food allergy as a variant of
IPEX syndrome caused by a deletion in a noncoding
region of the FOXP3 gene. Gastroenterology. May
2007;132(5):1705–1717.
199
Neonatology
The Division of Neonatology’s mission is to improve the
neonatal outcome of pregnancy by providing the region’s
best evidence-based neonatal clinical care, educating the
next generation of neonatal caregivers and advancing
neonatal scholarship.
Neonatology division faculty provide clinical service
and medical direction at four regional neonatal intensive
care units (NICUs). The 19-bed NICU at Seattle Children’s
Hospital provides care for critically ill newborns and infants
with a wide variety of problems including prematurity, infection, and cardiac and surgical defects. Key services include
inhaled nitric oxide treatment, high-frequency ventilation
and extra-corporeal membrane oxygenation (ECMO). The
University of Washington Medical Center is equipped to
handle some of the highest-risk deliveries in the nation,
Faculty
Christine A. Gleason
MD, Chief
200
Christine A. Gleason, MD, Chief
Maneesh Batra, MD, MPH
Shilpi Chabra, MD
W. Alan Hodson, MD, MMSc
J. Craig Jackson, MD, MPH
Sandra E. Juul, MD, PhD
Isabella Knox, MD, EdM
David J. Loren, MD
Dennis E. Mayock, MD
Janet H. Murphy, MB, ChB
Michael D. Neufeld, MD, MPH
Thomas P. Strandjord, MD
and its 32-bed NICU specializes in the care of extremely
preterm infants. The 29-bed NICU at Providence Everett
Medical Center serves high-risk newborns in the north end
of the Seattle region. Division faculty also direct and provide
services in a 14-bed NICU at Overlake Hospital Medical
Center, on the east side of Lake Washington. Infants at the
University of Washington Medical Center, Overlake and
Everett needing higher-level subspecialty care or cardiac
and surgical services are transferred to Children’s.
Division training programs include an ACGMEaccredited fellowship training program, plus medical
student and pediatrics resident education. Several fellows
choose to combine training in neonatology with a complementary MPH, and there is increasing interest in global
neonatal health. Division faculty also participate in and
direct regional educational programs in the WWAMI region,
Infant Transport Program, Medical Consultation Program
and the Center on Human Development and Disability’s
High-Risk Infant Follow-up Clinic.
Current bench lab research programs are focused on the
effects of narcotics on the developing brain, erythropoietin
(Epo) and neuroprotection, and the effects of neonatal
stress on neurodevelopment. Clinical research is focused
on clinical trials of Epo in preterm infants, biomedical
informatics, medical education, use of newborn infant
simulators, global health and epidemiologic research.
In 2007, Dr. Maneesh Batra from the University of
Washington joined the division, along with Dr. Isabella
Knox from the University of Connecticut School of
Medicine/Connecticut Children’s Medical Center.
Christine A. Gleason, MD, is chief of the Division of
Neonatology at Seattle Children’s Hospital and the
W. Alan Hodson Endowed Chair and professor in the
School of Medicine. Gleason’s primary clinical interest
is in the care of high-risk newborns, especially infants
born at the limits of viability (<25 weeks gestation).
Her research has been focused on the developing brain
— specifically, the effects of drugs such as alcohol
and cocaine on the cerebral circulation. She and
her colleagues are currently studying the long-term
effects of severe neonatal stress — and the attempts
to ameliorate these effects with narcotics such as
morphine — on the developing brain. Her local
teaching activities are focused on didactic teaching
Neonatology
of pediatrics residents and neonatology fellows.
Regionally, she teaches as a visiting professor, does case
reviews and presentations at regional hospitals and has
been invited to serve as a visiting professor at academic
medical centers. Gleason is an elected council member
of the American Pediatric Society and a member of
the American Board of Pediatrics, representing the
subspecialty boards. She is co-editor of a major
neonatal textbook, Avery’s Diseases of the Newborn.
Maneesh Batra, MD, MPH, is acting instructor/senior
fellow within the Department of Pediatrics at the
University of Washington School of Medicine. He teaches
medical students, residents and fellows at Seattle
Medical Center. He is an active participant in the Seattle
Children’s Research Institute Section on Prematurity
and Childhood Infections, and is collaborating with
Dr. Craig Rubens and other investigators from all over
the world in performing a landscape review of stillbirth
and prematurity in preparation for an international
summit to be held in Seattle in 2009. In addition,
Batra is a core member of the Children’s Centennial
Symposium Planning Committee.
Shilpi Chabra, MD, is assistant professor in the Department of Pediatrics at the University of Washington
School of Medicine and associate medical director of
the Overlake Hospital Medical Center Special Care
Nursery. She has a keen interest in teaching residents
and fellows. Her main scholarly focus is on the
epidemiology of abdominal wall defects — specifically,
gastroschisis. Her other scholarly interest is vitamin
A status in preterm infants and its association with
chronic lung disease. She serves as a mentor for pediatric residents at Seattle Children’s Hospital and is an
advisor on the Thesis Committee for students in the
University of Washington’s master’s in nutrition and
master’s in public health programs. She is also involved
in quality improvement projects in the Overlake
Special Care Nursery and has helped establish the
post-discharge nutrition clinic at Overlake Hospital.
W. Alan Hodson, MD, MMSc, is professor emeritus in
Washington School of Medicine. He was, until 1997,
head of the Division of Neonatal and Respiratory
Diseases at the University of Washington. His interests
and activities include providing assistance and guidance
to postdoctoral fellows in their pursuit of excellence as
Spotlight on team member — Patricia Jason, RN, BSN, CCRN
We recently expanded our service contract with American
Medical Response Ambulance to provide mobile intensive
care ambulance drivers on Seattle Children’s campus
24 hours a day. This new coverage enables our Neonatal
Intensive Care RN/RRT Transport Team to respond to
critically ill newborns minutes after help is requested
by community physicians and hospitals.
scholars in neonatal medicine, providing clinical service
to convalescing premature infants and teaching overall
neonatal medicine, fundamental to general pediatrics
training. He is also involved in enhancing and improving
the participation of other pediatrics subspecialists in
the evolving field of fetal medicine. He has developed
an interest in global neonatal health issues and in the
development of a curriculum for pediatrics residents
and post-residents interested in global health training.
He continues a long-standing interest in neonatal
respiratory disorders and is chair of the NHLBI External
Advisory Committee for the Collaborative Program
(U-10) on Bronchopulmonary Dysplasia.
J. Craig Jackson, MD, MPH, is professor in the
School of Medicine and medical director of the Neonatal
Intensive Care Unit at Seattle Children’s Hospital. He
serves as associate division head for Clinical Affairs. He
works with leaders in perinatology at the University
of Washington to build its program in fetal diagnostic
services. He serves as leader of the division’s clinical
activities, providing support for the division’s neonatal
medical directors at the University of Washington
Medical Center, Providence Everett Medical Center
in Everett and Overlake Hospital Medical Center in
Bellevue, and for the leaders of the Children’s infant
ground transport team, neonatal respiratory services
and neonatal nurse practitioner program.
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Neonatology
Sandra E. Juul, MD, PhD, is associate professor in the
Department of Pediatrics and director of the neonatology
fellowship training program at the University of
Washington School of Medicine. She serves as associate
division head for scholarship and research. She completed
medical training and pediatrics and neonatology
subspecialty training at the University of Washington.
She earned a PhD in developmental biology at the
University of Chicago. Juul has developed clinically
relevant animal models to help find better ways to treat
and protect the brains of high-risk neonates, and she
is principal investigator on studies focusing on the
neuroprotective effects of erythropoietin (Epo) in
neonatal models of brain injury and neonatal stress.
Her research shows that Epo protects the neonatal
brain from hypoxia and oxidative injury. Using a variety
of approaches, she is working to identify mechanisms
of Epo neuroprotection and to discover ways to optimize
its function in the developing brain at risk for injury.
Her ultimate goal is to bring this new treatment from
the laboratory to the bedside.
Isabella Knox, MD, EdM, is associate professor in the
School of Medicine. Her academic focus is in medical
education, in particular how to help learners develop
effective approaches to learning. She is a co-director
of the Pediatric Fellows’ College. She helps faculty and
fellows become more effective teachers. Her clinical
interests include ethics in the NICU; breast-feeding
support for NICU families; tongue tie and frenotomy;
individualized developmental care for NICU babies
and families; and jaundice and phototherapy.
David J. Loren, MD, is assistant professor in the Department of Pediatrics at the University of Washington
School of Medicine. He teaches and supports medical
students, residents and fellows at all neonatology
clinical practice sites. His teaching and research
interests center around the fusion of practical medical
ethics, quality improvement and communication. His
work with multidisciplinary neonatal intensive care
unit (NICU) teams explores how culture and individual
behavior support or inhibit strategies for process
enhancement. He has developed a parent-as-faculty
program in the NICU at Seattle Children’s Hospital
202
that helps medical teams improve their communication
skills with families. He is also part of the family-centered
care leadership team at Children’s. In the University
of Washington Medical Center’s NICU he helps guide
the quality leadership team, which has participated in
two international collaborations with Vermont Oxford
Network: reduction of nosocomial infection and value
compass–driven outcome improvement. His work
in quality of care focuses on how to provide the best
possible experience for parents in the NICU. He has
been a participant in the inaugural Pediatric Academic
Societies Educational Scholars Program, and he leads
a research project to develop a Web-based teaching
program for pediatrics residents on safe and effective
practices for disclosing medical errors.
Dennis E. Mayock, MD, is professor in the Department
of Medicine and medical director of the University of
Washington Medical Center neonatal intensive care
unit. His basic research interests include evaluation of
the effects of fetal alcohol exposure on fetal, neonatal
and adult cerebrovascular function. Additionally, he is
evaluating the effects of neonatal morphine exposure on
adult cerebrovascular function. These studies include
testing isolated cerebral resistance vessels and evaluating
specific vasoactive mediators such as adenosine and
vasoactive intestinal polypeptide. His clinical research
interests include evaluation of therapies such as
inhaled nitric oxide and late surfactant, which may
alter the development of chronic lung disease. He is
collaborating on an evaluation of whether high-dose
erythropoietin treatment has neuroprotective effects
in preterm and term human infants and subhuman
primates. He also serves as the section secretary to
the American Academy of Pediatrics District VIII
Perinatal Section.
Michael D. Neufeld, MD, MPH, is clinical assistant
medical director of the neonatal intensive care unit at
Providence Everett Medical Center. He is interested in
long-term neurodevelopmental outcomes of premature
infants and attends in the High Risk Infant Follow-up
(HRIF) Clinic at the Center on Human Development
Neonatology
and Disability. His research focuses on maternal
infection and the risk of cerebral palsy in term and
preterm infants and on markers of inflammation
and the risk of severe retinopathy of prematurity. He
manages the division’s clinical database and developed
a database of the patients seen in the HRIF Clinic.
Other interests include quality improvement and
medical education.
Thomas P. Strandjord, MD, is associate professor in
Washington School of Medicine and medical director
of the NICU at Overlake Hospital Medical Center.
He is chair of the University of Washington Medical
Center’s Perinatal/Neonatal Continuous Quality
Improvement Committee and directs resident education
in neonatology. His primary clinical interests involve
care of critically ill newborn infants. He is particularly
interested in the initial stabilization and resuscitation
of neonates, and his research focuses on developing
techniques for training care providers to resuscitate
newborns effectively and safely. He has collaborated in
the development of a screen-based computer simulator
of newborn resuscitation and is studying its effectiveness
as a training tool. Strandjord is also working on various
quality improvement projects for the safety of care
in the NICU. He is actively involved with developing
quality improvement programs for Washington state
through the Department of Health’s Perinatal Regional
Networks program.
Peter Tarczy-Hornoch, MD, is professor in the Department
of Medicine, head of the Division of Biomedical and
Health Informatics (BHI) and adjunct professor in
the Department of Computer Science and Engineering.
He also serves as director for the University of Washington NIH-funded Biomedical and Health Informatics
Research Training grant, biomedical informatics
director of the University of Washington Institute for
Clinical and Translational Science (an NIH CTSA)
and director of Web services and data integration for
the University of Washington Medicine Information
Technology Services Group. His research interests have
included real-time biomedical instrumentation control
system, bench research and mathematical modeling of
liquid ventilation, clinical information systems, and
electronic clinical knowledge resources. His current
research, in collaboration with computer scientists,
focuses on methods and models for data integration
of biomedical and health data, including looking at
ways of handling semi-structured data, representing
uncertainty at various levels in the system and doing
computerized reasoning over integrated data. The
challenges and opportunities his research is applied to
arise from collaborations with biologists and clinical
and translational researchers looking at large-scale
functional gene annotation of bacteria and protozoa,
single-nucleotide polymorphisms for elucidation of
disease mechanisms, expression array experiment
analysis and collaborative integrated analysis of a
combination of clinical data, experimental biological
data and clinical/translational research study data.
David E. Woodrum, MD, is professor in the Department
of Medicine. He is clinical director for the Treuman
Hospital and faculty associate in the Department
of Medical History and Ethics at the University of
Washington. Woodrum’s clinical and teaching activities
are focused on problematic fetal-maternal conditions,
convalescing premature infants and pediatric biomedical
ethics issues. He is co-director of the Pediatric Interim
Care Center in Kent, Wash., a nationally recognized
program providing medically supervised care for
drug-exposed infants.
AWARDS AND HONORS
David J. Loren, MD
2007 Outstanding Faculty Teaching Award. Seattle
Children’s Hospital.
2007 Excellence in Teaching Award in Biomedical and
Health Informatics. University of Washington.
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Neonatology
RESEARCH FUNDING
New
Christine A. Gleason, MD
Long-term behavioral effects of neonatal pain and
morphine treatment in mice. NIH/NIDA. $195,000.
Optimizing neuroprotection following perinatal
asphyxia. NIH. $706,395.
Northwest Perinatal Regional Network N15916.
Washington State Department of Health. $158,000.
Continuing
Mechanisms of erythropoietin-mediated neuroprotection.
Roche Foundation for Anemia Research. $79,459.
II + (SEI): information integration in the presence of
uncertainty. National Science Foundation. $167,695.
Christine A. Gleason, MD
Management of pain and stress in the NICU: do we
know what we’re doing? Syracuse University Perinatal
Symposium. Syracuse, N.Y. 2007.
Neonatal stress and morphine treatment: long-term
effects. Neonatal Developmental Biology Research
Seminar. Stanford University. Palo Alto, Calif. 2007.
Neonatal morphine exposure alters adult learning
in C57 BL/6 mice (co-presenter). A novel mouse
model of neonatal stress and morphine treatment
(co-presenter). Pediatric Academic Societies Annual
Meeting. Toronto, Ontario, Canada. May 5–8, 2007.
To transfuse or not to transfuse? That is the question
(co-presenter). Controversies in Neonatal-Perinatal
Care Conference. University of Washington. Seattle,
Wash. February 2007.
204
A phase I/II trial of high-dose erythropoietin in extremely
low birth weight infants: pharmacokinetics and safety
(co-presenter). Pediatric Academic Societies Annual
Meeting. Toronto, Ontario, Canada. May 5–8, 2007.
Anemia in preterm infants: how should we proceed?
Iron and the newborn infant. Neonatal neuroprotection:
where do we stand? Southeastern Association of Neonatology Meeting. Marco Island, Fla. May 17–20, 2007.
Update on neonatal neuroprotection: it’s time for
clinical studies (visiting professor). University of Utah.
Salt Lake City, Utah. Nov. 18–20, 2007.
David J. Loren, MD
Error disclosure among pediatricians. Houston, we
have a problem: a practical and principled approach
to error disclosure (workshop). Pediatric Academic
May 5–8, 2007.
Parents as faculty: changing neonatal caregiver behavior
one voice at a time. Parental involvement in quality
improvement programs: discovering the core values
of a newborn intensive care unit. When beginnings
are endings: an education program to guide caregivers
in end-of-life language in the newborn intensive care
unit. Third International Conference on Patient- and
Family-Centered Care: Partnerships for Enhancing
Quality and Safety. Seattle, Wash. July 30–Aug. 1, 2007.
Dennis E. Mayock, MD
The use of a standardized ventilation protocol for the
stabilization and transport of neonates with congenital
diaphragmatic hernia (co-presenter). Neonatal/Pediatric
Transport Conference. Salt Lake City, Utah. Feb. 21, 2007.
Effects of inhaled nitric oxide on pulmonary function
in preterm infants (co-presenter). A phase I/II trial of
high-dose erythropoietin in extremely low birth weight
infants: pharmacokinetics and safety (co-presenter).
Pediatric Academic Societies Annual Meeting. Toronto,
Ontario, Canada. May 5–8, 2007.
Neonatology
Michael D. Neufeld, MD, MPH
Outcome trends of infants weighing less than 800
grams at birth (co-presenter). Pediatric Academic
May 5–8, 2007.
To transfuse or not to transfuse? That is the question
(co-presenter). Controversies in Neonatal-Perinatal
Care Conference. University of Washington. Seattle,
Biomediator data integration and inference for
functional annotation of anonymous sequences.
Pacific Symposium on Biocomputing. Maui, Hawaii.
January 2007.
A randomized controlled trial of a computer counseling
intervention to support antiretroviral therapy adherence
and HIV transmission risk reduction: baseline findings
(co-presenter). Second International Conference on
HIV Treatment Adherence. Jersey City, N.J.
March 28–30, 2007.
PUBLICATIONS
Anderson DJ, Mondares RL, Born DE, Gleason CA.
The effect of binge fetal alcohol exposure on the
number of vasoactive peptide-producing neurons in
fetal sheep brain. Dev Neurosci. Epub Oct 25 2007.
Anderson NR, Ash JS, Tarczy-Hornoch P. A qualitative
study of implementation of a bioinformatics tool in
a biological research laboratory. Int J Med Inform.
Nov–Dec 2007;76(11–12):821–828.
Anderson NR, Lee ES, Brockenbrough JS, Minie
ME, Fuller S, Brinkley J, Tarczy-Hornoch P. Issues
in biomedical research data management and analysis:
needs and barriers. J Am Med Inform Assoc. Jul–Aug
2007;14(4):478–488.
Chabra S. Gastroschisis: brief early history [letter to
the editor]. J Perinat Med. 2007;35(5):455.
Di Fiore JM, Hibbs AM, Zadell AE, Merrill JD, Eichenwald EC, Puri AR, Mayock DE, Courtney SE, Ballard
RA, Martin RJ. The effect of inhaled nitric oxide on
pulmonary function in preterm infants. J Perinatol.
Dec 2007;27(12):766–771.
Juul SE, Aylward E, Richards T, McPherson RJ,
Kuratani J, Burbacher T. Prenatal cord clamping in
newborn Macaca nemestrina: a model of perinatal
asphyxia. Dev Neurosci. 2007;29(4–5):311–320.
Juul SE, Felderhoff-Mueser U. Epo and other
hematopoietic factors. Semin Fetal Neonatal Med.
Aug 2007;12(4):250–258.
Juul SE, McPherson RJ, Bammler TK, Wilkerson
J, Beyer RP, Farin FM. Recombinant erythropoietin
is neuroprotective in a novel mouse oxidative injury
model. Dev Neurosci. Epub Oct 25 2007.
Kellert B, McPherson RJ, Juul SE. A comparison
of high-dose erythropoietin treatment regimens
in brain-injured neonatal rats. Pediatr Res. Apr
2007;61(4):451–455.
Konduri GG, Vohr B, Robertson C, Sokol GM, Solimano A, Singer J, Ehrenkranz RA, Singhal N, Wright
LL, Van Meurs K, Stork E, Kirpalani H, Peliowski A,
Johnson Y, Neonatal Inhaled Nitric Oxide Study Group
(Mayock DE, site investigator). Early inhaled nitric
oxide therapy for term and near-term newborn infants
with hypoxic respiratory failure: neurodevelopmental
follow-up. J Pediatr. Mar 2007;150(3):235–240.
Louie B, Mork P, Martin-Sanchez F, Halevy A,
Tarczy-Hornoch P. Data integration and genomic
medicine. J Biomed Inform. Feb 2007;40(1):5–16.
Mayock DE, Bennett R, Robinson RD, Gleason CA.
Dopamine does not limit fetal cerebrovascular responses
to hypoxia. J Appl Physiol. Jan 2007;102(1):130–134.
Cadag E, Louie B, Myler P, Tarczy-Hornoch P.
Biomediator data integration and inference for
functional annotation of anonymous sequences.
Pac Symp Biocomput. 2007;343–354.
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Neonatology
Mayock DE, Ness D, Mondares RL, Gleason CA.
Binge alcohol exposure in the second trimester attenuates
fetal cerebral blood flow response to hypoxia. J Appl
Physiol. Mar 2007;102(3):972–977.
McPherson RJ, Demers EJ, Juul SE. Safety of highdose recombinant erythropoietin in a neonatal rat
model. Neonatology. 2007;91(1):36–43.
McPherson RJ, Gleason CA, Mascher-Denen M, Chan
M, Kellert B, Juul SE. A new model of neonatal stress
which produces lasting neurobehavioral effects in adult
rats. Neonatology. 2007;92(1):33–41.
McPherson RJ, Juul SE. High-dose erythropoietin
inhibits apoptosis and stimulates proliferation in
neonatal rat intestine. Growth Horm IGF Res. Oct
2007;17(5):424–430.
Ngai A, Mondares RL, Mayock DE, Gleason CA. Fetal
alcohol exposure alters cerebrovascular reactivity to
VIP in adult sheep. Neonatology. Epub Jul 12 2007.
Statler PA, McPherson RJ, Bauer LA, Kellert BA,
Juul SE. Pharmacokinetics of high-dose erythropoietin
in plasma and brain of neonatal rats. Pediatric Res.
Jun 2007;61(6):671–675.
Tarczy-Hornoch P, Markey MK, Smith JA, Hiruki T.
Biomedical informatics and genomic medicine: research
and training. J Biomed Inform. Feb 2007;40(1):1–4.
Taylor JA, Brownstein D, Klein EJ, Strandjord TP.
Evaluation of an anonymous system to report medical
errors in pediatric inpatients. J Hosp Med. Jul
2007;2(4):226–233.
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Nephrology
The Division of Nephrology provides specialized primary
and consultative care for infants, children and adolescents
with congenital and acquired renal problems. The division
serves as the regional referral center for children with endstage kidney disease and is a national leader in nephrology
care. We have extended our service to provide outpatient
care regionally at outreach clinics in the states of
Washington, Alaska and Montana. The division runs an
outpatient dialysis unit and also provides emergency dialysis
and ongoing renal support to critically ill hospitalized
children, including those in the intensive care units at
Seattle Children’s Hospital. The need for dialysis services
at Children’s continues to grow because of the increasing
complexity of care for children undergoing cardiac surgery
and transplants of bone marrow, heart and intestine.
Faculty members also provide nephrology care for children
at Mary Bridge Children’s Hospital in Tacoma, Wash.
Division physicians evaluate children who are
candidates for kidney transplantation; in conjunction with
other members of a multidisciplinary transplant program,
they manage the pre- and post-transplant care of renal
transplant recipients. Our nephrology team of physicians,
specialized nurses, dietitians and social workers provides
a variety of support and follow-up services to ensure the
best family-centered care. A new pediatric hypertension
clinic was established this year.
The nephrology research program at Children’s has
become one of the largest and most productive programs
in the country. Several division faculty members have
been awarded competitive research grants.
We are committed to training physicians for careers in
nephrology at academic pediatric centers. Our fellowship
Faculty
Allison A. Eddy
MD, Chief
Allison A. Eddy, MD, Chief
Nicole R. Becker, MD
Joseph T. Flynn, MD, MS
Coral D. Hanevold, MD
Sangeeta R. Hingorani, MD, MPH
Jesús M. López-Guisa, PhD
Ruth A. McDonald, MD
Daryl M. Okamura, MD
Jodi M. Smith, MD, MPH
Jordan M. Symons, MD
Sandra L. Watkins, MD
Ikuyo Yamaguchi, MD, PhD
Karyn Yonekawa, MD
Guoqiang Zhang, MD, PhD
program is one of the most sought-after fellowships in
the country, with the goal of training future leaders in the
field of academic pediatric nephrology. Since 1990, we
have trained 22 pediatric nephrologists with support from
Children’s and a training grant from the National Institutes
of Health; six more are currently in the program.
Division members fulfill important educational roles
in the community and continually participate in national
organizations and societies; several faculty members hold
leadership roles in these organizations. Division faculty
members are frequently invited to speak at national and
international meetings. In 2007, two new physicians were
recruited to the division: Dr. Joseph Flynn was recruited
from Albert Einstein College of Medicine of Yeshiva
University and Children’s Hospital at Montefiore, the
Bronx, N.Y., and Dr. Coral Hanevold was recruited from
the Medical College of Georgia in Augusta, Ga.
Allison A. Eddy, MD, is chief of the Division of Nephrology
at Seattle Children’s Hospital, director of the Tissue
and Cell Sciences Research Center and professor in
Washington School of Medicine. In addition to clinical
work, she directs a basic science research program and
is involved in mentoring, training and administrative
responsibilities for all of these programs. Eddy is internationally recognized for her research on the cellular
and molecular basis of progressive kidney disease. Her
laboratory is conducting two major NIH projects: one
investigates the role of the urokinase receptor family
in renal scarring, and the other investigates the role of
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Nephrology
Tacoma, where she provides adolescent medicine for
incarcerated youth as well as policy and management
oversight for the medical department. She also works
with the Pierce County Health Department and superior
court judges on the Juvenile Court Executive Committee.
Becker is working on a young-adult patient-transitioning
plan in the Division of Nephrology and has a special
interest in ensuring that adolescents and their parents
have normal life experiences, despite chronic illness,
and move successfully into adulthood.
Spotlight on team member — Tina Kvale, RN
Our new Hypertension Clinic allows us to respond to the
growing number of children being referred to us. We use
monitors that record blood pressures over a 24-hour period —
a tool that helps us diagnose more accurately and treat with
greater confidence. We are also working to expand our outreach
clinics to improve access for patients and families in our
four-state region.
scavenger receptors in chronic kidney disease. Eddy
is program director for the University of Washington
Child Health Research Center and principal investigator of the NIH research training program in pediatric
nephrology. She is an active member of the editorial
board for the journal Pediatric Nephrology and is
co-editor of the pediatric section of the British Medical
Journal book Evidence-Based Nephrology. Eddy also
has an interest in global medicine and was recently
awarded a grant from the Puget Sound Partners for
Global Health to conduct a study on acute kidney
injury in children admitted to Mulago Hospital,
Makerere University, Kampala, Uganda.
Nicole R. Becker, MD, is attending physician at Seattle
Children’s Hospital and associate clinical professor
MD from the University of Pennsylvania School of
Medicine, Philadelphia, Pa. She completed a pediatrics
residency and internship at Children’s Hospital of
Philadelphia and a pediatric nephrology fellowship at
Seattle Children’s. She also completed an adolescent
medicine fellowship while working as an attending
physician and assistant professor of pediatrics at RushPresbyterian-St. Luke’s Medical Center in Chicago, Ill.
Becker cares for children in the Nephrology Clinic and
is the nephrologist covering Mary Bridge Children’s
Hospital in Tacoma, Wash. She is medical director
at the Pierce County Juvenile Detention Center in
208
Joseph T. Flynn, MD, MS, is attending physician at Seattle
Medicine. He is medical director of dialysis services at
Children’s and the director of the new Pediatric Hypertension Program, the only such program in the WAMI
region. He earned his MD at the State University of
New York, Upstate Medical University in Syracuse,
N.Y., and his MS in clinical research methods at the
Albert Einstein College of Medicine in the Bronx, N.Y.
His clinical interests include hypertension in children
and adolescents, cardiovascular disease in children
with chronic kidney disease, and dialysis in infants
and children. His research has focused on clinical trials
of antihypertensive medications in children, complications of obesity and hypertension in children, and early
manifestations of cardiovascular disease in children
with underlying kidney disease. He has mentored more
than a dozen trainees in pediatric nephrology. He is a
section editor of the journal Pediatric Nephrology and
sits on the editorial board of the American Journal of
Hypertension. Nationally, Flynn is a councilor of the
American Society of Pediatric Nephrology and has
served on advisory committees of the National Heart,
Lung and Blood Institute and the National Institute
of Child Health and Human Development.
Coral D. Hanevold, MD, is attending physician at Seattle
Children’s Hospital and a clinical professor in the
Department of Pediatrics at the University of Washington School of Medicine. She received her MD from the
Medical College of Georgia and completed a pediatric
internship there. She finished her pediatric residency
at the University of Virginia in Charlottesville, Va.
Hanevold pursued a clinical pediatric nephrology
fellowship at St. Christopher’s Hospital for Children in
Philadelphia, Pa. From there she did a second fellowship in pediatric nephrology research and transplant
immunology at Cedars Sinai Hospital, a division of the
Nephrology
University of California, Los Angeles. Before joining
the University of Washington faculty, Hanevold served
as the section chief of pediatric nephrology at the
Medical College of Georgia. Hanevold cares for children
with kidney disease at Children’s and at Mary Bridge
Children’s Hospital in Tacoma, Wash. She serves as
the medical director of nephrology at Mary Bridge
Children’s Hospital, a contract service provided by
the Division of Nephrology.
Sangeeta R. Hingorani, MD, MPH, is attending physician
MD from Albert Einstein College of Medicine in the
Bronx, N.Y. She completed a pediatrics residency and
a fellowship in pediatric nephrology at the University
of Washington; she also earned her MPH from the
university. Her clinical research program is investigating the pathophysiology of acute and chronic kidney
disease after hematopoietic cell transplant. She has
prospective studies ongoing at the Fred Hutchinson
Cancer Research Center (FHCRC) to gain a better
understanding of the timing and mechanisms of renal
injury and to identify potential biomarkers for kidney
disease after stem cell transplant. Using the database
at FHCRC, Hingorani conducted large epidemiologic
studies to identify risk factors for both acute and
chronic kidney disease after transplant and to evaluate
the mortality associated with kidney injury in this patient
population. Hingorani is director of the university
pediatric nephrology fellowship program. She spends
time teaching and mentoring fellows in both the clinical
and clinical research arenas. She is a member of the
Pediatric Scientific Advisory Committee and serves
on several committees within the American Society
of Pediatric Nephrology.
Jesús M. López-Guisa, PhD, is affiliated research assistant
Medicine and supervises fellows and research associates
at the university. He earned his PhD in biochemistry
at the University of Wisconsin–Madison. López-Guisa
researches the mechanisms involved in the inflammatory
and fibrotic mechanisms in progressive renal diseases.
At Seattle Children’s Hospital he collaborated with the
cardiology faculty on studies of thyroid metabolism
and with the rheumatology faculty on the role of
microchimerism in renal diseases. He maintains study
collaborations outside Children’s on the role of the IL-6
family of genes during kidney development and in
normal and pathological conditions, and on the role of
the IL-6 family of genes in osteoarthritis in a strain of
mice he developed. López-Guisa is a member of several
minority programs at the University of Washington and
is a member of the American Association of Cancer
Research and the National Institute of Diabetes and
Digestive and Kidney Diseases minority network. He
has published numerous papers in peer-reviewed
publications.
Ruth A. McDonald, MD, is medical director of solid-organ
transplantation and clinical director of nephrology at
Washington School of Medicine. She also serves as
co-director of several outreach clinics in pediatric
nephrology in Washington, Alaska and Montana. She
earned her MD at the University of Minnesota. She
completed her residency and served as assistant chief
resident and completed a fellowship in the Division of
Pediatric Nephrology at the University of Washington.
She serves as principal investigator in many multicenter research studies on pediatric renal transplantation.
She serves on the North American Pediatric Renal
Trials and Cooperative Studies Board of Directors and
is chairwoman of the Participating Centers Committee.
She has a special clinical interest in post-transplant
lymphoproliferative disorder and viral infections after
transplant in all solid-organ transplant recipients.
