Contact: Leonard N. Karp
215-575-3720
lkarp@philadelphiamedicine.com
January 24, 2007
For immediate release:
In this month’s edition:
- Children’s Hospital Named Nation’s Best Pediatric Hospital by Child Magazine
- Real-Time Visualization of Tumors Leads to More Precise Radiation Treatment; Fox Chase Cancer Center’s Trilogy Offers Significant Technological Advance for Patients
- New Ideas from Penn Scientists on Developing Thought-Controlled Artificial Limbs
- Thomas K. Watanabe, MD, Named Clinical Director of the Drucker Brain Injury Center
Editors note: Research, new techniques and improved facilities by Philadelphia International Medicine hospitals and physicians may lead to new ways to treat some of our most challenging diseases. Below are just some examples from our hospitals.
Children’s Hospital Named Nation’s Best Pediatric Hospital by Child Magazine
Philadelphia – The Children’s Hospital of Philadelphia was named the nation’s best pediatric hospital by Child magazine. This is the hospital’s fourth consecutive number one ranking by the magazine. U.S. News & World Report also ranked the hospital as the best pediatric hospital in the United States.
In addition to the overall ranking, Child magazine also ranked Children’s Hospital’s pulmonology, neonatology, oncology and orthopedics divisions number one in the nation; the cardiac center and emergency medicine ranked second.
Children’s Hospital is a founding member of Philadelphia International Medicine.
"Children’s Hospital employees work tirelessly everyday to ensure every family has the ideal patient experience and we are truly grateful to our dedicated and talented staff," said Steven M. Altschuler, MD, president and chief executive officer of The Children’s Hospital of Philadelphia. "We recognize our responsibility to provide excellent patient care, to conduct innovative research and to train tomorrow’s pediatric specialists; our ultimate goal is to eradicate pediatric disease worldwide."
The Child magazine ranking is the result of a comprehensive data-based study of children’s hospitals across the United States, and it is based on hard data rather than subjective opinions. The comprehensive 247-question survey, guided by leading pediatric experts, examined vital medical information including survival rates, the number of complex procedures and intricate surgeries, volume of research studies, efforts to reduce medical errors, and the quality and training of the doctors and nurses—as well as child-friendliness, support for families, and community involvement.
The survey was sent to 116 full members of the National Association of Children’s Hospitals and Related Institutions; 76 hospitals completed the survey. The responses were graded to determine the best hospitals overall and the leaders in six pediatric subspecialty areas.
"We are honored to recognize The Children’s Hospital of Philadelphia as the nation’s leading pediatric hospital for the fourth consecutive time," said Miriam Arond, editor-in-chief of Child magazine. "Children’s Hospital’s consistent pursuit of the best practices for children’s health and well-being, the family-friendly environment and the caliber of their research efforts and clinical programs are examples of the best in healthcare today.
Real-Time Visualization of Tumors Leads to More Precise Radiation Treatment; Fox Chase Cancer Center’s Trilogy Offers Significant Technological Advance for Patients
Imagine a technology that would allow your doctor to see your tumor in three dimensions so that radiation treatment is targeted precisely. And imagine that significant side effects from treatment become the exception. That hope is the promise of a new technology at Fox Chase Cancer Center called Trilogy™.
"People move so of course tumors move," says Alan Pollack, MD, PhD, chair of radiation oncology at Fox Chase. "Locating the tumor right at the time of treatment gives us an unprecedented advantage. This is especially important when treating lung and liver tumors, which move with breathing."
Fox Chase has been a leader in research on 3-D-image-guided radiation therapy, treating more patients with such methods over the years than any other cancer center in the region. The new Trilogy linear accelerator system represents the newest and most powerful technology available for combining image-guidance with the latest radiation delivery methods.
Trilogy combines a linear accelerator (the machine that delivers radiation) with an on-board imager to check a patient’s position and improve the targeting of radiation to the tumor to achieve the precision needed for stereotactic radiosurgery.
The versatile Trilogy system can be used to deliver intensity modulated radiation therapy (IMRT), 3-D conformal radiotherapy, stereotactic radiosurgery (high radiation doses in a single treatment), fractionated stereotactic radiation therapy (high radiation doses over a few days), and intensity-modulated radiosurgery for cancer.
Stereotactic techniques involve delivering extremely high doses of radiation to very small areas over a shorter time, as compared to conventional external-beam radiation therapy. The technologies are linked through a sophisticated computer system that adjusts the aim of radiation with the patient’s external contours and daily changes in the patient’s internal organ positions.
"This is an advance that will benefit certain patients immediately by allowing us more options and more precision," explains Dr. Pollack. "Trilogy marries imaging technologies with the computer system programmed to deliver radiation. These systems work together to target the tumor precisely at the time of treatment.
