G. Kurkchubasche, M.D.
Interests focus on the management
of disorders of GI function, particularly as related to the Short
Bowel Syndrome, and originated during the research years
at the University of Pittsburgh, Children's Hospital. The basic
science research on transmucosal bacterial passage in an in vitro
(Ussing) model provided some of the fundamental principles involved
in protecting a compromised intestinal barrier, both in premature
neonates at risk for NEC and the older infant with intestinal
dysfunction. The clinical responsibilites in caring for infants
and children with short bowel syndrome spurred ongoing interest
in this field. This was expanded, through mentoring from Dr.
Tracy at St. Louis University and subsequently here at Brown
Medical School, to the impact of sepsis and intestinal dysfunction
on hepatic function. For a brief period of time this involved
direct participation in the NIH-funded laboratory activities
in Dr. Tracy's lab, leading to some joint publications on quantification
of hepatic fibrosis. An endotoxin vaccine was investigated in
terms of its effect on hepatic fibrosis after bile duct ligation.
The nutritional management of the surgical infant remains focused
on the prevention and/or reversal of cholestatic jaundice. As
part of this ongoing interest, Dr. Kurkchubasche has currently
become involved in the research committee of the American Society
for Parenteral and Enteral Nutrition (ASPEN). She continues to
be involved in advances in the care of infants with SBS and has
offered the serial transverse enteroplasty procedure with successful
Roggin K K, 2000, Ambruso
DR 2000, Roggin
KK 2001, Kurkchubasche AG 1998
Elizabeth J. Renaud, M.D.
Dr. Renaud was recently recruited from Albany Medical Center, to return to her home state of Rhode Island. Dr. Renaud's particular expertise includes baraitric surgery, and she is further developing a robust adolescent weight management program (CHANGES), with a strong emphasis on clinical research and excellence.
Her expert laparoscopic skills are not only critical to this program in bariatric surgery, but in minimally invasive fetal surgery as well. Together with Dr. Luks, she represents the surgical arm of the Fetal Treatment Program of New England, not only the oldest and most active such program in the region, but a pilar of fetal therapy nationwide. As such, the program has always been particularly active in multicenter research.
I. Luks, M.D.
Previous research has focused
on endoscopic fetal surgery and access to the fetal trachea,
in a large animal model (sheep). Projects have mainly centered
around fetal lung development and mechanisms of accelerated lung
growth after fetal tracheal occlusion. This was done in conjunction
with the Pathology Department (Monique E. De Paepe, M.D.) and
has been funded by the American Lung Association. In addition
to the ovine model, a small animal model (fetal rabbit) and in
vitro studies have been conducted into the fate of type II pneumocytes
and the role of apoptosis in normal and accelerated fetal lung
One or more undergraduate and medical students from Brown
University are given the opportunity each year to participate
in the various fetal research projects.
has focused on the pathophysiology of twin-to-twin transfusion
syndrome (TTTS). Following the development of a clinical program
in fetal surgery and our participation (as the only North-American
center) in the randomized trial on treatment for TTTS, we are
now pursuing more basic research in the mechanisms of TTTS, and
are developing an animal model for the condition. Clinical research
in this field includes the search for markers of outcome in TTTS.
In 2009, the Program in
Fetal Medicine received an Investigational Device Exemption (IDE)
from the FDA for the in utero treatment of congenital
diaphragmatic hernia, using endoscopic tracheal occlusion.
New collaborations with the Division of Engineering
have yielded research projects in non-invasive monitoring during
fetal surgery and the development of advanced image display systems
for laparoscopic surgery, in a partnership with Brown and the
industry. The research is conducted with graduate students in
Engineering and Economics, medical students and surgical residents,
and grant support is being sought from the Science and Technology
Advisory Committee of Rhode Island and the Food and Drug Administration.
Luks FI 2009, Chang J 2006, De
Paepe ME 1999, Papadakis K, 1998(a), Papadakis K 1998(b), De Paepe ME 1998, Luks FI 1997, Papadakis K 1997, Luks FI 1996(a), Luks FI 1996(b)
Hale E. Wills, M.D.
Dr Wills's clinical focus is
the establishment of a state-wide pediatric trauma system that
seamlessly integrates all the emergency medical services and
other prehospital systems with Hasbro Chidlren's Hospital's Level
I Trauma Center. Rhode Island may be the smallest state, but
its Emergency Medical Services have been fractionated for decades.
Newly implemented state legislation now makes it possible to
electronically track individual trauma patients throughout the
region, and Dr. Wills is spearheading a project to further consolidate
this system, and integrate it with the care of injured children
at Hasbro Children's Hospital.
Clinical responsabilities also
include the Vascular anomalies Clinic. This program offers
a multidisciplinary approach to complex vascular and lymphatic
malformations (commonly known as hemangiomas, cystic hygromas,
lymphangiomas, vascular malformations, venous malformations or
cavernous hemangiomas). The team is composed of pediatric surgeons, pediatric plastic surgeons, dermatologists and interventional radiologists. Patients are seen in the Pediatric
Surgery Office, and can undergo a variety of treatments, ranging
from close observation (if the lesion is expected to go away
over time) to radiologic, minimally invasive or surgical intervention.