She is an at-large member of the Children’s University
Medical Group Board of Directors and is chairwoman
of the group’s Clinical Practice Committee. McDonald
is respected nationally as a leader in national organ
allocation policy development. She serves on the
UNOS Kidney Committee and is an elected member
of the UNOS Board of Directors. Additionally, she
serves on the pediatric nephrology sub-board of the
American Board of Pediatrics.
Daryl M. Okamura, MD, is attending physician at Seattle
Department of Pediatrics at the University of Washington School of Medicine. He earned his MD and
completed pediatrics residency training at the University
of Hawaii and completed his pediatric nephrology
fellowship at Children’s. His clinical interests include
the diagnosis and management of patients with renal
vasculitis, dyslipidemia and chronic kidney disease.
His research goals are to understand the pathologic
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Nephrology
mechanisms of kidney fibrosis to develop therapies to
halt or reverse the progression of chronic kidney disease and kidney failure. His current research projects
are focused on elucidating the role of oxidative stress
and inflammation in the progression of chronic kidney
disease. Okamura has presented his research in many
regional and national nephrology conferences and
published several papers in peer-reviewed journals.
He has been appointed to the American Society of
Pediatric Nephrology Research Committee.
Jodi M. Smith, MD, MPH, is attending physician at Seattle
School of Medicine. She earned her MD and completed
her pediatrics residency at McGill University in Montreal.
She completed a pediatric nephrology fellowship and
earned an MPH in epidemiology from the University of
Washington. She is studying the role of subclinical viral
infections in the development of kidney transplant
dysfunction in pediatric recipients.
F. Bruder Stapleton, MD, is chief academic officer and
senior vice president at Seattle Children’s Hospital
and was pediatrician-in-chief from 1996 to 2007.
He is chairman of the Department of Pediatrics at
the University of Washington School of Medicine
and holds the Ford Morgan Endowed Chair. He
was chief of the Division of Pediatric Nephrology at
the University of Tennessee, where he founded the
pediatric General Clinical Research Center. He served
as A. Conger Goodyear Chair of the Department of
Pediatrics and pediatrician-in-chief and medical
director for Children’s Hospital of Buffalo in New York.
He has served as secretary-treasurer and president of
the American Society of Pediatric Nephrology, assistant
secretary-general and treasurer of the International
Pediatric Nephrology Association, president of the
Southern Society for Pediatric Research and chairman
of the Sub-board of Pediatric Nephrology of the
American Board of Pediatrics. Stapleton is chair of the
Subspecialties Committee of the American Board of
Pediatrics. He is on the executive council of the American
Pediatric Society and is founding editor-in-chief of
Journal Watch Pediatrics and Adolescent Medicine.
He is president of the Association of Medical School
Pediatric Department Chairs and head of the Data
Safety Monitoring Board for the NIH National Study
of Kidney Disease in Children.
210
Jordan M. Symons, MD, is attending physician at Seattle
Department of Pediatrics at the University of Washington School of Medicine. He treats general nephrology,
kidney transplant and dialysis patients. He received his
MD from Columbia University College of Physicians
and Surgeons. He completed a pediatrics residency
at Children’s Memorial Hospital in Chicago, Ill., and
pediatric nephrology training at Children’s Hospital
Boston. Symons has a primary interest in the care
and treatment of acute kidney injury in critically ill
patients; he is a founding member of the Prospective
Pediatric Continuous Renal Replacement Therapy
Registry, a pediatric multicenter consortium engaged
in cooperative study of CRRT methods. Symons also
has a strong interest in medical education; he is a
member of the College Faculty of the University of
Washington School of Medicine, a group of 35 medical
faculty dedicated to the development and implementation of a four-year integrated curriculum of clinical
skills and professionalism. He instructs and mentors
approximately 25 medical students per year.
Sandra L. Watkins, MD, is professor emerita in the
School of Medicine. She is immediate past president of
the American Society of Pediatric Nephrology. She is a
past board member of the Renal Physicians Association
and a past member of the Northwest Renal Networks
Medical Review Board. Her clinical interests include
the full breadth and depth of pediatric renal disease
and hypertension. Her research interests include
end-stage renal disease therapies, hemolytic uremic
syndrome and glomerulonephritis. She is a principal
investigator for the Focal Segmental Glomerulosclerosis
Clinical Trial, a multicenter interventional trial.
Ikuyo Yamaguchi, MD, PhD, is attending physician at
from Kumamoto University and her PhD from Kurume
University in Japan. She completed her pediatrics
training at Georgetown University Medical Center in
Washington, D.C., and pediatric nephrology training
at Children’s. Her clinical interests include hypertension
and chronic kidney disease in children. Her basic
research interest is to understand the role of the
microvasculature in acute and chronic renal diseases.
Yamaguchi has presented her research at many
Nephrology
regional and national nephrology conferences and
published more than a dozen papers in peer-reviewed
journals. She is a member of the American Academy of
Pediatrics, the American Society of Nephrology and the
American Society of Pediatric Nephrology.
Karyn Yonekawa, MD, is attending physician at Seattle
Children’s Hospital and a clinical instructor in the
Department of Pediatrics at the University of
MD from the University of Pittsburgh School of
Medicine. She completed her pediatrics residency at
Children’s Hospital of Orange County and her pediatric
nephrology fellowship at the University of Washington.
Yonekawa cares for children at Mary Bridge Children’s
Hospital in Tacoma, Wash. She also conducts basic
science research; her interests include the signaling
pathways involved in cellular death.
Child Health Research Center Young Investigator
Award. NIH/NICHD.
Guoqiang Zhang, MD, PhD, is acting instructor at the
University of Washington. He received two years of
postdoctoral training at Sheffield Kidney Institute,
University of Sheffield, U.K. Zhang’s research at the
University of Washington has focused on the molecular
mechanisms of chronic renal injury, in particular the
control of renal myofibroblast activation. His studies
have led to the finding of an alternative urokinase
fibroblast receptor. The pathological function of this
newly identified urokinase receptor in the progression
of kidney disease is being studied intensively. Zhang
is expanding his research to develop specific gene
silencing approaches for the treatment of cardiovascular
complications of chronic kidney disease. His goal is
to bring this knowledge and these technologies to the
bedside to benefit kidney patients. Zhang serves as
manuscript reviewer for the American Journal of
Kidney Disease and the Journal of the American Society
of Nephrology. He has supervised visiting research
fellows, research associates and summer students.
AWARDS AND HONORS
Listed in America’s Top Pediatricians.
Gottschalk and Siegel Research Scholar Grant Award.
American Society of Nephrology.
RESEARCH FUNDING
New
Role of CD36 in oxidative and inflammatory pathways in
renal fibrosis. National Kidney Foundation. $50,000.
Renal transplant and subclinical herpesvirus infection.
Viral surveillance in pediatric renal transplantation.
Roche Laboratories. $75,000.
Regulation of the renal microvasculature by placental
growth factor and vascular endothelial cadherin
during chronic kidney disease. American Society
of Nephrology. $100,000.
Roles of a newly identified alternative urokinase
receptor in the development of atherosclerosis and
renal injury. American Heart Association. $65,000.
Continuing
Allison A. Eddy, MD
Fibrotic sequelae of childhood renal disease.
Impact of kidney dysfunction on mortality rates in
Ugandan children hospitalized with acute infections.
Puget Sound Partners. $75,000.
Molecular mechanisms in renal interstitial fibrosis.
211
Nephrology
Pediatric Nephrology Training Program. NIH/NIDDK.
$198,949.
Renal injury after hematopoietic stem cell transplant.
Advances in the treatment of childhood hypertension.
38th Annual Meeting, German Association of Pediatric
Nephrology. Stuttgart, Germany. March 22–24, 2007.
Safety in immunomodulatory functions of campath-1H.
NIAID/NIH/DHHS. Children’s Hospital Boston.
$53,891.
Hypertension in childhood and adolescence: update
2007. Pediatric Grand Rounds, Long Island College
Hospital. Brooklyn, N.Y. March 28, 2007.
Multifunctional role of CD36 in progressive renal
fibrosis. NIDDK/NIH/DHHS. $128,250.
Management of hypertension in childhood and
adolescence. Icelandic Renal Association. Reykjavik,
Iceland. March 30, 2007.
Cancer Center support. NIH/DHHS. $111,100.
Hypertension and nephropathy in children and
adolescents with type II diabetes. Pediatric Academic
May 6, 2007.
Cellular and molecular biology of childhood disease.
United States Immunodeficiency Fund. Immune
Deficiency Foundation. $52,546.
Allison A. Eddy, MD
Mechanisms of renal fibrosis (visiting professor).
Seminar in Pediatric Nephrology. University of California, Los Angeles. Los Angeles, Calif. January 2007.
Piecing together the renal fibrosis puzzle. NIDDK
Kidney Development and Repair Conference. NIH.
Bethesda, Md. February 2007.
Interstitial nephritis (Mrs. Ho Tam Kit Hing Visiting
Professorship). University of Hong Kong at Queen
Mary Hospital. Hong Kong, P.R.C. May 2007.
Interstitial nephritis. Hong Kong Medical Forum.
Chengdu-Sichuan, China. May 2007.
Pharmacologic management of hypertension in
childhood. Pediatric Grand Rounds, Bronx-Lebanon
Hospital. The Bronx, N.Y. Jan. 9, 2007.
212
Incorporating updated childhood BP guidelines
into clinical practice. Pediatric Nephrology Seminar
XXXIV. Miami, Fla. March 3, 2007.
Invited moderator. Scientific Session, American
Society of Hypertension Annual Meeting. Chicago, Ill.
May 19, 2007.
Lifestyle changes and lifelong medications: how can
target organ injury be prevented? Role of ambulatory
BP monitoring in the treatment of hypertension
in children and adolescents. 14th Congress of the
International Pediatric Nephrology Association.
Budapest, Hungary. Aug. 30–Sept. 1, 2007.
Hypertension trials in pediatrics: where are we going?
Western Society of Pediatric Nephrology. Scottsdale,
Ariz. Oct. 14, 2007.
Ambulatory blood pressure monitoring in children and
adolescents: update 2007. Pediatric Grand Rounds,
Hospital for Sick Children. Toronto, Ontario, Canada.
Oct. 24, 2007.
Hypertension: incorporating the new guidelines into
office practice. American Academy of Pediatrics 2007
National Conference and Exhibition. San Francisco,
Calif. Oct. 30, 2007.
Renal complications after hematopoietic cell transplant.
American Society of Pediatric Nephrology Annual
Nephrology
The kidney in oncology and hematopoietic cell transplant patients. Ninth Annual Southwest Pediatric and
Neonatal Hematology/Oncology for the Practitioner
Conference. Albuquerque, N.M. October 2007.
Symposium on best adult deceased donors for
pediatric transplant candidates. Fourth Congress of
the International Pediatric Transplant Association.
Cancun, Mexico. March 17, 2007.
Pediatric renal transplantation. United Network of
Organ Sharing Pediatric Summit. San Antonio, Texas.
March 28, 2007.
CMV prophylaxis in solid organ transplant recipients.
Transplant Grand Rounds. Inland Empire Nephrology
Association. Loma Linda, Calif. April 24, 2007.
Transitioning the adolescent transplant patient to
adult care. American Transplant Congress Pediatric
Symposium. San Francisco, Calif. May 4, 2007.
Antiviral prophylaxis delays onset of subclinical viral
infection in pediatric renal transplant recipients.
Increased risk of transitional cell carcinoma in renal
transplant recipients with bladder augmentation.
American Transplant Congress. San Francisco, Calif.
May 5–9, 2007.
Hyperphosphatemia-associated risk of hospitalization
in pediatric chronic kidney disease (CKD): an analysis
of the NAPRTCS. American Society of Nephrology 40th
Annual Meeting. San Francisco, Calif. November 2007.
Atherogenic scavenger receptor modulation in the
tubulointerstitium in response to chronic renal injury.
American Society of Pediatric Nephrology Annual
Meeting. Toronto, Ontario, Canada. May 7, 2007.
Factors leading to chair burnout. Association of Medical
School Pediatric Department Chairs Annual Meeting.
San Antonio, Texas. March 6, 2007.
Top five stories in 2006 (plenary speaker). North
Pacific Pediatric Society Annual Meeting. Lynnwood,
Wash. March 15, 2007.
Creating family-friendly environments. University of
Washington Faculty Leadership Course. Seattle, Wash.
March 29, 2007.
Response to presidential address. How departments
should nurture clinical investigators (plenary speaker).
Pediatric Academic Societies Annual Meeting. Toronto,
Ontario, Canada. May 4, 2007.
Somewhere over 39th and Rainbow (White Coat
Ceremony address). Addressing new agendas in
academic medicine: professionalism and work/life
balance. Pediatric Grand Rounds, University of Kansas
School of Medicine. Kansas City, Kan. Aug. 3, 2007.
Bone disease in hypercalcuria (plenary speaker). 14th
Congress of the International Pediatric Nephrology
Association. Budapest, Hungary. Sept. 2, 2007.
Jordan M. Symons, MD
Fundamentals of dialysis in children. Physiology
of dialysis: fundamental concepts that underlie the
fundamentals. Eighteenth Annual Symposium on
Pediatric Dialysis. Denver, Colo. February 2007.
Choice of dialysis methods for pediatric critical care.
Annual Dialysis Conference. Denver, Colo. February 2007.
Pediatric CRRT: the basics (epidemiology, demographics,
outcome). CRRT in the newborn: principles and
application. Twelfth International Conference on
Continuous Renal Replacement Therapy. San Diego,
Calif. March 2007.
Role of oxidized lipids in progression of fibrosis in
obstructive uropathy. International Pediatric Nephrology
annual meeting, symposium on congenital ureter tract
obstruction. Budapest, Hungary. Aug. 31–Sept. 4, 2007.
Hematuria. Answering today’s challenges in pediatric
practice. American Academy of Pediatrics, Washington
Chapter. Seattle, Wash. July 15, 2007.
Effective leadership for academic general pediatric
divisions (panel discussant). APA Leadership Course.
Atlanta, Ga. March 1, 2007.
Fluid and electrolyte therapy for the busy pediatric
practitioner. American Academy of Pediatrics National
Conference and Exhibition. San Francisco, Calif.
October 2007.
213
Nephrology
Proteinuria for the pediatric practitioner. 27th Annual
F. Richard Dion Pediatric Update. Virginia Mason
Medical Center. Seattle, Wash. Dec. 7, 2007.
The management of children who have renal insufficiency
and ESRD. Fundamentals of Dialysis in Children.
Denver, Colo. Feb. 17, 2007.
Duties/salary discrepancies of a pediatric nephrologist
and how to approach job negotiation/renegotiation
from a nephrologist’s perspective. American Society
of Pediatric Nephrology Annual Meeting. Toronto,
Risk of hemolytic uremic syndrome (HUS) after
antibiotic treatment of Escherichia coli (E. coli)
O157:H7 infections: interim observations from
a continuing prospective cohort study. Pediatric
Academic Society Annual Meeting. Toronto,
Multicenter randomized clinical trial of FSGS in
children and young adults. American Society of
Nephrology 40th Annual Meeting. San Francisco,
Calif. Nov. 2, 2007.
Vascular endothelial cadherin modulates fibrogenesis
in the mouse unilateral ureteral obstruction model.
American Society of Nephrology Renal Week. American
Society of Nephrology 40th Annual Meeting. San
Francisco, Calif. November 2007.
The development of a novel synthetic nanovector that
can selectively deliver genes to targeted vascular lesions.
Northwestern Cardiovascular Young Investigators’
Forum. Chicago, Ill. October 2007.
The novel ligand-receptor relationship identified
between urokinase and the nicotinic receptor (nAChRα1):
its signaling and function in cell growth and chronic
renal injury. American Society of Nephrology 40th
Annual Meeting. San Francisco, Calif. November 2007.
214
PUBLICATIONS
Chang A, Hingorani SR, Kowalewska J, Flowers M,
Aneja T, Smith K, Meehan S, Nicosia R, Alpers C.
The spectrum of renal pathology in hematopoietic
cell transplantation: a series of 20 patients and
review of the literature. Clin J Am Soc Nephrol.
Sep 2007;2(5):1014–1023.
McDonald RA. Renal and urologic manifestations of
pediatric condition falsification/Munchausen by proxy.
Pediatr Nephrol. Jun 2007;22(6):849–856.
Flynn JT. Children with first urinary tract infection
may not benefit from antibiotic prophylaxis. J Pediatr.
Nov 2007;151(5):552–553.
Flynn JT. Hypertension in children and adolescents.
In: Lip GYH, Hall JE, eds. Comprehensive Hypertension.
New York, N.Y.: Mosby. 2007.
Flynn JT. Metabolic syndrome as a predictor of
cardiovascular risk in children and adolescents.
Am J Hypertens. Aug 2007;20(8):883.
Gipson DS, Gibson K, Gipson PE, Watkins SL,
Moxey-Mims M. Therapeutic approach to FSGS in
children. Pediatr Nephrol. Jan 2007;22(1):28–36.
Graham EA, Wallace CA, Stapleton FB, Association
of Medical School Pediatric Department Chairs Inc.
Developing women leaders in medicine at the grass
roots level. Evolution from skills training to institutional
change. J Pediatr. Jul 2007;151(1):1–2, 2.e1.
Harshfield GA, Hanevold CD, Kapuku GK, Dong Y,
Castles ME, Ludwig DA. The association of race and
sex to the pressure natriuresis response to stress.
Ethn Dis. Summer 2007;17(3):498–502.
Hingorani SR, Guthrie KA, Schoch G, Weiss NS,
McDonald GB. Chronic kidney disease in long-term
survivors of hematopoietic cell transplant. Bone
Marrow Transplant. Feb 2007;39(4):223–229.
Nephrology
Kumar J, Gordillo R, Del Rio M, Flynn JT. Recurrent
chyloperitoneum — a rare complication of peritoneal
dialysis. Pediatr Nephrol. Epub Dec 19 2007.
Lande MB, Flynn JT. Treatment of hypertension
in children and adolescents. Pediatr Nephrol. Epub
Aug 10 2007.
McKie KT, Hanevold CD, Hernandez C, Waller J,
Ortiz L, McKie KM. Prevalence, prevention and treatment of microalbuminuria and proteinuria in children
with sickle cell disease. J Pediatr Hematol Oncol.
Mar 2007;29(3):140–144.
McPhillips HA, Burke AE, Sheppard K, Pallant A,
Stapleton FB, Stanton B. Toward creating familyfriendly work environments in pediatrics. Pediatrics.
Mar 2007;119(3):e596–e602.
McPhillips HA, Stanton B, Zuckerman B,
Stapleton FB. Role of a pediatric department chair:
factors leading to satisfaction and burnout. J Pediatr.
Oct 2007;151(4):125–139.
Okamura DM, López-Guisa JM, Koelsch K, Collins S,
Eddy AA. Atherogenic scavenger receptor modulation
in the tubulointerstitium in response to chronic
renal injury. Am J Physiol Renal Physiol. Aug
2007;293(2):F575–F585.
Patel HP, Goldstein SG, Mahan JD, Smith B, Fried
CB, Currier H, Flynn JT. A standard, noninvasive
monitoring of hematocrit algorithm improves blood
pressure control in pediatric hemodialysis patients.
Clin J Am Soc Nephrol. Mar 2007;2(2):252–257.
Rafaelli RM, Paladini M, Hanson H, Kornstein L,
Agasan A, Slavinski S, Weiss D, Fennelly GJ, Flynn JT.
Child care-associated outbreak of Escherichia coli
O157:H7 and hemolytic uremic syndrome. Pediatr
Infect Dis J. Oct 2007;26(10):951–953.
Sectish TC, Stapleton FB, Schnaper HW, Degnon LE,
Behrman RE. The creation of the Council of Pediatric
Subspecialties. J Pediatr. Aug 2007;151(2):105–106.
Shatat IF, Schoeneman M, Flynn JT, Woroniecki RP.
Association of steroid and cyclosporine resistance in
focal segmental glomerulosclerosis. Pediatr Nephrol.
Jun 2007;22(6):834–839.
Smith JM, Corey L, Davis CL, McDonald RA. Primary
EBV infection in pediatric renal transplantation:
adolescents at higher risk for PTLD. Transplantation.
Jun 2007;83(11):1423–1428.
Smith JM, Dharnidharka V, Talley L, McDonald RA.
BK virus nephropathy in pediatric renal transplant
recipients: an analysis of the NAPRTCS registry.
Clin J Am Soc Nephrol. Sep 2007;2(5):1037–1042.
Smith JM, McDonald RA. Post-transplant management. In: Fine RN, Webber SA, Olthoff KM, Kelly DA,
Harmon W, eds. Pediatric Solid Organ Transplantation,
Second Edition. Oxford, U.K.: Blackwell. 2007.
Smith JM, Stablein DM, Munoz R, Hebert D,
McDonald RA. Contributions of the Transplant Registry:
the 2006 annual report of the North American Pediatric
Renal Trials and Collaborative Studies. Pediatr
Transplant. Jun 2007;11(4):366–373.
Stapleton FB. AMSPDC: current initiatives and future
opportunities. J Pediatr. Mar 2007;150(3):213–214.
Stapleton FB. What is a pediatrician and who is
asking? J Pediatr. Jun 2007;150(6):577–578.
Symons JM, Chua AN, Somers MJG, Baum MA,
Bunchman TE, Benfield MR, Brophy PD, Blowey D,
Fortenberry JD, Chand D, Flores FX, Hackbarth R,
Alexander SR, Mahan J, McBryde KD, Goldstein SL.
Demographic characteristics of pediatric CRRT: a
report of the prospective pediatric Continuous Renal
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Jul 2007;2(4):732–738.
Warady BA, Feneberg R, Verrina E, Flynn JT, MüllerWiefel DE, Besbas N, Zurowska A, Aksu N, Fischbach
M, Sojo E, Donmez O, Sever L, Sirin A, Alexander SR,
Schaefer F. Peritonitis in children who receive longterm peritoneal dialysis: a prospective evaluation
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2007;18(7):2172–2179.
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Woodahl EL, Hingorani SR, Wang J, Guthrie KA,
McDonald GB, Batchelder A, Li M, Schoch HG,
McCune JS. Pharmacogenomic associations in ABCB1
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Yamaguchi I, López-Guisa JM, Cai X, Collins SJ,
Okamura DM, Eddy AA. Endogenous urokinase lacks
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Am J Physiol Renal Physiol. Jul 2007;293(1):F12–F19.
Yonekawa K, Harlan J. Promises and limitations of
targeting adhesion molecules for therapy. In: Ley K, ed.
Adhesion Molecules: Function and Inhibition. Basel,
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Young G, Yonekawa K, Nakagawa PA, Blain RC,
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Blood Coagul Fibrinolysis. Mar 2007;18(2):97–103.
Young G, Yonekawa K, Nakagawa PA, Blain RC, Lovejoy
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ex vivo as measured using thromboelastography. Blood
Coagul Fibrinolysis. Sep 2007;18(6):547–553.
Zhang G, Kernan KA, Collins SJ, Cai X,
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Pulmonary Medicine
The Division of Pulmonary Medicine comprises 15 pediatric
pulmonologists and nurse practitioners. They focus on
exemplary clinical service and care, training and education
about respiratory conditions and their management, and
research on the prevention, diagnosis, understanding and
therapies of acute and chronic conditions affecting breathing
in childhood. The division provides comprehensive interdisciplinary care to children in the WAMI region. In 2007, more
than 2,600 children received care from clinicians of the
Division of Pulmonary Medicine at Seattle Children’s Hospital
and regional outreach clinics. The division is nationally
recognized for its expertise and research contributions.
The Division of Pulmonary Medicine includes a Cystic
Fibrosis Center, a Pediatric Sleep Disorders Center and an
Asthma Center; each conducts clinical, educational and
research activities. The division participates in multiple
national networks of research and care, including the
Cystic Fibrosis Therapeutics Development Network, the
Pediatric Interstitial Lung Disease Network, the Primary
Ciliary Dyskinesia Network and the Spine and Chest Wall
Deformity Network. The division also provides general
pulmonary evaluations for symptoms of cough, shortness
of breath, recurrent pneumonia, wheeze, chest pain and
exercise intolerance. Division staff members conduct
clinical and translational research, and research in
molecular genetics, microbiology, epidemiology and
health services and outcomes.
Current research focuses include the pathogenesis
and treatment of chronic airway infection in children with
cystic fibrosis, outcome measures of progressive airway
disease in infants with cystic fibrosis, inflammatory markers
in exhaled breath condensate among infants who wheeze,
Faculty
Gregory J. Redding
MD, Chief
Gregory J. Redding, MD, Chief
Edward R. Carter, MD
Maida Lynn Chen, MD
Jason S. Debley, MD, MPH
Julia C. Emerson, MD, MPH
Ronald L. Gibson, MD, PhD
Nicole Mayer Hamblett, PhD
Lucas R. Hoffman, MD, PhD
Yemiserach Kifle, MD
Susan G. Marshall, MD
Samuel M. Moskowitz, MD
Bonnie W. Ramsey, MD
Margaret Rosenfeld, MD, MPH
gene expression in airway epithelial cells from wheezy
infants, functional consequences of spine and chest wall
deformities in young children and epidemiology of sleep
disorders in high-risk populations such as children with
fetal alcohol syndrome and autism.
The division has an accredited pediatric pulmonary
fellowship program and participates in the sleep medicine
fellowship program administered by the University of
Washington School of Medicine. It has won numerous
teaching awards from the pediatric residency program and
medical students alike. Members of the pulmonary faculty
have served in leadership positions on regional and national
professional organizations. The Division of Pulmonary
Medicine remains productive, with its members publishing
more than 35 articles, chapters and national position papers
annually over the last three years.
Gregory J. Redding, MD, is chief of the Division of
Pulmonary Medicine at Seattle Children’s Hospital.
He is professor in the Department of Pediatrics and
director of the Pediatric Pulmonary Training Center
grant at the University of Washington School of
Medicine. He earned his MD from Stanford University.
He completed a pediatrics residency at Harbor
General/UCLA and a pediatric pulmonary fellowship
at the University of Colorado. Redding is committed
to improvement in children’s health and health care
through research, training, advocacy, clinical excellence
and improved systems of health care. He is an internationally recognized expert and leader in pediatric
217
Pulmonary Medicine
Spotlight on team member — Amber McAfee, MN, ARNP
A recent finding in the field of pediatric sleep is that children
with attention deficit hyperactivity disorder have more
periodic limb movements that disrupt their sleep, which is a
possible result of iron deficiency. Evaluating and successfully
treating children for issues such as this not only improves the
child’s sleep but also the entire family’s sleep — an outcome
that positively affects everyone’s daytime function!
pulmonary medicine, and president of the American
Lung Association of the Northwest. His current
interests include children with chest wall and spine
deformities, interstitial lung diseases, bronchiectasis
and asthma. Redding’s research interests include the
pathogenesis of chronic lung disease in developing
countries and disorders of the spine and thorax. His
training philosophy is to ensure critical thinking and
creative application of physiologic principles to clinical
problems. He is a consultant to the Maternal-Child
Health Bureau on national leadership training of
health-care professionals.
Edward R. Carter, MD, is attending physician at Seattle
School of Medicine. He is director of clinical services
for the division and head of the Pediatric Asthma
Program. His clinical areas of interest are asthma,
management of ventilator-dependent children,
pulmonary complications of neuromuscular disease
and cystic fibrosis. His research interests include
asthma management and outcomes and the treatment
of empyema. Carter is involved with teaching medical
students and pulmonary fellows on inpatient services
and in the clinics. He is a member of the steering
committee of the American College of Chest Physicians
Pediatric Chest Medicine Network. He was named
ARTist of the Month for professionalism and patientcentered care at Children’s.
218
Maida Lynn Chen, MD, is associate director of the
Pediatric Sleep Center, attending physician at Seattle
School of Medicine. She earned her MD at Northwestern
University and completed a pediatrics residency at
Rush–Presbyterian–St. Luke’s Medical Center in
Chicago, Ill. She completed her pediatric pulmonary
fellowship at Children’s Hospital Los Angeles, with
special focus on respiratory control and sleep medicine.
Her clinical interests center on sleep disorders in
infants, children and adolescents. Her research
interests focus on respiratory control disorders and
sleep-disordered breathing in special-needs populations,
including those with fetal alcohol spectrum disorders,
obesity and craniofacial anomalies. She is a member
of the American Academy of Pediatrics, American
Thoracic Society, American Academy of Sleep
Medicine and Sleep Research Society.
Jason S. Debley, MD, MPH, is attending physician and
director of the Flexible Fiberoptic Bronchoscopy
Service at Seattle Children’s Hospital and assistant
University of Washington School of Medicine. Debley
received his MD from Northwestern University
Medical School, and completed his pediatrics internship
and residency at Children’s Memorial Hospital in
Chicago, Ill. He completed his pediatric pulmonary
fellowship at Seattle Children’s and earned an MPH
from the University of Washington. He has clinical
expertise in asthma, cystic fibrosis, bronchopulmonary
dysplasia, restrictive lung diseases of childhood and
the management of acute and chronic respiratory
failure. Debley’s research program is focused on the
development and utilization of noninvasive measures
of airway inflammation in exhaled breath to assist
in the diagnosis and management of asthma, with
particular interest in improving methods of diagnosing
asthma in infants and toddlers and better understanding the origins of asthma in young children. Debley’s
research also includes translational/bench work
to better understand the role of the lower airway
epithelium in the development of asthma and airway
remodeling. In addition, Debley is actively involved
in medical student, resident and fellow training.
He received the pediatric research loan repayment
award from the NIH.
Pulmonary Medicine
Julia C. Emerson, MD, MPH, is epidemiologist at Seattle
Children’s Hospital and lecturer in the Department of
Medicine. Emerson’s research interests include the
natural history of early cystic fibrosis (CF) lung disease,
the design of clinical trials to improve CF therapies and
the development of better outcome measures for CF
clinical protocols. She also collaborates on studies of the
genotypic and phenotypic changes in airway pathogens
that may be associated with CF lung disease severity
and progression.
Ronald L. Gibson, MD, PhD, is director of the Cystic
Fibrosis Center, co-director of the pediatric pulmonary
fellowship program and attending physician at Seattle
Children’s Hospital; he is professor in the Department
Medicine. He earned his MD and PhD at Washington
University in St. Louis, and completed pediatrics
residency training and a fellowship in pediatric
pulmonology at the University of Washington. He is
committed to high-quality, multidisciplinary patient
care, small-group teaching, research and the acquisition
of new knowledge. His primary research focus is on
Pseudomonas aeruginosa airway infections in young
children with cystic fibrosis (CF). As a co-principal
investigator of the university’s Cystic Fibrosis
Therapeutics Development Center, he has been lead
and co-investigator for several phase I and phase II
clinical trials involving novel antimicrobial agents,
anti-inflammatory compounds and modulators of ion
transport. Gibson is director of the clinical core of the
university’s CF research development program with
the goal of catalyzing collaborations between local
basic and clinical investigators.
Nicole Mayer Hamblett, PhD, is research assistant
professor in the Division of Pulmonary Medicine at
Seattle Children’s Hospital and in the Department of
Medicine. Hamblett is director of Biostatistics and
Clinical Data Management at the Cystic Fibrosis
Therapeutics Development Network Coordinating
Center. Her research interests include the design and
analysis of clinical trials, with emphasis in the pediatric
and orphan disease setting. She is involved in the
development of new clinical outcome measures for
cystic fibrosis and, in particular, the validation of
biomarkers to enable early evaluation of new therapies.
Hamblett also provides statistical training to clinical
researchers and scientists, with applications to both
the preclinical and clinical fields.
Lucas R. Hoffman, MD, PhD, is attending physician at
Washington School of Medicine. Hoffman’s research
focuses on chronic lung infections, particularly in
patients with cystic fibrosis (CF). Chronic infections
have proven to be particularly difficult to treat with
standard antibiotic therapies. For example, the lung
infections in children with CF are not improved by
antibiotics to the degree we would expect. Hoffman
is working to understand why chronic lung infections
are so difficult to treat and how to improve current
treatments. Hoffman is also dedicated to the care of
patients and to teaching medical students, residents
and fellows. His areas of clinical expertise include
asthma, CF, bronchopulmonary dysplasia, restrictive
lung diseases and the pulmonary complications of
neuromuscular disease. He is a member of the American
Academy of Pediatrics, the American Thoracic Society
and the American Society for Microbiology.
