Warren symposium follows legacy of geneticist giant

If we want to understand how the brain creates memories, and how genetic disorders distort the brain’s machinery, then the fragile X gene is an ideal place to start. That’s why the Stephen T. Warren Memorial Symposium, taking place November 28-29 at Emory, will be a significant event for those interested in neuroscience and genetics. Stephen T. Warren, 1953-2021 Warren, the founding chair of Emory’s Department of Human Genetics, led an international team that discovered Read more

Mutations in V-ATPase proton pump implicated in epilepsy syndrome

Why and how disrupting V-ATPase function leads to epilepsy, researchers are just starting to figure Read more

Tracing the start of COVID-19 in GA

At a time when COVID-19 appears to be receding in much of Georgia, it’s worth revisiting the start of the pandemic in early 2020. Emory virologist Anne Piantadosi and colleagues have a paper in Viral Evolution on the earliest SARS-CoV-2 genetic sequences detected in Georgia. Analyzing relationships between those virus sequences and samples from other states and countries can give us an idea about where the first COVID-19 infections in Georgia came from. We can draw Read more

Children’s Healthcare

Children’s 1,000th pediatric transplant recognized

Emory University and Children’s Healthcare of Atlanta transplant surgeon Stuart Knechtle, MD, and his surgical team recently performed the 1,000th solid organ transplant on a Children’s patient. The milestone operation was performed on a child who received a liver through the Children’s Transplant Center.

Stuart Knechtle, MD

Stuart Knechtle, MD

Knechtle is chief of the Emory School of Medicine transplant division and professor of surgery, and surgical director of Children’s Liver Transplant Program. Children’s Liver Transplant program was founded in 1990 and has completed more than 300 liver transplants.

The liver transplant team is made up of many individuals who contribute to its success – liver transplant surgeons, transplant hepatologists (doctors with expertise in the treatment of the liver), and a team of gastroenterologists, anesthesiologists, pathologists, radiologists, mental health specialists, chaplains, nurses, social workers and pharmacists.

For more than 20 years, Emory and Children’s physicians have been at the forefront of pediatric transplant care, achieving several groundbreaking accomplishments, including:

  • Transplanted the world’s youngest (10 days old) and three smallest (2 to 4 pounds) liver transplant recipients
  • One of the first pediatric hospitals in the United States to perform three heart transplants in 24 hours
  • At the forefront of its field with ABO-incompatible liver and heart transplants
  • Performed more than 450 pediatric kidney transplants.
Children's kidney transplant recipient Quinn Roberts, age 8, poses with her donor Cheryl Thomas

Children’s kidney transplant recipient Quinn Roberts, age 8, with her donor Cheryl Thomas

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H1N1 pediatric flu vaccine clinical trials underway

Emory doctors discuss H1N1 flu vaccine testing

Emory doctors discuss H1N1 flu vaccine testing

Clinical trials are underway at Emory and Children’s Healthcare of Atlanta testing an investigational H1N1 flu vaccine along with the seasonal flu vaccine. Emory will enroll about 100 children, ages six months to 18 years, and up to 650 children nationally will participate in the study.

The study will look at the safety of and measure the body’s immune response to the H1N1 flu vaccine. In addition, it will help determine how and when the vaccine should be given with the seasonal flu vaccine to make it most effective.

Another important factor is learning if there are any potential problems by giving the vaccines together, such as whether one vaccine will undermine the protective power of the other.

The answer is important because experts are predicting that both strains of flu will circulate this fall and winter.

The clinical trial is part of the Vaccine and Treatment Evaluation Units (VTEUs), supported by the National Institute of Allergy and Infectious Diseases (NIAID) of the National Institutes of Health (NIH). At Emory, this team is led by Mark Mulligan, MD, executive director of the Hope Clinic of the Emory Vaccine Center.

The Emory pediatric clinical trial is taking place at the Emory-Children’s Center. It is led by Emory VTEU co-directors Harry Keyserling, MD, professor of pediatric infectious diseases at Emory School of Medicine and Paul Spearman, MD, chief research officer for Children’s Healthcare of Atlanta and vice chair of research for Emory’s Department of Pediatrics, along with Allison Ross, MD, Emory assistant professor of pediatric infectious diseases.

Keyserling says that because children and young adults are considered among the most vulnerable populations for new and emerging strains of influenza, such as the current H1N1 pandemic, it is critically important that testing for a vaccine is quick and efficient.

