Pulmonary Medicine

Faculty Members

Raouf Samy Amin, MD,  Professor ; Director, Division of Pulmonary Medicine

Research Interests: Cardiovascular morbidity of sleep apnea in children

James Acton, MD,  Assistant Professor Clinical ; Director, Cystic Fibrosis Center

Research Interests: Areas of research interest include Cystic Fibrosis (CF), quality improvement, clinical outcomes and pulmonary function testing in infants.

R. Paul Boesch, DO,  Assistant Professor Clinical ; Director, Transitional Care Center

Ronald Bokulic, DO,  Associate Professor Clinical

Barbara Chini, MD,  Associate Professor Clinical ; Director, Pulmonary Fellowship Program

Research Interests: Sleep Disordered Breathing, Outcomes Research, Self-Management of Chronic diseases

William Hardie, MD,  Associate Professor Clinical ; Director, Pulmonary Function Laboratory

Research Interests: Molecular mechanism of pulmonary fibrosis, pediatric pulmonary function tests, pediatric pneumonia complications

Patricia Joseph , MD,  Associate Professor

Research Interests: Cystic fibrosis infections and quality improvement

Maninder Kalra, MD,  Assistant Professor Clinical

Research Interests: Genetic susceptibility for OSA in children; Sleep disordered breathing associated with neuromuscular disorders

Carolyn Kercsmar, MD,  Professor ; Director, Asthma Center

Research Interests: Asthma, inner city asthma, clinical outcomes and clinical trials, airway inflammation

Karen McDowell, MD,  Associate Professor

Research Interests: Asthma, wheezing in infants, bronchoscopy, BAL, quality improvement, clinical outcomes

Gary McPhail, MD,  Assistant Professor

Research Interests: Cystic fibrosis, quality improvement, clinical outcomes, pulmonary vascular disease

Michael Seid, PhD,  Professor ; Director, Health Outcomes and Quality Care Research

Research Interests: Health outcomes for children with chronic health conditions, interventions to overcome barriers to care and adherence, clinical behavior and effects on self-management, quality improvement research, h

Abu Shamsuzzaman, MD,  Research Assistant Professor

Research Interests: Sleep and Cardiovascular Diseases

Narong Simakajornboon, MD,  Associate Professor ; Director, Sleep Disorders Center; Program Director, Sleep Medicine Fellowship

Research Interests: Sleep-disordered breathing in children, sleep apnea, restless legs syndrome, periodic limb movement disorders

Robert Wood, PhD, MD,  Professor ; Director, Pulmonary Bronchology Program

Research Interests: Airway abnormalities; pulmonary alveolar proteinosis

Jamie L. Wooldridge, MD,  Assistant Professor

Research Interests: Cystic fibrosis, cystic fibrosis related diabetes, abnormal metabolism and growth in cystic fibrosis

Lisa Young, MD,  Assistant Professor ; Director, Pediatric Rare Lung Diseases Program

Research Interests: Interstitial lung disease, lymphangioleiomyomatosis, rare lung diseases

Joint Appointment Faculty Members

Julio Aliberti, PhD,  Assistant Professor

Molecular Immunology

Thomas  Boat, MD,  Professor

Preventive, Predictive Medicine

Kelly Byars, PsyD,  Assistant Professor

Psychology

Current research focuses on improving the assessment and treatment of pediatric insomnia and pediatric obstructive sleep apnea

Daniel Grossoehme, DMin, BCC,  Research Assistant Professor

Pastoral Care

Cystic fibrosis, religious/spiritual coping, adherence

Christopher  Karp, MD, PhD,  Professor

Molecular Immunology

Bruce Trapnell, MD,  Professor

Neonatology and Pulmonary Biology

Rhonda VanDyke, PhD,  Assistant Professor

Biostatistics & Epidemiology

Current areas of interest are Mixture Models and Functional Data Analysis with focus on Bayesian statistics, primarily using Markov Chain Monte Carlo. Content-specific areas include integration of fMRI and MEG modalities; developing statistical models to assess impact of OSA; CF outcomes research

Clinical Staff Members

• Julie Malkin, PNP
• Jeanne Weiland, PNP

Trainees

• Hemant Sawnani, MD,  PL-7,  Staff Physician, Avera Children's
• Joseph Crisalli, MD,  PL-6,  Cincinnati Children's Hospital Medical Center-Pediatrics
• Patrick Sobande, MD,  PL-6,  Harlem Hospital Center/Columbia
• Elizabeth Bacon, MD,  PL-5,  Blank Children's Hospital
• Mathew Ednick, DO,  PL-4,  Maimonides Medical Center Brooklyn

Significant Accomplishments in FY08

 Asthma Center

Sleep Disorders Center

Rare Lung Diseases

Significant Publications in FY08

Amin R, Leonard A, Somers V, Fenchel M, McConnell K, Jefferies J,Willging P, Kalra M, Daniels S (2008) Growth Velocity Predicts Recurrence of Sleep-disordered Breathing 1 Year after Adenotonsillectomy. Am J Respir Crit Care Med 177(6): 654-9.

