division of developmental pediatrics - Saint Louis University School ...

2001-2002 

Annual Report 

Saint Louis University 

School of Medicine 

Department of 

Pediatrics

T ABLE OF C ONTENTS 

1 Welcome 

2 Division of Adolescent Medicine 

4 Division of Allergy/Immunology 

6 Division of Pediatric Cardiology 

8 Division of Child Protection 

10 Division of Critical Care Medicine 

12 Division of Developmental Pediatrics 

16 Division of Pediatric Endocrinology 

20 General Academic Pediatrics 

24 Division of Medical Genetics 

26 Division of Gastroenterology & Hepatology 

28 Division of Hematology Oncology 

32 Division of Hemostasis & Thrombosis 

35 Division of Infectious Diseases 

36 Division of Neonatal/Perinatal Medicine 

40 Division of Nephrology 

42 Pediatric Emergency Medicine Division 

44 Division of Pulmonary Medicine 

48 Division of Toxicology

Welcome to the 

Annual Report of 

the Department of 

Pediatrics at 

Saint Louis 

University School 

of Medicine. 

I have just completed my first 

year as Chairman of the 

Department. It has been an 

interesting and challenging 

time, and one that my family 

and I have enjoyed. We 

appreciate the warmth shown 

by the faculty and the other 

staff of the university in 

welcoming us to St. Louis. 

The year has been marked by a 

number of major events. The 

early part was overshadowed by 

the events of September 11th, 

yet we moved on with our 

planning and implementation of 

positive changes. In November, 

we held a faculty retreat where 

we planned all areas of our 

program; clinical, education, 

research, administrative, 

advocacy and others. We have 

since begun to implement these 

initiatives in many areas. 

Clinically, we have had success 

with recruitment and retention. 

Faculty turnover rates are 

significantly below the national 

and local rates, and we 

welcome our new colleagues 

in Child Protection, Genetics, 

Cardiology and Neonatology. 

Our residents and student 

educational programs continue 

to thrive. Congratulations to 

Dr. Jay Noffsinger for receiving 

the Golden Apple Award from 

the graduating class. 

Our plans in research involve 

rejuvenating the Pediatric 

Research Institute and 

initiating a new program in 

clinical research. We welcome 

Vikki Kociela, RN, who has 

joined the Department to 

merge a new Clinical Trials 

W ELCOME 

Unit that will provide logistical 

and material support for the 

clinical investigators. 

With regards to administration, 

recruitment is now the major 

focus. We have performed well 

financially and continue to this 

year. We look forward to moving 

into our new clinical facility and 

then creating new divisional 

facilities in the renovated 

Glennon Hall building. 

We have made excellent 

progress in the last year and 

the next year promises to be at 

least as eventful with continued 

expansion, new facilities, and 

the development of our clinical 

research program. 

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D IVISION OF A DOLESCENT M EDICINE 

INTRODUCTION AND DESCRIPTION 

The Division of Adolescent Medicine continues to grow and offer a diversity of services to the adolescent 

population of the St. Louis region. The division’s goals are to improve the health of adolescents in the 

St. Louis region as well as educate health care providers about adolescent health issues. 

Clinical services are provided at the main hospital location on a daily basis. These services include 

care for all health issues with a focus on routine preventive care, high-risk behaviors, gynecological 

evaluation and treatment, and care of teens with chronic illness. The Eating Disorder Program has 

grown over the past year and offers care for individuals as young as 8 years old through 

adolescence.Dr. Ohlemeyer continues to provide evaluation and management of obese children and 

adolescents in the Weight Management Program along with Sarah Barlow, MD, Joel Nadler, PhD, 

Nancy Lawson, RD, and Mary Kay Brasken, MSW. New this year for the division is the participation in 

the Myelodysplasia Clinic with provision of care addressing specific adolescent issues in this 

population. In October 2002, Dr. Dunstan began providing health services to 2 Division of Youth 

Services sites here in St. Louis. 

CLINICAL SERVICES 2001-2002 

Year Outpatient Wt Mgmt Admissions/ Total Pt Chg Over 

Visits Visits Consults Encounters Past Yr. 

2000-1 451 96 21 568 — 

2001-2 717 107 44 858 +51% 

The division provides educational opportunities to medical students and residents. Each intern of the 

Pediatric Residency program and each 2nd year Internal Medicine/Pediatrics Residency program 

spends a month with the division. Sites for education include: Adolescent Clinic, Eating Disorders 

Clinic, Sports Medicine Clinic, Weight Management Clinic, and Sports Medicine at McKendree College 

with Dr. Jay Noffsinger. Each resident has the opportunity to observe teens in the school environment 

by visiting the health services at Clayton High School and by observing and then teaching a Health 

Education class at a middle school of Parkway School District.

D IVISION OF A DOLESCENT M EDICINE 

FACULTY 

Chris L. Ohlemeyer, MD, Associate Professor in Pediatrics 

and Director of Adolescent Medicine 

Marianne Dunstan, MD, Assistant Clinical Instructor 

in Pediatrics 

Victoria Cornelius, MD, Clinical Instructor in Pediatrics 

Theresa Forsythe, Medical Secretary 

RESEARCH HIGHLIGHTS 

Poster presentation of the 2001 Annual Meeting of North 

American Association for the Study of Obesity, Quebec City, 

Quebec, Canada Ohlemeyer C, Barlow SE. Medical Profiles 

of Children and Adolescents Evaluated in a Multidisciplinary 

Weight Management Program. 

HONORS 

Ohlemeyer C: Vice Chairman of the Council for Adolescent 

and School Health (CASH), Missouri Department of Health 

and Senior Services 

Ohlemeyer C: Saint Louis University Women’s Commission 

Award, YWCA Women in Leadership, December 1999. 

PRESENTATIONS 

1. Ohlemeyer C (Eddy M): “Amenorrhea and Bone 

Density Issues.” Saint Louis University Dept. of 

Pediatrics Case Conference. St. Louis, Missouri, 

September, 2001. 

2. Ohlemeyer C: “Adolescent Menstrual Disorders.” 

Practical Pediatrics Conference. St. Louis, Missouri, 

November, 2001. 

3. Ohlemeyer C: “Behavioral Interventions in Overweight 

Patients.” Meeting the Challenge of Obesity in your 

Practice Conference. St. Louis Children’s Hospital, St. 

Louis, Missouri, November, 2001. 

4. Ohlemeyer C: “Sexually Transmitted Diseases in 

Adolescents.” STD/HIV Prevention Training Center 

Regional Teleconference, University of Missouri-Saint 

Louis. St. Louis, Missouri, November, 2001. 


Adolescents.” Hawthorn Children’s Psychiatric Hospital. 

St. Louis, Missouri, December, 2001. 

6. Ohlemeyer C: “Adolescent Health Care in the Office 

Setting.” Continuity Clinic Community Physician 

Conference. St. Louis, Missouri, January, 2002. 

7. Dunstan, M: “Preparing for Puberty” Oak Hill School. 

Faculty and students. St. Louis, Missouri, February, 2002. 

8. Ohlemeyer C (Vargo K, Williams S): “Teaching 

Adolescent Medicine Special Interest Group.” Society for 

Adolescent Medicine Annual Meeting. Boston, 

Massachusetts, March, 2002. 

