to Bedside - The Children`s Hospital of Philadelphia

Bench
July 2006
to Bedside
R  T C’ H  P
Hospital Breaks Ground for New Research Facility
The growth of the clinical and research
programs at The Children’s Hospital of
Philadelphia has propelled the dramatic
expansion of the institution’s physical
facilities. The latest expansion plans
supporting the Hospital’s flourishing
research enterprise were publicly revealed in
June with the ceremonial groundbreaking for
an eight-story research building dedicated to
translational research.
Sitting upon an eight-acre parcel of land that
was formerly the Philadelphia Civic Center
site, the building represents the first phase of
development for Children’s Hospital’s South
Campus Research Complex.
The ceremonial groundbreaking honored
longtime board trustees Ruth M. and
Tristram C. Colket Jr., in appreciation of
their substantial gift that will allow the
Hospital to move toward its goal of doubling
the size of its existing research space. In
recognition of their longstanding generosity
and leadership, which has spanned more than
three decades, the Hospital will name the
new research building in their honor.
“Ruth and Tristram Colket’s recent gift
of $25 million has given an enormous
boost to the advancement of research at
Children’s Hospital that will help to fund
our new research building on our South
Campus,” said Steven M. Altschuler, M.D.,
the Hospital’s president and chief executive
officer. “With more than 30 years of support,
they have given more than $35 million to
help ensure that Children’s Hospital remains
the preeminent pediatric institution in this
country and the world.”
The philanthropy of the Colkets is evident
in the Hospital’s light-filled atrium and the
lobby of the Leonard and Madlyn Abramson
Pediatric Research Center, both of which
bear their name. In addition, the Colkets’
generosity has fostered continued research
through endowed chairs in pediatric surgery
and pediatric nursing.
The $400 million, 558,000-square-foot
future research building comprises eight
stories — four new laboratory floors,
administration and conference space, and a
two-story ground floor housing a lobby and
cafeteria. There are an additional four stories
below grade consisting of infrastructure and
laboratory support space. To accommodate
future growth, there is potential to expand
the building to 22 stories.
“This state-of-the-art facility enables
Children’s Hospital to recruit top-level
researchers by providing the space,
equipment and technology required to
advance pediatric medicine,” said Chief
Scientific Officer Philip R. Johnson Jr.,
M.D. “The Hospital will be poised to be
the preeminent institution conducting
translational research for the benefit of
children.”
The South Campus Research Complex
directly across from the Hospital’s current
clinical and research facilities. Once
complete, the South Campus will house not
only a state-of-the-art translational research
facility but also a central utility plant to
support the entire Children’s Hospital
campus, underground parking and garage,
and an ambulatory building with outpatient
care, day medicine, day surgery and imaging,
as well as enhanced amenities for patients,
families and employees.
The total facility development is estimated
at $845 million and could total more than 1
million square feet.
“The Children’s Hospital of Philadelphia
provides us the greatest opportunity to
make a difference in the lives of children,”
said Ruth and Tristram Colket. “This new
research building will help ensure a healthier
future for the children of tomorrow.”
New Deputy Scientific
Director Joins Stokes
Tom Curran, Ph.D., joined Children’s Hospital
on July 1 as the new deputy scientific director
for the Stokes Institute and professor of
Pathology at the University of Pennsylvania.
During his career, Dr. Curran has
made numerous fundamental scientific
contributions in the fields of neurobiology,
signal transduction and cancer biology.
“His work has had profound implications for
our understanding of fundamental biological
processes as well as novel medical applications,”
said Philip R. Johnson Jr., M.D., chief
scientific officer.
He has authored more than 240 publications
and holds the rare distinction of being listed
as a high-impact scientist in three fields
(neuroscience, molecular biology, and genetics
and microbiology) by ISI HighlyCited.com,
and was ranked fourth in the world in
molecular biology and genetics from 1988
to 1992. In addition to these outstanding
academic credentials, Dr. Curran is also
known as an outstanding teacher, mentor
and administrator.
As deputy scientific director, Dr. Curran will
oversee certain critical administrative aspects
of research operations for the Stokes Institute.
In addition, he will continue his academic
pursuits by leading an interdisciplinary
translational research center devoted to
pediatric and adult brain tumors. The center
will bring together investigators from across the
academic campus to focus on this important
scientific and clinical problem.