Scientific Knowledge on the Subject: The current practice is to treat children with sleep-disordered breathing (SDB) by adenotonsillectomy without clear guidelines for postoperative follow-up to assess recurrence.

What This Study Adds to the Field:  Three clinical parameters confer independent increased risk for high recurrence of SDB after adenotonsillectomy: gain velocity in BMI, obesity, and being African American. Rapid body mass index gain is an independent risk for recurrence after adenotonsillectomy. Recurrence is associated with an increase in blood pressure that is independent of body mass index.

 

Hardie WD, Davidson C, Ikegami M, Leikauf GD, Le Cras TD, Prestridge A, Whitsett JA, Korfhagen TR (2008). EGF receptor tyrosine kinase inhibitors diminish transforming growth factor-alpha-induced pulmonary fibrosis. Am J Physiol Lung Cell Mol Physiol 294(6):L1217-25.

This article demonstrates the "proof-of-concept" that small molecule tyrosine kinase inhibitors targeting the epidermal growth factor receptor not only effectively inhibit progression of lung fibrosis, but also reverse established fibrosis in the transforming growth factor-alpha transgenic lung fibrosis model. These results support future studies to examine the role of EGFR activation in human fibrosis, which may be amendable to EGFR-targeted therapy.

Szefler SJ, Mitchell H, Sorkness CA, Gergen PJ, O’Connor GT, Morgan WJ, Kattan M, Pongracic JA, Teach SJ, Bloomberg GR, Eggleston PA, Gruchalla RS, Kercsmar CM, Liu AH, Wildfire JJ, Curry MD, Busse WW. Management of asthma based on exhaled nitric oxide in addition to guideline-based treatment for inner-city adolescents and young adults: A randomized controlled trial. Lancet 2008; 372: 1065–72.

This study provides important new information in several areas. First, the data demonstrate that the NHLBI guidelines for the management of asthma can be implemented. In addition, use of those guidelines to establish and adjust medical treatment for inner city adolescents with asthma results in rapid and excellent control of asthma over the course of one year. However, nearly 30% of the patients did not achieve good control. The use of a biomarker, exhaled nitric oxide, which is widely believed to be a marker of airway inflammation, in addition to the guideline level care, did not result in improved asthma outcomes (symptom days, hospitalizations, ER visits). There were fewer exacerbations requiring prednisone in the eNO group. Moreover, patients in the eNO group received higher doses of inhaled corticosteroids over the course of the study. Adherence to treatment and retention in the study were very high.

Conclusions: Implementation of guideline level care results in excellent asthma control for most, but not all inner city adolescents with asthma. Although eNO is thought to be an attractive, non-invasive biomarker for asthma, it failed to improve control when used in addition to guideline level care.

Seid, M (2008). Barriers to care and primary care for vulnerable children with asthma. Pediatrics,122(5), 994-1002.

Primary care is important for children with asthma. We know which groups of children are likely to experience poorer primary care but not why and how this occurs. Such knowledge is necessary for reducing disparities. This study measures ‘barriers to care’ and shows that they predict primary care experiences, beyond sociodemographic and access variables, in a highly vulnerable sample. Because barriers are modifiable, there are important implications for intervention.

LR Young, Y Inoue, and FX McCormack. “Diagnostic Potential of Serum VEGF-D for Lymphangioleiomyomatosis.” (2008)New England Journal of Medicine, 358:199-200.