Yemiserach Kifle, MD, is medical director of the
Pediatric Sleep Center at Seattle Children’s Hospital
She is also associate director of the Pediatric Pulmonary
Leadership Training Center. Her work focuses on
diagnosis, management and follow-up of patients with
sleep disorders, including obstructive sleep apnea,
obstructive hypoventilation, behavioral insomnia of
childhood, restless leg syndrome/periodic limb movement
disorder, delayed sleep phase syndrome and narcolepsy.
Her research interest is in looking at cognitive function
of children with sleep apnea before and after treatment
with continuous positive airway pressure (CPAP).
Her other area of interest is the prevalence of sleep
disturbance in children with autism, a project that is
part of the national Autism Treatment Network.
Susan G. Marshall, MD, is attending physician at Seattle
Children’s Hospital and associate dean for curriculum
She earned her MD at the University of California,
Los Angeles, and completed her pediatrics residency
and fellowship at Children’s. Marshall continues to
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Pulmonary Medicine
participate in the Chest Clinic on a weekly basis. Her
clinical interests span the entire scope of pulmonary
medicine, but she is especially involved with patients
suffering from neuromuscular disease and cystic fibrosis,
and those with psychosocial issues. At the school of
medicine, she is involved in teaching, educational planning and curriculum development. In the pulmonary
division she works with medical students, residents,
fellows and faculty.
Samuel M. Moskowitz, MD, is attending physician at
Seattle Children’s Hospital, a full member of the Center
for Clinical and Translational Research at Seattle
Children’s Hospital Research Institute and assistant
professor in the Department of Pediatrics at the University of Washington School of Medicine. His clinical
interests include all aspects of pediatric pulmonary
medicine. His educational interests include training
undergraduate students in basic and translational
research, training medical students and residents in
pediatric pulmonary medicine and providing career
guidance to pediatric residents and subspecialty fellows.
He serves as a member of the Pediatric Residency
Committee at Children’s. He also serves as co-chair
of the National Resource Center Committee of the
Cystic Fibrosis Therapeutics Development Network.
His research program focusing on the role of bacterial
infections and antibiotic resistance in cystic fibrosis
lung disease includes both basic and translational
research projects, and is funded by the Cystic Fibrosis
Foundation and the National Institute of Allergy and
Infectious Diseases.
Bonnie W. Ramsey, MD, is director of the Center for
Clinical and Translational Research at Seattle Children’s
Hospital Research Institute. At Children’s, she serves
as associate director of the Pediatric Clinical Research
Center, which she established, and as attending physician
in pulmonary medicine. She is professor and vice-chair
for research in the Department of Pediatrics and holds
the Endowed Chair in Cystic Fibrosis at the University
of Washington School of Medicine. Ramsey is a member
of the American Pediatric Society and the Association
of American Physicians. She earned her MD from
Harvard Medical School. She did pediatrics residency
training at Boston Children’s Hospital and was a
resident and fellow at Children’s. Her career has
focused on clinical care and research in the field of
cystic fibrosis (CF). She is internationally recognized
for her work in developing new therapies for patients
220
with CF, and she directs the CF Therapeutics Development Network. She is also interested in the ethics of
pediatric clinical research and has served on two
Institute of Medicine committees focused on this
topic. Ramsey has used her expertise in clinical and
translational research to help develop infrastructure for
research involving pediatric participants at the hospital.
Margaret Rosenfeld, MD, MPH, is attending physician
Washington School of Medicine. Her clinical interests
focus on the diagnosis and management of respiratory
illnesses in children of all ages. Her research program
focuses on the assessment and treatment of early
cystic fibrosis (CF) lung disease, including infant and
preschool lung function tests, determining risk factors
for early acquisition of Pseudomonas aeruginosa, and
clinical trials in infants with CF. She is also an investigator in a national network investigating rare disorders
of mucociliary clearance, including primary ciliary
dyskinesia. She is medical director of the Pediatric
Clinical Research Center, associate director of the
Seattle Children’s Hospital Research Institute Center
for Clinical and Translational Research, co-director of
the Children’s Hospital Fellows’ College and medical
director of the Pulmonary Function Laboratory. She
serves as CF consultant to the Washington State
Newborn Screening Program.
Benjamin S. Wilfond, MD, is director of the Treuman
Hospital and professor and chief of the Division of
Bioethics in the Department of Pediatrics at the
also adjunct professor in the Department of Medical
History and Ethics. Wilfond attends in the Chest Clinic
in the Division of Pulmonary Medicine at Children’s.
He is the co-director of the Regulatory Support and
Bioethics Core for the Institute of Translational Health
Sciences (ITHS) and coordinates the ITHS Research
Bioethics Consult Service. He earned his MD from the
University of Medicine and Dentistry of New Jersey–
New Jersey Medical School. He completed his pediatric
residency and his fellowship in pediatric pulmonology
and medical ethics at the University of Wisconsin.
He has held faculty appointments at the University
of Arizona, National Institutes of Health and Johns
Hopkins University. He conducts research on ethical
and policy issues related to genetic testing, genetic
Pulmonary Medicine
research and pediatrics research. He has recently worked
on issues related to newborn screening, disclosure of
genetic research results and pediatric biobanks. He
is a member of the Ethics Subcommittee of the FDA
Pediatric Advisory Committee and the National
Children’s Study Federal Advisory Committee.
AWARDS AND HONORS
Interscience Conference on Antimicrobial Agents and
Chemotherapy Young Investigator Award. American
Society of Microbiology.
Kalobios -173 CSA. Kalobios, Inc. $51,800.
Multicenter, multinational, randomized, placebocontrolled trial of azithromycin in participants with
cystic fibrosis 6–18 years old, culture negative for
Pseudomonas aeruginosa. Cystic Fibrosis Foundation.
$2,290,588.
Novartis 118 task orders 1,2,4,6. Novartis Pharmaceuticals
Corporation. $82,066.
Gregory J. Redding, MD
Pediatric Pulmonary Leadership Training Center.
Health Resources and Services Administration.
$388,450.
A pilot study to evaluate inhaled 7% hypertonic saline
in cystic fibrosis infants. Cystic Fibrosis Foundation.
$116,561.
Lifetime Achievement Award. University of Washington
General Clinic Research Center.
Spirometry in preschool CF patients. Cystic Fibrosis
Dr. Alvin J. Thompson Award. Northwest Association
for Biomedical Research.
Continuing
Kossoff Lectureship. Columbia University.
RESEARCH FUNDING
New
A multicenter, double-blind, placebo-controlled,
randomized efficacy and safety study of denufosol
tetra sodium (INS37217) inhalation solution in
patients with cystic fibrosis. Inspire. $100,475.
Aztreonam lysinate for inhalation in cystic fibrosis
patients. Gilead Sciences. $73,334.
Noninvasive measures in wheezy infants and toddlers.
Cystic Fibrosis Centers. Cystic Fibrosis Foundation.
$103,090.
Therapeutics Development Center. Cystic Fibrosis
Pediatric Pulmonary Training Center. HRSA/DHHS.
$71,599.
DNA collections for gene modifier studies. Cystic
Fibrosis Foundation. $256,323.
Standard vs. biofilm susceptibility testing in cystic
fibrosis. Cystic Fibrosis Foundation. $228,355.
Polymyxin-resistant pseudomonas in CF lung infection.
NIH/NIAID. $631,434.
Molecular Therapy Core Centers. NIH/NIDDK.
$870,217.
221
Pulmonary Medicine
A phase 2 study of PTC124 as an oral treatment for
nonsense-mutation-mediated cystic fibrosis. PTC
Therapeutics. $363,570.
Children’s administrative and clinical cores — molecular
biology in CF. Cystic Fibrosis Foundation. $51,089.
Edward R. Carter, MD
Bronchiolitis: what it is and isn’t and how we treat it.
Common problems in pediatric pulmonology. Practical
Pediatrics Seminar. Tri-Cities, Wash. April 2007.
Early antipseudomonal therapy in cystic fibrosis.
NHLBI/NIH/DHHS. $1,234,448.
Management of asthma exacerbations. Washington
State Asthma Coalition. SeaTac, Wash. May 2007.
Efficacy and safety of intermittent antimicrobial
therapy for the treatment of new onset Pseudomonas
aeruginosa airway infection in young patients with
cystic fibrosis (early antipseudomonal therapy in CF)
EPIC Observational. Cystic Fibrosis Foundation.
$418,650.
Making decisions on interventions in severely disabled
children — a physician’s perspective. Bioethics Seminar
on Growth Attenuation in Severely Disabled Children.
Seattle, Wash. May 2007.
Efficacy and safety of intermittent antimicrobial
therapy for the treatment of new onset Pseudomonas
aeruginosa airway infection in young patients with
cystic fibrosis (early antipseudomonal therapy in CF)
EPIC Clinical. Cystic Fibrosis Foundation. $720,274.
General Clinical Research Center–pediatric satellite.
NIH/DHHS. $1,204,177.
General Clinical Research Center–pediatric satellite.
NIH/DHHS. $953,431.
Therapeutics Development Network–coordinating
center. Cystic Fibrosis Foundation. $3,419,133.
Therapeutics Development Network–GCRC. Cystic
Fibrosis Foundation. $749,000.
Molecular Therapy Core Center–human core.
NIDDK. $61,176.
EPIC Observational Study. Cystic Fibrosis Foundation.
$442,126.
Genetic disorders of mucociliary clearance.
NIH/DHHS. $80,568.
222
Baseline asthma severity, controller medication use,
documentation of asthma education and frequency of
pulmonary consultation in children hospitalized with
acute asthma. Annual meeting of the American College
of Chest Physicians. Chicago, Ill. October 2007.
Update on the 2007 NHLBI asthma guidelines. Twentyseventh Annual F. Richard Dion Pediatric Update.
Seattle, Wash. December 2007.
Analysis of exhaled breath to assist in the diagnosis
and management of asthma: exhaled nitric oxide
and biomarkers in breath condensate as clinical and
research tools. North Pacific Pediatric Society Meeting.
Shoreline, Wash. March 2007.
Reproducibility of a standardized method of exhaled
nitric oxide (ENO) measurement in infants using a
single-breath technique (co-presenter). Airway affects
on exhaled breath condensate (EBC) composition
(co-presenter). Cysteinyl leukotriene storage stability
in exhaled breath condensate (EBC) (co-presenter).
American Thoracic Society International Conference.
San Francisco, Calif. May 2007.
Update on emerging therapies in the management
of CF lung disease. Seventh Annual New Horizons in
Pediatrics. Madigan Army Medical Center. Tacoma,
Pulmonary Medicine
Pseudomonas workshop (co-chairperson). Williamsburg
Cystic Fibrosis Conference. Williamsburg, Va. June 2007.
Cystic Fibrosis Foundation Leadership and Learning
Collaborative V — a national continuous quality
improvement project to improve pulmonary outcomes
in CF (panelist). Anaheim, Calif. October 2007.
Nicole Mayer Hamblett, PhD
Statistics for laboratory research. Short Course for
Pediatric Fellows and Faculty, Seattle Children’s
Hospital. Seattle, Wash. 2007.
The biofilm PK-PD study, aka modeling and optimization
of anti-biofilm drug regimens for cystic fibrosis lung
infection (MOAB) (research seminar). Division
of Pediatric Infectious Diseases, Seattle Children’s
Hospital. Seattle, Wash. September 2007.
Colistin-resistant pseudomonas in CF lung infection
(research seminar). Children’s Hospital Medical Center.
Cincinnati, Ohio. November 2007.
Ninth Annual CF TDN Spring Meeting (organizer and
leader). Seattle, Wash. April 2007.
Polymicrobial interactions (presenter and moderator).
2007 North American Cystic Fibrosis Foundation
Conference. Anaheim, Calif. October 2007.
Cystic fibrosis (CF): a paradigm for translational
medicine. Pediatric Grand Rounds. Rochester, N.Y.
April 2007.
Autism and sleep disturbance. Maternal Child Health
Bureau Annual Meeting. Washington, D.C. March 2007.
What is new in pulmonary management of cystic fibrosis
(WWAMI visiting professor). Port Angeles, Wash.
July 2007.
Pediatric sleep disorders. Pediatric residency program,
Addis Ababa University. Addis Ababa, Ethiopia.
April 2007.
Clinical outcome measures in CF (symposium leader).
NACF Conference. Anaheim, Calif. October 2007.
Hickam and Occam meet Murphy at Pizza Hut.
Professor’s Rounds Presentation, Department of
Pediatrics, University of Vermont School of Medicine.
Burlington, Vt. March 2007.
Inhaled antibiotic use among North American cystic
fibrosis patients. American Thoracic Society International
Conference. San Francisco, Calif. May 2007.
Clinical and genetic aspects of cystic fibrosis (lecture).
Introduction to Human and Medical Genetics,
University of Washington School of Medicine.
Seattle, Wash. June 2007.
Polymyxin-resistant pseudomonas in CF lung infection
(research seminar). Division of Pediatric Infectious
Diseases, Seattle Children’s Hospital. Seattle, Wash.
June 2007.
Antibiotic resistance in cystic fibrosis lung infection:
implications and strategies (research seminar). Vermont
Lung Center, University of Vermont School of Medicine.
Burlington, Vt. July 2007.
Novel therapeutic approaches to treatment of cystic
fibrosis lung disease: the road to a cure (Kossoff lecture
and visiting professor). Columbia University. New
York, N.Y. October 2007.
Drug development in orphan diseases: the power of a
clinical trials network in cystic fibrosis (Grand Rounds
and visiting professor). Rotterdam, Netherlands.
November 2007.
Developing a clinical trials network. The European
Society for Cystic Fibrosis Meeting. Leuven, Belgium.
November 2007.
Gregory J. Redding, MD
Spine and chest wall disorders in children and chronic
productive cough in childhood. American College of
Chest Physicians, Annual Pediatric Pulmonary Update.
San Antonio, Texas. March 2007.
Thoracic insufficiency of childhood and preschool
pulmonary function testing in children (visiting
professor). Children’s Hospital of Cincinnati.
Cincinnati, Ohio. April 2007.
223
Pulmonary Medicine
Bronchiectasis in Alaskan native children. Canadian
Pediatric Respiratory Society. San Francisco, Calif.
May 2007.
Preschool pulmonary function techniques. Northwest
Pediatric Pulmonary Society. Seattle, Wash. June 2007.
Heterogeneity of asthma in childhood. Pediatric Grand
Rounds, Alaska Native Medical Center. Anchorage,
Alaska. June 2007.
Non-CF-related bronchiectasis in children: lessons
learned from Alaska and Australia. Grand Rounds,
Richard Gutierrez Children’s Hospital. Buenos Aires,
Argentina. August 2007.
Gastroesophageal reflux in children: a pulmonary
perspective (WWAMI visiting professor). Pediatric
Grand Rounds, Sacred Heart Hospital. Spokane, Wash.
October 2007.
224
Pulmonary exacerbations. Cystic Fibrosis Learning and
Leadership Collaborative V. Bethesda, Md. March 2007.
Cystic fibrosis newborn screening. Grand Rounds,
Valley Medical Center. Renton, Wash. May 2007.
Cystic fibrosis epidemiology: an update. Italian Cystic
Fibrosis Conference. Verona, Italy. May 2007.
Pulmonary interventions in infants with CF diagnosed
by newborn screening. Cystic Fibrosis Foundation.
Bethesda, Md. July 2007.
Proposal for a CF infant clinical research network. CF
Newborn Screening Special Interest Group Meeting,
the North American Cystic Fibrosis Conference.
Anaheim, Calif. October 2007.
National asthma care guidelines update. Northwest
Pediatric Pulmonary Society. Seattle, Wash. October 2007.
Experience with the rubric in Washington. Large U.S.
cohort of young pseudomonas-negative CF patients:
mild lung disease, heterogeneous management,
pulmonary guidelines and care. North American Cystic
Fibrosis Conference. Anaheim, Calif. October 2007.
Early onset scoliosis. Pulmonary evaluation of young
children with early onset scoliosis. Impact of early
onset scoliosis on pulmonary function and postnatal
development. International Conference on Early
Onset Scoliosis. Madrid, Spain. November 2007.
Ethical issues in pediatric outcomes research. Pediatric
Trauma Care: A Workshop to Develop a National Study
on the Costs and Outcomes from Pediatric Trauma.
Washington, D.C. March 9, 2007.
Thoracic insufficiency of childhood and preschool
pulmonary function testing (visiting professor).
Oregon Health & Science University. Portland, Ore.
December 2007.
Disclosing incidental findings in pediatrics. Managing
Incidental Findings in Human Subjects Research:
From Imaging to Genomics. University of Minnesota.
Minneapolis, Minn. May 1, 2007.
Cystic fibrosis newborn screening: what does the primary
care physician need to know? CME presentation at
Pediatric Associates. Bellevue, Wash. February 2007.
May 16, 2007.
Infant pulmonary function testing: raised volume
technique. Preventing respiratory sequelae in children
diagnosed with cystic fibrosis by newborn screening.
European Respiratory Society Research Seminar.
Leuven, Belgium. February 2007.
Show me the money: financial considerations in
responding to parental wishes, navigating conflicts
when parents and providers disagree about health care.
Third Annual Pediatric Bioethics Conference. Treuman
Katz Center for Pediatric Bioethics. Seattle, Wash.
July 13–14, 2007.
Pulmonary Medicine
Ethical issues in pediatric research. Western IRB
seminar. Olympia, Wash. August 2007.
Family perspectives on returning research results
(moderator). ASCO/COG Symposium on Ethical
Considerations in Disclosing Study Results to
Research Participants. Denver, Colo. Oct. 16, 2007.
Ashley revisited: is growth attenuation ever justified in
a profoundly disabled child? (moderator). American
Society of Bioethics and Humanities Annual Meeting.
Washington, D.C. Oct. 19, 2007.
Parent-provider conflicts in children with chronic
illness. Pediatric Pulmonary Center Seminar, University
of Arizona. Tucson, Ariz. Nov. 16, 2007.
PUBLICATIONS
Birnkrant DJ, Panitch HB, Benditt JO, Boitano LJ,
Carter ER, Cwik VA, Finder JD, Iannaccone ST,
Jacobson LE, Kohn GL, Motoyama EK, Moxley RT,
Schroth MK, Sharma GD, Sussman MD. American
College of Chest Physicians consensus statement on the
respiratory and related management of patients with
Duchenne muscular dystrophy undergoing anesthesia
or sedation. Chest. Dec 2007;132(6):1977–1986.
Brogan T, Mellema J, Martin L, Redding GJ, Glenny R.
Temporal heterogeneity of regional pulmonary blood
flow in piglets. Pediatr Res. Oct 2007;62(4):434–439.
Clancy JP, Rowe SM, Bebok Z, Aitken ML, Gibson RL,
Zeitlin P, Berclaz P, Moss R, Knowles MR, Oster RA,
Mayer Hamblett N, Ramsey BW. No detectable
improvements in CFTR by nasal aminoglycosides in
CF patients with stop mutations. Am J Respir Cell
Mol Biol. Jul 2007;37(1):57–66.
Comeau AM, Accurso FJ, White TB, Campbell PW 3rd,
Hoffman G, Parad RB, Wilfond BS, Rosenfeld M,
Sontag MK, Massie J, Farrell PM, O’Sullivan BP.
Guidelines for implementation of cystic fibrosis newborn
screening programs: Cystic Fibrosis Foundation workshop report. Pediatrics. Feb 2007;119(2):e495–e518.
D’Argenio DA, Wu M, Hoffman LR, Kulasekara HD,
Deziel E, Smith EE, Nguyen H, Ernst RK, Larson
Freeman TJ, Spencer DH, Brittnacher M, Hayden
HS, Selgrade S, Klausen M, Goodlett DR, Burns JL,
Ramsey BW, Miller SI. Growth phenotypes of
Pseudomonas aeruginosa lasR mutants adapted to
the airways of cystic fibrosis patients. Mol Microbiol.
Apr 2007;64(2):512–533.
Davis SD, Brody A, Emond M, Rosenfeld M. Endpoints
for clinical trials in young children with cystic fibrosis.
Proc Am Thorac Soc. Aug 2007;4(4):418–430.
Debley JS, Hallstrand TS, Monge T, Ohanian A,
Redding GJ, Zimmerman J. Methods to improve
measurement of cysteinyl leukotrienes in exhaled
breath condensate from subjects with asthma
and healthy controls. J Allergy Clin Immunol.
Nov 2007;120(5):1216–1217.
Deterding RR, Lavange LM, Engels JM, Mathews DW,
Coquillette SJ, Brody AS, Millard SP, Ramsey BW.
Phase 2 randomized safety and efficacy trial of
nebulized denufosol tetrasodium in cystic fibrosis.
Am J Respir Crit Care Med. Aug 2007;176(4):362–369.
Dovey M, Aitken ML, Emerson JC, McNamara S, Waltz
DA, Gibson RL. Oral corticosteroid therapy in cystic
fibrosis patients hospitalized for pulmonary exacerbation:
a pilot study. Chest. Oct 2007;132(4):1212–1218.
Ernst RK, Moskowitz SM, Emerson JC, Kraig GM,
Adams KN, Harfey MD, Ramsey BW, Speert D,
Burns JL, Miller SI. Unique lipid A modifications in
Pseudomonas aeruginosa isolated from the airways
of patients with cystic fibrosis. J Infect Dis. Oct 1
2007;196(7):1088–1092.
Gerald LB, Sockrider MM, Grad R, Bender BG, Boss
LP, Galant SP, Gerritsen J, Joseph CL, Kaplan RM,
Madden JA, Mangan JM, Redding GJ, Schmidt DK,
Schwindt CD, Taggart VS, Wheeler LS, Van Hook KN,
Williams PV, Yawn BP, Yuksel B, American Thoracic
Society. An official ATS workshop report: issues in
screening for asthma in children. (Redding GJ,
co-author on behalf of the ATS Ad Hoc Committee
on Issues in Screening for Asthma in Children.)
Proc Am Thorac Soc. May 2007;4(2):133–141.
225
Pulmonary Medicine
Gibson RL, Emerson JC, Mayer Hamblett N, Burns
JL, McNamara S, Accurso FJ, Konstan MW, Chatfield
BA, Retsch-Bogart GZ, Waltz DA, Acton J, Zeitlin P,
Hiatt P, Moss R, Williams J, Ramsey BW. Duration of
treatment effect after tobramycin solution for inhalation
in young children with cystic fibrosis. Pediatr Pulmonol.
Jul 2007;42(7):610–623.
Goss CH, Mayer Hamblett N, Kronmal RA, Williams
J, Ramsey BW. Laboratory parameter profiles among
patients with cystic fibrosis. J Cyst Fibrosis. Apr
2007;6(2):117–123.
Hallstrand TS, Debley JS, Farin FM, Henderson
WR. Role of MUC5AC in the pathogenesis of exerciseinduced bronchoconstriction. J Allergy Clin Immunol.
May 2007;119(5):1092–1098.
Henderson GE, Churchill LR, Davis AM, Easter MM,
Grady C, Joffe S, Kass N, King NM, Lidz CW, Miller FG,
Nelson DK, Peppercorn J, Rothschild BB, Sankar P,
Wilfond BS, Zimmer CR. Clinical trials and medical
care: defining the therapeutic misconception. PLoS
Med. Nov 27 2007;4(11):e324.
Hentschel-Franks K, Bebok Z, Rowe SM, Gibson RL,
Aitken M, Zeitlin P, Berclaz Y, Knowles M, Foy G, Moss
R, Oster R, Ramsey BW, Sorscher EJ, Bedwell DM,
Clancy JP. No detectable improvements in CFTR by
nasal aminoglycosides in CF patients with stop mutations.
Am J Resp Cell Mol Biol. Jul 2007;37(1):57–66.
Hoffman LR, D’Argenio DA, Bader MW, Miller
SI. Microbial recognition of antibiotics: ecological,
physiological and therapeutic implications. Microbe.
2007;2(4):175–182.
Mayer Hamblett N, Aitken ML, Accurso FJ, Kronmal
RA, Konstan MW, Burns JL, Sagel SD, Ramsey BW.
Association between pulmonary function and sputum
biomarkers in cystic fibrosis. Am J Respir Crit Care
Med. Apr 2007;175(8):822–828.
Mayer Hamblett N, Ramsey BW, Kronmal RA.
Advancing outcome measures for the new era of drug
development in cystic fibrosis. Proc Am Thorac Soc.
Aug 2007;4(4):370–377.
226
Miller SI, Hoffman LR, Sanowar S. Did bacterial
sensing of host environments evolve from sensing
within microbial communities? Cell Host Microbe.
Apr 2007;1(2):85–87.
Myers RE, Weinberg DS, Manne SL, Sifri R, Cocroft
J, Kash K, Wilfond BS. Genetic and environmental
risk assessment for colorectal cancer risk in primary
care practice settings: a pilot study. Genet Med. Jun
2007;9(6):378–384.
Nguyen D, Emond MJ, Mayer Hamblett N, Saiman L,
Marshall BC, Burns JL. Clinical response to azithromycin
in cystic fibrosis correlates with in vitro effects on
Pseudomonas aeruginosa phenotypes. Pediatr Pulmonol.
Jun 2007;42(6):533–541.
Pearce N, Aït-Khaled N, Beasley R, Mallol J, Keil U,
Mitchell E, Robertson C, ISAAC Phase III Study
Group (Redding GJ, member). Worldwide trends in
the prevalence of asthma symptoms: phase III of
the International Study of Asthma and Allergies in
Childhood (ISAAC). Thorax. Sep 2007;62(9):758–766.
Ramsey BW. Outcome measures for development of
new therapies in cystic fibrosis: are we making progress
and what are the next steps? Proc Am Thorac Soc.
Aug 2007;4(4):367–369.
Redding GJ, Song K, Inscore S, Effmann E, Campbell
R. Lung function asymmetry in children with congenital
and infantile scoliosis. Spine J. Epub Jun 21 2007.
Rosenfeld M. Endpoints for cystic fibrosis clinical
trials: one size does not fit all. Proc Am Thorac Soc.
Aug 2007;4(4):299–301.
Striegl AM, Chen ML. Management of obstructive
sleep apnea in patients with congenital heart disease
and Fontan procedures. Sleep Med. 2007;8:537–538.
Tablizo MA, Jacinto P, Parsley D, Chen ML,
Ramanathan R, Keens TG. Supine sleeping position
does not cause clinical aspiration in neonates in
hospital newborn nurseries. Arch Ped Adolesc Med.
May 2007;161(5):507–510.
Pulmonary Medicine
Treggiari MM, Rosenfeld M, Retsch-Bogart G,
Gibson RL, Ramsey BW. Approach to eradication of
initial Pseudomonas aeruginosa in children with cystic
fibrosis. Pediatr Pulmonol. Sep 2007;42(9):751–756.
Veenstra DL, Harris J, Gibson RL, Rosenfeld M,
Burke W, Watts C. Pharmacogenomic testing to
prevent aminoglycoside-induced hearing loss in
cystic fibrosis patients: potential impact on clinical,
patient and economic outcomes. Genet Med. Oct
2007;9(10):695–704.
Waldhausen JHT, Redding GJ, Song KM. Vertical
expandable prosthetic titanium rib for thoracic
insufficiency syndrome — a new method to treat an
old problem. J Pediatr Surg. Jan 2007;42(1):76–80.
Wilfond BS. The Ashley case: the public response
and policy implications. Hastings Cent Rep.
Sep–Oct 2007;37(5):12–13.
Wilfond BS. Ethical considerations about
observational research in children. J Trauma.
Dec 2007;63(6 Suppl):S146–S151.
227
Department of Surgery
228
2007 was a successful year for the Department of Surgery, marked by enormous growth
in several divisions and a significant overall increase in surgical cases performed.
Recruitment: New faculty members recruited in 2007 included Dr. Mike McMullen to
Cardiothoracic Surgery; Dr. Martin Koyle as chief of Urology; Dr. Margarett Shnorhavorian
to Urology; Dr. Eunice Chen to Otolaryngology; Dr. Craig Birgfeld to Plastic and Craniofacial
Surgery; and Drs. Ken Gow and John Meehan (who joined us in 2008) to General Surgery.
Robert S. Sawin, MD
Surgeon-in-Chief
Leadership Changes: New leaders were appointed in three divisions in the Department
of Surgery. After a dozen years of strong leadership and creating one of the preeminent
craniofacial surgery programs in the world, Dr. Joseph Gruss groomed his successor,
Dr. Richard Hopper, who became the division chief in July 2007. In Neurosurgery,
Dr. Anthony Avellino succeeded Dr. Richard Ellenbogen as chief of Pediatric Neurosurgery.
A national search successfully attracted Dr. Martin Koyle, the former chief of Urology
at Denver Children’s Hospital, to lead our Pediatric Urology Division.
Focus on Quality Improvement: As part of Seattle Children’s continuous performance
improvement (CPI) work, several divisions within the Department of Surgery created
work plans to establish the focus of their work for the next five to 10 years.
The department’s participation in several hospitalwide projects has resulted in a significant
decrease in both surgical site infection (SSI) and bloodstream infection (BSI).
The department also actively collaborated in a statewide quality improvement project that
focused on using evidence-based practices to reduce surgical complications. Dr. Adam
Goldin has been a leader in this process and has helped modify the database to permit
better analysis of pediatric patients.
Scholarly Activity and Research: Surgical faculty frequently published in peer-reviewed
journals in 2007. Basic and translational research was active in almost every division.
Extramural funding supported research in Cardiac Surgery, Neurosurgery, Oral
and Maxillofacial Surgery and Urology. Additional research focuses on outcomes
and on simulation.
International Outreach: Several faculty participated in the hospital’s international health
initiatives. Drs. Richard Grady and Richard Hopper both led significant outreach programs
to Mozambique and West Africa, respectively. These programs focused on training local
surgeons in their areas of expertise and helping develop infrastructure for those surgeons
to sustain the specialized surgical care.
229
Cardiothoracic Surgery
The Division of Cardiothoracic Surgery treats neonates,
infants, children and teens with congenital heart disease.
We perform open and closed heart surgeries specializing in
single-stage corrective procedures. Services provided by
our team include: new and innovative surgical procedures,
consultation and surgery for patients with a prenatal
diagnosis, surgical repair of complex defects in neonates,
including premature and low-birth-weight infants, treating
newborns with hypoplastic left heart syndrome and other
complex defects, as well as heart transplantation (including
cardiac assist devices). We have a dedicated cardiac
intensive care unit with state-of-the-art equipment and an
exceptional nursing staff for all cardiac surgical patients.
Areas of research include areas of pediatric heart failure
such as developing an implantable ventricular assist device
and studying intracellular energetics of myocytes relating to
the pathophysiology of the failing heart.
Faculty
Gordon A. Cohen, MD, PhD, Chief
D. Michael McMullan, MD
Lester C. Permut, MD
Gordon A. Cohen
MD, PhD, Chief
230
Gordon A. Cohen, MD, PhD, is chief of the Division of
Cardiothoracic Surgery at Seattle Children’s Hospital
and professor of pediatric cardiothoracic surgery at
is co-director of Children’s Heart Center and holds the
Sam and Althea Stroum Endowed Chair in Pediatric
Cardiovascular Surgery. He received his MD from
Tulane University School of Medicine; he earned an
MS and a PhD in pharmacology from the University of
California, Los Angeles. He completed residencies in
cardiothoracic surgery at the University of Washington
School of Medicine and in general surgery at UCLA
Medical Center. Cohen has been consulting cardiothoracic surgeon at the Great Ormond Street Hospital for
Children in London and senior lecturer at the Institute
of Child Health at University College London. His
interests include complex neonatal repairs, pediatric
heart and lung transplant, mechanical cardiac assistance
and heart failure. He is conducting research on a
pediatric ventricular assist device (VAD) program.