"It’s another leap forward in technological capability. Trilogy allows us to deliver all types of external-beam radiation therapy using one machine in a single room."
Trilogy’s major capability involves image-guided radiosurgery (IGRS) technology. With IGRS, doctors can target tumors with high doses of radiation. IGRS is particular effective in treating patients with tumors that have spread (metastasized) to the brain, spine, lung and liver. Treatment of these areas must be extremely exact. Patients recover rapidly from radiosurgery because there are no incisions and the radiation is so focused.
In addition to allowing physicians to accurately locate the tumor, Trilogy’s optical system continuously monitors the patient to ensure the patient remains properly positioned during treatment. The delivery system adjusts to the patient’s movement. Trilogy is able to synchronize a patients breathing with the radiation delivery.
"For treatment planning, we are combining the Trilogy radiation delivery systems with the most advanced 4-D CT-simulation and MRI-simulation methods available," explains Dr. Pollack. "Fox Chase has been a leader in applying these sophisticated planning techniques. They provide a unique visualization of tumor motion during treatment so that adjustments in targeting or ‘gating’ the radiation beam on and off at different points in the respiration cycle are planned into the treatment delivery process."
New Ideas from Penn Scientists on Developing Thought-Controlled Artificial Limbs
Investigators at the University of Pennsylvania School of Medicine describe the basis for developing a biological interface that could link a patient’s nervous system to a thought-driven artificial limb. Their conceptual framework - which brings together years of spinal-cord injury research - is published in the January issue of Neurosurgery.
"We’re at a junction now of developing a new approach for a brain-machine interface," says senior author Douglas H. Smith, MD, professor of neurosurgery and director of the Center for Brain Injury and Repair at Penn. "The nervous system will certainly rebel if you place hard or sharp electrodes into it to record signals. However, the nervous system can be tricked to accept an interface letting it do what it likes - assimilating new nerve cells into its own network".
To develop the next generation of prosthetics the idea is to use regions of undamaged nervous tissue to provide command signals to drive a device, such as an artificial limb. The challenge is for a prosthesis to perform naturally, relaying two-way communication with the patient’s brain. For example, the patient’s thoughts could convert nerve signals into movements of a prosthetic, while sensory stimuli, such as temperature or pressure provides feedback to adapt the movements.
The central feature of the proposed interface is the ability to create transplantable living nervous tissue already coupled to electrodes. Like an extension cord, of sorts, the non-electrode end of the lab-grown nervous tissue could integrate with a patient’s nerve, relaying the signals to and from the electrode side, in turn connected to an electronic device.
This system may one day be able to return function to people who have been paralyzed by a spinal-cord injury, lost a limb, or in other ways. "Whether it is a prosthetic device or a disabled body function, the mind could regain control," says Dr. Smith.
To create the interface, the team used a newly developed process of stretch growth of nerve fibers called axons, previously pioneered in Smith’s lab. Two adjacent plates of neurons are grown in a bioreactor. Axons sprout out to connect the neuron populations on each plate. The plates are then slowly pulled apart over a series of days, aided by a precise computer-controlled motor system, until they reached a desired length.
For the interface, one of the plates is an electrical microchip. Because Smith and his team have shown that stretch-grown axons can transmit active electrical signals, they propose that the nervous-tissue interface - through the microchip - could detect and record real-time signals conducted down the nerve and stimulate the sensory signals back through the axons.
In another study, Dr. Smith and colleagues showed that these stretch-grown axons could grow when transplanted into a rat model of spinal-cord damage. The team is now in the midst of studies measuring neuronal electrical activity across newly engineered nerve bridges and the restoration of motor activity in experimental animals.
Co-authors are Niranjan Kameswaran, and Eric L. Zager, all from Penn and Bryan J. Pfister, New Jersey Institute of Technology, and Jason Huang at the University of Rochester, NY.
Thomas K. Watanabe, MD, Named Clinical Director of the Drucker Brain Injury Center
Thomas K. Watanabe, MD, has been named clinical director of the Drucker Brain Injury Center, at MossRehab, rated as one of the best rehabilitation hospitals in the United States, by U.S. News & World Report.
Since completing a traumatic brain injury fellowship in 1997, Dr. Watanabe has focused on the treatment and research of acquired brain injury rehabilitation, neuromuscular disorders and spasticity.
Dr. Watanabe succeeds Nathaniel H. Mayer, MD, who was named emeritus director, Drucker Brain Injury Center. Dr. Mayer will continue as director, motor control analysis laboratory, where he will expand his clinical, research and education roles.