Lymphangioleiomyomatosis  (LAM) is a progressive cystic lung disease of women. The diagnosis of sporadic LAM (S-LAM) can be made on clinical and radiographic grounds if an angiomyolipoma (AML) or chylous effusion is present. However, for the majority of women with S-LAM without AMLs or chylous disease, lung biopsy is required to distinguish LAM from other clinically overlapping disorders.  Vascular endothelial growth factor-D (VEGF-D) is a lymphangiogenic growth factor.  In this study, we report that serum VEGF-D levels are elevated in women with LAM, but not in patients with lymphangiomatosis, pulmonary Langerhans cell histiocytosis, and emphysema.  Furthermore VEGF-D levels were much higher in women with the tuberous sclerosis complex (TSC) and LAM than in women with TSC and normal high-resolution CT scans.   Therefore, serum VEGF-D may be a clinically useful diagnostic test that can distinguish LAM from other cystic and chylous lung diseases, potentially decreasing the need for lung biopsy.

Division Highlights

Raouf Amin, MD

Michael Seid, PhD

William Hardie, MD

Lisa Young, MD

Bruce Trapnell, MD

Jamie Wooldridge, MD

Division Collaboration

Collaboration with Pediatric Otolaryngology/Head and Neck Surgery; Pediatric Surgery; Gastroenterology, Hepatology and Nutrition; Interdisciplinary Feeding Clinic

Collaborating Faculty: Robin Cotton, MD; Richard Azizkhan, MD; Alessandro de Alarcon, MD; Victor Garcia, MD; Thomas Inge, MD; Ajay Kaul, MD; Charles Myer III, MD; Philip Putnam, MD; Michael Rutter, MD; Sally Shott, MD; Paul J. Willging, MD

Collaboration with Anesthesia; Cardiology; Endocrinology; Gastroenterology; Genetic Counseling; Neurology; Nutrition Therapy; Orthpaedics; Palliative Care; Pediatric Surgery; Physical Therapy; Rehabilitative Medicine

Collaborating Faculty: Norbert Weidner, MD; D. Woodrow Benson, MD, PhD; Linda Cripe, MD; Robert Spicer, MD; Susan Rose, MD; Meilan Rutter, MD; Ajay Kaul, MD; Martha Walker, MS; Brenda Wong, MD; Madeline Chadehumbe, MD; Twee Do, MD; A. Atiq Durrani, MD; Mark Meyer, MD; Thomas Inge, MD; Mary McMahon,MD

Collaboration with Allergy and Immunology; General Pediatrics

Collaborating Faculty: Amal Assa'ad, MD; Gurjit Hershey, MD; Maria Britto, MD; Thomas DeWitt, MD; Mona Mansour, MD; Jeffrey Simmons, MD

Collaboration with Pulmonary Biology; Radiology; Pulmonary Medicine, University of Cincinanti; Orthopedics

Collaborating Faculty: Alan Brody, MD; Alvin Crawford, MD; Gail Deutsch, MD; A. Atiq Durrani, MD; Thomas Inge, MD; Bruce Trapnell, MD

Collaboration with Cardiology; Neurology; Radiology; Otolaryngology

Collaborating Faculty: Robin Cotton, MD; Lane Donnelly, MD; Thomas Kimball, MD; Timothy Knilans, MD; Sally Shott, MD; J. Paul Willging, MD

Collaboration with Pulmonary Biology

Collaborating Faculty: Thomas Korfhagen, MD; Jeffrey Whitsett, MD

Collaboration with Molecular Immunology; Pulmonary Biology

Collaborating Faculty: Julio Aliberti, PhD; Christopher Karp, MD, PhD; Bruce Trapnell, MD; Jeff Whitsett, MD

Mentions in Consumer Media

• Chronic Snoring Remains After Surgery for Obese and African-American Children  Medical News Today , Web Site