D. Michael McMullan, MD, is a cardiothoracic surgeon
and surgical director of ECMO (extra-corporeal
membrane oxygenation) at Seattle Children’s Hospital
and assistant professor of surgery at the University
of Washington School of Medicine. After earning his
MD at the University of Texas Southwestern Medical
School, he completed a general surgery residency at
the University of Texas, a thoracic surgery residency at
the University of Washington and a pediatric cardiac
surgery fellowship at the Royal Children’s Hospital in
Melbourne, Australia. His clinical interests include
pediatric and neonatal heart surgery and mechanical
cardiopulmonary support. His research interests
include developing strategies to improve patient
safety during prolonged mechanical cardiopulmonary
support. He is interested in international health care
and is actively involved with several organizations that
work with local physicians to improve medical care for
children with heart disease in developing countries.
Lester C. Permut, MD, is attending surgeon in pediatric
cardiothoracic surgery at Seattle Children’s Hospital
and associate professor in the Department of Surgery
Permut received his MD from Boston University
School of Medicine and did postgraduate training
at Beth Israel Hospital in Boston and at the UCLA
Medical Center. He has completed the University of
Washington’s teaching scholars program. He is director
of education for the pediatric cardiac surgery program
and cardiothoracic surgery lecturer for the anesthesia
and pediatric ICU fellowship programs. His clinical
interests include pediatric cardiac surgery and complex
congenital heart defects.
AWARDS AND HONORS
Gordon A. Cohen, MD, PhD
Donald B. Doty Educational Award. Western Thoracic
Surgical Association.
Spotlight on team member — Greg Crockett, BS, CCP
I’m particularly excited about our participation in a
multi-center clinical trial to study the Berlin EXCOR Pediatric
Ventricular Assist Device — a surgically implanted device
that allows children with heart failure to move freely and,
possibly, live at home while awaiting heart transplantation.
The Berlin device could be another step toward reducing the
need for extracorporeal life support, which requires children
to be intubated and sedated in intensive care.
RESEARCH FUNDING
Continuing
Assessing the impact of pediatric ventricular assist
device on cardiac cellular function. McMillen
PUBLICATIONS
Baden H, Jeffries H, Cohen GA. Extracorporeal
support (ECMO) in children. In: Yuh DD, Vricella
LA, Baumgartner WA, eds. Johns Hopkins Manual
of Cardiothoracic Surgery. New York, N.Y.: McGrawHill. 2007.
Banki F, Salerno C, Cohen GA. Congenital anomalies
of the coronary circulation. In: Yuh DD, Vricella LA,
Baumgartner WA, eds. Johns Hopkins Manual of
Cardiothoracic Surgery. New York, N.Y.: McGrawHill. 2007.
231
Cohen GA, Stevenson JG. Intraoperative echocardiography for atrioventricular canal: decision-making for
surgeons. Semin Thorac Cardiovasc Surg Pediatr Card
Surg Annu. 2007;47–50.
Eisses MJ, Geiduschek JM, Jonmarker C, Cohen GA,
Chandler WL. Effect of polymer coating (poly 2methoxyethylacrylate) of the oxygenator on hemostatic
markers during cardiopulmonary bypass in children.
J Cardiothorac Vasc Anesth. Feb 2007;21(1):28–34.
Husain SA, Mokadam NA, Permut LC, Rodefeld MD.
Coarctation of the aorta and interrupted aortic arch.
In: Yuh DD, Vricella LA, Baumgartner WA, eds. Johns
Hopkins Manual of Cardiothoracic Surgery. New York,
N.Y.: McGraw-Hill. 2007.
Kronman MP, Baden HP, Jeffries HE, Heath J,
Cohen GA, Zerr DM. An investigation of Aspergillus
cardiac surgical site infections in 3 pediatric patients.
Am J Infect Control. Jun 2007;35(5):332–337.
McMullan DM, Cohen GA. Common arterial trunk.
In: Yuh DD, Vricella LA, Baumgartner WA, eds. Johns
Hopkins Manual of Cardiothoracic Surgery. New York,
N.Y.: McGraw-Hill. 2007.
McMullan DM, Elliott MJ, Cohen GA. ECMO in
neonates and infants. In: Gravlee GP, Davis RF,
Stammers AH, eds. Cardiopulmonary Bypass:
Principles and Practice. Philadelphia, Pa.: Lippincott
Williams & Wilkins. 2007.
McMullan DM, Moulick A, Jonas RA. Late embolization
of Amplatzer patent ductus arteriosus occlusion device
with thoracic aorta embedment. Ann Thorac Surg.
Mar 2007;83(3):1177–1179.
McMullan DM, Oppido G, Davies B, Kawahira Y,
Cochrane AD, d’Udekem d’Acoz Y, Penny DJ,
Brizard CP. Surgical strategy for the bicuspid aortic
valve: tricuspidization with cusp extension versus
pulmonary autograft. J Thorac Cardiovasc Surg.
Jul 2007;134(1):90–98.
232
McMullan DM, Reddy VM, Gottliebson WH,
Silverman NH, Perry SB, Chan F, Hanley FL, Riemer
RK. Morphological studies of pulmonary arteriovenous
shunting in a lamb model of cavopulmonary anastomosis.
Pediatr Cardiol. Epub Nov 2007.
Permut LC, Ricci M, Cohen GA. Left ventricle outflow
tract obstruction. In: Yuh DD, Vricella LA, Baumgartner
WA, eds. Johns Hopkins Manual of Cardiothoracic
Surgery. New York, N.Y.: McGraw-Hill. 2007.
Pieters B, Johnston TA, Jones TK, Cohen GA,
Jonmarker C. Resistant hypoxemia in an infant with
a right ventricle-to-pulmonary artery (Sano) shunt.
Salerno C, Reemsten B, Cohen GA. Palliative operations
in children. In: Yuh DD, Vricella LA, Baumgartner WA,
eds. Johns Hopkins Manual of Cardiothoracic Surgery.
New York, N.Y.: McGraw-Hill. 2007.
Craniofacial, Plastic and
Reconstructive Surgery
The Division of Craniofacial, Plastic and Reconstructive
Surgery provides a comprehensive range of plastic and
craniofacial services for congenital and acquired conditions
affecting infants, children and adolescents. Drs. Richard
Hopper, Joseph Gruss and Craig Birgfeld are all members
of the large multidisciplinary Craniofacial Center at Seattle
Children’s Hospital. They play an integral role in the treatment
of patients with cleft and craniofacial conditions and
also help manage maxillofacial trauma, tumors and other
developmental anomalies of the head and neck. Dr. Jeffrey
Friedrich joined the division in September 2007 and is
a specialist in congenital and acquired pediatric hand
conditions in the interdisciplinary Children’s Hand Program.
Dr. Peter Neligan also joined the faculty in 2007 and brings
his international reputation in reconstructive microsurgery
to the care of our patients. Drs. Birgfeld and Neligan have
expanded the services offered by the Division of Plastic
Surgery to include microsurgical facial reanimation surgeries
for patients with facial paralysis and soft tissue augmentation
Faculty
Richard A. Hopper
MD, Chief
Richard A. Hopper, MD, Chief
Craig B. Birgfeld, MD
Loren H. Engrav, MD
Jeffrey B. Friedrich, MD
Joseph S. Gruss, MD
Jennifer N. Keagle, MD
Matthew B. Klein, MD, MS
David W. Mathes, MD
Peter C. Neligan, MD
Hakim K. Said, MD
Nicholas B. Vedder, MD
for patients with hemifacial microsomia. Four faculty
members staff an evening pediatric plastic surgery clinic to
treat children with general plastic surgical issues such as
skin and soft tissue tumors and abnormalities and other
reconstructive problems.
Richard A. Hopper, MD, is chief of the Division of
Craniofacial, Plastic and Reconstructive Surgery as
well as surgical director of the Craniofacial Center
at Seattle Children’s Hospital. He holds an associate
professor position in the Department of Surgery at
Hopper received his MD from Memorial University
of Newfoundland in St. John’s, Newfoundland, and
Labrador, Canada. He received his plastic surgery
training at the University of Toronto, Canada, and
completed a craniofacial fellowship at New York
University. His clinical practice focuses on the surgical
treatment of cleft lip and palate, craniosynostosis, and
rare and severe birth deformities of the bones and soft
tissues of the face. Hopper’s research interests include
quality improvement initiatives in surgical care protocols
for children with craniofacial conditions, bioengineering
of implants to heal cranial defects after surgery, and
design of presurgical devices to minimize the severity
of cleft lip deformities and improve surgical outcomes.
233
Craniofacial, Plastic and Reconstructive Surgery
Surgery from 1977 to 2001 and also attends at University
of Washington Medical Center, Harborview Medical
Center and the Veterans Affairs Puget Sound Health
Care System Hospital. He does didactic and clinical
teaching at the University of Washington. His clinical
interests include reconstructive burns and general
plastic surgery, and his research interests include
hypertrophic scarring and wound healing.
Spotlight on team member — Bay Sittler, ARNP
Having a nurse practitioner on the Plastic Surgery team
gives our patients and families better access to care. In
addition to spending time with families to make sure their
questions are answered and they understand the care their
child will need at home, I can also quickly see patients with
urgent post-operative concerns or talk by phone to families
with emergent questions.
Craig B. Birgfeld, MD, is attending surgeon in plastic and
craniofacial surgery at Seattle Children’s Hospital and
assistant professor in the Division of Plastic Surgery
at the University of Washington. After attending the
College of William and Mary, he completed medical
school at the Medical College of Virginia in 2000.
He then pursued a residency in plastic surgery at the
University of Pennsylvania, including a chief residency
at The Children’s Hospital of Philadelphia. He then
moved to Seattle, where he trained in craniofacial
surgery at Seattle Children’s Hospital. In 2007 Birgfeld
was a recipient of the American Society of Maxillofacial
Surgeons (ASMS) CRANIO Fellowship, which provides
funding for travel to international craniofacial centers
to learn new surgical techniques and treatments.
Birgfeld’s clinical interests include cleft and craniofacial
surgery as well as treatment of hemifacial microsomia
and facial reanimation. His research interests include
outcomes of craniofacial surgery utilizing facial CT
scans and three-dimensional analysis of the growing
face. His goal is to make the Craniofacial Center at
Children’s a world leader and to optimize the care for
all children born in the Northwest with craniofacial
difference who are treated in our Center.
Loren H. Engrav, MD, is attending surgeon at Seattle
of Surgery at the University of Washington School of
Medicine. He served as chief of the Division of Plastic
234
Jeffrey B. Friedrich, MD, is an attending surgeon at
in the Department of Surgery at the University of
Washington School of Medicine. He also attends at
the Harborview Medical Center where he is primarily
based. He earned his MD from University of Texas
Houston Medical School, followed by plastic surgical
training at the University of Washington as well as a
hand surgery special fellowship at the Mayo Clinic in
Rochester, Minn. Friedrich’s clinical focus is on hand
surgery and reconstructive microsurgery. Friedrich
does didactic and clinical teaching and has hospital
appointments at Children’s, Harborview Medical
Center, University of Washington Medical Center,
Seattle Cancer Care Alliance and the Veterans Affairs
Puget Sound Health Care System Hospital.
Joseph S. Gruss, MD, is attending surgeon at Seattle
of Surgery at the University of Washington School of
Medicine. He is the first holder of the Marlys C. Larson
Endowed Chair in Pediatric Craniofacial Surgery. He
earned his MD in Johannesburg, South Africa, and
completed general and plastic surgery training as
well as a fellowship in head and neck oncological and
craniofacial surgery. He came to Children’s in 1991
to establish a state-of-the-art craniofacial surgical
program; the Craniofacial Center is now the busiest
program of its type in North America. He has pioneered
the application of craniofacial techniques to the care
of facial trauma and the use of rigid internal fixation of
the craniofacial skeleton. In addition he has pioneered
numerous techniques in the field of infant cleft and
craniofacial surgery. He has supervised and trained
fellows from all over the world and is a regular teacher in
North America, Europe and the Far East. In 2007, he
was an ASMA visiting professor and a specially selected
visiting professor at the University of Tennessee,
Memphis; Tulane University (New Orleans); Louisiana
State University; and Washington University (St. Louis).
Jennifer N. Keagle, MD, is plastic surgeon at Seattle
Division of Plastic Surgery at the University of Washington School of Medicine. She earned her MD from
Northwestern University School of Medicine in Chicago.
She completed her general surgery and plastic surgery
residency at the University of California, San Francisco,
and then completed a fellowship in craniofacial
surgery at the University of California, Los Angeles.
Her clinical practice focuses on acquired and genetic
deformities of the face and skull, including cleft lip and
palate, deformities of the bones and soft tissues, and
jaw abnormalities. Her special clinical interest is in
orthognathic/jaw surgery and her basic science research
is focused on the genetic basis of facial differences using
an inbred mouse model. In 2007, Keagle received an
academic enrichment fund for her study “A morphologic
and genetic study of mouse craniofacial variability.”
Matthew B. Klein, MD, MS, is attending surgeon at
in the Department of Surgery at the University of
Washington School of Medicine. He also attends at
the Harborview Medical Center where he is primarily
based. He is the associate program director for the
plastic surgery residency program at the University of
Washington. He earned his MD from Yale University
and an MS in epidemiology from the University of
Washington. Klein does didactic and clinical teaching
and has hospital appointments at Children’s, Harborview
Medical Center, University of Washington Medical
Center and the Veterans Affairs Puget Sound Health
Care System Hospital.
David W. Mathes, MD, is attending surgeon at Seattle
Department of Surgery at the University of Washington
School of Medicine. He is chief of the plastic surgery
service at the Veteran Affairs Puget Sound Health
Care System Hospital. His clinical interests include
plastic and reconstructive surgery, cosmetic surgery
and reconstructive microsurgery. His research interest
involves the field of composite tissue transplantation.
He is currently working with a research group at
Fred Hutchinson Cancer Research Center to explore
methods of inducing tolerance to foreign tissues.
Peter C. Neligan, MD, is a professor in the Departments
of Surgery and Otolaryngology-Head and Neck Surgery
at the University of Washington. He is section chief of
plastic surgery at the University of Washington Medical
Center. He received his medical education at the
University of Dublin, Trinity College, and has completed
fellowships in surgical research, pediatric plastic surgery,
microvascular surgery and burn surgery. He served as
chief of plastic surgery at Toronto General Hospital from
1996 to 2007, and was university chair of plastic surgery
during that same period. He is active in numerous
societies and currently serves as president-elect of
the Plastic Surgery Educational Foundation and vicepresident of the American Society for Reconstructive
Microsurgery. He also serves on the board of the
American Society of Plastic Surgeons and the American
Head and Neck Society. He is widely published in the
area of reconstructive microsurgery and is editor-inchief of the Journal of Reconstructive Microsurgery.
His clinical practice focuses on reconstructive microsurgery, and he is particularly interested in the surgical
treatment of facial paralysis using functioning muscle
transfer as a means of reanimating the paralyzed
face. His current research interest is in the area of
functioning component transplantation in the area
of facial reconstruction.
Hakim K. Said, MD, is attending surgeon at Seattle
School of Medicine. He also attends at the University
of Washington Medical Center. He earned his MD from
the University of Michigan, followed by plastic surgical
training at Northwestern University and a reconstructive microsurgery fellowship at MD Anderson Cancer
Center in Houston, Texas. He does didactic and clinical
teaching at Children’s, University of Washington Medical
Center, Harborview Medical Center and Seattle Cancer
Care Alliance. His clinical focus is on microsurgical
reconstruction with a special interest in aesthetic
reconstruction as well as clinical outcomes research.
Nicholas B. Vedder, MD, is attending surgeon at Seattle
Children’s Hospital and chief of the Division of Plastic
Medicine. He is professor in the departments of
Surgery and Orthopedics and in the Division of Plastic
Surgery at the University of Washington. His clinical
and research interests include plastic and reconstructive
surgery, hand surgery and reconstructive microsurgery.
235
AWARDS AND HONORS
Washington Society of Plastic Surgeons Golden
Scalpel Award.
Northwest Society of Plastic Surgery Best Members
Oral Presentation.
Craig B. Birgfeld, MD
Post-operative changes of the orbital bandeau advancement and frontal cranioplasty two years after surgical
correction of metopic craniosynostosis. Annual
meeting of the American Cleft Palate/Craniofacial
Association. Broomfield, Colo. April 2007.
Volume enhancement for facial deficiency. Annual
meeting of the Washington Society of Plastic Surgeons.
Woodinville, Wash. June 2007.
Joseph S. Gruss, MD
NOE fractures. Facial clefts. Cranio-orbital neurofibromatosis. Craniofacial Symposium. University of Utah.
Snowbird, Utah. February 2007.
Vascular anomalies in adults and kids (invited lecturer).
2007 Annual Meeting of the Northwest Society of
Plastic Surgery. Lanai, Hawaii. Feb. 17–21, 2007.
Facial fractures. Craniofacial techniques with orbital
reconstruction. Management of secondary facial
trauma. Facial fractures in Children’s Hospital
and Regional Medical Center. (Visiting professor.)
University of Manitoba. Winnipeg, Manitoba, Canada.
March 2007.
Management of facial fractures. Cranio-orbital reconstruction. (Visiting professor.) Georgetown University.
Washington, D.C. April 2007.
Orbital fractures. Complex facial reconstruction.
Secondary facial trauma. (Visiting professor.) University
of Minnesota. Minneapolis, Minn. May 2007.
Complex facial fractures. Facial reconstruction.
(Visiting professor.) University of Tennessee.
Memphis, Tenn. June 2007.
236
Craniofacial approaches. NOE fractures. Orbital
reconstruction. ACMF Symposium. Oregon Health
& Science University. Portland, Ore. June 2007.
Craniofacial tumors in adults and kids. Development
and use of resorbable plates in pediatric craniofacial
surgery. Post-graduate symposium. University of
Kansas. Kansas City, Kan. June 2007.
Craniofacial techniques in orbital reconstruction.
Midface and NOE fractures. ACMF Symposium.
Las Vegas, Nev. August 2007.
Gunshot wounds of the face. Vascular anomalies in the
head and neck. (Invited lecturer.) International Society
of Craniofacial Surgery. Salvador, Brazil. August 2007.
Role of resorbable plates. AIC-ACMF Symposium.
Mahwah, N.J. September 2007.
Complications of midface and mandible trauma.
Symposium on complications in craniomaxillofacial
surgery. Plastic Surgery Education Foundation.
Baltimore, Md. October 2007.
Management of complex facial fractures. Board
review course. Stanford University. Palo Alto, Calif.
October 2007.
Management of craniofacial fibrous dysplasia.
(Invited lecturer.) American Society of Plastic
Surgeons. Baltimore, Md. October 2007.
Enucleated orbit. Metopic craniosynostosis.
Craniomaxillofacial Symposium. University of Toronto.
Toronto, Ontario, Canada. November 2007.
The orbit with skull base surgery. Uses of bronchial
bone grafts. ACMF Symposium. Washington, D.C.
November 2007.
Orbital fibrous dysplasia. Pediatric orbital fractures.
AO Advanced Orbital Symposium. New York, N.Y.
November 2007.
Facial reconstruction. Pediatric facial fractures.
NOE fractures. (Visiting professor.) Tulane University
and Louisiana State University. New Orleans, La.
December 2007.
Midface distraction. Use of ultrasound-assisted
resorbable cranial plating (Sonicweld). Snowbird
Facial Reconstructive Symposium. Snowbird, Utah.
February 2007.
PUBLICATIONS
Coronal ring defect healing—a quantitative study
(co-presenter). 2007 Annual Meeting of the Northwest
Society of Plastic Surgeons. Lanai, Hawaii.
Feb. 17–21, 2007.
Birgfeld CB, Chang B. The periglabellar flap for
closure of central forehead defects. Plast Reconstructr
Surg. Jul 2007;120(1):130–133.
Fractional healing of pediatric coronal ring defects
two years following fronto-orbital advancement for
craniosynostosis (co-presenter). American Association
of Plastic Surgeons. Coeur d’Alene, Idaho. May 2007.
Distraction osteogenesis of the craniofacial skeleton.
107th Annual Session, American Association of
Orthodontists. Seattle, Wash. May 21, 2007.
Practical approaches to craniomaxillofacial trauma
and reconstruction. Invited course faculty: lecturer
on naso-orbitoethmoid fractures. Portland, Ore.
June 2–3, 2007.
External midface distraction (invited lecturer).
Distraction osteogenesis. AO Experts Symposium.
Naples, Italy. Sept. 12, 2007.
Visiting professor, University of British Columbia,
Division of Plastic Surgery. Vancouver, British Columbia,
Canada. Oct. 3, 2007.
External midface distraction and external mandible
distraction (invited lecturer). AO International Course
on Endoscopic Fixation and Advances in Distraction
Osteogenesis. University of Hong Kong. Hong Kong,
P.R.C. Nov. 4–6, 2007.
Peter C. Neligan, MD
Optimizing results in head and neck reconstruction.
Vascularized rib transfer for spinal stabilization.
Complications of the ALT donor defect. The BVI
Plastic Surgery Meeting. Tortola, British Virgin
Islands. Jan. 22–25, 2007.
Smoke is sterile, sister! I got gas. Sure I can close
that. The facial artery perforator flap. American
Alpine Workshop in Plastic Surgery. Aspen, Colo.
Feb. 4–7, 2007.
Birgfeld CB, Chang B. Fractures of the distal radius
and ulna. In: Kryger ZB, Sisco M, eds. Practical Plastic
Surgery. Austin, Texas: Landes Bioscience. 2007.
Birgfeld CB, Glick P, Singh D, LaRossa DL, Bartlett
SP. Midface growth in patients with ectrodactylyectodermal dysplasia-clefting syndrome. Plast Reconstr
Surg. Jul 2007; 120(1):144–150.
Bitton A, Keagle JN, Varma M. Small bowel bezoar
in a patient with Noonan syndrome: report of a case.
MedGenMed. Feb 2007;9(1):34.
Bordeleau LJ, Lipa JE, Neligan PC. Management
of the BRCA mutation carrier or high-risk patient.
Clin Plast Surg. Jan 2007;34(1):15–27.
Gevorgyan A, La Scala GC, Neligan PC, Pang CY,
Forrest C. Radiation-induced craniofacial bone
growth disturbances. J Craniofac Surg. Sep
2007;18(5):1001–1007.
Gevorgyan A, La Scala GC, Neligan PC, Pang CY,
Forrest CR. Radioprotection of craniofacial bone
growth. J Craniofac Surg. Sep 2007;18(5):995–1000.
Gevorgyan A, La Scala GC, Sukhu B, Leung IT,
Ashrafpour H, Yeung I, Neligan PC, Pang CY, Forrest
CR. An in vitro model of radiation-induced craniofacial
bone growth inhibition. J Craniofac Surg. Sep
2007;18(5):1044–1050.
Golger A, Young DS, Ghazarian D, Neligan PC.
Epidemiological features and prognostic factors of
cutaneous head and neck melanoma: a populationbased study. Arch Otolaryngol Head Neck Surg.
May 2007;133(5):442–447.
Hopper RA, Grayson B, Cutting C. Cleft lip and palate.
In: Thorne C, ed. Grabb and Smith’s Plastic Surgery,
Sixth Edition. Philadelphia, Pa.: Lippincott Williams
and Wilkins. 2007.
237
Keagle JN, Scott J, Liu D. Radiology in craniomaxillofacial trauma. ASMS Hyperguide—Craniofacial
Trauma. Nov 2007.
Kelley P, Hopper RA, Gruss JS. Evaluation and
treatment of zygomatic fractures. Plast Reconstr Surg.
Dec 2007;120(7 Suppl 2):5S–15S.
Seto ML, Hing AV, Chang J, Hu M, Kapp-Simon
KA, Patel PK, Burton BK, Kane AA, Smyth MD,
Hopper RA, Ellenbogen RG, Stevenson K, Speltz
ML, Cunningham ML. Isolated sagittal and coronal
craniosynostosis associated with TWIST box mutations.
Murray DJ, Gilbert RW, Vesely MJ, Novak CB,
Zaitlin-Gencher S, Clark JR, Gullane PJ, Neligan PC.
Functional outcomes and donor site morbidity following
circumferential pharyngoesophageal reconstruction
using an anterolateral thigh flap and salivary bypass
tube. Head Neck. Feb 2007;29(2):147–154.
Murray DJ, Novak CB, Neligan PC. Fasciocutaneous
free flaps in pharyngolaryngo-oesophageal reconstruction: a critical review of the literature. J Plast Reconstr
Aesthet Surg. Nov 2007. Epub.
Neligan PC, Gullane PJ, Vesely M, Murray D.
The internal mammary artery perforator flap:
new variation on an old theme. Plast Reconstr Surg.
Mar 2007;119(3):891–893.
Ploplys E, Keagle JN. Regional and local anesthesia
in facial trauma. ASMS Hyperguide—Craniofacial
Trauma. Dec 2007.
Thurnher D, Novak CB, Neligan PC, Gullane PJ.
Reconstruction of lateral skull base defects after tumor
ablation. Skull Base. Feb 2007;17(1):79–88.
Vesely MJ, Murray DJ, Novak CB, Gullane PJ,
Neligan PC. The internal mammary artery perforator
flap: an anatomical study and a case report. Ann Plast
Surg. Feb 2007;58(2):156–161.
238
Vyas RM, Keagle JN, Wexler A, Cahan L, Kawamoto
HK, Lazareff J, Wasson KL, Bradley JP. Unilateral
vision impairment from a carotid-cavernous fistula
after a monobloc osteotomy in a patient with Apert
syndrome. J Craniofac Surg. Jul 2007;18(4):960–965.
Whitaker L, Birgfeld CB. Glabella rejuvenation via
corrugator excision and volume replacement. Aesthetic
Surgery Journal. Sept 2007;27(5);563–567.
General and Thoracic Surgery
The Division of General and Thoracic Surgery includes
dedicated pediatric surgeons who provide comprehensive
care for infants and children with a wide variety of surgical
conditions. The division’s patients range from newborns
with birth defects to adolescents, teens and young adults
with problems that are best treated in a children’s hospital
environment. Our faculty’s experience covers the entire
spectrum of pediatric surgical problems, including expertise
with minimally invasive surgery, and nonsurgical options
when appropriate.
Working with the Seattle Children’s Hospital’s outstanding
hematology and oncology program and with the bone
marrow transplant program, the Division of General and
Thoracic Surgery maintains a strong clinical and research
interest in childhood cancer treatment. We also partner
closely with the nationally renowned Nephrology and
Gastroenterology Divisions at Children’s, yielding a wealth
of experience with patients who have end-stage organ failure,
inflammatory bowel disease and upper gastrointestinal
problems. Our research has focused on surgical outcomes,
innovative uses of minimally invasive surgery and robotics,
surgical oncology and solid organ transplant. The division
is actively involved in using the principles of the Toyota
Production System and lean methodology and developing
ways to apply these concepts to medicine. We believe
that these tools will allow us to provide better patient care
and be more responsive to the needs of our patients and
referring providers.
Faculty
John H.T. Waldhausen, MD, Chief
Adam B. Goldin, MD, MPH
Kenneth W. Gow, MD
Patrick J. Healey, MD
Stephen S. Kim, MD
Daniel J. Ledbetter, MD
Robert S. Sawin, MD
John H.T. Waldhausen
MD, Chief
Surgical education and training is also an important
area of scholarship. Several of the division’s faculty are
active in University of Washington School of Medicine
programs for medical students. General surgery residents
from training programs throughout the Puget Sound region
do clinical rotations with our service, and we offer an
ACGME-accredited fellowship training program in pediatric
surgery. Graduates of our program are broadly trained
and have taken positions in many academic and private
teaching institutions throughout the country, confirming our
reputation as one of the top pediatric surgery programs in
the country.
John H.T. Waldhausen, MD, is chief of the Division of
General and Thoracic Surgery at Seattle Children’s
Hospital and professor in the Department of Surgery
He also attends at Children’s Bellevue Clinic and at
Seattle Children’s in the Division of Transplant Surgery.
He is director of the pediatric surgery fellowship and of
general surgery resident education at Seattle Children’s.
Waldhausen’s primary research is in clinical outcomes.
His clinical activities cover the broad range of pediatric
surgery with a focus on minimally invasive surgery,
congenital surgical problems and pediatric cancer
surgery. Waldhausen received his MD from Pennsylvania
State University College of Medicine, Hershey, Penn.
He completed his residency at the University of Virginia
and his fellowship at the University of Washington.
239
Columbia, a pediatric general surgery fellowship at
British Columbia Children’s Hospital and a pediatric
surgical oncology fellowship at St. Jude Children’s
Research Hospital. His area of interest and research
is pediatric surgical oncology. He is interested in
developing new tools for visualization of tumors
to assist diagnosis, staging and resection.
Spotlight on team member — Ronelle Caskey, PNP
Our new morning-rounds process will more actively involve
patients and families and ensure that the General Surgery
team understands each child’s plan of care first thing in the
morning. After reviewing and updating the daily plan together,
the team will visit each patient’s bedside, share the plan and
spend time answering questions that the family has jotted
down on a white board the previous day.
Adam B. Goldin, MD, MPH, is pediatric surgeon at
the Department of Surgery at the University of Washington School of Medicine. He received his MD from
Rush Medical College of Rush University, Chicago. He
completed his general surgery residency and clinical
research fellowship at the University of Washington
and earned his MPH in epidemiology at the university’s
School of Public Health. He also completed a pediatric
surgery fellowship at Children’s Hospital of Wisconsin.
Goldin cares for children in Seattle Children’s general
and thoracic surgery clinics and has expertise and
training in laparoscopic surgery. Specific areas of clinical interest include pediatric tumors, neonatal surgery
and laparoscopic surgery. Specific areas of research
interest include clinical outcomes and quality of care
in pediatric surgery. Goldin believes in maintaining
the highest standard of care throughout the scope of
pediatric general and thoracic surgery. He believes
in continual re-evaluation of surgical care delivery
methods, with particular attention to individually
and culturally sensitive delivery.
Kenneth W. Gow, MD, is attending surgeon at Seattle
Children’s Hospital and associate professor of surgery
joining the faculty in September 2007. He received his
MD at the University of Manitoba. He completed his
general surgery residency at the University of British
240
Patrick J. Healey, MD, is chief of the Division of
Transplant Surgery at Seattle Children’s Hospital.
He received his MD from Boston University School of
Medicine. He completed his general surgery residency
at the Hartford Hospital. He completed fellowship
training in abdominal transplantation and pediatric
surgery at the University of Washington and Children’s,
respectively. Dr. Healey has expertise and training in
pediatric transplantation, specifically of the liver and
kidney. He is a member of the UNOS Organ Availability
Committee (2007–2008) and the UNOS Pediatric
Committee (2007–2009). His clinical and research
interests include transplantation in infants and small
children, neonatal surgery, congenital anomalies and
pediatric tumors.
Stephen S. Kim, MD, is attending surgeon at Seattle
Children’s Hospital; he is assistant professor in the
School of Medicine and adjunct assistant professor in
the Department of Bioengineering. He received his MD
from the University of Virginia School of Medicine. He
completed his general surgery residency at the University
of Chicago hospitals, his surgery research fellowship at
Children’s Hospital Boston and his pediatric surgery
fellowship at Seattle Children’s. Kim attends and
consults on the inpatient service and sees outpatients
in the general and thoracic surgery outpatient clinics.
His clinical interests include neonatal surgery, minimally
invasive and robotic surgery and gastrointestinal
diseases. His basic science research interests include
tissue engineering of the gastrointestinal tract. Kim’s
recent manuscript was honored as best manuscript
by a new member by the Association for Academic
Surgery. In 2007 he also received Children’s Research
Institute’s basic science steering committee award.
Daniel J. Ledbetter, MD, is attending surgeon at Seattle
School of Medicine. He received his MD from University
of Florida College of Medicine. Ledbetter completed
his residency at the University of Washington and
his fellowship at Children’s. He performs pediatric
general and thoracic surgery and has special interests
in thyroid, parathyroid and other endocrine surgery
and in neonatal surgery. He also has special interest
and is certified in surgical critical care of newborns,
infants and children.