9. Ohlemeyer C (Kokotailo P): “Using Young Adult 

Literature to Teach Adolescent Medicine.” Society for 

Adolescent Medicine Annual Meeting. Boston, 

Massachusetts, March, 2002 


Adolescents.” STD/HIV Prevention Training Center 

Regional Teleconference. University of Missouri-St. 

Louis. St. Louis, Missouri, April, 2002. 

11. Dunstan, M: “Preparing for Puberty” Visitation 

Academy. St. Louis, Missouri, April, 2002. 

12. Ohlemeyer C: “Medicine in Literature Journal Club.” 

Saint Louis University School of Medicine. St. Louis, 

Missouri, May, 2002. 

13. Ohlemeyer C: “Eating Disorders in Adolescents.” 

Hawthorn Children’s Psychiatric Hospital. St. Louis, 

Missouri, May, 2002. 

14. Ohlemeyer C (Eddy M): “Pelvic Inflammatory Disease 

in Adolescents.” Saint Louis University Dept. of 

Pediatrics Tuesday Case Conference. St. Louis, Missouri, 

May, 2002. 

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D IVISION OF A LLERGY/IMMUNOLOGY 


The Allergy/Immunology Division in the Department of Pediatrics provides clinical care of allergic 

and immunologic diseases, including: 

• Asthma 

• Allergic and non-allergic rhinitis 

• Allergic conjunctivitis 

• Atopic dermatitis (eczema) 

• Urticaria, angioedema 

• Food allergy 

• Drug allergy 

• Latex allergy 

• Adverse reaction to vaccines 

• Anaphylaxis 

• Insect allergy 

• Allergic bronchopulmonary aspergillosis 

• Hypersensitivity pneumonitis 

• Sinusitis, fungal sinusitis 

• Congenital immunodeficiency diseases 

o T-cell, e.g. SCID, DiGeorge anomaly, MCC 

o B-cell, e.g. Bruton’s, CVID, THI 

o Phagocytic, e.g. CGD, Hyper-IgE, LAD 

o Complement, e.g. C2, C5-9 (MAC), C1 esterase inhibitor 

• Acquired immunodeficiency diseases, e.g. PAIDS 

Asthma Center for Children. The Divisions of Allergy/Immunology and Pulmonology formed an 

Asthma Center to provide care for pediatric asthma patients. 

Immunodeficiency Treatment Clinics. The Immunodeficiency Treatment Clinic is located in the Costas 

Center to treat immunodeficiency patients. The Division works with the Bone Marrow 

Transplantation Division in transplantation of severe T-cell immunodeficiencies. 

Allergy Challenge Clinic. The Allergy/Immunology Division has developed special clinics to perform 

food and drug challenges to evaluate these allergic diseases. 

A/I Fellowship Training Program. The Pediatric and Internal Medicine Allergy/Immunology Divisions 

provide an Allergy/Immunology Fellowship Training Program. In addition, the Division regularly 

provides electives for Pediatric residents and medical students. Division members are active in the 

AAAA/I serving on committees, presenting talks and abstracts. 

The Allergy/Immunology Divisions maintains a Clinical Immunology Laboratory as a reference 

laboratory to Pathology that performs diagnostic cellular functional studies, including lymphocytes 

proliferation, cellular cytotoxicity and cytokine synthesis. In addition, specialized studies to analyze 

T-cell signaling, CD40L expression and NBT are available.

D IVISION OF A LLERGY/IMMUNOLOGY 

FACULTY 

Alan P. Knutsen, MD, Professor of Pediatrics, Director of 

the Division of Allergy/Immunology 

Bradley A. Becker, MD, Assistant Professor of Pediatrics, 

Co-Director, Asthma Center for Children 

Cori Coplivetz, MD, Fellow 

Manoj Warrier, MD, Fellow 


Chris Fultz, RN, BSN 

Geri Sanders, RN, MSN, CPNP 


Dr. Knutsen’s current research focuses on Th2 T-cells, IL-4, 

and IL-4R in ABPA. Previous A/I fellows, Jim McClellan and 

Seema Khan, have participated on this project. Manoj 

Warrier is currently participating on this project. 

Dr. Becker participated in a study that determined the 

safety of influenza vaccine in patients with asthma. 

PUBLICATIONS 

1. Knutsen AP. Acute asthma. AJ Scalzo (editor), PACTS 

for Life Textbook: Pediatric Advanced Cardiopulmonary 

and Trauma Support for Life; 2001. p. 1-13. 

2. Knutsen AP. Complement Receptor Deficiencies 

(Leukocyte Adhesion Defect). eMedicine J 2001 Sept; 

2:1-6. 

3. Knutsen AP.. Purine nucleoside phosphorylase 

deficiency. eMedicine J 2002 Jan; 3:1-3. 

4. Knutsen AP. Cartilage hair hypoplasia. eMedicine J 

2002 Jan; 3:1-9. 

5. Knutsen AP. Transient hypogammaglobulinemia of 

infancy. eMedicine J 2002 Apr; 3:1-7. 

6. Knutsen AP, Bellone C, Kauffmann H. 

Immunopathogenesis of allergic bronchopulmonary 

aspergillosis in cystic fibrosis. J Cystic Fibrosis 2002 

June; 1:76-89. 

7. Knutsen AP, Hutcheson PS, Kurup V. IL-4 sensitivity 

and Th2 T cells in cystic fibrosis patients with allergic 

bronchopulmonary aspergillosis. J Allergy Clin Immunol 

2002 Jan; 109:S343 (abstract). 

8. Castro M, Dozor A, Fish J, Irvin C, Scharf S, Scheipeter 

ME, Holbrook J, Tonascia J, Wise R, American Lung 

Association Asthma Clinical Research Centers. The 

safety of inactivated influenza vaccine in adults and 

children with asthma. N Engl J Med 2001 Nov; 345:1529- 

1536. (Becker BA contributed) 

9. Becker BA. A severe allergic reaction presenting as an 

asthma exacerbation with respiratory failure following 

hepatitis B vaccination. J Allergy Clin Immunol 2002 Jan; 

109:S145 (abstract). 

HONORS 

Knutsen, AP: America’s Top Pediatricians, Guide to 

America’s Top Pediatrician, May 2002. 

PRESENTATIONS 

1. Becker BA: “Asthma and Allergies: Why Are Their 

Prevalence Increasing?” Saint Louis University School of 

Medicine, Department of Pediatrics, Grand Rounds, 

6/7/01 

2. Becker BA: “Current Management of the Child with 

Asthma”, Pediatric Grand Rounds, Hannibal Regional 

Hospital, Hannibal, MO, 11/16/01 

3. Slavin RG, Bellone C, Knutsen AP: “New Insights 

into ABPA”, Pediatric Grand Rounds, CGCH, St. Louis, 

MO, 11-7-2001. 

4. Becker BA: “A Severe Allergic Reaction Presenting as 

an Asthma Exacerbation With Respiratory Failure 

Following Hepatitis B Vaccination”, 58th AAAA/I 

Annual Meeting, New York, NY, 3-5-2002. 

5. Knutsen AP: “IL-4 sensitivity and Th2 T cells in cystic 

fibrosis patients with allergic bronchopulmonary 

aspergillosis”, 58th AAAA/I Annual Meeting, New York, 

NY, 3-5-2002. 