Division Publications

1. Gibson RL, Emerson J, Mayer-Hamblett N, Burns JL, McNamara S, Accurso FJ, Konstan MW, Chatfield BA, Retsch-Bogart G, Waltz DA, Acton J, Zeitlin P, Hiatt P, Moss R, Williams J, Ramsey BW. Duration of treatment effect after tobramycin solution for inhalation in young children with cystic fibrosis. Pediatr Pulmonol. 2007; 42: 610-23.
2. Amin R. "Inflammatory association with childhood obstructive sleep apnea syndrome ." In: CL Marcus, J Carroll, D Donnelly, G Loughlin, eds. Sleep and breathing in children : developmental changes in breathing during sleep (Lung biology in health and disease; v.224). New York: Informa Healthcare; 2008: 489-501.
3. Amin R, Anthony L, Somers V, Fenchel M, McConnell K, Jefferies J, Willging P, Kalra M, Daniels S. Growth velocity predicts recurrence of sleep-disordered breathing 1 year after adenotonsillectomy. Am J Respir Crit Care Med. 2008; 177: 654-9.
4. Amin R, Somers VK, McConnell K, Willging P, Myer C, Sherman M, McPhail G, Morgenthal A, Fenchel M, Bean J, Kimball T, Daniels S. Activity-adjusted 24-hour ambulatory blood pressure and cardiac remodeling in children with sleep disordered breathing. Hypertension. 2008; 51: 84-91.
5. Romero-Corral A, Somers VK, Pellikka PA, Olson EJ, Bailey KR, Korinek J, Orban M, Sierra-Johnson J, Kato M, Amin RS, Lopez-Jimenez F. Decreased right and left ventricular myocardial performance in obstructive sleep apnea. Chest. 2007; 132: 1863-70.
6. Boat T, Acton JF. "Cystic fibrosis." In: R Kliegman, R Behrman, H Jenson, B Stanton, eds. Nelson textbook of pediatrics. Philadelphia: Saunders/Elsevier; 2007: 1803-1817.
7. Boat TF. The future of pediatric research. J Pediatr. 2007; 151: S21-7.
8. Boat TF, Chao SM, O'Neill PH. From waste to value in health care. JAMA. 2008; 299: 568-71.
9. Sandler I, Boat TF. Implications of parental bereavement and other family adversities for preventive and health promotion pediatric services. Arch Pediatr Adolesc Med. 2008; 162: 487-8.
10. Boesch RP, Acton JD. Outcomes of fundoplication in children with cystic fibrosis. J Pediatr Surg. 2007; 42: 1341-4.
11. Byars KC, Amin R. "Fatigue and sleep disorders." In: GB Slap, ed. Adolescent medicine: the requisites in pediatrics. Philadelphia: Elsevier; 2008: 110-116.
12. Cotton S, Grossoehme DH, Tsevat J. "Religion/spirituality and health in adolescents." In: TG Plante, CE Thoresen, eds. Spirit, science and health: how the spiritual mind fuels physical wellness. Westport, CT: Greenwood; 2007: 143-156.
13. Grossoehme DH. Development of a spiritual screening tool for children and adolescents. J Pastoral Care Counsel. 2008; 62: 71-85.
14. Grossoehme DH, Cotton S, Leonard A. Spiritual and religious experiences of adolescent psychiatric inpatients versus healthy peers. J Pastoral Care Counsel. 2007; 61: 197-204.
15. VandeCreek L, Grossoehme DH, Ragsdale JR, McHenry CL, Thurston C. Attention to spiritual/religious concerns in pediatric practice. What clinical situations? What educational preparation? . Chaplaincy Today. 2007; 23: 3-9.
16. Deshmukh HS, Shaver C, Case LM, Dietsch M, Wesselkamper SC, Hardie WD, Korfhagen TR, Corradi M, Nadel JA, Borchers MT, Leikauf GD. Acrolein-activated matrix metalloproteinase 9 contributes to persistent mucin production. Am J Respir Cell Mol Biol. 2008; 38: 446-54.
17. Hardie WD, Davidson C, Ikegami M, Leikauf GD, Le Cras TD, Prestridge A, Whitsett JA, Korfhagen TR. EGF receptor tyrosine kinase inhibitors diminish transforming growth factor-alpha-induced pulmonary fibrosis. Am J Physiol Lung Cell Mol Physiol. 2008; 294: L1217-25.
18. Hardie WD, Korfhagen TR, Sartor MA, Prestridge A, Medvedovic M, Le Cras TD, Ikegami M, Wesselkamper SC, Davidson C, Dietsch M, Nichols W, Whitsett JA, Leikauf GD. Genomic profile of matrix and vasculature remodeling in TGF-alpha induced pulmonary fibrosis. Am J Respir Cell Mol Biol. 2007; 37: 309-21.