Before joining the Hospital, Dr. Curran was
with St. Jude Children’s Research Hospital in
Memphis, where he served as chairman of the
Department of Developmental Neurobiology
and was a member of the senior leadership.
New Research Employees
(June 2006)
We welcome the following new
research employees:
High-resolution Genomic Microarrays Allow
Rapid Diagnosis of Birth Defects
Adolescent Case Manager
For years, many children with multiple
congenital problems, such as developmental
delays, heart defects and facial abnormalities,
have gone undiagnosed because they may not
have an easily recognizable syndrome.
samples from two patients with known
chromosomal rearrangements and wellcharacterized genetic diseases. In a blinded
analysis, the experiment found the correct
location of the abnormal regions.
More refined laboratory technology, however,
has made it possible for Children’s Hospital
investigators to detect many of these small
rearrangements in chromosomes and find
the abnormal gene or genes that give rise
to a disorder.
The researchers then studied samples from 10
patients with multiple congenital anomalies,
identifying novel submicroscopic deletions
in two patients. These deletions were not
detected in the patients’ parents, providing
strong evidence that the deletions were the
underlying cause of the multiple defects seen
in the children.
Jennifer Rasco
Administrative Director
Robert Skraban
Animal Caretaker
T.D. Montgomery
Chaplain
Mirabai Galashan
Clinical Research Assistant
Christine Leas
Director, Technology Transfer
Joseph DiDonato
Program Coordinator
Stephen LaMonica
Research Assistant
Kelly Lannutti
Research Associates
Andrew Eckert
Cecilia Kim
Research Technicians
Joseph Glessner
Janeflora Kanya
Johanna Murray
Rebecca Schray
Svetoslav Stratiev
Rati Venkatesh
Resource Coordinator
Diana Stratigakis
Statistical Technician
Laura Lawrence
Using commercially available gene chips,
molecular geneticist Tamim H. Shaikh,
Ph.D., led a team of investigators that
scrutinized all of a patient’s chromosomes
to identify small defects that cause genetic
diseases. Because current genetic tests usually
cannot detect these abnormalities, the new
research may lead to more accurate diagnosis
of congenital diseases, including puzzling
disorders that lead to mental retardation.
Conditions that originate in alterations of
chromosome architecture have been called
“genomic diseases.” The smallest of these
structural defects are microdeletions, a
loss of a small amount of genetic material,
or microduplications, an excess of
genetic material.
Individually, many genomic diseases are
rare, but collectively, they may occur in one
in 1,000 live births. Frequently, the gene
aberrations harm multiple organ systems.
For example, patients with chromosome
22q11.2 deletion syndrome may have
heart defects, impaired immunity and
developmental delays. Deletions of several
genes in Prader-Willi syndrome may cause
obesity and mental retardation.
To seek out miniscule rearrangements in
chromosomes, Dr. Shaikh and his team
employed the types of gene chips, or
microarrays, originally designed to identify
genes involved in common, complex diseases
like diabetes and hypertension. Children’s
Hospital's study is one of the first to report
using these microarrays in a clinical setting
to detect constitutional rearrangements that
lead to severe birth defects.
The results of their study, published in
the May 2006 issue of Human Mutation,
validated the microarray by using it to test
Bench to Bedside
Dr. Shaikh’s laboratory has subsequently used
the microarray to analyze DNA samples from
more than 60 patients, and have detected
novel microdeletions and microduplications
in 25 percent of the cases. He also has
received a grant to investigate chromosomal
rearrangements in bipolar disease, a complex
disorder thought to involve interactions
among multiple genes.
Dr. Shaikh is currently collaborating with
other Hospital researchers, particularly
Elaine H. Zackai, M.D., director of Clinical
Genetics, and Hakon Hakonarson, M.D.,
Ph.D., director of the Center for Applied
Genomics, to evaluate other higherdensity gene chips that provide greater
resolution. His team is also developing better
computational tools to evaluate data from
these chips.
“Our ability to detect even smaller
rearrangements will only get better as there
are improvements in the resolution of the
microarrays and the computational tools
required to analyze and mine the data
generated,” said Dr. Shaikh.
The National Institutes of Health supported
this research, as did the Ethel Brown
Foerderer Fund at Children’s Hospital. Dr.