6. Knutsen AP: “Managing Pediatric Asthma”, Asthma 

Conference (Novartis sponsored), St. Louis, MO, 3-27-2002. 

7. Knutsen AP: “DiGeorge anomaly”, Pediatric Grand 

Rounds, CGCH, St. Louis, MO, 6-12-2002. 

GRANTS 

Bradley A. Becker, MD 

Site investigator 

Asthma Clinical Research Center (multicenter clinical 

trials) 

Source: American Lung Association 

Period: 1999-present. 

Alan P. Knutsen, MD - PI 

Immunopathogenesis of ABPA 

Source: Cystic Fibrosis Foundation 

Effort: 10% 

Direct Cost: $240,000 

Period: 2-1-01 to 2-28-04 

Project ARK (AIDS/HIV Resources for KIDS) 

Source: Ryan White Title IV 

PI: Gregory Storch, MD (Washington University) 

Direct Cost: $3,487 

Indirect Cost: $279 

Period: 8-1-01 to 7-31-02 

PI: Gary Albers, MD 

Co-Investigator: Alan P. Knutsen, MD 

A Multicenter Randomized Controlled Open-labeled 

Study to Evaluate the Safety of Omalizumab in 

Moderate to Severe Persistent Asthma Subjects Already 

Treated with Other Therapies 

Source: Genentech 

Period: 1-1-01 to 12-31-01 

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D IVISION OF P EDIATRIC C ARDIOLOGY 


The Division of Cardiology provides care, teaching and research with regard to cardiovascular 

diseases in fetuses, neonates, children, adolescents and adults with heart disease. The Fetal 

Cardiology Services are provided by one dedicated cardiologist along with support from Neonatology, 

Perinatology and Cardiovascular Surgery. The clinics cover all spectrums of ages, which include 

infants, children, adolescents and adults with congenital heart disease. The outreach clinics cover 

wide areas in Missouri and Illinois and provide expertise to areas that are void of such experts. The 

Cardiac Catheterization Laboratory covers both diagnostic and wide spectrum of interventional 

therapeutic procedures, which include valvuloplasties and device closures of defects. 

Electrophysiology covers a wide spectrum of diagnostic and therapeutic interventions for cardiac 

arrhythmias. In-patient services cover patient admitted for various cardiac related conditions and 

post operative management of heart disease. The Lipid Clinic covers preventive aspect of cardiology 

and is run by a dedicated team. The Cardiac Transplantation Service covers the preparation for the 

cardiac transplantation procedure and then the immediate and late management of patients who 

underwent cardiac transplantation. 

Teaching of Cardiology is performed through the members of cardiology and covers education of 

Medical Students, Interns, Residents and Community Physicians. It also provides education to Nurses 

and other Allied Health providers. Education of other cardiologists includes presentations of our 

research data in National and International meetings. 

The research aspect of Cardiology is provided by each of the cardiologist who has specific areas of 

interest. Our research has focused on important clinical aspects of Cardiology and resulted in 

improved care of individuals with congenital heart disease. 

FACULTY 

Ian C. Balfour, MD, Professor of Pediatrics, Division of 

Pediatric Cardiology 

Su-chiung Chen, MD, Professor of Pediatrics, Division of 


Barbara R. Ferdman, MD, Assistant Professor of 

Pediatrics, Division of Pediatric Cardiology 

Saadeh B. Jureidini, MD, Professor of Pediatrics, Interim 

Director, Division of Pediatric Cardiology 

Gautam K. Singh, MD, Associate Professor, Division of 


Mary Kay Thompson, Medical Secretary 

Angela Riehn, Medical Secretary 

Mike Heffner, Cardiology Clinic Manager 

Colleen Puers, RN 

Donna Marshall, RN 

MaryPat Spillane, RN 

Jan Lutman, RN 

Cath Lab: 

Kathy Tinker, LPN 

David Bash, RT 

Lisa Bade, RT 

Echo Lab: 

Cindy Marino, RDCS 

Chrissy Seithel 

Lisa Hohmann 

Clinic Support Staff: 

Dorothy Cavanaugh 

Barbara Stewart 

Charlotte Manning 

Kim McHenry 

Ermina Keric

D IVISION OF P EDIATRIC C ARDIOLOGY 


Dr. Ian Balfour: Interaction of 

Volume and Era on Survival of 

Pediatric Heart Transplant Patients 

Dr. Su-chiung Chen: Analyzed the 

changes in destruction and 

regurgitation in children with subaortic 

stenosis in respect to intervention or 

non-intervention. 

Barbara R. Ferdman: 1) Cardiac graft 

dysfunction, rejection and apoptosis; 

2) Cytokine interaction and cardiac 

function; 3) Heterotaxy syndrome and 

associated anomalies 

Dr. Saadeh Jureidini: Assessment of 

the coronary artery normal flow 

dynamics by Doppler echocardiography 

and abnormal variations in the 

coronary artery in congenital and 

acquired heart disease, which have 

resulted in numerous publications. 1) 

Effect of thrombolysis on clots in the 

heart and great vessels which also 

have resulted in several publications. 2) 

Pulmonary hypertension and its 

influence on the pulmonary artery 

pulsatility and size as assessed by 

echocardiography. 3) Interventional 

Cardiology, which is a new innovative 

field and has resulted in several 

publications. (The above clinical 

research has resulted in improvement 

in the management of children affected 

with heart conditions.) 

Dr. Gautam Singh: Research 

Highlights and Grants: 1) “Fetal 

echocardiographic study on prenatal 

evolution of tricuspid atresia” - a 

prospective study: 2002 - continuing; 

2) “Prediction of the severity of the 

stenotic cardiac lesions by Doppler 

echocardiography: a prospective 

simultaneous Doppler catheter 

correlative study in pediatric patients’” 

- ongoing prospective study since 

1998; 3) “A study of the safety, 

tolerance and efficacy of Pulivizumab 

(Medi-493, Synagis) prophylaxis of 

respiratory syncytial virus in children 

with congenital heart disease” - 

principal investigatory for the 

multicenter study for 1999 - 2002. 

Industry sponsored grant $30,000 for 

2001-2001 and $91,500 since 1999; 4) 

“A multicenter, placebo-controlled, 8month 

study of the effect of twice daily 

Carvedilol in children with congestive 

heart failure due to systemic 

ventricular systolic dysfunction”. - 

principal investigator for the 

multicenter study since 2000 - 

continuing. Industry sponsored grant 

$7,500. for 2002; 5) “Ven Pro contegra’ 

pulmonary valve conduit phase II trial” 

- co-investigator for the multicenter 

study since 2001 - continuing. 

PUBLICATIONS 

1. Balfour I, Marino C, Tinker K, 

Jureidini S. Arcade mitral valve 

and anomalous left coronary 

artery originating from the 

pulmonary artery. J Am Soc 

Echocardiogr 2001;14:641-643. 

2. Pokorny JJ, Roth F, Balfour IC, 

Rinehart G. An unusual 

complication of the treatment of a 

hemangioma. Ann Plast Surg 

2002;48:83-87. 

3. Chen S. Cardiomyopathy in 

Children. Current Treatment 

Options in Cardiovascular 

Medicine Oct. 2001;3:403-413. 