19. Kramer EL, Deutsch GH, Sartor MA, Hardie WD, Ikegami M, Korfhagen TR, Le Cras TD. Perinatal increases in TGF-{alpha} disrupt the saccular phase of lung morphogenesis and cause remodeling: microarray analysis. Am J Physiol Lung Cell Mol Physiol. 2007; 293: L314-27.
20. Fricke BL, Abbott MB, Donnelly LF, Dardzinski BJ, Poe SA, Kalra M, Amin RS, Cotton RT. Upper airway volume segmentation analysis using cine MRI findings in children with tracheostomy tubes. Korean J Radiol. 2007; 8: 506-11.
21. Guimaraes CV, Kalra M, Donnelly LF, Shott SR, Fitz K, Singla S, Amin RS. The frequency of lingual tonsil enlargement in obese children. AJR Am J Roentgenol. 2008; 190: 973-5.
22. Kalra M, Pal P, Kaushal R, Amin RS, Dolan LM, Fitz K, Kumar S, Sheng X, Guha S, Mallik J, Deka R, Chakraborty R. Association of ApoE genetic variants with obstructive sleep apnea in children. Sleep Med. 2008; 9: 260-5.
23. Kercsmar CM. Meeting the challenges of asthma: conference summary. Respir Care. 2008; 53: 787-95.
24. McPhail GL, Hardie WD. Cavitary lung lesions in a 2-year-old child. Respiration. 2008; 76: 117-8.
25. Krugman SD, Racine A, Dabrow S, Sanguino S, Meyer W, Seid M, Serwint JR. Measuring primary care of children in pediatric resident continuity practices: a Continuity Research Network study. Pediatrics. 2007; 120: e262-71.
26. Lotstein D, Seid M, Ricci K, Leuschner K, Margolis P, Lurie N. Using quality improvement methods to improve public health emergency preparedness: PREPARE for Pandemic Influenza. Health Aff (Millwood). 2008; 27: w328-39.
27. Mattke S, Seid M, Ma S. Evidence for the effect of disease management: is $1 billion a year a good investment?. Am J Manag Care. 2007; 13: 670-6.
28. Seid M, Lotstein D, Williams VL, Nelson C, Leuschner KJ, Diamant A, Stern S, Wasserman J, Lurie N. Quality improvement in public health emergency preparedness. Annu Rev Public Health. 2007; 28: 19-31.
29. Singh P, Hoffmann M, Wolk R, Shamsuzzaman AS, Somers VK. Leptin induces C-reactive protein expression in vascular endothelial cells. Arterioscler Thromb Vasc Biol. 2007; 27: e302-7.
30. Naqvi SK, Sotelo C, Murry L, Simakajornboon N. Sleep architecture in children and adolescents with cystic fibrosis and the association with severity of lung disease. Sleep Breath. 2008; 12: 77-83.
31. Sobande PO, Acton JD, Amin RS, Weiland J. Obliterative bronchiolitis in a 13-year-old pre-transplant cystic fibrosis patient. J Cyst Fibros. 2008; 7: 92-4.
32. Sobande PO, Kercsmar CM. Inhaled corticosteroids in asthma management. Respir Care. 2008; 53: 625-33; discussion 633-4.
33. Elder DA, Wooldridge JL, Dolan LM, D'Alessio DA. Glucose tolerance, insulin secretion, and insulin sensitivity in children and adolescents with cystic fibrosis and no prior history of diabetes. J Pediatr. 2007; 151: 653-8.
34. Bissler JJ, McCormack FX, Young LR, Elwing JM, Chuck G, Leonard JM, Schmithorst VJ, Laor T, Brody AS, Bean J, Salisbury S, Franz DN. Sirolimus for angiomyolipoma in tuberous sclerosis complex or lymphangioleiomyomatosis. N Engl J Med. 2008; 358: 140-51.
35. Deutsch GH, Young LR, Deterding RR, Fan LL, Dell SD, Bean JA, Brody AS, Nogee LM, Trapnell BC, Langston C, Albright EA, Askin FB, Baker P, Chou PM, Cool CM, Coventry SC, Cutz E, Davis MM, Dishop MK, Galambos C, Patterson K, Travis WD, Wert SE, White FV. Diffuse lung disease in young children: application of a novel classification scheme. Am J Respir Crit Care Med. 2007; 176: 1120-8.
36. Thomas H, Risma KA, Graham TB, Brody AS, Deutsch GH, Young LR, Joseph PM. A kindred of children with interstitial lung disease. Chest. 2007; 132: 221-30.
37. Young LR, Inoue Y, McCormack FX. Diagnostic potential of serum VEGF-D for lymphangioleiomyomatosis. N Engl J Med. 2008; 358: 199-200.
38. Young LR, Pasula R, Gulleman PM, Deutsch GH, McCormack FX. Susceptibility of Hermansky-Pudlak mice to bleomycin-induced type II cell apoptosis and fibrosis. Am J Respir Cell Mol Biol. 2007; 37: 67-74.

Grants, Contracts, and Industry Agreements

Acton, J

Amin, R

Bacon, E

Hardie, W

Kalra, M

Seid, M

Shamsuzzaman, A

Trapnell, B

Wood, R

Young, L

Acton, J

Amin, R

Wooldridge, J