Robert S. Sawin, MD, is surgeon-in-chief at Seattle
Children’s Hospital and vice chairman of the Department of Surgery at the University of Washington
School of Medicine. He completed his residency at
Harvard’s Brigham and Women’s Hospital and completed a fellowship at Children’s. Sawin helped establish
the liver transplant program at Children’s and its ECMO
(extra-corporeal membrane oxygenation) program; in
1990 he performed the first pediatric liver transplant in
the Northwest with James Perkins, and he performed
the region’s first ECMO cannulation. In addition to a
clinical interest in pediatric liver and tumor surgery,
Sawin developed a research interest in the biology of
pediatric tumors. He was an active member of the
national oncology cooperative and the Children’s Cancer
Group, and has published many articles on subjects
related to cancer surgery, including the treatment of
neuroblastoma, sarcomas and Wilms tumor. Sawin has
been active in many regional, national and international
surgical societies, and has served as secretary of the
Pacific Association of Pediatric Surgeons and secretarytreasurer of the North Pacific Surgical Association.
AWARDS AND HONORS
Kenneth W. Gow, MD
Top Surgeons, Pediatric Surgery.
Robert S. Sawin, MD
John H.T. Waldhausen, MD
Distinguished Alumnus Award. Department of
Surgery. University of Washington School of Medicine.
TEACHINGS AND PRESENTATIONS
Kenneth W. Gow, MD
Melanoma in children and adolescents: the Emory
experience. 6th Annual Emory University Department
of Surgery Research Symposium. Atlanta, Ga.
May 17, 2007.
The ins and outs of portacaths: a port in the storm. 13th
Annual Lysosomal Storage Disorders Meeting. Allied
Health Seminar. Salt Lake City, Utah. May 18, 2007.
Laparoscopic distal pancreatectomy for pancreatic
transection in a 10-year-old boy. 38th Annual Meeting,
American Pediatric Surgical Association. Video session.
Orlando, Fla. May 24, 2007.
American Transplant Congress Annual Meeting.
Chronic vascular access in unusual circumstances:
hemodialysis, ultrafiltration. 93rd Clinical Congress,
American College of Surgeons. New Orleans, La.
October 2007.
Stephen S. Kim, MD
Genetically engineered intestine — hype or hope?
Guts and the City: The Mount Sinai Intestinal Symposium. Mount Sinai Medical Center. New York, N.Y.
February 2007.
Neonatal thoracoscopic repair of congenital diaphragmatic hernia. Seattle Surgical Society annual meeting.
Seattle, Wash. February 2007.
Small bowel AVM as a cause of gastrointestinal
bleeding in a child. Seattle Surgical Society annual
meeting. Seattle, Wash. February 2007.
A perfusion bioreactor for intestinal tissue engineering.
Second Annual Academic Surgical Congress and 40th
Annual Meeting of the Association for Academic
Surgery. Phoenix, Ariz. February 2007.
241
Perfusion culture of intestinal epithelial cells seeded
on biodegradable polymer scaffolds. Keystone Symposium: Tissue Engineering and Development Biology.
Snowbird, Utah. April 2007.
Thoracoscopic repair of congenital diaphragmatic
hernia in infancy. 2007 annual meeting, Combined
Washington and Oregon Chapters of the American
College of Surgeons. Chelan, Wash. June 2007.
Evaluation of a perfusion bioreactor for culture of
intestinal cells under physiologic conditions. 2007
Annual Meeting of the Biomedical Engineering Society.
Los Angeles, Calif. September 2007.
Left-sided gastroschisis: higher incidence of extraintestinal congenital anomalies. 94th Annual Meeting
of the North Pacific Surgical Association. Victoria,
British Columbia, Canada. November 2007.
The initiation of a robotic surgery program at a pediatric
hospital: the Seattle Children’s experience. 2007
Northwest Urological Society Conference. Vancouver,
British Columbia, Canada. December 2007.
Robert S. Sawin, MD
Fetal surgery: shooting for the moon. Minerva Society
Lecture Series. Community Medical Center. Missoula,
Mont. June 2007.
Is fetal surgery a real option? Management of
Hirschsprung’s disease in infants. Timely Topics in
Neonatology and Perinatology. Community Medical
Center. Missoula, Mont. June 2007.
Disaster Management Symposium (moderator).
American Pediatric Surgery Association. Orlando, Fla.
May 2007.
242
Pyloric stenosis: how I do it. Rib distractors for Jeune
syndrome. 16th Annual Congress for Endosurgery
in Children, International Pediatric Endosurgery
Group/World Federation of Associations of Pediatric
Surgeons. Buenos Aires, Argentina. September 2007.
Use of the vertical expandable prosthetic titanium rib
(invited talk hosted by Dr. Carlos Fraire). Difficult
Pectus Cases Grand Rounds, Argentine BIOMET.
Buenos Aires, Argentina. September 2007.
PUBLICATIONS
Acierno SP, Waldhausen JH. Congenital cervical cysts,
sinuses and fistulae. Otolaryngol Clin North Am. Feb
2007;40(1):161–176, vii–viii.
Castellan M, Gosalbez R, Perez-Brayfield M,
Healey PJ, McDonald R, Labbie A, Lendvay T.
Tumor in bladder reservoir after gastrocystoplasty.
J Urol. Oct 2007;178(4 Pt 2):1771–1774.
Chui CH, Gow KW, Molagool S, Rao BN. Benign adrenal
tumors in children. In: Gupta DK, Carachi R, eds.
Pediatric Oncology Surgery and Medical Aspects. New
Delhi, India: Jaypee Brothers Medical Publishers. 2007.
Cribbs RK, Wulkan ML, Heiss KF, Gow KW.
Minimally invasive surgery and childhood cancer.
Surg Oncol. Nov 2007;16(3):221–228.
Downard CD, Rapkin LB, Gow KW. Melanoma
in children and adolescents. Surg Oncol. Nov
2007;16(3):215–220.
Goldin AB, Sawin RS, Garrison MM, Zerr DM,
Christakis DA. Aminoglycoside-based triple-antibiotic
therapy versus monotherapy for children with ruptured
Low recurrence rate after Gore-Tex/Marlex composite
patch repair for posterolateral congenital diaphragmatic
hernia. Washington State Chapter of the ACS. Lake
Chelan, Wash. June 2007.
Gow KW. Pediatric surgical oncology [editorial].
Surg Oncol. Nov 2007;16(3):147.
Current concepts in pediatric surgery. Children’s
National Medical Center. Washington, D.C.
August 2007.
Gow KW, Chui CH, Molagool S, Rao BN. Malignant
liver tumors in children and adolescents. In: Gupta
DK, Carachi R, eds. Pediatric Oncology Surgery and
Medical Aspects. New Delhi, India: Jaypee Brothers
Medical Publishers. 2007.
Kim SS, Penkala R, Abrahimi P. A perfusion bioreactor
for intestinal tissue engineering. J Surg Res. Oct
2007;142(2):327–331.
Kletter GB, Sweetser DA, Wallace SF, Sawin RS,
Rutledge JC, Geyer JR. Adrenocorticotropin-secreting
pancreatoblastoma. J Pediatr Endocrinol Metab.
May 2007;20(5):639–642.
Molagool S, Gow KW, Chui CH, Rao BN. Benign
liver tumors in children. In: Gupta DK, Carachi R, eds.
Pediatric Oncology Surgery and Medical Aspects. New
Delhi, India: Jaypee Brothers Medical Publishers. 2007.
Penkala RA, Kim SS. Gastrointestinal tissue engineering.
Expert Rev Med Devices. Jan 2007;4(1):65–72.
Tamburro R, Barfield R, Metzger M, Geiger T, Call S,
Gow KW. Hematologic/oncologic problems in critical
illness and injury. In: Rubenstein J, ed. Pediatric Critical
Care Study Guide: Text and Review. New York, N.Y.:
Springer. 2007.
Tamburro R, Gow KW. Mediastinal Masses.
In: Wong H, Wheeler D, eds. Pediatric Critical Care
Medicine: Basic Science and Clinical Evidence.
New York, N.Y.: Springer. 2007.
Waldhausen JH, Redding GJ, Song KM. Vertical
expandable prosthetic titanium rib for thoracic
insufficiency syndrome: a new method to treat an
old problem. J Pediatr Surg. Jan 2007;42(1):76–80.
Rice HE, Frush DP, Farmer D, Waldhausen JH, APSA
Education Committee. Review of radiation risks from
computed tomography: essentials for the pediatric
surgeon. J Pediatr Surg. Apr 2007;42(4):603–607.
Rice HE, Frush DP, Harker MJ, Farmer D,
Waldhausen JH, APSA Education Committee. Peer
assessment of pediatric surgeons for potential risks of
radiation exposure from computed tomography scans.
J Pediatr Surg. Jul 2007;42(7):1157–1164.
Riehle KJ, Magnuson DK, Waldhausen JH. Low
recurrence rate after Gore-Tex/Marlex composite patch
repair for posterolateral congenital diaphragmatic
hernia. J Pediatr Surg. Nov 2007;42(11):1841–1844.
Shah R, Gow KW, Sobol SE. Outcome of thyroglossal
duct cyst excision is independent of presenting age
or symptomatology. Int J Pediatr Otorhinolaryngol.
Nov 2007;71(11):1731–1735.
Smith JM, Corey L, Healey PJ, Davis CL, McDonald RA.
Adolescents are more likely to develop post-transplant
lymphoproliferative disorder after primary Epstein-Barr
virus infection than younger renal transplant recipients.
Transplantation. Jun 2007;83(11):1423–1428.
243
Neurosurgery
The Division of Neurosurgery provides inpatient and
outpatient surgical services for patients from infancy
through young adulthood. The division’s mission primarily
focuses on providing cutting-edge operative treatment of
the brain and spine, but it also provides excellent routine
clinic access five days a week with three board-certified
pediatric neurosurgeons and three experienced pediatric
nurse practitioners. We have also implemented intermittent
weekend clinics to improve access for our patients. Another
unique feature of this division is our surgeons’ ability and
Faculty
Anthony M. Avellino, MD, Chief
Richard G. Ellenbogen, MD
Jeffrey G. Ojemann, MD
Anthony M. Avellino
MD, Chief
244
willingness to provide a continuum of high-quality care
at the University of Washington Medical Center and
Harborview Medical Center for our adult patients with
congenital diseases once they graduate Seattle Children’s
Hospital. The neurosurgery staff work in a robust, cooperative,
multidisciplinary manner with many medical and surgical
specialties at Children’s, consulting with colleagues in
anesthesia, neurology, general surgery, developmental
pediatrics, genetics, orthopedic surgery, rehabilitation
medicine and at the Craniofacial Center.
The emphasis of our Division is treating congenital
conditions of the central nervous system as well as brain
and spinal cord tumors, epilepsy, vascular diseases, trauma
and craniofacial anomalies. Our nationally renowned
multidisciplinary referral programs encompass four areas:
craniofacial surgery, epilepsy surgery, neuro-oncology
(brain tumors) and congenital conditions (hydrocephalus,
Chiari malformations and birth defects). The division is
also involved in basic, clinical and translational research
programs that aim to improve the health of children with
neurological disease. There are three areas of research
emphasis in our Division: epilepsy; hydrocephalus and
CSF proteomics; and molecular imaging and targeting
therapies of brain tumors.
Anthony M. Avellino, MD, the chief of pediatric neurosurgery at Seattle Children’s Hospital, is an associate
professor in the Department of Neurological Surgery
and a joint associate professor of orthopedics and
sports medicine at the University of Washington School
of Medicine. He also directs the residency program for
the University’s Department of Neurological Surgery.
Avellino earned his MD at the Columbia University
College of Physicians and Surgeons in New York.
Avellino’s current research focuses on understanding
and improving the treatment of hydrocephalus, one of
the most common congenital conditions in children.
The goal of the hydrocephalus proteomics lab is to find
new treatments and thus improve neurological and
cognitive development in children with hydrocephalus.
Avellino is working with a molecular biologist,
Professor Richard Morrison at the University of Washington, defining the proteins in the CSF of children
with hydrocephalus. Their goals are to ascertain the
Neurosurgery
trends and mechanisms of protein production in
the CSF of children with hydrocephalus. In addition,
Avellino is studying evolving endoscopic techniques in
a variety of challenging patients with hydrocephalus,
with the goal to provide treatments that are minimally
invasive and safer for this common condition.
Richard G. Ellenbogen, MD, is professor and chairman
in the Department of Neurological Surgery at the
University of Washington School of Medicine, and he
attends at both Harborview Medical Center and Seattle
Children’s Hospital. He is the current recipient of
the Theodore S. Roberts Endowed Chair in Pediatric
Neurosurgery at Children’s. Ellenbogen received his MD
from Brown University in Providence, R.I. Ellenbogen
received NIH funding for his study of the imaging
and clinical diagnosis of a congenital condition called
Chiari malformation and syringomyelia. He maintains
a large referral practice of children with this condition
with the goal of developing safer and more effective
treatments. In addition, he is a principal investigator
(NIH/NCI) with Drs. Jim Olson (pediatrics) and Miqin
Zhang (engineering/nanotechnology) in the molecular
imaging nanotechnology platform at the University of
Washington that aims to develop novel intraoperative
molecular imaging techniques and safer and more
effective targeted therapies in the treatment of
malignant brain tumors.
Jeffrey G. Ojemann, MD, is an attending neurosurgeon
and the director of epilepsy surgery at Seattle Children’s
Hospital. He is also an associate professor in the
Department of Neurological Surgery at the University
of Washington School of Medicine and has held the
Richard G. Ellenbogen Endowed Chair in Pediatric
Neurosurgery at Children’s since 2004. After graduating
with a degree in physics from Princeton University,
Ojemann received his MD from Washington University
in St. Louis, Mo. Ojemann receives several sources
of extramural funding (NIH, NSF and foundations)
and leads the research program in surgical epilepsy. He
collaborates across many disciplines at the University
of Washington and Children’s, such as neurology,
computer science and neuropsychology. Ojemann
and his team are studying innovative brain mapping
approaches that preserve brain function and improve
surgical outcomes. He is using fMRI as a less invasive
tool to understand brain function and dysfunction. The
goal is to gain knowledge on the functional anatomy
Spotlight on team member — Nadine Nielsen, ARNP, CPNP
We are working on changing our clinic model to improve
patient access and decrease wait times. We plan to increase
clinic days to four per week with an attending physician.
Nurse practitioners will be in clinic every day so that we can
see all of our patients and families and get their questions
answered. We are also looking forward to participating in
a multidisciplinary neuro-oncology clinic.
and physiology of the brain in disease states such
as tumors and epilepsy using animal models and
noninvasive imaging techniques. His research includes
studying signals for a brain–computer interface that
could restore neurologic function across many types
of injury.
AWARDS AND HONORS
Anthony M. Avellino, MD
Listed in Guide to America’s Top Surgeons.
Conservative management of cerebrospinal fluid shunt
infections (co-presenter). 51st Annual Scientific Meeting
of the Society for Research into Hydrocephalus and
Spina Bifida. Heidelberg, Germany. 2007.
Fractional healing of pediatric coronal ring defects
two years following fronto-orbital advancement for
craniosynostosis (co-presenter). American Association
of Plastic Surgeons. Coeur d’Alene, Idaho. 2007.
245
Neurosurgery
Coronal ring defect healing — a quantitative study
(co-presenter). Northwest Society of Plastic Surgeons.
Lanai, Hawaii. 2007.
Paediatric posterior fossa tumours: medulloblastoma:
advances in management and prognosis. Paediatric skull
base and spine. European Congress of Neurosurgery.
Glasgow, Scotland, United Kingdom. Sept. 2–7, 2007.
Neurosurgical practice development, negotiation and
liability: acute care specialization: good or bad. The
grown-up children: taking care of the adult “pediatric”
patient. Digital masters video symposium: potential
strategies: airline or government approach — mandatory
age of retirement regardless of volume, skill, outcomes.
Congress of Neurological Surgery 2007 Annual Meeting.
San Diego, Calif. Sept. 13–19, 2007.
Fantastic voyage: surgery for the third millennium.
Alumni Symposium, Seattle Children’s Hospital
and Regional Medical Center. Seattle, Wash.
Sept. 28–29, 2007.
Surgical options in the treatment of intractable
epilepsy. MultiCare CME course in pediatric epilepsy.
Mary Bridge Children’s Hospital. Tacoma, Wash.
Jan. 26, 2007.
Optimizing brain signal for brain–computer interface:
restoring neurological function. Science and Technology
Discovery Series. Rainier Club. Seattle, Wash.
March 9, 2007.
Dynamics between supplementary and primary motor
areas during finger movement (co-presenter). Highfrequency activity correlates of face and object recognition
near fusiform face area with ECoG (co-presenter).
Learning to predict cortical potentials using simultaneous
transcranial recordings (co-presenter). Pacific Cascade
Chapter of the Society for Neuroscience. Seattle, Wash.
April 6, 2007.
The behavioral split in the gamma band (co-presenter).
Finger movement classification for an electrocorticographic BCI (co-presenter). 3rd International
IEEE/EMBS Conference on Neural Engineering.
Kohala Coast, Hawaii. May 2007.
246
PUBLICATIONS
Abel TJ, Chowdhary A, Gabikian P, Ojemann JG,
Ellenbogen RG, Avellino AM. Spontaneous subdural
fluid collections following transection of a fatty filum
terminale: case report and review of the literature.
Pediatr Neurosurg. 2007;43(6):507–511.
Arthur TM, Saneto RP, de Menezes MS, Devinsky O,
Lajoie J, Murphy PJ, Cook WB, Ojemann JG. Vagus
nerve stimulation in patients with mitochondrial
electron transport chain deficiency. Mitochondrion.
Jul 2007;7(4):279–283.
Cirak B, Wang P, Avellino AM. Implications of a
neurosurgical intervention in a patient with a surgically
repaired hypoplastic left heart syndrome. Pediatr
Neurosurg. 2007;43(6):488–491.
Heike CL, Avellino AM, Mirza SK, Kifle Y, Perkins
J, Sze R, Egbert M, Hing AV. Sleep disturbances in
22q11.2 deletion syndrome: a case with obstructive
and central sleep apnea. Cleft Palate Craniofac J.
May 2007;44(3):340–346.
Leuthardt EC, Miller K, Anderson NR, Schalk G,
Dowling J, Miller J, Moran DW, Ojemann JG. Electrocorticographic frequency alteration mapping: a clinical
technique for mapping the motor cortex. Neurosurgery.
Apr 2007;60(4 Suppl 2):260–271.
Lynn AM, Bradford H, Kantor ED, Seng KY, Salinger
DH, Chen J, Ellenbogen RG, Vicini P, Anderson GD.
Postoperative ketorolac tromethamine use in infants
aged 6–18 months: the effect on morphine usage, safety
assessment and stereo-specific pharmacokinetics.
Anesth Analg. May 2007;104(5):1040–1051.
Maccotta L, Buckner RL, Gilliam FG, Ojemann JG.
Changing frontal contributions to memory before and
after medial temporal lobectomy. Cereb Cortex. Feb
2007;17(2):443–456.
Miller KJ, denNijs M, Shenoy P, Miller JW, Rao RPN,
Ojemann JG. Real-time functional brain mapping
using electrocorticography. Neuroimage. Aug 15
2007;37(2):504–507.
Neurosurgery
Miller KJ, Hebb AO, Ojemann JG, Rao RP, denNijs
M. Task-related principal component analysis: formalism and illustration. Conf Proc IEEE Eng Med Biol Soc.
2007:5469–5472.
Miller KJ, Leuthardt EC, Schalk G, Rao RP, Anderson
NR, Moran DW, Miller JW, Ojemann JG. Spectral
changes in cortical surface potentials during motor
movement. J Neurosci. Feb 28 2007;27(9):2424–2432.
Miller KJ, Makeig S, Hebb AO, Rao RP, denNijs
M, Ojemann JG. Cortical electrode localization
from X-rays and simple mapping for electrocorticographic research: the “Location on Cortex” (LOC)
package for MATLAB. J Neurosci Methods. May 15
2007;162(1–2):303–308.
Miyagawa R, Sotero M, Avellino AM, Kuratani J, Saneto RP, Ellenbogen RG, Ojemann JG. Apnea caused by
mesial temporal lobe mass lesions in infants: report of
3 cases. J Child Neurol. Sep 2007;22(9):1079–1083.
Ojemann JG, Leuthardt EC, Miller KJ. Brain-machine
interface: restoring neurological function through
bioengineering. Clin Neurosurg. 2007;54:134–136.
Peterson EC, Alden TD, Patterson K, Lipson A, Friedman D, Garcia J, Avellino AM. Epidural metastases
from endodermal sinus tumor arising from benign
sacral teratoma: case report and review of the literature.
J Neurosurg. Oct 2007;107(4 Suppl):303–306.
Schalk G, Kubanek J, Miller KJ, Anderson NR,
Leuthardt EC, Ojemann JG, Limbrick D, Moran D,
Gerhardt LA, Wolpaw JR. Decoding two-dimensional
movement trajectories using electrocorticographic signals in humans. J Neural Eng. Sep 2007;4(3):264–275.
Seto ML, Hing AV, Chang J, Hu M, Kapp-Simon KA,
Patel PK, Burton BK, Kane AA, Smyth MD, Hopper R,
Ellenbogen RG, Stevenson K, Speltz ML, Cunningham
ML. Isolated sagittal and coronal craniosynostosis
associated with TWIST box mutations. Am J Med
Genet A. Apr 1 2007;143(7):678–686.
Smyth MD, Limbrick DD Jr, Ojemann JG, Zempel J,
Robinson S, O’Brien DF, Saneto RP, Goyal M, Appleton
RE, Mangano FT, Park TS. Outcome following surgery
for temporal lobe epilepsy with hippocampal involvement
in preadolescent children: emphasis on mesial temporal
sclerosis. J Neurosurg. Mar 2007;106(3 Suppl):205–210.
Souter MJ, Rozet I, Ojemann JG, Souter KJ, Holmes
MD, Lee L, Lam AM. Dexmedetomidine sedation
during awake craniotomy for seizure resection: effects
on electrocorticography. J Neurosurg Anesthesiol.
Jan 2007;19(1):38–44.
Temkin NR, Anderson GD, Winn HR, Ellenbogen RG,
Britz GW, Schuster J, Lucas T, Newell DW, Mansfield
PN, Machamer JE, Barber J, Dikmen SS. Magnesium
sulfate for neuroprotection after traumatic brain
injury: a randomised controlled trial. Lancet Neurol.
Jan 2007;6(1):29–38.
Valadka AB, Ellenbogen RG, Wirth FP Jr, Laws ER Jr.
Acute care surgery: challenges and opportunities
from the neurosurgical perspective. Surgery. Mar
2007;14(3):321–323.
Vavilala MS, Muangman S, Waitayawinyu P, Roscigno
C, Jaffe K, Mitchell P, Kirkness C, Zimmerman JJ,
Ellenbogen RG, Lam AM. Neurointensive care;
impaired cerebral autoregulation in infants and
young children early after inflicted traumatic brain
injury: a preliminary report. J Neurotrauma.
Jan 2007;24(1):87–96.
Veiseh M, Gabikian P, Bahrami SB, Veiseh O, Zhang M,
Hackman RC, Ravanpay AC, Stroud MR, Kusuma Y,
Hansen SJ, Kwok D, Munoz NM, Sze RW, Grady WM,
Greenberg NM, Ellenbogen RG, Olson JM. Tumor
paint: a chlorotoxin:Cy5.5 bioconjugate for intraoperative visualization of cancer foci. Cancer Res.
Jul 15 2007;67(14):6882–6888.
247
Ophthalmology
The Division of Ophthalmology works in conjunction with
other specialists to provide the full spectrum of medical and
surgical treatment options for eye diseases in childhood.
The division includes an outpatient clinic, a visual sensory
laboratory and an ocular motor laboratory.
Our Eye Clinic is staffed by two full-time pediatric
ophthalmologists, residents from the University of
Washington School of Medicine and ophthalmic technicians
who are dedicated to providing high-level, comprehensive
care for infants and children with eye problems. The
Ophthalmology Clinic provides standard eye evaluations for
children with straightforward eye problems and consultations
for children with complex ocular and medical problems.
Diagnostic evaluations, by a team of clinicians and vision
scientists, employ state-of-the-art technology. Behavioral
Faculty
Avery H. Weiss, MD, Chief
Francine M. Baran, MD
John P. Kelly, PhD
James O. Phillips, PhD
Avery H. Weiss
MD, Chief
248
testing and visual evoked potential are used to assess
vision in preverbal infants and nonverbal children.
Electroretinograms probe function of the macula and retina
while confocal microscopy provides corresponding anatomic
details about these structures in children with retinal
diseases. Visual field testing and transient visual evoked
potentials measure optic nerve function and supply information
about cortical processing of visual inputs to the brain.
Children with strabismus and eye movement abnormalities
receive the benefit of eye muscle imaging technology and
quantitative analysis of their eye movements.
The division’s most recent accomplishments include 1)
comparison of visual deficits in children with visual pathway
tumors using visual evoked potentials and perimetry, 2)
assessment of visual development in infantile nystagmus,
3) reappraisal of astigmatism induced by periocular capillary
hemangioma and treatment with intralesional corticosteroid
injections and 4) retinal function and corresponding histology
in children with advanced retinoblastoma. Our research
provides valuable information for the care of our patients
and improves our ability to communicate with the family
about the underlying problems of their child’s vision disability.
Dr. Francine Baran, a pediatric ophthalmologist, was
recruited recently to Seattle Children’s. Her primary focus is
patient care and serving the needs of infants and children
with routine and complex eye problems. The addition of
Baran has enabled Children’s to expand vision services
to children across the Northwest region.
Avery H. Weiss, MD, is chief of the Division of
Ophthalmology at Seattle Children’s Hospital and
professor in the Department of Ophthalmology at
the University of Washington School of Medicine. His
clinical interests include visual disorders, eye movement
abnormalities, cataract and glaucoma, retinoblastoma
and orbital tumors, ocular malformations and ophthalmological manifestations of systemic diseases. His
research focuses on four areas: 1) assessment of optic
nerve and visual cortical function in infants with optic
nerve and brain malformations, visual pathway tumors,
amblyopia and cerebral visual impairment; 2) analysis
of eye movement abnormalities in children with brain
Ophthalmology
tumors, CNS malformations, brain injuries, autism
and nystagmus; 3) characterization of abnormalities
of the oculomotor plant in craniofacial disorders; and
4) assessment of macular development, probing local
retinal function and development of retinal imaging
techniques to study congenital and genetic retinal
diseases. He served on the editorial board of EyeNet,
official journal of the American Academy of Ophthalmology, and he received an honor award in recognition
of his contributions to the Academy. He served as a
medical consultant for ABC News, and he has been ad
hoc reviewer for more than 15 journals. He is an active
member of COG and several other pediatrics and
ophthalmology associations.
Francine M. Baran, MD, is attending physician at Seattle
Department of Ophthalmology at the University of
Washington School of Medicine. She received her MD
at MCP Hahnemann School of Medicine, Philadelphia,
Pa. She completed fellowship training in pediatric
ophthalmology at Children’s Hospital National Medical
Center, Washington, D.C. She specializes in pediatric
ophthalmology and adult strabismus. Her interests
include resident teaching and the mechanisms behind
the development of myopia.
John P. Kelly, PhD, is a research assistant professor
of Seattle Children’s Hospital and adjunct research
assistant professor at the University of Washington
School of Medicine. He completed a postdoctoral
fellowship at the University of Washington. He is
responsible for clinical electrophysiology and clinical
testing in pediatric patients. His interests include
application of signal processing algorithms for objective
measurement of visual responses, brain adaptations
during treatment of amblyopia, retinal imaging by
scanning laser ophthalmoscopy, prognostic research
of cortical visual impairment and cortical blindness,
optic pathway tumors, optic nerve diseases and other
common pediatric vision disorders. His interests also
extend to development of advances in technology; he
is consultant to the human interface laboratory in the
College of Engineering at the University of Washington.
Spotlight on team memberS —
Kyna Buchanan, COA
Tricia Armstrong, COA
We are passionate about patient education, and we are
continuously looking for better ways to help patients and
families understand their diagnoses. Doing diagnostic testing, keeping the clinic running smoothly and participating
in all the behind-the-scenes patient care helps us build strong
connections and consistently positive encounters with our
patients and families.
James O. Phillips, PhD, is researcher at Seattle Children’s
Hospital and research associate professor in the Department of Otolaryngology–Head and Neck Surgery at the
University of Washington. His focus is translational
research, taking innovations in basic neurophysiology
and genetics and applying them to the diagnosis and
treatment of clinical disorders in children. The Roger
H. Johnson Clinical Oculomotor Laboratory (COL) is a
result of this interest. The COL is a world-class clinical
and research laboratory created through collaboration
between basic scientists and clinicians at Children’s
and the University of Washington. The COL uses
innovations from testing in nonhuman primates and
adult patients at the University of Washington to guide
the development of testing in pediatric patients. In
addition, the COL is used for basic scientific inquiry
into the neural mechanisms underlying pediatric
disorders. With his colleagues, Phillips is studying the
mechanisms and progression of pediatric vestibular
disorders associated with congenital hearing loss,
such as Usher syndrome, and the basic cerebellar
mechanisms potentially underlying autism and
developmental delay.
249
Ophthalmology
RESEARCH FUNDING
New
Gravitational influence on cerebellar control of gaze
movement and adaptation. NASA/FSB. $187,426.
Francine M. Baran, MD
Power of the patch: amblyopia treatment trials.
Washington Academy of Eye Physicians and Surgeons.
May 17, 2007.
University of Washington Research Core Center.
NIDCD. $500,000.
Retinoblastoma: screening and treatment. Seattle
Rainier Lion’s Club. Seattle, Wash. June 14, 2007.
Vestibular and optokinetic testing for research and
clinic. NIDCD. $140,000.
Strabismus basics: exotropia and esotropia for the
pediatrician. Pediatric Associates, Inc PS. Bellevue,
Wash. Sept. 5, 2007.
Continuing
Linking cerebellar pathology to functioning in
individuals with autism: implications for translational
research. NAAR. $55,000.
Avery H. Weiss, MD
Effect of actual nystagmus waveforms on check reversal
and pattern-onset VEPs. (Co-presenter.) Association
for Research in Vision and Ophthalmology Annual
Meeting. Fort Lauderdale, Fla. May 6–10, 2007.
Neurobiology and genetics of autism: project II
precursors to language. NIH/NICHD. $30,000.
PUBLICATIONS
Neurophysiological studies of electrical stimulation
for the vestibular nerve. NIDCD. $353,475.
Pharmacotherapy of Meniere’s disease. American
Otological Society Research Fund. $36,350.
Deficits in auditory and vestibular function in episodic
ataxia type-1: a comparison of auditory and vestibular
function in human patients and mouse models.
Schmitt Research Award.
Vestibular influences on movement. NIH/NIDCD.
$29,511.
Bierer SM, Ling L, Nie K, Rubinstein JT, Phillips JO.
Design and validation of a vestibular prosthesis.
NWAVM. 2007.
Bollinger KE, Kattouf V, Arthur B, Weiss AH, Kivlin J,
Kerr N, West CE, Kipp M, Traboulsi EI. Hypermetropia
and esotropia in myotonic dystrophy. J AAPOS. Epub
Oct 29 2007.
Kelly JP, Seibel EJ. Accommodation during static
retinal imaging with a confocal scanning laser ophthalmoscope. Ophthalmology. Jun 2007;114(6):1205–1211.
Weiss AH, Kelly JP. Acuity development in infantile
nystagmus. Invest Ophthalmol Vis Sci. Sep 2007;
48(9):4093–4099.
Weiss AH, Kelly JP. Reappraisal of astigmatism
induced by periocular capillary hemangioma and
treatment with intralesional corticosteroid injection.
Ophthalmology. Epub Jun 22 2007.