4. Jureidini SB, Marino C, Singh GK. 

Congenital coronary artery 

abnormalities in children. Current 

Treatment Options in 

Cardiovascular Medicine Oct. 

2001;3:393-401. 

5. Pugh KJ, Jureidini SB, Ream R, 

Rao PS, Dossier J. Successful 

thrombolytic therapy of 

pulmonary embolism complicating 

urosepsis in an infant. Pediatr 

Cardiol 2002;23:77-79. 

6. Rao PS, Balfour IC, Singh GK, 

Jureidini SB, Chen S. Bridge 

stents in the management of 

obstructive vascular lesions in 

children. Am J Cardiol 88:699-702, 

2001. 

7. Singh GK, Marino CJ. 

Transesophageal 

echocardiography in adults with 

congenital heart disease. Cardiac 

US Today 2001;7(7):131-147. 

8. Singh GK. Aortic stenosis. Ind J 

Pediatr 2002;69(4):351-58. 

HONORS 

1. Ian C. Balfour, MD: Co-chaired, 

Organizing Committee for 2002 

Annual Scientific Meeting of the 

Association of Black Cardiologists. 

Chaired Congenital Heart Disease 

Session of the March 2002 

Meeting of the Association of 

Black Cardiologists. 

2. Barbara R. Ferdman, MD: 

1996- Merck-Lange Book Award 

for outstanding service to the 

University. 

PRESENTATIONS 

1. Balfour, IC. “Ventricular Septal 

Defects in Adults”. Presented at 

the 14th Annual Dr. Walter M. 

Booker Sr. Memorial Symposium 

at the National Medical 

Association Annual Meeting, 

August 4, 2001. 

2. Ferdman BR, States L, Hedrick H, 

Rychik J: Abnormalities of 

Intestinal Rotation in Patients with 

Heterotaxy Syndrome and 

Congenital Heart Disease Poster 

presentation, American Heart 

Association Scientific Sessions, 

Anaheim, Ca, 11/2001. 

3. Jureidini SB, Marino C, Balfour 

IC, Chen S, Singh GK: Imaging a 

coronary artery segment in the 

anterior aortic wall is a reliable 

and easily recognizable sign of 

aberrant coronary origin. Abstract 

Presentation Presented to the 

Annual Midwest Pediatric 

Cardiology Society in Omaha, 

Nebraska, November, 2001. 

4. Singh GK. 2001, Guest Lecture, 

Fetal Cardiac Evaluation, Continuing 

Medical Education for Cardiac 

Sonographers, St. Louis, MO. 

5. Singh GK, Marino C, Fiore AC, 

Winn H, Rao S. Morphogenetic 

insight in evolution of tricuspid 

atresia: a fetal echocardiographic 

study. The 13th Annual Scientific 

Sessions of American Society of 

Echocardiography, Orlando, FL, 

June 9-12, 2002. J Am Soc 

Echocardiogr 2002;15:547. 

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D IVISION OF C HILD P ROTECTION 


The Division of Child Protection utilizes a multidisciplinary approach while providing expert 

assessment of victims and suspected victims of child maltreatment including physical abuse, sexual 

abuse, and neglect. Both inpatient and outpatient consultative services are provided at Cardinal 

Glennon Childrens Hospital. Outpatient clinical services are also provided through the Childrens 

Advocacy Center of Greater Saint Louis. In addition, expert medical consultation and testimony is 

provided to the legal community. 

Educational responsibilities include medical students and faculty at Saint Louis University School of 

Medicine as well as residents, fellows, and staff at Cardinal Glennon Childrens Hospital. 

Preceptorship is provided to Forensic Pediatric fellows at Washington University School of Medicine. 

Educational opportunities are available to the medical, legal, child protective services, and law 

enforcement communities. Education and crisis intervention are provided families on a regular basis. 

FACULTY 

Timothy J. Kutz, MD, Assistant Professor of Pediatrics, 

Director, Child Protection 


Cara Christanell, MSN, RN CPNP, Nurse Practitioner 

Karen Bly, RN, Nurse Counselor 

HONORS 

Kutz, TJ: Reviewer, Journal of Pediatrics; member, Ray Helfer 

Society (honorary society recognizing contribution to the field 

of child maltreatment) 

PRESENTATIONS 

1. Bly, K: “What to Do When You Suspect Sexual Abuse,” 

Child Maltreatment Conference, Cardinal Glennon 

Children’s Hospital, St Louis, Missouri, October, 2002. 

2. Kutz, TJ: “Child Maltreatment: Diagnosis and 

Intervention.” Advanced Practice Nursing Conference 

and Workshops. Saint Louis University School of 

Nursing. Saint Louis, Missouri, March, 2002. 

3. Kutz, TJ: “Child Sexual Abuse: Issues in Recognition.” 

Pediatric Grand Rounds. Cardinal Glennon Childrens 

Hospital. Saint Louis, Missouri, April, 2002. 

4. Kutz, TJ: “Child Maltreatment.” Saint Louis CASA 

Program Training.Saint Louis, Missouri, April, 2002 

5. Kutz, TJ: “Sexual Abuse Evaluation and Management.” 

Cardinal Glennon Childrens Hospital Community 

Outreach. Cape Girardeau, Missouri, May, 2002 

6. Kutz, TJ: “Skull Fractures.” Pediatric Clinical Case 

Conference. Cardinal Glennon Childrens Hospital. 

Saint Louis, Missouri, June, 2002 

GRANTS 

T. Kutz, MD - PI 

Deaconess Foundation Support of Nurse Practitioner 

position 

01 yr $ 5,000 09/01/01 - 06/30/02 

02 yr $25,000 07/01/02 - 05/30/02

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D IVISION OF C RITICAL C ARE M EDICINE 


The Division of Pediatric Critical Care provides patient care, multidisciplinary education, community 

service, and biomedical research. Our intent is to provide state of the art medical management for 

critically ill children while improving the care of future patients through our education and research 

efforts. We provide community service through the individual specialized interests of our members. 

The Critical Care Division provides intensivists staffing for the Pediatric Intensive Care Unit at 

Cardinal Glennon Children’s Hospital. We also on occasion provide care in the Emergency Room, 

Operating Room, Transitional Care Unit, as well as responding to codes wherever they may occur in 

the hospital. 

Increasingly, the division provides sedation services for patients with airway risk factors as well as 

providing vascular access services for difficult patient situations. 

Our particular role in the PICU centers around state of the art respiratory management and 

hemodynamic management of critically ill children. In addition we facilitate the care provided by 

multiple divisions and services whose patients are cared for in the ICU. In particular, we are involved 

in the care of complex cardiac post-operative patients and solid organ transplant patients. The 

Division of Pediatric Critical Care provides education to pediatric residents, medicine/pediatric 

residents, emergency pediatric fellows, nursing personnel, medical students, and post graduate 

continuing medical education. Residents rotate through the ICU 3 at a time and form the Critical Care 

Service along with the pediatric attending, any fourth year medical student also rotating, and the 

advanced practice critical care nurse. 

Fellows in Pediatric Emergency Medicine routinely spend 1 month in the Pediatric Intensive Care Unit 

becoming familiar with management issues and procedures related to critical care. Historically, the 

division has provided continuing medicaleducation on a local, regional, national, and international basis. 

