General and Thoracic Surgery

Significant Accomplishments

Projects Explore Intestinal Rehabilitation

Michael Helmrath, MD, Director of Surgical Research, focuses on the adaptive response of stem cells following surgical loss of the bowel. Multiple projects in the laboratory are studying the expansion of intestinal stem cells and the ability to culture and expand both murine and human intestinal epithelium. Clinically, Helmrath is the Surgical Director of the Intestinal Rehabilitation Center and is actively involved in establishing the intestinal failure registry and outcome trials in this patient population.

Virus Related to Biliary Atresia Replicates Better in Newborn Cells

Gregory Tiao, MD, continues to study the causes of biliary atresia in infants with the assistance of his research team, including Sujit Mohanty, PhD, research assistant Bryan Donnelly and research fellow Ashley Walther. Recently published data from Tiao’s  lab illustrated that the temporal nature of biliary atresia may be in part due to the ability of virus to replicate better in newborn cholangiocytes compared to mature cholangiocytes through defects or down-regulation of the interferon alpha pathway. The team also has shown that a specific gene/protein on the rhesus rotavirus strain is necessary to induce obstruction in the murine model through activation of T cells and NK cells. Tiao and colleagues are looking for the epitopes in this protein responsible for the disease pathogenesis.

Trauma Collaborative Produces Results

Richard Falcone, MD, MPH, and Trauma Services have developed the Pediatric Trauma Transformation Collaborative (PTTC) to support trauma centers in providing the highest level of care and when appropriate, reduce the need to transfer these patients away from their families and support systems. The collaborative includes monthly performance improvement meetings, guideline development and support, pediatric trauma focused education, simulation training, phone consultation, support for trauma center verification, and shadowing opportunities for physicians, nurses and other providers. The PTTC currently supports three institutions: St. Mary’s, Evansville, IN; Parkview, Fort Wayne, IN; and Sanford, Fargo, ND. Each site is demonstrating improvements including reduced radiation exposure, shorter lengths of stay, fewer transfers, increased patient volumes and American College of Surgeons trauma verification. The results of this program will be presented at the Trauma Center Association of America conference as well as the Eastern Association for the Surgery of Trauma meeting. More partners also are being identified. Trauma Services also has been active in performance improvement. We now have more than 50 percent of our staff involved in a performance improvement initiative in their area. Falcone also has been intimately involved in forming the Comprehensive Children’s Injury Center (CCIC). This center brings together members of Emergency Medicine, Critical Care, Sports Medicine, Orthopedics, Physical Medicine and Rehabilitation, Pediatrics and others to more collaboratively work to improve pediatric injury outcomes.