Shaikh’s co-authors were Jeffrey E. Ming,
M.D., Elizabeth Geiger, Alison C. James,
Karen L. Ciprero, Manjunath Nimmakayalu,
Ph.D., Yi Zhang, Andrew Huang, Madhavi
Vaddi, Eric Rappaport, Ph.D., and Elaine H.
Zackai, M.D.
Study Confirms Safety Seats and Boosters Provide a Safety Advantage
Improper positioning of the lap or shoulder portion of seat belts place
children at risk for ejection from the belt and from the vehicles, as well
as for serious injuries to the head, neck, abdomen and spinal cord. Child
restraints, such as child safety seats and belt-positioning booster seats,
are designed to keep children safe until they are old enough for the adult
seat belt — designed to protect an average adult-sized male.
Researchers led by Dennis Durbin, M.D., M.S.C.E., and Flaura
Winston, M.D., Ph.D., co-directors of the Center for Injury Research
and Prevention, found that children who used child restraints were
28 percent less likely to be killed in a crash than children who were
wearing seat belts alone. Including in the analysis gross misuse of a
child restraint — a restraint that was not attached to the vehicle seat
or a child who was not wearing the seat’s harness — children were 21
percent less likely to be killed than children using seat belts alone.
The investigators studied records of nearly 9,000 children aged 2
through 6 involved in serious motor-vehicle crashes occurring between
1998 and 2003. This data represents vehicles and child restraint designs
in use by today’s families, previous analyses of child-crash fatalities and
restraint types involved crashes dating back to 1975. To avoid potential
biases seen in past analyses that looked only at fatal crashes, the data
was collected from two national crash databases that include data from
fatal and non-fatal crashes: the U.S. Department of Transportation’s
Fatality Analysis Reporting System (FARS) and the National
Automotive Sampling System.
“Our research to date has focused primarily on preventing serious
injury, because we felt this is where we could have the greatest effect,”
said Dr. Durbin. “Now we can assure parents that, while rear seating
and seat belts are better than no restraint at all, child restraints are
significantly more effective at preventing both injuries and death for
children younger than 7 years old.”
The study was supported by State Farm Mutual Insurance Company
through a research partnership called Partners for Passenger Safety,
and the findings were published in the Archives of Pediatric and
Adolescent Medicine.
Study Reveals New Findings on Ventricular Fibrillation in Children
Ventricular fibrillation (VF), a life-threatening heart-rhythm disorder
that may accompany full cardiac arrest, is one of the most common
causes of cardiac arrest in adults but thought to be much less common
in children.
Hospital investigators Vinay Nadkarni, M.D., and Peter A. Meaney,
M.D., M.P.H., found that VF occurs more frequently in children
than commonly believed. Abnormal rhythms during cardiac arrests in
children were thought to occur in fewer than 10 percent of the cases,
but investigators found the occurrence to be 27 percent.
The study — by far the largest ever considered for outcomes from VF
in children — analyzed records from 1,005 children who suffered
in-hospital cardiac arrest. More than one in four (272 patients) had
documented VF or tachycardia — rapid heart beats — that required
shocks at some point during the arrest.
In 104 of those patients, VF or tachycardia occurred initially. In 49
patients, it occurred subsequently during the arrest. Investigators found
VF is more likely to be fatal if it is not the initial heart rhythm detected
at the start of cardiac arrest, but instead develops later during the arrest,
typically during resuscitation. Of the children with initial abnormal
rhythms, 35 percent survived to hospital discharge, compared with 11
percent of children with subsequent abnormal rhythms.
The largest group of patients with cardiac arrest, 733 children, had no
documented VF or tachycardia. Of this group, a majority (602 patients)
were known to have asystole — no heart contractions — or no pulse at
the start of cardiac arrest. This group had intermediate outcomes and 27
percent survived to hospital discharge. Investigators were surprised that
this group had better outcomes than children with subsequent VF.
Researchers plan to conduct additional research on why survival
outcomes from subsequent VF were so low. Possible explanations may
be that children with subsequent VF have more severe underlying heart
disease or that clinicians are less aware of the possibility of subsequent
VF and may not diagnose and treat it until it is recognized late in
resuscitation efforts.
The authors explain that although outcomes vary, the majority of
children with cardiac arrest do not survive to hospital discharge;
however, CPR and advanced life support are certainly not futile,
even among the group with the worst outcomes.