Dr’s Loftis and Andreone are heavily involved in basic research as collaborators in the laboratories of 

George Matuschak and John Corbett, respectively. Dr. Ream and Dr. Lynch perform clinical research 

and have been institutional PI’s for multiple clinical studies.

D IVISION OF C RITICAL C ARE M EDICINE 

FACULTY 

Teresa Louise Andreone, MD, PhD, Assistant Professor 

of Pediatrics 

Laura Lynn Loftis, MD, Associate Professor of Pediatrics 

Robert E. Lynch, MD, PhD, Professor of Pediatrics, 

Director, Division of Pediatric Critical Care 

Robert Stephen Ream, MD, Associate Professor, Assistant 

Director, Division of Pediatric Critical Care 

Georgene Menshouse, RHIT, Medical Secretary 

Kelly Murawski, RN, MSN, CS, PNP 


The basic science laboratories in which Drs. Loftis and 

Andreone work have both received competitive renewal 

funding during this past year. Dr. Ream has been the 

local investigator for the pediatric observational study of 

activated Protein C in sepsis and has been accepted as the 

institutional lead investigator for the upcoming 

randomized control trial of activated Protein C in pediatric 

septic patients. 

PUBLICATIONS 

1. Lynch RE. Lisofylline: Anti-acute respiratory distress 

syndrome or just anti- inflammatory? Crit Care Med 

2002 January; 30(1):246-247. 

2. Lynch RE. A procedure for placing pediatric femoral 

venous catheter tips near the right atrium. Pediatr 

Emerg Care 2002 April; 18(2):130-132. 

HONORS 

Robert Ream, M.D., President Elect, Cardinal Glennon 

Children’s Hospital Medical Staff. 

Laura Loftis, M.D., ad hoc reviewer; Journal of Intensive 

Care Medicine. 

Robert Lynch, M.D., Ph.D., ad hoc reviewer and invited 

editorialist; Critical Care Medicine. 

PRESENTATIONS 

Teresa Andreone 1,2 . John Corbett 1 , and Alvin Denenberg 2 , 

Paul Hake 2 , Michael O’Conner 2 , and Basilia Zingarelli 2 , 

St. Louis, MO 1 and Cincinnati, OH 2 , Poly(ADP-Ribose) 

Polymerase (PARP) Regulates Activator Protein-1 (AP-1) 

through Jun Terminal Kinase. Poster Presentation at 62nd 

Annual Scientific Meetings for American Diabetes 

Association, June 14-18, 2002, San Francisco, CA. 

Laura Loftis. Acute hypoxia decreases E coli. -induced NNF 

and IL-1beta production in rat alveolar macrophages. R.P. 

Nayak, T.M. Doyle, Z. Chen, L.L. Loftis, A.J. Lechner, G.M. 

Matuschak. Poster presentation at American Thoracic 

Society in Atlanta, 2002; manuscript in preparation. 

GRANTS 

Laura Loftis, M.D. 

Effects of glutathione depletion on the activation of NF- 

KappaB and CREB following sequential gram-negative 

bacteremia and hypoxia in isolated perfused rat liver 

and lung. $9,500.00, Fleur-de-Lis Foundation. 

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D IVISION O F D EVELOPMENTAL P EDIATRICS 


The Division of Developmental Pediatrics, Department of Pediatrics, Saint Louis University School of 

Medicine is housed in the Knights of Columbus Developmental Center, SSM Cardinal Glennon 

Children’s Hospital. The Knights of Columbus organization, with their mission of identifying 

programs supporting children and families with mental retardation, began continuous funding of the 

center in April,1980. 

The clinical goal of the division is to provide diagnostic evaluation, follow-up, and support and 

advocacy in the community for children and their families with concerns regarding a broad range of 

neurodevelopmental disabilities, behavioral, and psychosocial issues. This includes young children 

with global developmental delay and mental retardation, prematurity, genetic and metabolic 

disorders, cerebral palsy, speech and language concerns, specifically autism spectrum disorders, and 

school age children and adolescents with attention deficit disorder and learning disabilities, and 

accompanying psychiatric and behavioral concerns, including sleep disorders. 

Within the Department of Pediatrics, the teaching goal of the division is to support the educational 

needs of a wide variety of trainees, at different levels of their undergraduate and professional 

education. We have published a comprehensive curriculum of developmental and behavioral 

pediatrics, geared to the primary care physician and the problems they may encounter in their office 

or clinic setting. In addition, we participate in the core lecture series for the third year medical 

students and pediatric residents and have established our own subspecialty lecture series during the 

developmental/behavioral pediatrics rotation. Finally, we have developed a three-hour didactic and 

case-based seminar for the intern orientation program. Each month we have 2 to 5 trainees rotating 

with us. This includes 4th year medical students, 2nd and 3rd year pediatric, combined 

medicine/pediatric, and general psychiatry residents. Over the last several years we have supported 

one to two summer internships for college students interested in pursuing postgraduate careers in 

medicine and allied health fields. 

Outside of the department, each faculty member participates in a wide range of educational venues, 

including invited lectures, professional panels, and CME programs to physicians and allied health 

professionals, professional pediatric societies, special education school districts, and support and 

advocacy groups, both in the greater St. Louis region, and nationally and internationally.


FACULTY 

Monica H. Ultmann, MD, Professor 

of Pediatrics and Psychiatry, and 

Director of the Division of 

Developmental Pediatrics 

Rolanda A. Maxim, MD, Assistant 

Professor of Pediatrics and Psychiatry 

Samuel H. Zinner, MD, Assistant 

Professor of Pediatrics and Psychiatry 

Carol Bettlach, Medical Secretary 


Dr. Rolanda Maxim is currently 

pursuing two active areas of 

investigation. The first examines the 

impact of the early introduction of 

age-appropriate manipulatives and 

toys on the long term development of 

200, 2 to 12 month old infants from 

low income families, using a 

randomized intervention versus 

control group design. The specific 

aims of the project are: 1) Assess 

improvement in problem solving, 

visual motor integration, language, 

adaptive functioning, and social 

interaction skills by providing ageappropriate 

toys, coupled with 

guidance to parents regarding the 

importance of playing with their 

children beginning at an early age 

and 2) Demonstrate whether the 

children and parents in the 

intervention group show a higher 

level of play-related behavior. 

In the second project, Dr. Maxim is 

examining the impact of a pediatric 

intern orientation seminar on the 

ability of the trainees to assess and 

diagnose developmental issues in the 

primary care setting. The workshop is 

divided into three distinct components: 

1) a didactic lecture summarizing basic 

concepts in developmental disabilities 

and introducing several screening 

tools helpful in creating a 

developmental differential diagnosis, 

2) a videotape presenting a 

developmental assessment of a child, 

and 3) a series of workstations where 

participants apply the screening tools 

to different clinical scenarios 

(speech/language disorders, cerebral 

palsy, autism spectrum disorder, and 

mental retardation. Using a pre- and 

immediate post- seminar 

questionnaire, the latter administered, 

again, one year later, Dr. Maxim is 

examining the efficacy of this 

teaching tool. 