The pediatric trial follows the launch of a VTEU-led adult clinical trial of the H1N1 and seasonal flu vaccines, which began at Emory’s Hope Clinic on Aug. 10 and will continue with followup visits for the next six weeks by a group of more than 170 volunteers.

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Pediatric liver disease on the rise

Miriam Vos, MD with patient.

Miriam Vos, MD with patient.

Miriam Vos, MD treats a growing number of children with nonalcoholic fatty liver disease. Yet little research has been conducted into the development of the illness. Nonalcoholic fatty liver disease in children, which often is associated with obesity, occurs when fat deposits itself in the liver. It eventually can lead to inflammation, cirrhosis and even liver failure.

In the hopes of preventing the disease in children, Vos, a pediatric hepatologist at Emory University School of Medicine

and Children’s Healthcare of Atlanta, is conducting research into the origins of this disorder in children. She suspects a diet high in sugar and too little exercise are tied to its onset.

In fact, a recent study led by Vos found that Americans are getting more than 10 percent of their daily calories from fructose, used mainly in sugar-sweetened beverages and processed foods.

The study analyzed the amount and sources of dietary fructose consumption among U.S. children and adults from 1988 to 1994. The researchers found that U.S. children and adults consumed 54.7 grams of fructose per day, an almost 50 percent increase from a national study sample conducted in 1977-1978.

Fructose occurs naturally in fruits and vegetables, however, it is added to many processed foods as table sugar (sucrose) and high-fructose corn syrup.

Vos has written a book aimed at helping children and their families shed pounds and achieve better nutrition through changes in lifestyle and diet.

To hear Vos’s own words about nonalcoholic fatty liver disease in children, listen to Emory University’s Sound Science podcast.

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Childhood cancer treatment may raise diabetes risk

Cancer survivors who got radiation treatments as children have nearly twice the risk of developing diabetes as adults. That’s according to a study led by Emory and Children’s Healthcare of Atlanta pediatric oncologist Lillian R. Meacham, MD.

Lillian Meacham, MD

Lillian Meacham, MD

The study, published in the August 10/24 issue of Archives of Internal Medicine, compared rates of diabetes in nearly 8,600 childhood cancer survivors diagnosed between 1970 and 1986, and nearly 3,000 of their siblings who did not have cancer.

Children who were treated with total body radiation or abdominal radiation to fight off cancer appear to have higher diabetes risks later in life, regardless of whether they exercise regularly or maintain a normal weight.

After adjusting for other risk factors, including body mass index – a ratio of height and weight – Meacham and team found that childhood cancer survivors overall were 1.8 times more likely to have diabetes.

And the more radiation that was used, the greater the diabetes risk. For those treated with total body radiation — a treatment often used before bone marrow transplants to treat childhood leukemia — the diabetes risk was more than seven times greater.

More study is needed to understand how radiation could promote diabetes in cancer survivors, notes Meacham.

She says it is imperative that clinicians recognize this risk, screen for diabetes and pre-diabetes when appropriate, and approach survivors with aggressive risk-reducing strategies.

Meacham is a professor of pediatrics in the Emory School of Medicine and medical director of the Cancer Survivor Program with the AFLAC Cancer Center and Blood Disorders Services, Children’s Healthcare of Atlanta.

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Small, single incision for surgery helps young patients

Emory University and Children’s Healthcare of Atlanta pediatric physician Dr. Mark Wulkan is among the first surgeons in Georgia to perform single-site incision surgery on pediatric patients for routine surgeries.

Dr. Mark Wulkan

Dr. Mark Wulkan

Dr. Wulkan is using this method for multiple procedures, including appendectomy, removal of the spleen, and stomach surgery.

“Single-site surgery takes minimally invasive surgery (laparoscopic surgery) to the next level,” said Dr. Wulkan, is an associate professor of surgery and pediatrics in the Emory University School of Medicine and who performs surgery at Children’s Healthcare of Atlanta at Egleston. “Children leave the operating room with virtually no scars.”

Traditional laparoscopic surgical incisions are made in different locations on the abdominal wall, resulting in several small scars. The single-site method, however, is considered scarless because only one incision is made in the belly button and is typically difficult to see. Pediatric patients who undergo single-site procedures enjoy all the benefits of laparoscopic surgery, such as rapid recovery and less pain than that associated with traditional open surgery.

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