“Our findings reinforce the concept that CPR with early recognition
of shockable rhythms remains a most important aspect of successful
cardiac resuscitation,” said Dr. Nadkarni. “We need to continue to
develop, teach and implement better strategies using registries and
networks that help us to discern key aspects of cardiac arrest.”
This study was published in the June issue of the New England Journal
of Medicine. Support was granted by the Emergency Cardiovascular
Care Committee of the American Heart Association and the Children’s
Hospital of Philadelphia Endowed Chair in Anethesiology and Critical
Care Medicine.
R at The Children’s Hospital of Philadelphia
New Human Subjects/HIPAA and Animal
Care and Use Training Coming
As part of Stokes’ commitment to delivering
high-quality, effective education and
training, the Department of Research
Education will launch two nationally
recognized training programs this summer:
the Collaborative Institutional Training
Initiative (CITI) Course in the Protection of
Human Research Subjects and the AALAS
Learning Library (ALL) for Animal Care
and Use.
Both the CITI and AALAS programs
are online courseware packages used by
many institutions across the country. The
Hospital’s adoption of these programs reflects
the increased federal oversight governing
research and national trends emphasizing the
need for a more comprehensive and pertinent
training curriculum.
The CITI program will replace the existing
five-module Institutional Review Board
training and the HIPAA for research
booklets. The Web-based modules from
ALL will replace the Hospital’s current video
presentations used for general training for
animal care and use. In addition, efforts
are underway to finalize an agreement
with the University of Pennsylvania to
reduce duplicative training requirements for
researchers collaborating across institutions.
CITI offers customizable training tracks
for biomedical, social/behavioral, data/
specimen users and research administration.
Hospital investigative team members and
administrative staff who support research will
complete the appropriate CITI track, which
includes reviewing the required modules
and passing each corresponding quiz with a
minimum score of 80 percent.
The ALL initiative involves new speciesspecific training for animal care and use.
This online training will supplement the
existing requirement for species-specific,
hands-on training, which presents Hospital
policies and procedures for the care and use
of animals and a guided tour of the animal
facility. In addition, a Web-based module
addressing occupational health and safety
and the special hazards facing investigators
working with animals will be added.
New clinical researchers or administrators
supporting research must complete the
appropriate CITI track before engaging in
human subject research. In addition, new
primary and co-investigators, trainees or
lab personnel working with animals must
complete the ALL course curriculum and
hands-on training before they begin
their research.
Existing researchers are being asked to
complete the appropriate CITI track and/or
ALL course curricula by the end of the
calendar year. As of Jan. 1, 2007, the IRB
and IACUC will not approve any new or
continuing review submission until all
investigative team members and animal users
have completed the appropriate training.
Recertification of CITI and ALL training
will be required every three years.
Questions about the training programs
may be directed to Research Education at
[email protected].
Registration Required for New Clinical Research Studies
Investigators about to start a new clinical
research study that will generate either
professional or technical bills to be paid
through a research account must register
the study to become part of the Clinical
Research Business Project (CRBP).
The CRBP is part of a Hospital-wide
strategic initiative designed to ensure
compliance and improve subject, investigator
and other stakeholder experiences with the
clinical research business process. The CRBP,
a compliance initiative and an important
contributor to the ideal patient experience,
provides for accurate billing based on
registrations that ensure separation of stand
and of care from research-only charges.
The CRBP affects all clinical research
systems and processes, including subject
preregistration, scheduling, registration,
budgeting, billing and reconciliation.
For more information, visit the CRBP Web
site at http://stokes.chop.edu/intranet/CRBP/
index.html. Investigators may register their
studies and select a training date through
the site.
Study Finds Medication,
Behavior Changes May
Aid Weight Loss
When combined with behavior therapy, the
weight loss medication sibutramine — sold
under the brand name Meridia — may help
obese adolescents lose weight, according to a
Children’s Hospital study.
Robert I. Berkowitz, M.D. Psychiatrist-in-cheif
and chief of Child and Adolescent Psychiatry,
led the first large multicenter trial of the
weight loss medication sibutramine for obese
adolescents. The study enrolled 498 severely
obese adolescents, ages 12 to 16, in 33 outpatient
clinics throughout the United States from 2000
to 2002. The patients were randomized into two
double-blinded groups, one receiving sibutramine
and one receiving a placebo, while both groups
received behavior therapy.
The research team found that patients who
received the medicine lost an average of 14
pounds over a year, while patients who received
a placebo gained four pounds over the year.