250
Oral and Maxillofacial Surgery
The surgeons in the Division of Oral and Maxillofacial
Surgery provide surgical treatment of congenital and
acquired conditions of the jaws, teeth and face. We provide
a range of inpatient and outpatient services, including
surgical correction of jaw deformity, cleft lip and palate
and craniofacial abnormalities. Maxillofacial trauma, head
and neck infection and pathology of the oral cavity and
jaws are also managed. The division also offers minor oral
surgery for medically compromised children. Our staff has
extensive experience caring for children of all ages with
disabling conditions.
We work closely with orthodontists and surgeons from
other specialties to provide comprehensive, coordinated
treatments to improve facial function and appearance by
creating facial symmetry, properly aligning the jaws and
ensuring proper placement of teeth. Research in the
division focuses on facial growth, distraction osteogenesis
and cleft management.
Faculty
Professional Profile
Mark A. Egbert, DDS, Chief
Mark A. Egbert, DDS, is chief of the Division of Oral
and Maxillofacial Surgery (OMS) at Seattle Children’s
Hospital and associate professor in the Department
of Oral and Maxillofacial Surgery at the University of
Washington School of Dentistry. He served as chief
of OMS trauma services and chair of the dental
department at Harborview Medical Center for 12 years.
Egbert received his dental and OMS training at the
University of Washington and spent one year studying
OMS at the Gemeente Ziekenhuis, Arnhem, Netherlands.
His particular interests include the biological basis
of facial growth and development, the management
of cleft lip and palate, applications of distraction
osteogenesis in the correction of facial anomalies
and the treatment of pediatric oral and maxillofacial
pathology. Egbert serves on numerous review boards
for journals, including the International Journal
of Oral and Maxillofacial Surgery, the American
Journal of OMS and Triple O. His professional society
memberships include the AAOMS and ACPA, and he
has served as president of the Western Society of OMS
and the Washington State Society of OMS. He chairs
and serves on committees of the American Association
of OMS. He has served on the examining committee of
the American Board of Oral and Maxillofacial Surgery.
Mark A. Egbert
DDS, Chief
Publications
Rafferty KL, Sun Z, Egbert MA, Bakko DW, Herring
SW. Changes in growth and morphology of the
condyle following mandibular distraction in minipigs:
overloading or underloading? Arch Oral Biol. Oct
2007;52(10):967–976. Epub Jun 14, 2007.
251
Otolaryngology
The Division of Otolaryngology manages the complete
spectrum of pediatric otolaryngologic disorders, including
hearing and speech problems, tonsil disease and sleep
apnea, head and neck masses including thyroid disease
and cancer, upper airway obstruction and voice problems.
The division comprises six pediatric otolaryngologists and
one nurse practitioner. The division is closely associated
with the Childhood Communication Center, which brings
together staff from audiology, the cochlear implant team,
education, genetics, pediatrics, psychiatry and speech
language services to provide multidisciplinary care to
Faculty
Scott C. Manning, MD, Chief
Eunice Y. Chen, MD, PhD
Andrew F. Inglis Jr., MD
Henry C. Ou, MD
Jonathan A. Perkins, DO
Kathleen C.Y. Sie, MD
Scott C. Manning
MD, Chief
252
children with communication needs. Division members
also participate in the Craniofacial Center to serve children
with cleft lip and palate and other craniofacial disorders.
The division has several subspecialty clinics. The
Hearing Loss Clinic provides a multidisciplinary evaluation
of children with hearing problems. The Vascular Anomalies
Clinic treats children with birthmarks ranging from port
wine stains to large vascular tumors. Other specialty clinics
include the Complex Airway Clinic, Voice Clinic, Microtia
Clinic, Velopharyngeal Insufficiency Clinic and Chronic
Sinusitis Clinic. The division is closely affiliated with the
University of Washington and the Virginia Merrill Bloedel
Hearing Research Center in its research efforts. In addition,
the division supports basic science research focusing on
lymphatic malformations. Ongoing research projects
include speech processing for young cochlear implant
recipients, gene mapping for vasculogenesis in vascular
anomalies, immunologic profiling in chronic sinusitis
patients, outcomes with speech surgery and ototoxicity.
The Division of Otolaryngology is involved in training
otolaryngology residents from the University of Washington
and Madigan Army Medical Center. We offer a one-year
clinical fellowship in pediatric otolaryngology. Fellows
may also pursue a second year of research funded by the
University of Washington Department of Otolaryngology
NIH Training Grant.
Scott C. Manning, MD, is chief of the Division of
Otolaryngology at Seattle Children’s Hospital and
professor in the Department of Otolaryngology-Head
and Neck Surgery at the University of Washington
School of Medicine. He is president of the Northwest
Academy of Otolaryngology. Manning earned his
MD from Tulane Medical School, completed his
residency at University of Texas Southwestern Medical
Center at Dallas, and did a fellowship in pediatric
otolaryngology in Pittsburgh. He served as chief of
pediatric otolaryngology at Parkland Hospital and
Dallas Children’s Hospital. Manning is president-elect
of the American Society of Pediatric Otolaryngology.
His clinical interests are pediatric sinusitis, chronic
ear disease and vascular anomalies.
Otolaryngology
Eunice Y. Chen, MD, PhD, is the newest member of
the Division of Otolaryngology at Seattle Children’s
Hospital and acting assistant professor in the Department of Otolaryngology-Head and Neck Surgery at
earned her MD and PhD in cancer biology at Stanford
University School of Medicine and completed residency
training in otolaryngology-head and neck surgery
at Stanford University Medical Center. She did her
pediatric fellowship training at Children’s. Her clinical
practice and interests involve all aspects of pediatric
otolaryngology while her research focuses on the basic
science of vascular anomalies.
Andrew F. Inglis Jr., MD, is attending physician at
the Department of Otolaryngology-Head and Neck
Medicine. His work focuses on pediatric airway
diseases and general pediatric otolaryngology. Among
his clinical and research interests are diseases of the
larynx, including laryngeal stenosis and recurrent
respiratory papillomatosis. He is on the national
Recurrent Respiratory Papillomatosis Task Force.
Henry C. Ou, MD, is otolaryngologist at Seattle Children’s
Hospital and assistant professor in the Department of
Otolaryngology-Head and Neck Surgery at the University
of Washington School of Medicine. Ou earned his MD
at the Washington University School of Medicine, did
his residency training in otolaryngology at the University
of Washington and obtained a pediatrics fellowship at
Children’s and the University of Washington. While
he practices all aspects of pediatric otolaryngology,
his primary research interests are hearing loss and
cochlear implantation.
Jonathan A. Perkins, DO, is otolaryngologist at Seattle
Department of Otolaryngology-Head and Neck
Medicine. Perkins earned his DO at the University of
Osteopathic Medicine and Health Sciences, did his
residency training in otolaryngology at Madigan Army
Medical Center in Fort Lewis, Wash., and completed a
pediatrics fellowship at Children’s and the University of
Washington. While he practices all aspects of pediatric
otolaryngology, his primary research interests are
communication disorders and vascular anomalies
of the head and neck.
Spotlight on team member — Stacy Russ, BA
The Vascular Anomalies Program is taking great strides in
providing enhanced care for current and future patients.
Soon, we will implement a national relational database
across multiple institutions in order to have a larger population of de-identified patients for clinical outcomes research.
We are also planning to study the efficacy of the long-term
follow-up care that our patients receive.
Kathleen C.Y. Sie, MD, is director of the Childhood
Communication Center at Seattle Children’s Hospital
and associate professor in the Department of
Otolaryngology-Head and Neck Surgery at the
developed the Childhood Communication Center in
2002 to optimize the multidisciplinary care available
to children with complex communication needs. She
also participates in the Craniofacial Center. She earned
her MD from the University of Michigan Medical
School, completed a residency in otolaryngology and
a fellowship in auditory research at the University of
Washington, and completed a clinical fellowship in
pediatric otolaryngology at Children’s Hospital Boston.
Her clinical efforts are focused on communication
issues of childhood. She directs the Hearing Loss Clinic
and co-directs the Cochlear Implant Program. Sie
performed the first cochlear implant at Children’s in
1994, and performed all of Children’s cochlear implants
until 2005. She also works with speech language
pathologists in the evaluation and management of
children with velopharyngeal insufficiency (VPI), and
she works with colleagues to perform complex auricular
reconstruction using autologous tissue and on prosthetic
management of microtia. Her research efforts have
focused on surgical outcomes in VPI management
and epidemiological studies on pediatric cochlear
implantation.
253
Otolaryngology
AWARDS AND HONORS
Pediatric Otolaryngology Dialogues. Bordeaux, France.
June 2007.
Scott C. Manning, MD
Family Choice Award. Family Advisory Council.
RESEARCH FUNDING
New
Henry C. Ou, MD
Evaluation of candidate otoprotective compounds in
the mouse utricle. National Organization for Hearing
Research Foundation. $7,500.
Evaluation of candidate otoprotective compounds in
the mouse utricle. University of Washington Royalty
Research Fund (RRF) grant. $40,000.
Hearing loss and quality of life of children
and youth. NIH.
Continuing
Susan J. Norton, PhD
Monitoring of risk factors for late-onset hearing loss
among children. CDC/DHHS. $210,835.
Development of a standardized scale for ototoxicity.
American Society of Pediatric Otolaryngology –
CORE grant. $20,000.
254
Scott C. Manning, MD
Pediatric sinusitus. Grand Rounds, Department of
Otolaryngology. University of Texas Health Science
Center. Houston, Texas. Feb. 1, 2007.
Oto manifestations of chronic vasculitis. Rheumatology
Conference, Department of Rheumatology. Seattle
Children’s Hospital. Seattle, Wash. March 5, 2007.
Sinusitis. Vascular anomalies (visiting professor).
Columbia University. New York, N.Y. May 24, 2007.
Ear tube mini-seminar. Lymphatic malformation
course. American Academy of Otolaryngology.
Washington, D.C. Sept. 15–18, 2007.
Pediatric sinusitis, neck masses, vascular anomalies,
fungal sinusitis (visiting professor). University of
Santiago. Santiago, Chile. Oct. 1–3, 2007.
Pediatric sinusitis seminar (co-presenter).
American Academy of Pediatrics. San Francisco, Calif.
Oct. 29, 2007.
Pediatric sinusitis (visiting professor). Yale University.
New Haven, Conn. Nov. 2, 2007.
Henry C. Ou, MD
Using the zebrafish lateral line to screen an FDA library
for compounds that protect hair cells (co-presenter).
2007 Association for Research in Otolaryngology
Midwinter Meeting. Denver, Colo. February 2007.
Functional loads of tongue and consequences of volume
reduction (co-presenter). University of Washington,
Seattle, and Cukurova University, Adana, Turkey.
The IADR/AADR/CADR 85th General Session and
Exhibition. New Orleans, La. March 22, 2007.
Otolaryngology
Management of lymphatic malformations. American
Academy of Otolaryngology-Head and Neck Surgery
Annual Conference. Washington, D.C. September 2007.
SENTAC panel on multidisciplinary vascular anomaly
management. Milwaukee, Wis. December 2007.
Pediatric conductive hearing loss, BAHA and atresia
(co-presenter). Northwest and Oregon Academies of
Otolaryngology, Annual Winter Conference. Whistler,
British Columbia, Canada. Jan. 15, 2007.
Perkins JA, Tempero RM, Hannibal MC, Manning SC.
Clinical outcomes in lymphocytopenic lymphatic
malformation patients. Lymphat Res Biol.
2007;5(3):169–174.
Sie KC, Chen EY. Management of velopharyngeal
insufficiency: development of a protocol and modifications of sphincter pharyngoplasty. Facial Plast Surg.
May 2007;23(2):128–139.
Medical evaluation of childhood sensorineural hearing
loss: update 2007. Late onset and progressive hearing
loss in children. AUCD, University of Washington,
Seattle Children’s Hospital. Seattle, Wash. Aug. 10, 2007.
Medical evaluation of childhood hearing loss.
Pediatric Otolaryngology Didactic Series. University
of Washington, Department of Otolaryngology-Head
and Neck Surgery. Aug. 28, 2007.
VPI management: surgical approach. Pediatric
Otolaryngology Didactic Series. University of
Washington, Department of Otolaryngology-Head
and Neck Surgery. Sept. 5, 2007.
PUBLICATIONS
Heike CL, Avellino AM, Mirza SK, Kifle Y, Perkins
JA, Sze R, Egbert M, Hing AV. Sleep disturbances in
22q11.2 deletion syndrome: a case with obstructive
and central sleep apnea. Cleft Palate Craniofac J.
May 2007;44(3):340–346.
McCullough BJ, Adams JC, Shilling DJ, Feeney MP,
Sie KC, Tempel BL. 3p- syndrome defines a hearing
loss locus in 3p25.3. Hear Res. Feb 2007;224(1–2):51–60.
255
Transplant Surgery
The Division of Transplant Surgery at Seattle Children’s
Hospital offers comprehensive care to patients with
end-stage disease of the intestine, liver and kidneys.
It is the only pediatric intestinal transplant program in
the Northwest.
Solid organ transplantation is the treatment of choice for
end-stage organ disease in children. We provide consultation,
diagnosis, treatment and management for end-stage organ
failure with skilled teams of health-care professionals
focusing on the needs of our patients and families. A
candidate’s team includes the appropriate members from
Faculty
Patrick J. Healey, MD, Chief
Simon P. Horslen, MBChB
Karen F. Murray, MD
Jorge D. Reyes, MD
Patrick J. Healey
MD, Chief
256
our staff of doctors — board-certified pediatric hepatologists,
gastroenterologists, nephrologists, surgeons and transplant
surgeons — as well as dietitians and pediatric nurses
specially trained in the care of transplant patients. We assist
our pediatric transplant candidates and their families before,
during and after organ transplantation, providing physical,
emotional and financial support for this life-changing
experience.
We use advanced technologies and the most current
treatment protocols, including state-of-the-art interventional
radiological procedures, for improved diagnosis, care,
management and recovery. We also provide assistance
in accessing and coordinating financial resources.
Educating patients and their families is a critical
component of our care. We teach them to monitor and to
administer anti-rejection medications and to recognize
signs of infection and rejection. We also help them return
to a normal lifestyle, and we provide education to patients’
school staff as well as other physicians and care providers.
We conduct psychosocial evaluations and follow-up and
offer referrals to patient and family support groups.
We have developed an Intestinal Care Program for
children with diseases of the intestine requiring total
parenteral nutrition (TPN). Another way we advance
treatment is by participating in numerous clinical research
trials that study new medications and treatments.
Patrick J. Healey, MD, is chief of the Division of
Transplant Surgery at Seattle Children’s Hospital and
associate professor in the Division of Transplantation
and the Division of Pediatric Surgery in the Department
of Surgery at the University of Washington School
of Medicine. He received his MD from the Boston
University School of Medicine. He completed his
general surgery residency at the Hartford Hospital
and completed fellowship training in abdominal
transplantation at the University of Washington and
in pediatric surgery at Children’s. Healey has expertise
and training in pediatric transplant, specifically of the
liver and kidney. He is a member of the UNOS Organ
Availability Committee (2007–2008) and the UNOS
Pediatric Committee (2005–2007). His clinical and
research interests include transplantation in infants
and small children, neonatal surgery, congenital
anomalies and pediatric tumors.
Transplant Surgery
Simon P. Horslen, MBChB, is medical director for liver
and intestine transplant at Seattle Children’s Hospital
and professor of pediatrics at the University of Washington School of Medicine. He is helping lead the
expansion of Children’s transplant program. Horslen
earned his medical degree from the University of
Bristol, England. He is a founding member and fellow
of the Royal College of Paediatrics and Child Health,
is a member of the Royal College of Physicians and is
accredited in general pediatrics and pediatric gastroenterology. He was medical director of the pediatric
transplant program at the University of Nebraska
Medical Center. His clinical and research interests
include metabolic liver disease, intestinal failure,
and liver and intestine transplant. Horslen serves as
chair of the Education Committee and member of the
Nominating Committee for the International Pediatric
Transplant Association. He is the incoming chairman
of the UNOS Pediatric Transplant Committee.
Ruth A. McDonald, MD, is medical director of solid organ
transplantation and clinical director of nephrology at
Seattle Children’s Hospital, and she is associate professor
of Medicine. She also serves as co-director of several
outreach clinics in pediatric nephrology in Washington, Alaska and Montana. She earned her MD at the
University of Minnesota. She completed her residency
and served as assistant chief resident, and completed
a fellowship in the Division of Pediatric Nephrology at
the University of Washington. She serves as principal
investigator in many multicenter research studies on
pediatric renal transplantation. Currently she serves
on the North American Pediatric Renal Trials and
Cooperative Studies Board of Directors and is chair of
the Participating Centers Committee. She has a special
clinical interest in post-transplant lymphoproliferative
disorder and viral infections after transplant in all solid
organ transplant recipients. She is an at-large member
of the Children’s University Medical Group Board of
Directors and chairs the group’s Clinical Practice
Committee. McDonald is respected nationally as a
leader in organ allocation policy development. She
serves on the UNOS Kidney Committee, and she is
an elected member of the UNOS Board of Directors.
Additionally she serves on the pediatric nephrology
sub-board of the American Board of Pediatrics.
Spotlight on team member — Keli Hansen, ARNP
I am really looking forward to the installation of a new
transplant database, which will help our team manage the
large amount of patient information required for safe and
effective care. With the amount of time the database will
save, we will be able to focus on patient satisfaction, program
growth and developing a world-class transplant program
with outstanding outcomes.
Karen F. Murray, MD, is director of the Hepatobiliary
Program at Seattle Children’s Hospital and program
director of Gastroenterology Education; she is
She received her MD from Johns Hopkins School of
Medicine and did a pediatrics residency and a chief
resident year at Children’s. She completed a clinical
and research fellowship in gastroenterology and
nutrition in the combined program at Children’s
Hospital Boston and Massachusetts General Hospital,
Harvard Medical School. Murray has done research
and work in Bangladesh and Tanzania. In addition to
clinical care in gastroenterology and transplantation,
she has an active clinical research program in hepatology.
Her main focus is in the treatment and pathophysiology
of hepatitis C viral infection, but her studies also
include the treatment of hepatitis B viral infection and
nonalcoholic fatty liver disease. Murray is president
of Children’s medical staff. She is a member of the
Gastroenterology Sub-board Credentialing Committee
and the Transplant Hepatology Certificate of Added
Qualifications Standard Setting Committee of the
American Board of Pediatrics, and is on the steering
committees of three National Institute of Diabetes and
Digestive and Kidney Diseases clinical research networks
related to her research. She mentors pediatrics residents
and speaks at the noon conferences at Children’s.
257
Transplant Surgery
Jorge D. Reyes, MD, is director of Transplant Services at
Seattle Children’s Hospital and chief of the Division of
Transplantation in the Department of Surgery at the
University of Washington. He received his MD and a
surgery residency in Belo Horizonte, Brazil. He also
completed surgical residencies, research positions and
fellowships at Harvard, New York Medical College and
the University of Pittsburgh. Reyes is internationally
known for his research in the development of new
immunosuppressive drug therapies and strategies,
including the weaning of immunosuppression, and
tolerance. He established the intestine program at the
University of Pittsburgh, as well as the living donor
and split liver transplant programs, and made developmental strides in liver transplantation for primary
liver tumors in children. Reyes is medical director for
LifeCenter Northwest, and serves on various UNOS
committees and on the Advisory Committee on Organ
Transplantation (ACOT) of the Health Resources and
Services Administration (HRSA).
Infantile liver disease. Short bowel syndrome.
(WWAMI visiting professor.) Great Falls, Mont.
April 23–24, 2007.
The argument for induction immunosuppression.
Studies of Pediatric Liver Transplantation Annual
Meeting. Nashville, Tenn. October 2007.
Challenges of clinical diagnosis for the patients
presenting with liver disease; liver transplantation
outcome. Wilson Disease Association Regional
Meeting. Chicago, Ill. Nov. 11, 2007.
Symposium on best adult deceased donors for pediatric
transplant candidates. 4th Congress of the International
Pediatric Transplant Association. Cancun, Mexico.
March 17–21, 2007.
Pediatric renal transplantation. UNOS Pediatric Summit
on Pediatric Organ Donation and Transplantation.
San Antonio, Texas. March 28, 2007.
American Transplant Congress Annual Meeting.
Chronic vascular access in unusual circumstances:
hemodialysis, ultrafiltration. American College of
Surgeons 93rd Clinical Congress. New Orleans, La.
October 2007.
Acute immunologic events in organ transplantation.
Chronic allograft dysfunction. (Course organizer, postgraduate courses.) 4th Congress of the International
Pediatric Transplant Association. Cancun, Mexico.
March 17–21, 2007.
Liver and intestine transplantation (speaker and workshop director). UNOS Pediatric Summit on Pediatric
Organ Donation and Transplantation. San Antonio,
Texas. March 28, 2007.
258
CMV prophylaxis in solid organ transplant recipients.
Transplant Grand Rounds. Loma Linda, Calif.
April 24, 2007.
Anti-viral prophylaxis delays onset of subclinical
viral infection in pediatric renal transplant recipients.
Transitioning the adolescent transplant patient to
adult care. American Transplant Congress Pediatric
Symposium. San Francisco, Calif. May 2007.
Impact of anti-viral prophylaxis on subclinical viral
infection in pediatric renal transplant recipients.
American Society of Pediatric Nephrology. Toronto,
Ontario, Canada. May 2007.
Hyperphosphatemia-associated risk of hospitalization
in pediatric chronic kidney disease (CKD): an analysis
of the NAPRTCS. American Society of Nephrology.
San Francisco, Calif. November 2007.
Transplant Surgery
Karen F. Murray, MD
Career in academic medicine: striking a balance
(faculty leader and speaker). NASPGHAN Academic
Skills Workshop for Junior Faculty in Pediatric
Gastroenterology. New Orleans, La. January 2007.
The art of mentoring (faculty organizer and leader).
NASPGHAN Annual Meeting. Salt Lake City, Utah.
Oct. 25, 2007.
Fibrocystic conditions in the liver (chairperson).
AASLD/NASPGHAN Pediatric Symposium. Boston,
Mass. Nov. 2, 2007.
NASH: it is not just a fatty liver (plenary speaker).
27th Annual F. Richard Dion Pediatric Update. Virginia
Mason Medical Center. Seattle, Wash. December 2007.
Pediatric DCD: how we made it work. Transplant
surgeon considerations in donor management.
UNOS Pediatric Summit on Organ Donation and
Transplantation. San Antonio, Texas. March 28, 2007.
Predicting post-transplantation survival for patients
with hepatocellular carcinoma. Should liver transplant
patients be extubated immediately in the operating
room or in their ICU stay? Living related versus split
liver transplantation for pediatric recipients. 13th
Annual Congress, International Liver Transplantation
Society. Rio de Janeiro, Brazil. June 2007.
Co-moderator, plenary session 4. Xth International
Small Bowel Transplantation Symposium. Santa
Monica, Calif. Sept. 8, 2007.
Jorge D. Reyes, MD
Liver transplantation after cardiac death donors:
factors influencing the development of ischemic
cholangiopathy. 7th Annual State of the Art Winter
Symposium, American Society of Transplant Surgeons.
Marco Island, Fla. Jan. 12–14, 2007.
PUBLICATIONS
LifeCenter Northwest Organ Donation Network
outreach presentation. Grand Rounds, Kootenai
Medical Center. Coeur d’Alene, Idaho. Jan. 23, 2007.
Chan EY, Larson AM, Gernsheimer T, Kowdley K,
Carithers RL, Reyes JD, Perkins JD. Recipient and
donor factors influence the incidence of graft-vs.-host
disease in liver transplant patients. Liver Transpl.
Apr 2007;13(4):516–522.
New horizons in organ donation and transplantation
in Eastern Washington. LifeCenter Northwest Organ
Donation Network outreach presentation. Spokane,
Wash. Jan. 23, 2007.
Recipient and donor factors influence the incidence
of graft versus host disease in liver transplant patients.
2nd Annual Academic Surgical Congress. Phoenix,
Ariz. Feb. 6–9, 2007.
LifeCenter Northwest Organ Donation Network
outreach presentation. Kadlec Medical Center.
Richland, Wash. Feb. 8, 2007.
Optimal use of calcineurin inhibitors in children.
Ethical issues in pediatric transplantation (chair,
plenary symposium 3). 4th Congress of the
International Pediatric Transplant Association.
Cancun, Mexico. March 17–21, 2007.
Castellan M, Gosalbez R, Perez-Brayfield M, Healey PJ,
McDonald R, Labbie A, Lendvay T. Tumor in bladder
reservoir after gastrocystoplasty. J Urol. Oct
2007;178(4 Pt 2):1771–1774.
McDonald RA. Renal and urologic manifestations of
pediatric condition falsification/Munchausen by proxy.
Pediatr Nephrol. Jun 2007;22(6):849–856.
Horslen SP, Barr ML, Christensen LL, Ettenger R,
Magee JC. Pediatric transplantation in the United
States, 1996–2005. Am J Transplant. May
2007;7(5 Pt 2):1339–1358.
Hsu EK, Murray KF. Hepatitis C virus in children.
Pediatr Infect Dis J. 2007;2(1):3–9.
Malone FR, Horslen SP. Medical and surgical
management of the pediatric patient with intestinal
failure. Curr Treat Options Gastroenterol. Oct
2007;10(5):379–390.
259
Transplant Surgery
Murray KF. Autoimmune hepatitis: are we using
the right therapy? J Pediatr Gastroenterol Nutr.
Jan 2007;44(1):18–19.
Murray KF, Rodrigue JR, González-Peralta RP, Shepherd J, Barton BA, Robuck PR, Schwarz KB, PEDS-C
Clinical Research Network. Design of the PEDS-C
trial: pegylated interferon +/- ribavirin for children
with chronic hepatitis C viral infection. Clin Trials.
2007;4(6):661–673.
Reyes JD. Intestinal transplantation: historical notes.
In: Fine RN, Webber SA, Olthoff KM, Kelly DA, Harmon WE, eds. Pediatric Solid Organ Transplantation,
Second Edition. Oxford, England: Blackwell. 2007.
Smith JM, Corey L, Healey PJ, Davis CL, McDonald RA.
Adolescents are more likely to develop post-transplant
lymphoproliferative disorder after primary EpsteinBarr virus infection than younger renal transplant
recipients. Transplantation. Jun 2007;83(11):1423–1428.
Smith JM, McDonald RA. Post-transplant management.
In: Fine RN, Webber SA, Olthoff KM, Kelly DA, Harmon WE, eds. Pediatric Solid Organ Transplantation,
Second Edition. Oxford, England: Blackwell. 2007.
Smith JM, Stablein DM, Munoz R, Hebert D,
McDonald RA. Contributions of the transplant registry:
the 2006 annual report of the North American Pediatric
Renal Trials and Collaborative Studies (NAPRTCS).
Pediatr Transplant. Jun 2007;11(4):366–373.
Suskind DL, Murray KF. Increasing the mutation
rate for Jagged1 mutations in patients with Alagille
syndrome. Hepatology. Aug 2007;46(2):598–599.
260
Urology
The Division of Urology is nationally and internationally
recognized for its long-standing commitment to and expertise
in the care of children with complex genitourinary anomalies.
The division’s tradition of innovative clinical research and
surgical techniques dates back to the seminal work in the
primary repair of exstrophy carried out by Dr. Julian Ansell
over 30 years ago. Since that time, we have pioneered other
approaches, including the complete primary repair of
exstrophy originated by our former division chief, Dr. Michael
Mitchell, and current division associate chief, Dr. Richard
Grady. We continue to embrace the concepts of minimally
invasive open, laparoscopic and robotic pediatric urological
surgery under the leadership of the new division chief,
Dr. Martin Koyle. Complex patients are treated in multispecialty programs that allow collaboration with colleagues
in nephrology, transplant, oncology, endocrinology and
neurodevelopmental medicine. A specialized clinic, the
Bladder Health Clinic, has been developed to evaluate and
care for children with disorders of elimination (dysfunctional
elimination) under physician faculty guidance and that of
Teresa Soucie, PA-C, and four urology nurse specialists.
Such common disorders include enuresis, constipation,
recurrent lower urinary tract infections and other medically
related urological conditions.
To critically evaluate the results of new approaches
to the medical and surgical treatment of pediatric urologic
conditions, all of the faculty members jointly have created
clinical research protocols to follow these patients and are
creating a large-scale relational multiplatform database
to track children with a variety of urologic conditions. The
division’s research efforts are supported by a clinical research
nurse, Amy Anderson, BSN, who assists in protocol development and patient recruitment for a number of clinical
research trials, such as the evaluation of complementary
medical therapies (i.e., cranberries) to treat urinary tract
infections in children, novel treatment for vesicoureteral
Faculty
Martin A. Koyle, MD, Chief
James A. Bassuk, PhD
Richard W. Grady, MD
Byron D. Joyner, MD
Thomas S. Lendvay, MD
Margarett Shnorhavorian, MD, MPH
Teresa Soucie, PA-C
Martin A. Koyle
MD, Chief
reflux and medical therapies for voiding dysfunction. Junior
faculty members Dr. Margarett Shnorhavorian and Dr. Thomas
Lendvay are involved in clinical outcomes research pertaining
to pediatric tumors and robotic simulation models, respectively.
The latter has led to a close involvement with the newly
formed Institute for Surgical and Interventional Simulation
Center at the University of Washington, which works on
the integration of simulation technologies and learning.
The focus of our basic research laboratory, led by
James Bassuk, PhD, is growth regulation of the bladder.
Previous efforts in the laboratory have led to current
initiatives for regenerative medicine approaches allowing
direct translation of applications to our patient population.
The division’s teaching commitment includes an
ACGME-approved, nationally respected two-year fellowship
in pediatric urology and an active role in the University of
Washington as well as the Madigan Army Medical Center
urology residency programs. The division’s Dr. Byron Joyner
continues as director of the University of Washington
Urology Residency Program. Division plans include expansion
of the clinical and research faculty in order to meet the
growing needs of the local, regional and national communities
as well as to increase our presence in the Children’ssponsored satellite clinics.
Martin A. Koyle, MD, is professor of urology at the
University of Washington and chief of the Division of
Urology and attending surgeon at Seattle Children’s
Hospital. He received his postgraduate urological
training at Harvard and the University of California
after receiving his MD at the University of Manitoba.
His clinical interests are focused around urinary tract
infections, vesicoureteral reflux and antibiotics, as well
as the fields of transplantation and pediatric urological
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Urology
has been an author or co-author on more than 200
peer-reviewed publications, chapters and manuscripts.
Recently he co-authored the textbook Pediatric Urology:
Surgical Complications & Management. Koyle has
received numerous awards and honors throughout his
years of practice, of which these are just a few: Selected
Member of National Register of Who’s Who; named
one of America’s Top Doctors six times; listed as one
of the Best Doctors in America three times; named
Colorado’s Physician of the Year in 2003; selected
for Who’s Who in American Education three times;
selected for Who’s Who in the World in 2007.
Spotlight on team member — Teresa Soucie, PA-C
This past year I was given the opportunity to develop a
Bladder Health Clinic for patients who need extensive medical
management rather than surgical management. In clinic, we
use a variety of teaching tools, provide emotional support and
send families home with a well-defined plan to resolve their
child’s problem in the home and school environments.
oncology. At present, active clinical research is being
carried out in projects pertaining to endoscopic injection therapy for vesicoureteral reflux and the use and
efficacy of antibiotics for urinary tract prophylaxis and
definitive therapy. Clinically, he has gained recognition
for his work in minimally invasive open and endoscopic
surgeries, and complex genitourinary reconstruction.