Other areas of interest include 

identifying screening instruments for 

autism in normal children between six 

months and three years, in 

conjunction with Parents as Teachers 

in St. Louis, and collaborating with the 

Department of Psychiatry at Saint 

Louis University (Raymond Tait, Ph.D., 

Director, Medical Trials Unit) and 

McNeill Pharmaceutical Company in 

developing medication trials for 

children with autism spectrum disorder. 

Dr. Sam Zinner is pursuing his 

project, “Developmental-Behavioral 

Pediatrics- Resource and Referral 

Directory: Impact of a Unique and 

Comprehensive and Comprehensive 

Guide on the Management Practices of 

Pediatric Primary Care”. The design of 

the study entails a two part survey 

(before and six months after 

distribution of the directory). Dr. Zinner 

has recruited 132 regional general 

pediatricians as qualified study 

participants. Pediatricians were selfselected 

through a mass mailing to 

approximately 500 general 

pediatricians in Eastern Missouri. 

Exclusion criteria included familiarity 

with the directory, less than half-time 

employment in general pediatrics, and 

subspecialty focus outside of general 

pediatrics. Each of these participating 

pediatricians received a copy of the 

Directory in November 2001 after 

submitting the first of two surveys, and 

each has now received the follow-up 

survey. The study design requires the 

participation of 112 pediatricians in the 

completion of the pre- and postsurveys. 

Survey data will be analyzed 

using a SPSS program, in collaboration 

with two faculty members in the 

School of Public Health, Drs. Terry 

Tomazic and Randy Richter. 

In collaboration with Dr. Timothy Fete, 

Division Director of General Academic 

Pediatrics, Drs. Maxim and Zinner are 

examining the psychoeducational 

profile of children with hypohidrotic 

ectodermal dysplasia. 

PUBLICATIONS 

1. Zinner SH, Directory of 

Resources and Referral 

Information: St. Louis Regional 

Access Guide to Developmental 

and Behavioral Pediatric, 

Adolescent and Family Services. 

Saint Louis: Saint Louis University, 

2002. 610 pages Copyright File 

No.: 02Z103/02 001CO02/2 

HONORS 

1. Ultmann, MH: Ad Hoc Reviewer- 

Academic Medicine and Journal 

of Pediatrics. 

2. Zinner, SH: Bronze Medal, 

National Health Information 

Award for Metropolitan St. Louis 

Developmental/Behavioral 

Pediatrics Community Referral 

Directory. 

PRESENTATIONS 

1. Ultmann, MH: “Inattention, 

Impulsivity, and Hyperactivity: 

Considerations in the Diagnosis of 

Attention/Deficit Hyperactivity 

Disorder (ADHD)” given at 

Challenges in Developmental and 

Behavioral Pediatrics: 

Identification and Management of 

Children and Adolescents with 

Developmental and Behavioral 

Disorders, Hannibal, Missouri, 


2. Maxim, RA: “Autism Spectrum 

Disorder” and “Developmental 

Assessment in the Primary Care 

Setting” given at Challenges in 


Pediatrics: Identification and 

Management of Children and 

Adolescents with Developmental 

and Behavioral Disorders, Hannibal, 

Missouri, November, 2001. 

3. Maxim, RA: “Developmental 

Assessment of Children in the 

Primary Care Setting: A Teaching 

Model for a Pediatric Resident 

Training Program”. Workshop 

presentation at the Society for 


Pediatrics Annual Meeting, 

Chicago, Illinois, March, 2002. 

4. Zinner, SH: “Attention 

Deficit/Hyperactivity Disorder: 

Medication Management”, Family 

Care Health Center, St. Louis, 

Missouri, October, 2001. 



Medication Management”, 

CHADD, South County Health 

Center, St. Louis, Missouri, 

October, 2001. 

13

14 




Medication Management”, The 

Miriam School Faculty Lecture 

Series< St. Louis, Missouri, 


7. Zinner, SH: “Learning Disabilities” 

given at Challenges in 


Pediatrics: Identification and 

Management of Children and 

Adolescents with Developmental 

and Behavioral Disorders, Hannibal, 

Missouri, November, 2001. 

8. Zinner, SH: “Office-Based 

Assessment/Referral for 

Behavioral Issues” given at 

Community Office-Based 

Preceptors Practicum, Saint Louis 

University School of Medicine, St. 

Louis, Missouri, January, 2002. 



Medication Management”, St. 

Louis Learning Disabilities 

Association, St. Louis, Missouri, 

January, 2002. 



New Guidelines”, Panel 

Presentation, St. Louis Pediatric 

Society, St. Louis Children’s 

Hospital, March, 2002. 

11. Zinner, SH: “Progress Update: 

Developmental-Behavioral 

Pediatrics St. Louis Resource 

Guide”, presented to the School 

and Community Health Special 

Interest Group, Ambulatory 

Pediatrics Association Annual 

Meeting, Baltimore, Maryland, 

May, 2002. 

12. Zinner, SH: “Behavior 

Management: 0 to 3 years”, 

“Learning Disabilities”, and 

“Tourette’s Disorder and 

Comorbidity” given to 3rd 

Congress of Pediatrics, Evangelical 

University Hospital of Curitiba, 

Parana, Brazil, May, 2002. 

GRANTS AND CONTRACTS 

M.H. Ultmann, MD 

Developmental Pediatric 

Consultant, Southern Illinois 

Medical 

Diagnostic Network/ Child and 

Family Connection 

State of Illinois, Department of 

Human Services, Division of 

Community Health and 

Prevention, Community Service 

Agreement #211G2581000 

$ 36,000 

R.A. Maxim, MD-PI 

“Influence of the Early 

Introduction of Age-Appropriate 

Toys on the Development of 

Children From Low-Income 

Families” 

Fleur-de-Lis Grant, Initially 

awarded in 2000, extended 

through 2003 

$10,000 

R.A. Maxim, MD- PI (in 

collaboration with S.H. Zinner, MD and 

T.J. Fete, MD) 

“Psychoeducational 

Characteristics in Children with 

Hypohidrotic Ectodermal 

Dysplasia” 

National Foundation for 

Ectodermal Dysplasias awarded in 

2002 

$14,229 

S.H. Zinner, MD - PI 

“Developmental-Behavioral 

Pediatrics: Resource and Referral 

Directory 

Impact on the Management 

Practices of Pediatric Primary Care 

Providers” 

Fleur-de-Lis Grant Initially 

awarded in July, 2001 

$10,000 

ADVOCACY/COMMUNITY SERVICE 

M.H. Ultmann: 

Developmental Pediatric Consultant, 

Child and Family Connections, 

Southern Illinois Medical Diagnostic 

Network 

Clayton School District (Clayton, 

Missouri): Judge, Individual 

Extemporaneous Speaking: Clayton 

Varsity Forensics Tournament, Clayton 

Fall Classic, November, 2001 

High School Building Representative, 

Clayton Special School District 

Education Parent Advisory Council, 

May, 2002 (ongoing) 

Parent Representative, Early Childhood 

Education Curriculum Committee, 

June, 2002 (ongoing) 

R.A. Maxim: 

Member, First Steps Health Advisory 

Group, Missouri 

Department of Elementary and 

Secondary Education 

2001 (ongoing) 