At the end of a year of treatment, body mass
index decreased by 9.4 percent in the treatment
group compared to 1.2 percent in the control
group. One-third of the adolescents who received
medication were no longer severely overweight,
and one out of six dropped below the standard
definition of being overweight at the end of
the study.
In addition to reductions in body mass index and
weight, the treated adolescents had improvements
in disease risk factors related to obesity such as
triglycerides, high-density lipoprotein cholesterol
and insulin levels.
Further investigations are needed to analyze
long-term weight management and health
outcomes for adolescents with obesity and to
focus on possible long-term risks of medication
versus risks of continued weight gain.
“Although much research remains to be done,
our findings are encouraging for clinicians, and
may offer treatment options for obese adolescents
for whom behavioral therapies alone are not
successful,” said Dr. Berkowitz.
The study’s findings were published in the
July issue of the Annals of Internal Medicine.
Support for the study was provided by Knoll
Pharmaceutical Company, now Abbott
Laboratories, which manufactures sibutramine.
Award Focuses on a Protein’s Structure and Interactions
Atherosclerosis — hardening of the arteries — generally is not
considered a pediatric condition, but the formation of fatty streaks that
contribute to the condition starts in utero and builds up over decades.
Although children usually have low cholesterol concentrations, by
the age of 12 to 14 years approximately 70 percent of children have
fatty streak lesions that may eventually contribute to atherosclerosis.
Obtaining information at the molecular level about this process
may lead to the understanding of early pathophysiological events
in atherosclerosis.
Serum lipoproteins — complexes of fats and proteins present in the
blood — play a role in lipid and cholesterol transport and in the
development of atherosclerosis. One of the structural proteins of
lipoproteins, called apolipoprotein (apo) E, is involved in the
metabolism of cholesterol and triglycerides. ApoE prevents plaque
buildup by interacting with lipids and molecules on a cell’s surface like
low-density lipoprotein receptors (LDLR) and glycosaminoglycans.
However, the structural basis for these interactions is not
fully understood.
ApoE is also part of lipoproteins in the central nervous system where it
mediates neuronal repair, remodeling and protection against dementia
and Alzheimer’s disease. There are three major forms of apoE, some
of which can increase the risk of developing atherosclerosis and
Alzheimer’s disease.
With support from the National Institutes of Health, Sissel
Lund-Katz, Ph.D., of the Lipid Research Group in the Division
of Gastroenterology, Hepatology and Nutrition, is leading a study
on the molecular features that control apoE’s binding to lipids,
lipoprotein particles and cell surface receptors.
As part of the $1.6 million, four-year award, Dr. Lund-Katz and her
colleagues will also investigate how the receptor binding domain
for apoE controls its binding to glycosaminoglycans as compared to
members of the LDLR family. The team will also characterize how
apoE interacts with cells to create high-density lipoprotein particles,
which protect against harmful deposition of cholesterol in tissues.
Understanding the molecular basis for apoE’s different activities
may lead to the design of treatments or preventative strategies for
atherosclerosis and other conditions.
FYI
TraumaLink Changes Name: TraumaLink has changed its name to the
Center for Injury Research and Prevention at The Children’s Hospital
of Philadelphia to more accurately reflect its mission of conducting and
disseminating research on the causes of childhood injury and developing
interventions to prevent injury.
As part of the name change, the Center has updated its Web site
(http://www.chop.edu/traumalink) to make it easier for healthcare
professionals, educators and government officials to locate, order and
download educational and advocacy materials, including videos, reports,
images and fact sheets on child passenger safety and pediatric
traumatic stress.
New LAF Director: Rebecca Wiltshire, D.V.M., joined Children’s
Hospital as the new director of the Laboratory Animal Facility (LAF).
In this role she will be responsible for the institution’s animal care and
use programs, providing veterinary care, surgery and animal husbandry,
and will work closely with investigators to design and implement
experiments involving animals.
She will also manage the ongoing development of the LAF, including
animal management, veterinary research services, population
management, and the design and commissioning of new or renovated
animal facilities.
The Center for Injury Research and Prevention is the umbrella
organization for Partners for Child Passenger Safety and other programs.
Stokes Recruits Associate OCTR Director
Lisa Speicher, Ph.D., joined Children’s Hospital on July 10 as the
associate director for the Office of Clinical and Translational Research
(OCTR).