At present, active research is being carried out in
projects pertaining to endoscopic injection therapy
for vesicoureteral reflux and the use and efficacy of
antibiotics for urinary tract prophylaxis and definitive
therapy. Prior to coming to Children’s in 2007, Koyle
was chief of pediatric urology as well as professor of
surgery and vice-chief of the Division of Urology
at the University of Colorado. During his 19-year
tenure there, he was the first to perform laparoscopic
nephrectomy in an infant and also the first surgeon in
the United States to promote the use of the Malone
antegrade continence enema (MACE). He was a pioneer
in demonstrating the applicability of the laparoscopic
approach to varicoceles and the undescended testis,
and in describing the utility of the Bianchi approach
for inguinal scrotal pathology. Koyle is past president
of the Rocky Mountain Urology Society, the Society
for Pediatric Urology and the American Association
for Pediatric Urology. As well as being on the editorial
boards of The Journal of Urology, Journal of Pediatric
Urology and Pediatric Surgery International and being
associate editor of Dialogues in Pediatric Urology, he
262
James A. Bassuk, PhD, is an associate professor of urology
director of the Program in Human Urothelial Biology
at Seattle Children’s Hospital, and a founding member
of the Center for Tissue and Cell Sciences at Seattle
Children’s Hospital Research Institute. He obtained his
PhD in zoology from Iowa State University by completing a dissertation titled High Mobility Group Proteins
of Drosophila melanogaster. His postdoctoral training
at the Fox Chase Cancer Center in Philadelphia was
focused on fatty acid binding proteins as molecular
targets of liver carcinogens. Bassuk’s current research
interests are in urothelial cell biology and in tissueengineered corrective surgeries for hypospadias and
the nonfunctional bladder. In collaborative partnerships
with University of Washington biomedical engineers
and Children’s urologists, Bassuk founded the Center
for Bioengineering and Urologic Research and
Development in Seattle (CBURDS).
Richard W. Grady, MD, is associate chief of the Division
of Urology. He is also the director of the fellowship
program and director of clinical research. Grady is
attending physician at Seattle Children’s Hospital
and associate professor of urology at the University of
Washington School of Medicine. Grady received his
MD from the University of Michigan and completed a
urology residency at the Cleveland Clinic Foundation.
His training includes a research scholarship at the NIH
in cell-mediated immunity and a fellowship in pediatric
urology at Children’s. Grady’s research interests include
urinary tract infection. His clinical research interests
include the study of complex congenital anomalies
such as exstrophy, neurogenic bladder conditions
and disorders of sex differentiation. Current projects
include the development of a multiplatform relational
Urology
clinical database, a study of quality of life in patients
with spina bifida (as part of a multicenter project)
and several clinical research trials studying methods
to treat urinary tract infections in children. Grady is
active in regional, national and international urologic
societies. He has an interest in international medicine
and has been a visiting professor internationally in
addition to participating in medical missions to India.
Byron D. Joyner, MD, is associate professor at the University of Washington School of Medicine. He completed
his residency at Massachusetts General Hospital, a
research fellowship at Children’s Hospital Boston and
two years of training at the Hospital for Sick Children
in Toronto. He served for four years in the U.S. Army
as chief of pediatric urology at Madigan Army Medical
Center. Joyner is director of the urology residency
program at the University of Washington School of
Medicine. He trained in the Seattle Children’s teaching
scholars program and received the University of
Washington’s Julian S. Ansell Teaching Award for his
new approaches to teaching residents about interpersonal
and communication skills and professionalism. Joyner
has interests in clinical research related to voiding
dysfunction and urinary tract infections in children.
He is an active member of many professional societies
including the American Urological Association, American
Academy of Pediatrics, Society of University Urologists
and American College of Surgeons.
Thomas S. Lendvay, MD, is an assistant professor of
urology at the University of Washington School
of Medicine and attending surgeon in the Division of
Urology at Seattle Children’s Hospital. He graduated
from Rice University in Houston, Texas, with a dual
degree in German and biology, and received his
MD from Temple University School of Medicine in
Philadelphia, Pa. He completed a urology residency
at Emory University in Atlanta, Ga., and went on to
complete a two-year pediatric urology fellowship at
Children’s under Dr. Michael Mitchell. Lendvay’s
research interests include surgical simulation education
and surgical biorobotics development. He is a member
of the University of Washington BioRobotics Lab and
has been involved in transcontinental telerobotic
surgery demonstrations with NASA. He is research
faculty for ISIS (Institute of Surgical and Interventional
Simulation) and is developing curricula to train
surgical residents in robotic surgery. His clinical
research interests include the application of surgical
robotics in the correction of urologic congenital birth
defects and the impact minimally invasive anti-urinary
reflux procedures have had on the treatment of
vesicoureteral reflux. Current projects include the
development of a portable two-armed surgical robot
and the development of automated robotic surgical
control mechanisms. Lendvay is active in regional and
national urologic societies including being the chairman
of the Pediatric Surgery Interest Group in the Society
of Laparoscopic Surgeons. He has authored and
co-authored more than 10 peer-reviewed manuscripts
submitted and accepted this year and was awarded
“Best Poster” for two abstracts at the 2007 Medicine
Meets Virtual Reality Conference in Long Beach, Calif.
In addition, he has given interviews regarding research
in telerobotic surgery to national and international
media organizations including BBC World News, KBS
(Korean Broadcast Station), NPR (National Public Radio)
and various online science journals and news blogs.
Margarett Shnorhavorian, MD, MPH, is attending
physician at Seattle Children’s Hospital. Shnorhavorian
is acting assistant professor of urology at the University
of Washington School of Medicine. She received her
MD from the University of California, San Francisco,
and completed a urology residency at Yale. Her
training includes a Master in Public Health from the
University of California, Berkeley, and a fellowship in
pediatric urology at Children’s. She was recruited to
develop clinical outcomes research programs for the
Division of Urology. Her clinical research interests
include management of antenatal hydronephrosis,
long-term outcomes in survivors of childhood cancer
and congenital urinary anomalies. She received a
clinical research award from the Section of Urology
at the 2007 American Academy of Pediatrics National
Conference for research on clinical outcomes of
complete primary repair of bladder exstrophy. She is
an expert member of the University of Washington
Surgical Outcomes Research Consortium. She is an
instructor of ambulatory surgery for University of
Washington medical students. She has recently been
awarded a K–12 grant in the University of Washington
Male Reproductive Health Research program for a
collaboration with Children’s, the Seattle Cancer
Care Alliance and the University of Washington
Department of Epidemiology.
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Urology
Teresa Soucie, PA-C, joined Seattle Children’s Hospital
in July 2005, after graduating from the MEDEX
Northwest physician assistant program in 1994. From
1994 to 2005 she was in family practice caring for a
diverse population of patients of all ages, from newborn
to senior, with a wide variety of medical conditions.
Soucie was a registered nurse at the University of
Washington from 1975 to 1992, where she worked with
patients with renal failure requiring dialysis and those
preparing for renal transplantation as well as patients
with a diversity of urologic problems. During the last
five years of her nursing career, she was the nurse
manager for the Outpatient Urology Clinic and also
was a clinical nurse specialist/educator for patients
requiring treatment for prostate cancer and bladder
cancer. Her professional path has now come full circle
back to urology from adults with urologic problems to
children with urologic problems. Soucie truly enjoys
her current practice and the team of colleagues she
works with at Children’s.
RESEARCH FUNDING
AWARDS AND HONORS
University of Washington Mary Gates Undergraduate
Research Scholarship, Adam Mina. $6,000.
Continuing
James A. Bassuk, PhD
Evaluation of heterogeneity in urothelial cells in interstitial cystitis and clinical management of the disease
by recombinant modulators. NIDDK/NIH/DHHS.
$155,432.
Heterogeneity in urothelial cells. NIH/NIDDK.
$124,818.
Proteins as signals in urothelial cell proliferation.
University of Washington Bioengineering Undergraduate
Scholars in Research Program, Kiran Dyamenahelli.
$2,300.
Research Scholarship, Bryson Hicks. $6,000.
Research Scholarship, Kiran Dyamenahelli. $4,500.
Martin A. Koyle, MD
Selected for Guide to America’s Top Urologists.
Selected for “Leading Health Professionals of
the World.”
Clinical Research Award. American Academy of Pediatrics National Conference, Section on Urology. 2007.
Endocrine disruptors and the developing genitourinary
system. Grand Rounds, Miller Children’s Hospital.
Long Beach, Calif. Jan. 12, 2007.
Management of urinary tract infections from infancy
through adolescence. Pediatric Nurse Practitioner
Program. University of Washington Medical Center.
Seattle, Wash. February 2007.
The primary repair: best approach to exstrophy.
Mini-debate. Society for Pediatric Urology. Anaheim,
Calif. May 20, 2007.
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Urology
UTI: evidence-based approach. Postgraduate course.
American Urological Association Annual Meeting.
Anaheim, Calif. May 21, 2007.
Hydronephrosis — update in management. Maputo
Medical School. Maputo, Mozambique. October 2007.
Pediatric Urology Panel (moderator). Northwest
Urological Society Meeting. Vancouver, British
Columbia, Canada. December 2007.
Byron D. Joyner, MD
Improving professionalism: making the implicit more
explicit. Combined Conference Lecture, University of
Washington. Seattle, Wash. Jan. 3, 2007.
Urinary tract infections. Presentation at Lynndale
Elementary School Science Day. Lynnwood, Wash.
Feb. 1, 2007.
Video: Dimensions in Diversity (co-producer).
AUA Education Workshop. Washington, D.C.
July 13–16, 2007.
Martin A. Koyle, MD
Voiding dysfunction: International Children’s Continence Society update. Urology/Radiology Conference.
Children’s Hospital and Regional Medical Center.
Seattle, Wash. Feb. 20, 2007.
Evaluating measurable outcomes in resident curriculum.
Dean’s Special Committee, International Medical
Workforce Collaborative. University of Washington
Medical Center. Seattle, Wash. March 26, 2007.
Resident evaluation and hidden curriculum. Graduate
Medical Education Council. University of Washington
School of Medicine. Seattle, Wash. March 2007.
Hypospadias — how I do it! Postgraduate Teaching
Course on Paediatric Urology & Live Surgery. Bologna,
Italy. April 2007.
Antibiotic prophylaxis in the management of
vesicoureteral reflux isn’t proved or always necessary
(invited debater). Plenary Session of the Annual
Meeting of the American Urological Association.
Anaheim, Calif. May 2007.
Should hormone therapy be a primary treatment in
boys with cryptorchidism? (invited debater). Society
for Pediatric Urology Annual Meeting. Anaheim, Calif.
May 2007.
Pediatric urological oncology and pediatric incontinence and voiding dysfunction. Annual AUA Board
Review Course. Dallas, Texas. June 2007.
Defining diversity in urology training and administration. Evaluating professionalism. Preparation of the
program information form (PIF). Resident evaluation
and feedback. AUA Educational Workshop for Chairpersons and Program Directors. Washington, D.C.
July 2007.
Wilms’ tumor and rhabdomyosarcoma: past, present
and future. Curso Internacional de Urología Pediátrica
and Congreso Internacional de Sociedad Colombiana
de Urología — 50 Años. Cartagena, Colombia.
August 2007.
Defining diversity in urology training and administration
(video and combined lecture). University of Washington.
Seattle, Wash. September 2007.
The evolution of pediatric urology fellowship training
in North America (invited lecturer). BAPU Annual
General Meeting and BAPU 2007 Course. Cambridge,
England, United Kingdom. September 2007.
Options in the management of penoscrotal transposition
(invited lecturer). II World Congress of the Federation
of Associations of Pediatric Surgeons — WOFAPS and
VII Congress of Pediatric Surgical Association of the
South Cone of America — CIPESUR. Buenos Aires,
Argentina. September 2007.
Long-term issues in pediatric urological oncology
(invited moderator). Section on Urology, National
Conference and Exhibition of the American Academy
of Pediatrics. San Francisco, Calif. October 2007.
Defining diversity in urology. American Urological
Association Western Section. Scottsdale, Ariz.
November 2007.
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Urology
Development of surgical patterns in the patient with
disorders of sexual differentiation. University of Manitoba. Winnipeg, Manitoba, Canada. November 2007.
Where are we going with current paradigm changes
in vesicoureteral reflux? University of Missouri.
Columbia, Mo. December 2007.
Thomas S. Lendvay, MD
Robotic-assisted laparoscopic bilateral ureteral
reimplants (video). Robotic-assisted laparoscopic
mitrofanoff and ACE procedure (video). Trends in the
management of UPJ obstruction: a PHIS database study.
American Association of Pediatric Urologists Annual
Meeting. Steamboat Springs, Colo. January 2007.
Telesurgery: a new way to teach and treat. Society of
Urologic Nurses and Associates, Northwest Regional
Meeting. Seattle, Wash. March 22, 2007.
Robotic-assisted laparoscopic pediatric urology
reconstructive surgery. American Urological Association
Annual Meeting. Anaheim, Calif. May 2007.
Outcomes databases symposium (panelist discussant).
SPU Annual Meeting. Anaheim, Calif. May 19, 2007.
Pediatric surgery, tips and tricks. Robotic Program
Coordinators Conference. Intuitive Surgical, Inc.
Sunnyvale, Calif. June 14, 2007 and Sept. 10, 2007.
Robotic surgery demonstration. Seattle Pacific Science
Center. Seattle, Wash. June 16, 2007.
Long-term follow-up of complete primary repair of
exstrophy: the Seattle experience. American Academy
of Pediatrics National Conference, Section of Urology.
San Francisco, Calif. 2007.
266
PUBLICATIONS
Carmean N, Kosman JW, Leaf EM, Hudson AE,
Opheim KE, Bassuk JA. Immortalization of human
urothelial cells by human papillomavirus type-16
E6 and E7 genes in a defined serum-free system.
Cell Prolif. Apr 2007;40(2):166–184.
Castellan M, Gosalbez R, Perez-Brayfield M, Healey P,
MacDonald R, Labbie A, Lendvay TS. Tumor in
bladder reservoir after gastrocystoplasty. J Urol.
Oct 2007;178(4 Pt 2):1771–1774.
Chacko JK, Koyle MA, Mingin GC, Furness III PD.
Ipsilateral ureteroureterostomy in surgical management of severely dilated ureter in ureteral duplication.
J Urol. Oct 2007;178(4 Pt 2):1689–1692.
Chacko JK, Koyle MA, Mingin GC, Furness III PD.
Minimally invasive open renal surgery. J Urol. Oct
2007;178(4 Pt 2):1575–1578.
Feldman K, Feldman M, Grady RW, Burns M,
McDonald R. Renal and urologic manifestations of
pediatric condition falsification/Munchausen by
proxy. Pediatr Nephrol. Jun 2007;22(6):849–856.
Grady RW, Baker L. Exstrophy and epispadias.
In: Docimo S, Canning D, eds. Clinical Pediatric
Urology, Fourth Edition. Oxford, England: Isis
Medical Media, Ltd. 2007.
Healy KA, Baumgarten DA, Lendvay TS, Fountain
AJ, Galloway NTM, Ogan K. Occult spinal dysraphism
(OSD) and urolithiasis: are patients with OSD at
an increased risk of stone disease? J Endourol.
Nov 2007;21(11):1293–1296.
Higham-Kessler J, Reinert SE, Snodgrass WT, Hensle
TW, Koyle MA, Hurwitz RS, Cendron M, Diamond
DA, Caldamone AA. A review of failures of endoscopic
treatment of vesicoureteral reflux with dextranomer
microspheres. J Urol. Feb 2007;177(2):710–714.
Urology
Hudson AE, Carmean N, Bassuk JA. Extracellular
matrix protein coatings for facilitation of urothelial cell
attachment. Tissue Eng. Sep 2007;13(9):2219–2225.
Joyner BD, Vemulakonda VM. Improving professionalism: making the implicit more explicit. J Urol. Jun
2007;177(6):2287–2291.
Kitchens DM, Minevich E, DeFoor WR, Reddy PP,
Wacksman J, Koyle MA, Sheldon CA. Incontinence
following bladder neck reconstruction — is there
a role for endoscopic management? J Urol. Jan
2007;177(1):302–306.
Kosman J, Carmean N, Leaf EM, Dyamenahalli K,
Bassuk JA. The motif of SPARC that inhibits DNA
synthesis is not a nuclear localization signal. J Mol Biol.
Aug 24 2007;371(4):883–901.
Kosman J, Carmean N, Leaf E, Dyamenahalli K,
Bassuk JA. Translocation of fibroblast growth factor-10
and its receptor into nuclei of human urothelial cells.
J Cell Biochem. Oct 15 2007;102(3):769–785.
Parisi MA, Ramsdell LA, Burns MW, Carr MC,
Grady RW, Gunther DF, Kletter GB, McCauley E,
Mitchell ME, Opheim KE, Pihoker C, Richards GE,
Soules MR, Pagon RA. A gender assessment team:
experience with 250 patients over a period of 25 years.
Genet Med. Jun 2007;9(6):348–357.
Samuelson AL, Koyle MA, Strain JD. Repair of
right renal vein avulsion after auto-pedestrian crash.
J Trauma. Aug 2007;63(2):432–434.
Vemulakonda VM, Kopp RP, Sorensen MD, Grady RW.
Recurrent nephrogenic adenoma in a 10-year old boy
with prune belly syndrome: a case presentation.
Pediatr Surg Int. Nov 28 2007;23:e605–e607.
Walsh T, Hsieh S, Grady RW, Mueller B. Antenatal
hydronephrosis and the risk of pyelonephritis
hospitalization during the first year of life. Urology.
May 2007;69(5):970–974.
Koyle MA, Caldamone AA. Part 4: Considerations
regarding the medical management of VUR: what
have we really learned? Curr Med Res Opin. Sep
2007;23(Suppl 4):S21–S25.
Lendvay TS, Elderway A, Marshall F. Renal
angiomyolipoma. American Urological Association
Updates. 2007;36:Lesson 32.
Lendvay TS, Smith, J, Stapleton, B. Acute management of nephrolithiasis in children. In: Rose BD, ed.
UpToDate.com. Waltham, Mass. March 2007.
Lendvay TS, Sweet R, Han C-H, Soygur T, Cheng
JF, Plaire JC, Charleston JS, Charleston LB, Bagai S,
Cochrane K, Rubio E, Bassuk JA. Compensatory paracrine mechanisms that define the urothelial response
to injury in partial bladder outlet obstruction. Am J
Physiol Renal Physiol. Oct 2007;293(4):F1147–F1156.
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Centers
268
269
Craniofacial Center
Children’s Craniofacial Center is one of the largest programs
of its kind in the country and one of the busiest clinics in the
hospital. It comprises an interdisciplinary team of more than
48 members from 17 specialty areas. Our team provides
Faculty
Michael L. Cunningham, MD, PhD
Medical Director of Children’s
Craniofacial Center; Chief of the
Division of Craniofacial Medicine;
Adjunct Faculty Member, University
of Washington Departments of
Biological Structure, Oral Biology,
and Pediatric Dentistry (see also,
Department of Pediatrics, Division
of Craniofacial Medicine)
Surgical Director of Children’s
Craniofacial Center; Chief of the
Division of Craniofacial, Plastic and
Reconstructive Surgery (see also,
Department of Surgery, Division
of Craniofacial, Plastic and
Reconstructive Surgery)
Chief of the Division of Neurosurgery
(see also, Department of Surgery,
Division of Neurosurgery)
Maida Lynn Chen, MD
Associate Director of the Pediatric
Sleep Center (see also, Department
of Pediatrics, Division of Pulmonary
Medicine)
270
(see also, Department of Psychiatry
and Behavioral Medicine)
Timothy C. Cox, PhD
Research Associate Professor of
Pediatrics, University of Washington
School of Medicine, Adjunct Faculty
Member, Department of Oral Biology
Mark A. Egbert, DDS
Chief of the Division of Oral and
Maxillofacial Surgery (see also,
Department of Surgery, Division of
Oral and Maxillofacial Surgery, and
Department of Dental Medicine)
Division of Neurosurgery)
Director of the Medical Genetics
Clinic (see also, Department of
Pediatrics, Division of Genetics
and Developmental Medicine)
Joseph S. Gruss, MD
Division of Craniofacial, Plastic
and Reconstructive Surgery)
diagnosis and long-term management for children with
complex craniofacial abnormalities. We treat all craniofacial
conditions, from the most common — cleft lip and palate
and craniosynostosis — to the rarest, such as Apert and
Treacher Collins syndromes. The Craniofacial Center is
organized to meet patients’ medical and surgical needs
related to their condition, including breathing, feeding,
sleeping, growth, hearing, vision and dental. We also offer
prenatal counseling and a craniofacial genetics clinic.
Surgical techniques developed by our craniofacial
surgeons are revolutionizing the way craniofacial surgery
is done all over the world. These innovative procedures
enable doctors to address even the most serious and
complex craniofacial abnormalities and to provide the
benefits of improved health and a more normal appearance
for an increasing number of children. Our leadership team
includes both a medical and a surgical director, which
strengthens our ability to provide the highest-quality
outcomes for our patients.
Director of the 22q (Velocardiofacial
Syndrome) Clinic (see also,
of Craniofacial Medicine)
Anne V. Hing, MD
Director of the Craniofacial Genetics
Clinic (see also, Department of
Pediatrics, Division of Craniofacial
Medicine, and Division of Genetics
and Developmental Medicine)
Medical Director of the Pediatric
Sleep Center (see also, Department
of Pediatrics, Division of Pulmonary
Medicine)
Cynthia L. Koudela, DDS, MSD
(see also, Department of Dental
Medicine)
(see also, Department of Pediatrics,
Division of Craniofacial Medicine,
and Division of General Pediatrics)
Division of Otolaryngology)
Director of Dental Medicine
Fellowships and Education (see
also, Department of Dental Medicine)
Director of the Childhood
Communication Center (see also,
of Otolaryngology)
Dennis I. Sipher, DDS
(see also, Department of
Dental Medicine)
Chief of Outpatient Services,
Department of Psychiatry and
Behavioral Medicine (see also,
Department of Psychiatry and
Behavioral Medicine)
Jacqueline R. Starr, PhD,
MS, MPH
Division of Craniofacial Medicine)
Avery H. Weiss, MD
Chief of the Division of
Ophthalmology (see also,
of Ophthalmology)
Heart Center
Seattle Children’s Heart Center is one of the nation’s most
comprehensive cardiac programs. We provide extensive
cardiac care for fetuses, infants, children and teens
and assist with the transition of care into adulthood. Our
specialized team includes pediatric cardiologists, cardiac
surgeons, cardiac intensive care specialists, cardiac
anesthesiologists, nurses, echocardiography technicians
and caring staff. We have a national reputation for
excellence in a full range of cardiac services and
procedures, from advanced catheterization for cardiac
defects and heart rhythm disorders, to minimally invasive
surgery for the simplest problems, to open heart surgical
repairs and transplantation for infants with more complex
cardiac problems.
We are committed to the best possible outcome for
each patient, with ongoing research into new treatments
and technologies, ensuring that Children’s Heart Center
will continue to provide state-of-the-art care to all children.
Faculty
Co-director of Children’s Heart
Center, Chief of the Division of
Cardiothoracic Surgery (see also,
of Cardiothoracic Surgery)
Mark B. Lewin, MD
Co-director of Children’s Heart
Center, Chief of the Division of
Cardiology, Co-director of Cardiac
Ultrasound (see also, Department of
Pediatrics, Division of Cardiology)
Harris P. Baden, MD
Director of the Cardiac Intensive
Care Program (see also, Department
of Pediatrics, Division of Critical
Care Medicine)
Division of Cardiology)
Terrence U. Chun, MD
Robert Mazor, MD
Division of Critical Care Medicine)
Stephen P. Seslar, MD, PhD
Bruce Hardy, MD
D. Michael McMullan, MD
Surgical Director of ECMO (see
also, Department of Surgery,
Division of Cardiothoracic Surgery)
Brian D. Soriano, MD
Co-director of Cardiac MRI (see
also, Department of Pediatrics,
Aaron Olson, MD
Stanley J. Stamm, MD,
FAAP, FACC
Clinical Professor of Pediatrics,
University of Washington School of
Medicine (see also, Department of
Pediatrics, Division of Cardiology)
Howard E. Jeffries, MD,
MPH, MBA
Division of Critical Care Medicine)
Troy A. Johnston, MD
Assistant Director of Cardiac
Catheterization Laboratories (see
Thomas K. Jones, MD
Director of Cardiac Catheterization
Laboratories (see also, Department
of Pediatrics, Division of Cardiology)
Isamu Kawabori, MD
Yuk M. Law, MD
Director of Cardiac Transplant and
Heart Failure Service (see also,
of Cardiology)
Lester C. Permut, MD
Division of Cardiothoracic Surgery)
Director of Research in the Division
of Cardiology (see also, Department
of Pediatrics, Division of Cardiology)
Jack C. Salerno, MD
Director of the Electrophysiology
and Pacing Service (see also,
of Cardiology)
Karen Stout, MD
Margaret M. Vernon, MD
Delphine Yung, MD
Amy H. Schultz, MD, MSCE
271
Transplant Center
Seattle Children’s Transplant Center offers comprehensive
evaluation and care to patients with end-stage diseases of
the heart, liver, kidneys and intestines. We are committed
to providing optimal growth and quality of life for all of our
patients — and helping families return to normal, active
Faculty
Chief of the Division of Transplant
Surgery (see also, Department of
Surgery, Division of Transplant
Surgery)
Medical Director of Solid Organ
Transplant (see also, Department of
Pediatrics, Division of Nephrology,
and Department of Surgery, Division
of Transplant Surgery)
272
Dennis L. Christie, MD
Gastroenterology, Hepatology and
Nutrition (see also, Department
of Pediatrics, Division of
Gastroenterology, Hepatology
and Nutrition)
Cardiothoracic Surgery (see also,
of Cardiothoracic Surgery)
Medical Director for Liver and
Intestine Transplant (see also,
Department of Pediatrics,
Division of Gastroenterology,
and Department of Surgery,
Division of Transplant Surgery)
lives. The Transplant Center is a leader in pediatric liver,
heart and kidney transplant and viral surveillance, and
our graft and survival outcomes are excellent. Our liver
transplant program is at the forefront of improving surgical
techniques for split-liver and living donor liver transplants.
Our heart transplant program is an innovative clinical program
that can handle complex neonate and infant transplants.
Children’s is one of the top five pediatric kidney transplant
centers in the United States and is actively involved in
multicenter studies to reduce patients’ dependence on
immunosuppressive drugs. Our pediatric nephrology
fellowship program is one of only six in the country funded
by the National Institutes of Health. The center’s intestinal
care program, established in 2005, brings together Drs. Simon
Horslen and Jorge Reyes, who have more combined
experience treating children with intestinal failure than
any other physician pair in the nation.
Our physician leadership is also actively involved in
shaping national organ donation policy through the United
Network for Organ Sharing (UNOS).
Yuk M. Law, MD
Director of Cardiac Transplant and
Heart Failure Services (see also,
of Cardiology)
Karen F. Murray, MD
Director of the Hepatobiliary Program
Division of Gastroenterology, and
Department of Surgery, Division of
Transplant Surgery)
Jorge D. Reyes, MD
Director of Transplant Services
Division of Transplant Surgery)
Robert S. Sawin, MD
Surgeon-in-Chief (see also,
of General and Thoracic Surgery)
Division of Nephrology)
Chief of the Division of General
and Thoracic Surgery, Director of
Pediatric Surgery Fellowship and
Pediatric Surgery Education (see
also, Department of Surgery,
Division of General and
Thoracic Surgery)
Treuman Katz Center for
Pediatric Bioethics
The Treuman Katz Center for Pediatric Bioethics at
Seattle Children’s Hospital is the first program in the United
States to focus on pediatric issues with a broad mission of
research, consultation, education and training. The Center
was established in 2005 to enhance ethical deliberations
in pediatric health care and research throughout the country.
Our consultation and research programs provide the
foundation for training the next generation of pediatric
bioethicists and clinicians.
Each year, the Center sponsors a bioethics conference
that focuses on current controversies in pediatric care. The
2007 conference, Navigating Conflicts When Parents and
Faculty
Director, Treuman Katz Center
for Pediatric Bioethics (see also,
of Bioethics)
Director of Education, Treuman Katz
Center for Pediatric Bioethics (see
Division of Bioethics, and Division
of Emergency Medicine)
Ross M. Hays, MD
Ethics Consultant, Treuman Katz
Division of Bioethics, and Department
of Rehabilitation Medicine)
Providers Disagree about Medical Care, attracted over
200 participants from around the country.
Our research focuses on the interface between
population and individual concerns. We pay particular
attention to how these issues relate to parental decision
making and chronic illness. Current projects examine research
recruitment, genetic testing in children, justice and global
health, adolescent decision making, treatment decisions for
vulnerable populations and quality improvement in ethics.
The Center coordinates the Clinical Bioethics Consult
Service, advising families and clinicians about ethical issues
in health care decisions. Faculty have played a leadership
role in the development of the Research Bioethics Consult
Service, part of the Institute for Translational Health
Sciences, which provides advice to researchers, research
participants and institutional review boards. This program
serves Seattle Children’s Hospital, the University of
Washington, the Fred Hutchison Cancer Research Center
and WAMI affiliates.
Our pediatric bioethics fellowship program trains
clinicians for careers in bioethics. The program includes a
strong academic focus and includes a mentored research
project and training in clinical and research ethics consultation. The first fellow will complete training in 2009.
Clinical Director, Treuman Katz
Center for Pediatric Bioethics
Division of Bioethics, and Division
of Neonatology)
Maureen Kelley, PhD
Ethics Consultant, Treuman Katz
Division of Bioethics)
273
Seattle Children’s Hospital
Research Institute
274
Seattle Children’s Hospital Research Institute continues to experience
phenomenal growth. Throughout 2007, we made major investments in
building the infrastructure and critical mass of research talent that will
position us to be national leaders in pediatric medical research.
President, Seattle
Children’s Hospital
Research Institute
We are actively recruiting prominent investigators to bring their innovative
research programs to Seattle and join our growing scientific community.
We continue to develop state-of-the-art space so our research teams
have the facilities and sophisticated technical resources they need. Our
bold mission — discovering the care and cures of the future — guides
this swift progress.
In this section, you will find highlights of some of our most innovative
research from 2007, along with a special focus on our unique environment
and collaborative culture — discriminators that support our researchers
in their quest to find tomorrow’s solutions to some of the most daunting
challenges in pediatric medicine today.
275
Building for the Future
Investing for
Life-Saving Returns
Research Centers
Center for Childhood Cancer:
Dr. Irv Bernstein, Director
Center for Child Health, Behavior and
Development: Dr. Dimitri Christakis, Director
Center for Childhood Infections and
Prematurity Research: Dr. Arnold Smith,
Interim Director
Center for Clinical and Translational
Research: Dr. Bonnie Ramsey, Director
Center for Developmental Therapeutics:
Dr. Charles Vincent (Skip) Smith, Director
Center for Genetics and Development:
Dr. Phillip Chance, Director
Center for Immunity and Immunotherapies:
Dr. David Rawlings, Director
Center for Neurosciences: Dr. Sidney Gospe,
Interim Director
Center for Tissue and Cell Sciences:
Dr. Allison Eddy, Director
276
> Health outcomes: Studies led by
Dr. Dimitri Christakis offer new insights
into child development: playing with
toy blocks may improve language develIn 2007, Seattle Children’s research
opment in young children; watching
program made major leaps forward in
violent television programs between
preparing for the future. Members are
age 2 and 5 is linked to aggressive
now enrolled in nine interdisciplinary
and antisocial behaviors in boys when
research centers. Investigators, staff and
they reach age 7 to 9; and watching
high-tech core resources have filled the
educational videos may hinder language
Seattle Children’s Hospital Research
development in infants, but it has no
Institute’s 216,000-square-foot Building 1
positive or negative effect on the vocabuto capacity, and are spilling over into
laries of toddlers. Dr. Rita Mangioneadditional research facilities in downtown
Smith found that children in the United
Seattle. Our investigators received more
States fail to get recommended health
than $31 million of grant and contract
care more than 50% of the time.
revenue in 2007 — $19 million in
National Institutes of Health (NIH)
> Neonatology: Dr. Daniel Rubens found
and other federal funding alone —
a strong connection between Sudden
with more than 500 active studies.
Infant Death Syndrome (SIDS) and an
Significant research advances
abnormality in the inner ear. Rubens’
were made in areas such as:
findings may help doctors identify
> Immunology: Dr. David Rawlings
identified a connection between allergic
diseases and autoimmune diseases.