Speaker and Saint Louis University 

Representative, Educational and Policy 

Symposium on Autism, Missouri 

Department of Education, Jefferson 

City, Missouri, May 2002 

S.H. Zinner: 

Medical Advisor and Ad-Hoc Reviewer 

for Grants and Articles, 

National Tourette Syndrome 

Association 

Medical Advisor, Missouri Tourette 

Syndrome Association 

Medical Advisor, St. Louis CHADD 

(Children and Adults with ADD) 

Group Organizer and Facilitator, 

Missouri Tourette Syndrome 

Association Youth Support Group 

Medical Editor, Focus on Pediatrics 

Facilitator, Developmental/Behavioral 

Pediatrics Focus Group

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D IVISION OF P EDIATRIC E NDOCRINOLOGY 


The Division of Pediatric Endocrinology in the Department of Pediatrics is dedicated to improving the 

health of children through clinical care, teaching, and research. The faculty in the Division currently 

includes four pediatric endocrinologists. An experienced clinical nurse specialist provides education 

in endocrine disorders and coordinates the clinical research studies of the Division. A second clinical 

nurse performs specialized endocrine function testing and provides in- and out-patient diabetes 

education. A third master’s-level diabetes nurse, who is also a pediatric nurse practitioner and 

Certified Diabetes Educator, provides patient and family education and maintains a high level of inpatient 

diabetic care through education of the hospital nursing staff. In addition, two 

dietitians/nutritionists, a social worker, and a child psychologist are available to offer nutritional 

guidance and psychosocial evaluation and advice. 

Clinical care for infants, children, and adolescents with growth disorders, complex endocrine system 

disorders, diabetes, and metabolic bone disease is comprehensive and state-of-the-art. The Division 

is an official referral center for the newborn screening programs for the states of Missouri and 

Illinois. In calendar year 2001, over 4000 new and return out-patient visits were made to the 

Division’s clinics in the Ambulatory Care Center at Cardinal Glennon Children’s Hospital and in the 

Glennon Care facility at St. Joseph’s Hospital in Kirkwood. Out-patient visits have increased 

dramatically over the last 5 years, and the 9.0% increase from 2000 to 2001 reflects our ongoing 

growth in clinical services. Children are also seen every other month in a rapidly-expanding outreach 

program at Southeast Missouri Hospital in Cape Girardeau, MO. In addition, one faculty 

member is responsible each month for patient care on the in-patient service. Most newly-diagnosed 

diabetic children are hospitalized for a brief period to initiate therapy and education. Consultations to 

assess and assist in the management of complex in-patients are also provided, as requested by other 

services. 

The teaching programs of the Division of Pediatric Endocrinology are closely intertwined with both 

the Department of Pediatrics and the Division of Endocrinology in the Department of Internal 

Medicine. In addition to departmental conferences, which include Grand Rounds, Practical Pediatrics, 

and Noon Case Conferences, nine lectures in the 18-month Core Curriculum lecture series for 

residents and a lecture every 8-weeks for third year medical students are given by Division faculty. A 

popular elective is offered to residents, and third and fourth year medical students are supervised in 

the out-patient clinics. Finally, the Division assists in the training of fellows from the Division of 

Endocrinology in the Department of Internal Medicine by its supervision of fellows in a one-month 

rotation and its participation in a combined case conference. 

Members of the Division of Pediatric Endocrinology have participated in clinical trials of growth 

hormone (GH) therapy and have contributed patient information to post-marketing surveillance 

programs for many years. Division members also conduct the clinical research studies discussed in 

detail below.


FACULTY 

Sherida E. Tollefsen, MD, Associate Professor in 

Pediatrics, Director of the Division of Pediatric Endocrinology 

Susan E. Myers, MD, Associate Professor in Pediatrics 

David P. Dempsher, MD, PhD, Assistant Professor 

in Pediatrics 

Mark C. Eddy, MD, Assistant Professor in Pediatrics 

Barbara Y. Whitman, MSW, PhD, Professor of Pediatrics 

Pamela Ahlf, Medical Secretary 

LaTunya Lockett, Senior Patient Coordinator 

Bonnie Wolff, CNS 

Colleen Weber, CNS 

Debi Kienstra, CNS 


The research studies of Dr. Susan E. Myers in the Division 

of Pediatric Endocrinology, Dr. Barbara Y. Whitman, and 

their collaborators at the University of Wisconsin have 

contributed significantly to our understanding of the effect of 

GH treatment in children with Prader-Willi syndrome (PWS). 

A major research highlight this year has been the further 

elucidation of the benefits of long-term GH therapy in 

children with PWS. As Dr. Myers and her colleagues reported 

in the Journal of Clinical Endocrinology and Metabolism 

(2002 Apr; 87(4):1581-1585), continued beneficial effects on 

body composition, bone mineral density, growth velocity, 

and resting energy expenditure occurred during months 24- 

48 of GH therapy in children with PWS. In addition, prior 

improvements in strength and agility were sustained. In a 

second publication (Pediatrics 2002 Feb; 109(2):e35), Drs. 

Myers and Whitman and their collaborators reported that 

behavioral improvement, including a lack of predictable 

behavioral deterioration, occurred in children with PWS 

during the first 24 months of GH treatment. Dr. Myers and 

her colleagues are currently examining the benefits of GH 

therapy in infants with PWS and participating in a multicenter 

study of GH treatment in adults with PWS. 

Another research highlight has been the Division’s 

participation in a randomized trial to compare weekly 

Nutropin Depot with daily Nutropin AQ for the treatment of 

short stature due to GH deficiency in pediatric subjects. 

Nutropin Depot, a sustained-release formulation of 

recombinant GH, was recently developed to provide a means 

to reduce the frequency of injections in children with GH 

deficiency. The growth rates achieved using currentlyapproved 

dosing regimens of Nutropin Depot are generally 

lower than those historically observed for daily dosing of GH. 

Two GH-deficient children were treated in the Division’s 

Endocrine clinics with weekly Nutropin Depot injections by 

Dr. Sherida E. Tollefsen, PI of the Saint Louis University 

center in this multi-center trial. Comparison of the two 

regimens is underway and initiation of the second phase of 

the trial is anticipated within the next year. 

The Division of Pediatric Endocrinology participates in three 

large programs that address issues related to the safety and 

efficacy of recombinant GH therapy: the Genentech National 

Cooperative Growth Study (NGCS); the Pharmacia and 

Upjohn Kabi International Growth Study (KIGS); and the 

Genetics and Neuroendocrinology of Short Stature 

International Study (GeNeSIS), a program recently initiated by 

Lilly Research Laboratories. The Division is one of 27 centers 

in the U.S. - and the only center in Missouri - to be invited to 

participate in GeNeSIS. GeNeSIS has a similar primary 

objective as the aforementioned programs but also has the 

following secondary objectives: (1) the characterization of 

gene defects associated with GH deficiency and 

hypopituitarism, (2) the characterization of clinical features 

and defects in the SHOX gene in patients with Turner 

syndrome, Leri-Weill syndrome, and Langer syndrome, and 

(3) the characterization of the natural history of neoplastic 

disease in children evaluated or treated for growth disorders. 

Dr. Sherida E. Tollefsen is the PI and Colleen Weber, RN, 

is the study coordinator for these programs. 