Drawing upon her more than 15 years of experience in translational
research and development, Dr. Speicher will support the OCTR’s
mission by helping to facilitate research collaborations between
investigators, sponsors and academic institutions; matching
investigators to funding opportunities; and developing procedures
to enhance clinical and translational research experience across the
institution.
She will also take a leading role in the Clinical Trials Office, which
supports the Hospital’s clinical and translational investigators by
providing study coordinators, assisting with submissions to the
Institutional Review Board, developing budgets for clinical research,
and preparing Investigational New Drug and Investigational Device
Exemption applications.
Immediately before joining the Hospital, Dr. Speicher served as the
director of Translational Research at Wyeth Research. She also served
as the associate director for the Clinical Trials Unit at the University
of Pennsylvania Health System.
Faculty Awards/Honors
A study by Charles Stanley, M.D., chief, Division of Endocrinology,
and his colleagues was featured as the “Paper of the Week” in
the Journal of Biological Chemistry, a journal of the American Society
for Biochemistry and Molecular Biology. The study confirmed that
mutations in an enzyme called glutamate dehydrogenase can cause
congenital hyperinsulinism.
The results of the study on congenital hyperinsulinism, which can
cause hypoglycemia in infants and children, have potential for many
therapeutic and diagnostic applications. Specifically, the results may
provide targets for developing new drugs that inhibit the glutamate
dehydrogenase enzyme. The results also support the use of genetic
mutation analysis of glutamate dehydrogenase to diagnose children
with hypoglycemia and suggest that the enzymes could ultimately
serve as targets for drugs to treat diabetes.
An internationally recognized expert in the after-effects of children’s
cancer, Dr. Meadows and her colleagues were the first to investigate
the late effects of childhood cancer. Their studies, which began in the
1970s, showed that radiation then used to treat leukemia damaged the
children’s cognitive development and increased the risk of later brain
cancer. The findings prompted a change in medical practice, with
physicians eliminating or reducing the doses of radiation to the head.
Since 1993, Dr. Meadows has served as a prominent investigator in
the Childhood Cancer Survivor Study, a National Cancer Institutesponsored long-term national study of 15,000 cancer survivors. She
also directs the Hospital’s Cancer Survivorship Program and leads both
the Cancer Survivorship Research Program and the Lance Armstrong
Foundation Living Well After Cancer Program at the University of
Pennsylvania.
The American Society of Clinical Oncology awarded Anna T.
Meadows, M.D., with its 2006 Pediatric Oncology Award, which is
presented to those who have contributed outstanding scientific work to
the future of pediatric oncology.
Research Education Develops Materials to Facilitate Postdoc Mentoring
Mentoring is critical for the future success of postdoctoral fellows, but
the quality of mentoring can be compromised for international postdocs.
Unlike postdocs supported by federal training grants, their training
needs are not addressed by NIH policy and U.S. mentors are often illequipped to deal with potential barriers to the advancement of foreign
postdocs such as immigration problems, language difficulties and
cultural biases.
With the support of a grant from the Office of Research Integrity
(ORI), the Department of Research Education at Children’s Hospital
developed video vignettes with a supplemental guidebook to facilitate
mentoring between mentors and their international postdocs.
The video vignettes and comprehensive guidebook are available to
mentors nationwide through ORI’s Web site at: http://ori.dhhs.gov/ as
well as on Research Education’s site at http://stokes.chop.edu/intranet/
departments/education/edu10.html. DVDs and hard copies of the
guidebook are also available from Research Education.
HAVE NEWS?
The video vignettes and guidebook can:
help to identify and create awareness and sensitivity to specific issues
improve mentor skills and competencies in problem areas
● define mentor and postdoc roles and responsibilities
● illustrate positive mentoring practices and different styles and
approaches to resolving conflict.
●
●
The topics addressed include hiring practices, mentor expectations,
immigration issues, mentor/trainee trust, trainee expectations,
communication, performance assessment, career guidance, cultural bias,
ethnic stereotypes, working environment, abuse of power and cultural
barriers.
Contact Jennifer Long at ext. 4-2105
or by e-mail at [email protected].
Read this and previous versions of Bench to Bedside
online at http://stokes.chop.edu/intranet/pubs/
Produced by the Joseph Stokes Jr. Research Institute for The Children’s Hospital of Philadelphia.
Copyright © 2006 by The Children’s Hospital of Philadelphia.