His study implies that allergic and
inflammatory diseases may trigger
autoimmune diseases by relaxing the
controls that normally eliminate
newly produced self-reactive B cells.
> Cancer: A study led by Dr. James
Olson showed that “tumor paint”
is 500 times better than a standard
MRI at helping surgeons distinguish
between cancer cells and normal
tissue. Olson and his team, who are
working to bring the paint into
human trials, developed the paint
from a scorpion-derived peptide
called chlorotoxin and Cy5.5, a
fluorescent, light-emitting molecule.
newborns at risk for SIDS by a simple,
affordable and routine hearing test
administered shortly after birth.
In 2007, Seattle Children’s also received
a $23.7 million NIH grant to study new
methods for gene repair, an innovative
approach to gene therapy. Dr. Andrew
Scharenberg and Dr. David Rawlings
co-direct the five-year grant, which supports
the Northwest Genome Engineering
Consortium (NGEC), a collaboration
between Seattle Children’s, the University
of Washington (UW) School of Medicine
and Fred Hutchinson Cancer Research
Center (FHCRC).
“We are growing rapidly and recruiting
more of the best and brightest scientific
minds to help us achieve our mission,” says
Dr. James Hendricks, president of Seattle
Children’s Hospital Research Institute.
“Our investments in research conducted
today will directly improve the future of
pediatric health care.”
This model offers a preview of the
Seattle Children’s Hospital Research
Institute campus once fully built out.
With four interconnected buildings
across two city blocks, the campus
will provide nearly 2 million square
feet of research space.
Building the space for discovery
To create the space needed for
tomorrow’s discoveries, Seattle
Children’s will continue to grow
our research campus in downtown
Seattle, close to our two major
research partners, the UW and
FHCRC, and other prominent
bioscience organizations. This campus
will ultimately encompass four inter
connected buildings spanning two
city blocks in one of the nation’s
fastest-growing hubs for biomedical
innovation, and provide nearly
2 million square feet of state-ofthe-art research space.
“In the past, our research program
was stymied by lack of space,” says
Dr. Thomas Hansen, CEO of Seattle
Children’s. “We have made the commitment to create a lively, unified research
campus to serve as our foundation for
finding new cures and setting new
standards of pediatric clinical care. Our
bold mission — to treat, prevent and,
ultimately, eliminate pediatric disease —
demands major investment in the
future of research at Seattle Children’s.”
“Why are we thinking so big?”
asks Hendricks. “We want to ensure
that our scientists have what they
need — the space, tools, resources and
environment — to change the future
for kids with illnesses and injury.”
Plans are already underway
to construct an 18-story building
connected to Building 1 via a sky
bridge, creating a campus with
high-tech laboratory facilities, an
ultramodern vivarium, open green
space, child care facilities, workout
space and “green roofs” with dramatic
views of mountains and water.
Dr. Laura Jansen is pioneering a way to extend the length of time that neuron
function in brain tissue samples can be studied.
New Technique Extends Window for Studying Brain Function
Simply put, time is a major limitation in studying how neurons function in brain tissue.
Specimens are typically rushed to the laboratory so they can be studied within hours.
Dr. Laura Jansen is pioneering an innovative new “frozen tissue” technique that allows
more time to study these tissues — a major improvement that may lead to significant
discoveries in brain research.
Jansen’s research, building on a groundbreaking technique developed by a team
of Italian scientists, begins by freezing brain tissue specimens in liquid nitrogen. This
stabilizes proteins in the cellular membranes, which are then isolated and injected
into an egg of a Xenopus frog.
“Once the cellular membranes naturally fuse with the egg membranes, the
proteins and receptors on the surface of the human cell are expressed on the surface
of the frog cell,” explains Jansen, a pediatric neurologist and member of the Center
for Neurosciences. “The frog cell is alive, so now the proteins and neuronal receptors
are functional, giving us much more time to study the process.”
This enables Jansen and her team, whose research focuses on the underlying
mechanisms that cause seizures, to measure the activity of the proteins and
receptors on the surface of the live frog cell and learn how different receptors
respond to various drugs.
Ultimately, the goal is to stop seizures before they become intractable —
unresponsive to medications or other treatments — and potentially require
brain surgery.
“Despite the most advanced care, there are inherent risks in every brain surgery,”
says Jansen. “We want to help identify what groups of epilepsy medications will work
best for individual children. This new frozen tissue technique allows much greater
opportunity to study these questions.”
277
Research
Creating a culture of collaboration
Ultimately, research is not about
square footage or high-tech
equipment.
“It is the interactions, the
environment and the philosophy
that make discovery happen,”
says Hendricks.
Seattle Children’s research
philosophy is marked by a strong
collegial environment of openness,
collaboration and teamwork.
“Groundbreaking research
does not occur in a vacuum, confined to individual laboratories,”
says Dr. F. Bruder Stapleton, chief
academic officer and senior vice
president at Seattle Children’s.
“The most innovative research
happens when experts from bench,
clinical and health-outcomes
research collaborate. We believe
this makes for better science.”
Seattle Children’s facilities are
designed to stimulate interaction among
researchers from different disciplines
and types of research. Our lab bays
reflect this “open laboratory” concept, as
does the intermixing of researchers from
a variety of scientific specialty areas on
each of the 11 stories of Building 1.
“The environment here is, ‘Let’s
share, let’s work together, let’s not
reproduce everything separately,’” says
Dr. Lakshmi Rajagopal, a member of
the Center for Childhood Infections
and Prematurity Research. “Lab teams
interact with each other and talk about
what’s working, what’s not working. It’s
very open here.”
The desire to stimulate interaction
underlies the very structure of the
research institute: nine centers organized
by common focus areas to promote collaboration and interdisciplinary research.
This allows experts in multiple areas to
grapple with similar questions — and
contribute their perspectives as specialists.
“People from different disciplines are
always willing to answer questions and
help out,” says Dr. Laura Jansen, a pediatric
neurologist and member of the Center
for Neurosciences. “It gives you access
to hundreds of people and their worlds
of experience.”
Conducting full-circle research
Ultimately, this philosophy forms the
framework for research that can come
full circle: An investigator’s idea, perhaps
sparked by a clinical encounter, leads to
bench research in the laboratory and yields
promising results that can then be transferred
to patients, igniting new questions for the lab.
“We aim to move our research beyond
bench to bedside to include implementation
to practice and evaluating health outcomes
in populations,” says Stapleton. “Taking
the bench-to-bedside philosophy full circle
guides future research and makes it more
fine-tuned, focused and effective.”
Helping an Infant’s Heart Heal More Quickly
Dr. Michael Portman’s research on the
effect of thyroid hormone on infants’
hearts could lead to new breakthroughs
in cardiac medicine.
278
Seattle Children’s director of cardiac research
Dr. Michael Portman wants to know how to
hasten an infant’s recovery after open-heart
surgery. He thinks thyroid hormone — which
affects the body’s response to stress — may
be one answer.
“During surgery, thyroid levels can drop
more than 50% in some patients and often
stay low for days,” Portman says. “We want
to know if maintaining higher thyroid hormone
levels will help an infant’s heart recover
faster and enable them to be taken off a
ventilator sooner.”
He’s the first researcher to study how the
regulation of thyroid hormone impacts the
neonatal heart’s ability to recover after blood
flow is restored. Portman and his lab team
are using a neonatal pig model to emulate
cardiopulmonary bypass surgery and examine
the effect of thyroid hormone on the heart.
Portman is also the principal investigator
for a large multisite study funded by the Food
and Drug Administration that tests whether
giving children under age 2 a drug called
Triostat (triiodothyronine or T3) after surgery
will prevent their thyroid levels from dropping.
With nearly 200 participants, the study is the
largest ever conducted for babies under 2
years old undergoing congenital heart surgery.
While the results are not yet finalized,
Portman is optimistic.
“We anticipate this study will provide
valuable guidance of where to look next,”
he says. “Ultimately, our goal is to prevent the
thyroid levels from dropping in the first place,
which we believe will improve heart function
and response after the surgery.”
Research
Dr. Colleen Delaney’s work to
improve cord blood transplantation
(CBT) by expanding the number of
transplantable stem cells harvested
from cord blood is directly inspired
by her clinical work with patients
at Seattle Children’s.
“Patient care is my passion,”
says Delaney, a faculty member in
the Pediatric Hematology/Oncology
Division at Seattle Children’s and
an assistant member at FHCRC.
“I see my lab research as an exciting
extension of that care. I start by
applying my patients’ experiences to
my lab research, which informs my
work in creating new CBT protocols
and leads to new insights in patient
care. I can then refine the questions
I need to ask back at the lab.”
Delaney now has five new clinical
trials underway. Each provides access
to stem cell transplants to patients
without a conventional donor match.
One protocol is a cutting-edge phase I
trial evaluating the safety of infusing
cord blood progenitors that have been
cultivated in the lab. Although early
in the course of the trial, results have
been quite promising. Delaney will use
the outcomes from these transplants
to direct her investigations at the
bench and back again to the bedside.
Forming world-class partnerships
A signature strength of Seattle Children’s
research is our strong partnerships with
world-class institutions, particularly
the UW School of Medicine, the
nation’s top-funded public research
university, and FHCRC, one of the
highest-acclaimed cancer research
institutions in the world.
Together, we have created the
Seattle Cancer Care Alliance, a joint
effort to speed laboratory discoveries
into cancer treatments. Investigators
from Seattle Children’s, UW and
FHCRC formed the NGEC, the NIHfunded partnership to pioneer new
approaches to gene therapy. We are
also at the forefront of a national NIHfunded movement to eliminate barriers
to clinical and translational research.
Partnering with patients and
families is at the core of our research.
In 2007, Seattle Children’s continued
expanding the research and family
liaison (RFL) role to advocate for a
truly informed patient consent process.
This means obtaining consents in
a family’s native language, working
more closely with patients and families
to make sure their questions are
answered, and being certain that they
clearly understand their rights while
participating in a clinical study.
“This communication is vitally
important to conduct research under
the highest possible ethical standards,”
says Hendricks. “So we want to
roll this out as a model program
nationwide.”
Connecting with the community
Forming partnerships with the
community is critical to address
complex health problems, such as
childhood obesity. That’s why Seattle
Children’s collaborates with
community organizations like the
Austin Foundation, which operates
community-based fitness training,
nutrition and health awareness
programs for about 3,000 youth
in Seattle.
“We can offer the Austin
Foundation some standardized
methods and data to help evaluate
the effectiveness of its program,”
says Dr. Christian Roth, an endocrinologist and member of the Center
for Developmental Therapeutics.
“And we benefit by learning the
community’s perspective about
what motivates participation and
Dr. Lakshmi Rajagopal and her team
identified signaling enzymes in
bacteria previously thought to exist
only in higher life forms.
Novel Insights into Bacterial
Signaling
Providing antibiotics to mothers during
labor is a proven treatment to prevent
newborns from acquiring group B
streptococcus (GBS), the most common
cause of life-threatening bacterial
infections in newborns.
However, bacteria constantly
evolve, adapting to their environment
to survive and establish infection.
Antibiotic-resistant strains of GBS,
therefore, require a different approach.
While studying the basic mechanisms of
how bacteria communicate, Dr. Lakshmi
Rajagopal and her lab team identified
two signaling enzymes in bacteria —
such as GBS — that were previously
thought to exist only in higher life forms.
This revolutionary finding is the
first to describe similarities in how a
bacteria and a human cell respond to
their environment, providing new insights
into the role of signaling in these bacteria.
“We discovered that the enzyme
Stk1 is very important for GBS disease;
without it, toxins produced by GBS are
severely reduced,” explains Rajagopal,
a member of the Center for Childhood
Infections and Prematurity Research.
“This could potentially lead to new
alternatives to treating GBS and
possibly other bacterial infections
because inhibitors to these enzymes
are already known.”
279
Research
2007 Fellows’ Research
Day Award Winners
Kym Ahrens, MD: General Pediatrics
Marissa H. Braff, PhD: Infectious Disease
Marta E. Bull, PhD: Infectious Disease
H. Mollie Greves, MD: General Pediatrics
Marcella Mascher-Denen, MD: Neonatology
Heather Mefford, MD, PhD: Medical Genetics
Almut Meyer-Bahlburg, MD: Immunology
Miguel E. Moreno-Garcia, PhD: Immunology
Monica S. Thakar, MD: Hematology-Oncology
Thor Wagner, MD: Infectious Disease
engagement in these programs. Overall, we hope our partnership will teach
us how we, as scientists, can best help
improve physical fitness, decrease
obesity and improve the quality of life
of children in our region.”
Seattle Children’s also receives
extraordinary support from generous
donors. We boast the largest guild
network of any hospital in the country,
most of which raises money to support
uncompensated care at the hospital.
However, special-interest guilds
raise money for other areas, such
as research programs.
In 2007, these special-interest
guilds, including the Mitochondrial
Research Guild and the Hydrocephalus
Research Guild, raised nearly
$495,000 for research. Since 2002,
the Mitochondrial Research Guild
alone has raised $800,000 for
research and improvements in care.
The Children’s Hospital Guild
Association also designates an annual
funding focus for research, which has raised
more than $6 million since 2004. Generous
community support also helped establish
the Jeffrey Modell Endowed Chair in
Pediatric Immunology Research in 2007.
“We have an unsurpassed level of
guild support that stretches throughout
the region,” says Hendricks. “I see it as
the ‘power of one’ that just multiplies. In
1994, we had one mitochondrial researcher
at Seattle Children’s. Now we have six —
largely because of the support of one guild.”
Olson’s “tumor paint” research —
which will enable surgeons to distinguish
cancer cells from healthy tissue — was
originally funded by guild support.
“The support we receive is inspiring,”
says Hansen. “Seattle has an incredible
entrepreneurial spirit and a community
that understands our mission requires a
significant investment. They know the
return on that investment will be the
life-saving care and cures of the future.”
Preventing Prematurity and Stillbirth
Under the leadership of Dr. Craig Rubens,
the Global Alliance for the Prevention of
Prematurity and Stillbirth is conducting
research and developing policy and
advocacy programs that will improve the
health of pregnant women and newborns.
280
Every year, at least 3 million babies are
stillborn and more than 1 million die because
they were born too early. In 2007, Seattle
Children’s formed the Global Alliance for
the Prevention of Prematurity and Stillbirth
(GAPPS) to address these serious global
health problems.
GAPPS is completing a comprehensive
literature review of published and unpublished
research on the global impact of preterm
birth and stillbirth. It is also identifying gaps in
current scientific knowledge and challenges
to successful preventive strategies.
Findings will be presented in May 2009
in Seattle at another key program initiative,
the International Conference on Prematurity
and Stillbirth. The conference will bring
together experts from around the world to
identify and prioritize recommendations for
advancing research and developing new,
more effective interventions.
“Our goal is to find the most promising
next steps to advance understanding of
these worldwide problems, inspire research
initiatives and help find solutions,” says
Dr. Craig Rubens, who leads the alliance and
holds the Guild Association Endowed Chair
in Pediatric Infectious Disease Research.
The Bill & Melinda Gates Foundation
provided funding for the conference, gap
analysis and literature review.
Research
Training future leaders in
pediatric research
Seattle Children’s strongly emphasizes
training and mentoring the next
generation of research leaders. In
partnership with the UW School of
Medicine, we serve as the primary
pediatric teaching resource for
the region, drawing highly skilled
physician-scientists from around
the world.
“We have a large pool of talented
physician-scientists here who we
believe will be very productive in
the years ahead,” says Stapleton. “We
are institutionalizing ways to help
them gain traction in their careers.”
In 2007, Seattle Children’s
increased the number of fellowships
awarded, provided a forum for fellows
to present their research to the
broader community, and developed
mentorship programs for young
investigators. The support is already
paying dividends. In 2007, nearly 30
members of the UW Department of
Pediatrics received NIH K awards,
given to promising physicians and
scientists early in their careers.
“Our investigators and staff are
the fuel that powers our research
engine,” says Hendricks. “We fully
support and train them as they pursue
the discoveries we hope will radically
improve the health of people of all ages.”
This next generation of leaders
will help write the next chapter of
Seattle Children’s research story.
“Our goal is to never stop striving,”
says Stapleton. “We are never satisfied
with the results we get and are always
studying how to make them better.
Failure is if we ever become satisfied.”
2007 NIH Career Development Award (K Award) Winners
The National Institutes of Health funds various K Awards to support the career
development of outstanding investigators. In 2007, 29 members of the UW Department
of Pediatrics held K awards.
Lauri Burroughs, MD
Mari Dallas, MD
Jason Debley, MD, MPH
Colleen Delaney, MD
Dan Doherty, MD, PhD
Ian Glass, MD
Carrie Heike, MD, MS
Sangeeta Hingorani, MD, MPH
Lucas Hoffman, MD, PhD
Laura Jansen, MD, PhD
Charlotte Lewis, MD, MPH
Rita Mangione-Smith, MD, MPH
Thomas Manley, MD
Carolyn McCarty, PhD
John McGuire, MD
Daryl Okamura, MD
Melissa Parisi, MD, PhD
Julie Park, MD
Jessica Pollard, MD
Tamara Pozos, MD, PhD
Laura Richardson, MD, MPH
Brian Saelens, PhD
Jodi Smith, MD
Troy Torgerson, MD, PhD
Scott Weissman, MD
How Defective Genes Affect
Autoimmunity
Children born with gene defects
in their immune systems often
face dual challenges: Not only
are they unprotected from outside
infections, but their natural defenses
sometimes turn against them,
afflicting them with autoimmune
diseases like lupus or juvenile
rheumatoid arthritis.
Dr. Troy Torgerson, an immunologist in the Center for Immunity and
Immunotherapies, studies the basic science underlying autoimmune diseases. His
research examines how mutations in a specific gene, FOXP3, affect the function of
regulatory T cells, which control other immune cell functions.
“When FOXP3 is defective, it’s like the immune system has no brakes,” says
Torgerson. “It gets activated — even by eating food — and can’t be turned off. It’s
completely out of control.”
This gene mutation, found only in males, causes a rare autoimmune disease
known as IPEX. Newborns with IPEX are afflicted with severe autoimmune bowel
disease, dermatitis and endocrine problems. Without treatment — typically a bone
marrow transplant (BMT) — many would die before age 2.
Torgerson studies patient tissue samples from around the world in his role as
co-director of the internationally renowned Immunodeficiency Molecular Diagnostics
(IMD) lab at Seattle Children’s.
“We then analyze this data using gene sequencing and flow cytometry to
determine the molecular basis of the mutation, express it in cell lines and learn more
about the function of FOXP3,” says Torgerson. “Ultimately, by accumulating this genetic
and clinical data of patients from around the world, we’ve been able to modify BMT
protocols and improve patient treatments.”
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Fellows and Residents
2007–2008
Seattle Children’s Hospital Fellows
Adolescent Medicine
Critical Care
Medical Genetics
Pathology
Kym R. Ahrens, MD
Megan A. Moreno, MD
J. Elaine Albert, MD
Tellen D. Bennett, MD
Kristina H. Deeter, MD
J. Linsley Di Gennaro, MD
Jeremy S. Hertzig, MD
Kihan Kim, MD
Mithya Lewis-Newby, MD
Ruxandra BachmannGagescu, MD
Robyn C. Reed, MD, PhD
Allergy/Immunology
Kelly A. Hetherington, MD
Anjuli K. Mehrotra, MD
Thomas E. Scarborough, MD
Anesthesiology
Benjamin M. Chang, MD
Svetlana Helms, DO
Iskra I. Ivanova MD
Thomas R. Latendresse, MD
Heather L. Naumann, MD
Nicholas A. Riegels, MD
Emergency Medicine
S. Health Ackley, MD
Elena M. Shephard, MD
Patrick B. Solari, MD
Endocrinology
Harvey K. Chiu, MD
Rohan K. Henry, MD
Cardiology
Nadine F. Choueiter, MD
Child Psychiatry
Daniel J. Crawford, MD
Michael J. Enenbach, MD
Mohammad Jafferany, MD
Ian M. Kodish, MD
John C. Lowry, MD
Jennifer L. Lowry, MD
L. Janine Morris, MD
Maia S. Robison, MD
Tong Shen, MD
Joshua P. Werblin, MD
282
Hematology/Oncology
Scott C. Borinstein, MD
Scott J. Diede, MD
Rebecca A. Emmons, MD
Abraham P. Fong, MD
Rabi Hanna, MD
Phoenix A. Ho, MD
Elizabeth H. Villavicencio, MD
Trisha E. Wong, MD
Infectious Disease
Michael J. Gilbert, MD
Audrey R. Odom, MD
Thor A. Wagner, MD
Pulmonary
Neonatology
Marcella T. Mascher Denen, MD
Annie H. Nyugen-Vermillion, MD
Janna Patterson, MD, MPH
Jessica D. Perkins, MD
Jessica D. Slusarski, MD
Pamela A. Statler Chapman, MD
Nephrology
Susan M. Halbach, MD
Kera E. Luckritz, MD
Yosuke Miyashita, MD
David A. Myers, MD
Allison C. Redpath, MD
Priya Verghese, MD
Neurodevelopmental
Gwen M. Glew, MD
Neurology
Alana S. Golden, MD
Mario T. Coleman, MD
Timothy J. Feyma, MD
Ann E. Hyslop, MD
Randal C. Richardson, MD
Olufemi O. Soyode, MD
Danny W. Hsia, MD
Don B. Sanders, MD
Amanda M. Striegl, MD
Radiology
Puneet Bhargava, MD
Harigovinda R. Challa, MD
Molly E. Raske, MD
Rheumatology
Kristen N. Hayward, MD
Christi J. Inman, MD
Sarah Ringold, MD
Elizabeth A. Shaw, DO
Surgery
Stephanie P. Acierno, MD
Jeffrey R. Avansino, MD
Seattle Children’s Hospital Pediatric Residents
Chief Residents
R1
R2
R3
Kelly N. Evans, MD
Eric A. Gustafson, MD
Erica A. Michiels, MD
Seema J. Afridi, MD
Abena E. Boateng, MD
Pia A. Bonura, MD
Lisa M. Cranmer, MD
Jaclyn A. Czaja, MD
Alison L. Dickson, MD
James A. Feinstein, MD
Leslie A. Field, MD
Jennifer H. Foster, MD
Lindsay L. Fox, MD
Emily R. Gallagher, MD
Marah E. Gotcsik, MD
Aaron W. Grigg, MD
Akiko E. Hall, MD
Jocelyn W. Hanna, MD
Sarah L. Hilgenberg, MD
Borah J. Hong, MD
Carl J. Koschmann, MD
K. Casey Lion, MD
Benjamin Mackowiak, MD
Daniel P. Mallon, MD
Maya Maxym, MD
Jenny S. Radesky, MD
Peter A. Rowinsky, MD
Jenny D. Smokey, MD
Lucie M. Turcotte, MD
Louise E. Vaz, MD
Johannes C. von Alvensleben, MD
Allison A. Young, MD
Lisa M. Barker, MD
Susanne H. Baumeister, MD
Shaquita L. Bell, MD
Chelsea E.F. Bodnar, MD
Kathleen L. Broadman, MD
Jill A. Cook, MD
R. Jason Coryell, MD
Luz M. Gonzalez, MD
Brandon K. Hadland, MD
Kate E. Halamay, MD
Kathleen A. Hannifan, MD
Maria C. Huang, MD
Harbir K. Juj, MD
Mara W. Kelley, MD
Samuel M. Kohn, MD
Jessica A. Lindsay, MD
Alison D. Longnion, MD
Jocelyn R. Manangan, MD
Ami D. Mehta, MD
James B. Metz, MD
Katie R. Nielsen, MD
Shreya J. Patel, MD
Abby R. Rosenberg, MD
Nivedita S. Srinivas, MD
Hannah M. Tully, MD
William C. Van Cleve, MD
Anupama V. Vijay, MD
Thu B. Vu, MD
Mikelle D. Bassett, MD
Andrew C. Beckstrom, MD
Rachel S. Bercovitz, MD
Omar J. Bhutta, MD
Matthew S. Blessing, MD
Ann E. Dahlberg, MD
J. Wesley Diddle, MD
Andrew C. Dietz, MD
Yolanda N. Evans, MD
Reid W. Farris, MD
Rachel A. Fleishman, MD
Erica R. Freeman, MD
Sabrina E. Guse, MD
Hiwot Hiruy, MD
Benjamin K. Jackson, MD
Katie M. Kazmier, MD
Malaika L. Little, MD
Nicolas L. Madsen, MD
Jennifer A. Montoya, MD
Lila N. O’Mahony, MD
Jeffrey P. Otjen, MD
Vijaya L. Soma, MD
Kristina A. Toncray, MD
Kathryn M. Wheeler, MD
Amie C. Wu, MD
Garland G. Youngblood, MD
283
Financial Summary
Fiscal Year 2006 – 2007
O p e r at i n g r e v e n u e s a n d e x p e n s e s f o r THE
Contributions to children’s
F I S C AL YEAR Oc t. 1 , 2 0 0 6 – S e p t. 3 0 , 2 0 0 7
Sources of Contributions (% of total $ received)
D o l l a rs i n T h o us a n ds
5% Organizations
& other donors*
Children’s Health care System
Sources of Revenues
Patient service revenues
Research and other government grants
Other revenues
Uncompensated care donations
Unrestricted donations and restricted
donations used in operations
Investment income*
Total
9% Corporations
$499,020
41,107
25,301
14,922
22,625
115,136
$718,111
* This category includes donations from service groups (such as Elks, Kiwanis,
Foresters) as well as workplace campaigns and non-guild special events.
Uses of Contributions
Uses of Revenues
Uncompensated care
Salaries and benefits
Supplies and other expenses
Depreciation and interest
Provision for renovation, new equipment
and new programs
Total
2% Facilities
& equipment
$65,430
246,969
219,193
49,663
136,856
$718,111
Expenses
Fundraising and administrative expenses
Total
57% Individuals
4% Foundations
10% Patient care &
hospital programs
Children’s Hospital Foundation,
Guild Association and Retail
284
24% Guild projects
*Includes unrealized investment gains
Sources of Revenues
Fundraising revenues and support
Children’s retail
(net revenue from gift shops and thrift stores)
Subtotal 1% Children’s thrift stores
28% Greatest need
(unrestricted gifts)
17% Fundraising
& administration
13% Research
30% Uncompensated
care
Volunteers
An average of 1,100 people contributed time and services
each month for a total of 137,062 work hours in 2007. Here’s
how they spent their time:
3% Patient care, outpatient
$47,702
448
$48,150
29% Patient care,
inpatient
2% Research
40% Gift shops &
thrift stores
8,041
$40,109
26% Support services
Financial Summary
Research Funding
2007 Patient StatISTICS
Sources of Extramural Funding
In 2007 our grant and contract revenue (exclusive of philanthropic
gifts) totaled in excess of $31 million. Federal grants accounted
for 63% of the total revenue. Included in this federal figure is more
than $19 million of National Institutes of Health (NIH) funding
where Seattle Children’s was the prime recipient of the NIH
award. This NIH funding to Seattle Children’s in 2007 increased
by 25% compared to 2006. Based on NIH award data from 2007,
Seattle Children’s ranked 11th in its peer group.
> 232,569 annual patient visits (72,542 individual patients)
– 176,608 appointments in outpatient clinics
– 33,773 visits to the emergency room
– 12,785 admissions to the hospital
– 9,403 short-stay visits
> 250 patient beds
> 5.3 days average length of stay (for all admissions)
> 4,839 inpatients who had surgical procedures
> 6,030 outpatients who had surgical procedures
> 82,069 diagnostic imaging tests performed
> 984,238 laboratory tests performed
27% Foundations
($8,661,908)
10% Corporate
($3,075,232)
Where Our Inpatients Come From
63% Federal
($19,654,210)
5% Alaska, Montana
& Idaho
1% Outside Washington, Alaska,
Montana & Idaho
17% Seattle
50% Other Washington
locations
staff statistics
27% Other King County
locations
As o f S EPT. 3 0 , 2 0 0 7
> 3,973 active staff employed at Children’s Hospital
> 546 research institute staff:
– 190 investigators
– 278 grant-funded research staff
– 78 research support staff
> 1,065 active medical staff
– 565 hospital-based physicians
– 100 hospital-based mid-level health professionals
– 400 private practice providers
Where Our Physicians Travel to Provide Care
(total of 463 clinic days)
4% (20 days)
Kennewick, Wash.
22% (102 days)
Yakima, Wash.
20% (93 days)
Wenatchee, Wash.
1% (6 days)
Montana
Top 10 Reasons for Inpatient Admissions
Asthma
Chemotherapy
Seizure disorders
Bronchiolitis and RSV pneumonia
Diabetes
Non-bacterial gastroenteritis
Cellulitis and other bacterial disorders
Appendectomy
Cleft lip and palate repair
Malnutrition, failure to thrive
# of admissions
467
427
416
335
243
230
222
219
203
184
19% (86 days)
Other Washington
locations
34% (156 days)
Anchorage & other
Alaska locations
285
Acknowledgments
Thank you
Editorial and Production
Leadership
Editorial and Production
Contractors
Chief Executive Officer
Kathi Elliott
Robyn Fritz
Mark Del Beccaro, MD
Production Manager
Marketing Communications
Project Manager
Department and Division Reports
Jennifer Fisch
Phinney Bischoff Design House
Senior Editor
Design
Lisa Brihagen
Printer
Annual Report Leadership
Thomas N. Hansen, MD
Pediatrician-in-Chief
David Fisher, MD
Senior Vice President
Medical Director
President, Seattle Children’s
Hospital Research Institute
Writer
David Perry
ColorGraphics
James Forkner
Production and Design
Brad Broberg
Vice President
Editorial and Production Team
Writer
Robert Sawin, MD
Kim Arthur
Copyeditor
Communications Specialist
Nancy LeVine
Elizabeth Austen
Mi Ae Lipe
Surgeon-in-Chief
Bruder Stapleton, MD
Senior Vice President
Chief Academic Officer
Produced by the Marketing
Communications Department,
Seattle Children’s Hospital,
Seattle, Washington
Senior Communications Specialist
Nate Brown
Production Coordinator
Tina Russell
Kyra Freestar
Feature Photographer
Copyeditor
Emily Maltby
Marjorie Manwaring
Copyeditor
Ellen Parker
Chris Tobey
Laurel Robinson
Creative Services Director
Copyeditor
Copyeditor
Erik Stuhaug
Photographer
Blue Rain Marketing
Technical Support
286
A special thank you to the
following individuals who
gathered all of the faculty
data for this report.
Gretchen Anderson
Sara Battin
Kathleen Beaudry
Neysa Bell
Jerrie Bishop
Alanna Coyote
Sandy Craig
Kana Crealock
Alyson Fenton
Brooke Freed
Scott Ford
Elizabeth Gaytan
Caitlin Gerhardt
Maria Gonzalez-White
Sandy Heatley
Mildred Hill
Rose Howard
Angel Hui
Casey Jones
Holly Kaopuiki
Barbara Killam
AnhTri Le
Jason Lane
Joan Laughlin
Stephanie Leak
Frances McKee
Mary Nelson-Brown
Carolyn Newcom
Dawn Marie Pares
Rhiannon Pennington
Sean Poppoff
Lynn Rise
Madeline Ruth
Deana Semenza
Erin St. Michele
Susan Salas
Gretchen Stronks
Brianne Vanderlinden
Ellen Veum
Chris Wong
Jane Yoon
Our Vision
We will be the best
children’s hospital
We will:
> P
rovide patients and their families
excellent care with compassion
and respect
> D
eliver superior, accessible,
cost-effective service
> A
ttract and retain the best talent
at all levels of the organization
> B
e one of the top five pediatric
research institutions in the country
> B
e the nation’s premier pediatric
educator
> A
chieve worldwide prominence by
integrating patient care, research,
education and advocacy
4800 Sand Point Way N.E.
Seattle, Washington 98105
(206) 987-2000
www.seattlechildrens.org
© 2008 Children’s Hospital and Regional Medical Center, Seattle, Washington. All rights reserved.
9/08

Seattle Children’s Hospital and the Department of Pediatrics,

Transcription

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