Monday, July 30, 2012

Conference Report: Pediatric bioengineering innovations presented at international symposia


Guest post by Kevin Cleary, PhD, and Katherine Davenport, MD

The Bioengineering Initiative of the Sheikh Zayed Institute was well represented at two recent important meetings in Europe. At the Computer Aided Radiology and Surgery (CARS) conference in Pisa from June 27-30, institute members gave four talks and presented four posters. At the Hamlyn Symposium on Medical Robotics at the Imperial College London from July 1-3, institute members gave a talk, organized a special session, and presented two posters.

Our participation in these meetings elevates pediatric-focused device development to the international bioengineering stage. We are able to share with colleagues around the world how building tools specifically for children’s surgery can benefit the field of medical engineering as a whole.

The CARS conference is a leading forum for the latest advances in topics such as image-guided interventions, computer-aided surgery, and surgical navigation. The conference has four tracks and more than 800 people attended, including a good mix of clinicians, scientists, and engineers. The Children’s team organized a special session on pediatrics that consisted of five talks. Dr. Davenport presented on the “Challenges in Pediatric Laparoscopic Surgery” and focused on the unique characteristics of minimally invasive surgery in children. Raj Shekhar, PhD, described his work on augmented reality for pediatric laparoscopic surgery, including a prototype system that has been built and should be in clinical trials by the end of the year. More information on the conference can be found at www.cars-int.org.

The Hamlyn Symposium was a more focused meeting that was hosted by the robotics group at Imperial College London and had about 100 attendees, which included both clinical and technical personnel. Dr. Cleary, presented posters titled “Robotic NOTES: System Concept and Architecture” and “Navigated endoscopy: prototype system for robotically assisted ureteroscopy.” Dr. Cleary also co-chaired a special session on Augmented Reality in Medicine where both he and Dr. Davenport presented. More information on the conference can be found at www.hamlyn-robotics.org.

Attendees at the Hamlyn Symposium view the special session, "Augmented Reality in Medicine."

 --Kevin Cleary is the Technical Director of the Bioengineering Initiative for the Sheikh Zayed Institute. Katherine Davenport was a member of the 2011 class of Joseph E. Robert, Jr., Fellows in Pediatric Surgical Innovation. 

Monday, July 23, 2012

More pediatric robotic surgery around the world


In an effort to build wider understanding and application of robotic surgery for pediatric urology, Craig Peters, MD, our pediatric robotic surgery expert, travels around the world sharing knowledge about how the da Vinci Surgical System can be used for pediatric surgery. He recently traveled to Milan, Italy, where he performed several cases. He shared the following about his experiences there:

"We worked with the team in Milan to perform some of the first robotic surgeries in children in Italy. We did two robotic pyeloplasties and a unilateral ureteral reimplantation surgery for vesicouretal reflux. The children did very well and were discharged in about half the time that is usual for these procedures in Italy. The day after the surgery, one little boy we treated was happily playing video games with his sister, looking perfectly happy."

In addition to working with hands on with the surgical teams in the operating room and through case review, Dr. Peters also gave a guest lecture about the future promise of robotic surgery, similar to his recent Grand Rounds at Children's.  
Dr. Peters and the surgical team in Milan, Italy.

Monday, July 2, 2012

Study finds a new potential explanation for why the body can't fight tumors on its own


A study in the journal PLoSOne has identified a completely novel function for a previously known molecule, which may finally shed light on why the body's natural immune system does not attack and destroy cancer cells on contact. The protein, protocadherin-18 (pcdh18), is most often found and commonly associated in neurological functions.

The research, led by the New York University Langone School of Medicine with support from Children's National Medical Center, finds that this protein, which has been identified in CD8+ white blood cells, or so called "killer" white blood cells, plays a significant role in how these key components of the body's immune response to foreign bodies react and respond to tumor cells.

It is the first study to discover that this pcdh18 protein impacts how the body's natural immune system fights (or fails to fight) tumors. In the study, pcdh18 on the CD8+ cells interacts with molecules on the tumor surface, and this interaction inhibits the white blood cell's killer instinct to target and destroy the tumor. The interaction between pcdh18 and the tumor's molecules causes these killer white blood cells to lose their potency, and renders them ineffective in combating the tumor.

The laboratories of Alan Frey, PhD, at NYU, were the primary home for this research, with support and collaboration from investigators in the Immunology Initiative of the Sheikh Zayed Institute for Pediatric Surgical Innovation at Children's National Medical Center, led by Sasa Radoja, PhD.

Researchers have worked for many years to identify what it is about a tumor's genetic and proteomic makeup that allows it to slip past the body's natural defenses. This study is the first to attribute the white blood cells inability to fight the tumor to this specific protein's reaction to the tumor surface. It brings scientists one step closer to finding out why the body's natural immunity is not able to effectively seek and destroy tumor cells.

Next, these teams will work to understand the mechanisms of these protein interactions better, but also, the Immunology Initiative will begin preliminary translational research aimed at exploring ways to avoid the suppression, and possibly open the door for CD8+ white blood cells to zero in on tumors and effectively attack them.

"Our whole research program in Immunology at the Sheikh Zayed Institute is focused on finding ways to alter the function of white blood cells," said Dr. Radoja, co-author of the study. "We want to see how we can change these white blood cells to make them better, stronger, more robust tumor killers."

Read the full study here.