Dr. Whitman’s research in defining and managing 

behavioral components of Prader-Willi syndrome has been 

seminal in the field. Following her initial work, she, along 

with Dr. Susan Myers, conducted the first controlled 

research regarding both the physiologic and behavioral 

impact of growth hormone replacement therapy in this 

population, leading to an FDA indication for this therapy. A 

corollary to this work has been the intersection of research 

in autistic spectrum disorders and attention disorders and 

research in Prader-Willi syndrome. Dr. Whitman was the first 

to describe ADHD in persons with Prader-Willi syndrome 

and the first in this country to conduct systematic 

investigation into the incidence of autistic spectrum 

disorders in this population. This broad spectrum of work 

has resulted in a number of invitational presentations at 

international meetings including a recent memorial 

conference for Dr. Andrea Prader. 

Ongoing research in both attention disorders and autistic 

spectrum disorders is underway. At least two books have 

resulted from this work. 

In conjunction with Dr. Susan E. Myers in the Division of 

Endocrinology, additional studies on the use of growth 

hormone in infants and adults with Prader-Willi syndrome 

are currently underway. Additional studies regarding the 

range of developmental concerns in children with congential 

hypothyroidism are also underway. 

17

18 


PUBLICATIONS 

1. Whitman BY, Myers S, Carrel A, Allen D. The 

behavioral impact of growth hormone treatment for 

children and adolescents with Prader-Willi syndrome: A 

two-year, controlled study. Pediatrics 2002 Feb; 

109(2):e35. 

2. Carrel AL, Myers SE, Whitman BY, Allen DB. Benefits 

of long-term growth hormone therapy in Prader-Willi 

syndrome: A 4-year study. J Clin Endocrinol Metab 2002 

Apr; 87(4):1581-1585. 

3. Pang S, Wang W, Rich B, David R, Chang YT, Carbunaru 

G, Myers SE, Howie AF, Smillie KJ, Mason JI. A novel 

nonstop mutation in the stop codon and a novel 

missense mutation in the type II 3ß-hydroxysteroid 

dehydrogenase (3ß-HSD) gene causing, respectively, 

nonclassic and classic 3ß-HSD deficiency congenital 

adrenal hyperplasia. J Clin Endocrinol Metab 2002 Jun; 

87(6): 2556-2563. 

4. Myers S, Carrel A., Whitman B, Allen D. (2000) 

Sustained benefit after 2 years of growth hormone on 

body composition, ft use, physical strength and agility, 

and growth in Prader-Willi syndrome. Journal of 

Pediatrics 137 (1): 42-49. 

5. Carrel A, Myers S, Whitman B, Allen D. (2000) The 

Effect of Growth Hormone on Childhood Body 

Composition. The Endocrinologist. 10 (4):43S-49S 

6. Whitman B, Myers S, Carrel A, Allen D. (2000) A 

Treatment/control group study of growth hormone 

treatment: impact on behavior - a preliminary look. The 

Endocrinologist. 10 (4):31S-37S 

7. Carrel AL, Myers SE, Whitman BY, Allen DB. (2001) 

Sustained benefits of growth hormone on body 

composition, fat utilization, physical strength and agility, 

and growth in Prader-Willi syndrome are dosedependent. 

J Ped Endo Metab 14: 1097-1105. 

8. Accardo P.J., Blondis T.A., Whitman B.Y., Stein M. (eds) 

Attention Deficit Disorder and Hyperactivity in Children and 

Adults, second edition. New York: Marcel Dekker. 2000) 

9. Accardo PJ, Whitman BY. Morrow J. Dictionary of 

Developmental Disabilties: An Interdisciplinary 

Introduction to Multidisciplinary Terminology - 2nd Ed. 

(Paul H. Brookes, in press) 

HONORS 

1. Dempsher, DP: Selection to The Best Doctors in 

St. Louis 2002 

2. Tollefsen, SE: Selection to The Best Doctors in St. Louis 

2002; ad hoc reviewer for The Journal of Pediatrics 

PRESENTATIONS 

1. Dempsher DP: “Systemic Effects of Inhaled 

Glucocorticoids.” CME presentation at the Cape 

Girardeau County Area Medical Society, Cape Girardeau, 

MO, October, 2001. 

2. Dempsher DP: “Genital Ambiguity and Gender 

Assignment.” Grand Rounds, Department of Pediatrics, 

Cardinal Glennon Children’s Hospital, St. Louis, MO, 

February, 2002. 

3. Eddy MC: “Spectrum of Rachitic Disorders in Children.” 

CME presentation at the Cape Girardeau County Area 

Medical Society, Cape Girardeau, MO, February, 2002. 

4. Myers SE: “Type II Diabetes Mellitus in Adolescents.” 

Practical Pediatrics, Department of Pediatrics, Cardinal 

Glennon Children’s Hospital, St. Louis, MO, 


5. Myers SE: “Update on Diabetes.” SSM Cardinal 

Glennon Children’s Hospital CME Practical Pediatrics 

Conference at the Sheraton - St. Louis City Center, 

St. Louis, MO, November, 2001. 

6. Myers SE: “Type II Diabetes Mellitus in Adolescents.” 

St. Louis Association of Diabetes Educators, St. Louis, 

MO, March, 2002. 

7. Tollefsen SE: “New Indications for Growth Hormone 

Therapy.” Practical Pediatrics, Department of Pediatrics, 

Cardinal Glennon Children’s Hospital, St. Louis, MO, 


8. Tollefsen SE: “Short Stature.” SSM Cardinal Glennon 

Children’s Hospital CME Practical Pediatrics Conference 

at the Sheraton-St. Louis City Center, St. Louis, MO, 


9. Tollefsen SE and Myers SE: “Advances in Pediatric 

Endocrinology.” Grand Rounds, Department of 

Pediatrics, Cardinal Glennon Children’s Hospital, 

St. Louis, MO, January, 2002. 

10. Whitman, BY: Prader Willi Syndrome: An Overview. 

International Conference on Endocrinology. Monaco, 

October 2000. 

11. Whitman, BY: A Day in the life of the person with 

Prader-Willi Syndrome. International Conference on 

Endocrinology. Malta. April 24, 2001 

12. Whitman, BY: The Impact of Growth Hormone on the 

Behavioral Components of Prader-Willi Syndrome. 

International Conference on Endocrinology. Malta. 

April 24, 2001 

13. Whitman, BY: Prader-Willi Syndrome: An Overview. 

Prader-Willi Association of Holland. Amsterdam 

Holland. January 2002 

14. Whitman, BY: The Impact of Growth Hormone on the 

Behavioral Components of Prader-Willi Syndrome. 

International Symposium, Growth Hormone and Growth 

Factors I Endocrinology and Metabolism. Barcelona, 

Spain April 29-30 2002


15. Whitman, BY: Educational and Policy Symposium 

on Autism. Missouri Department of Mental Health. 

Jefferson City, MO. May 6, 2002 

16. Whitman, BY: Attention Disorders Revisited and 

Revisited and Revisited. 24th Annual Pediatrics at 

the Beach Primary Care Conference, Virginia Beach, 

Virginia July 2002 

17. Whitman, BY: The Multidisciplinary Management 

of Prader-Willi syndrome. Conference on Prader- 

Willi syndrome as a Model for Obesity. Zurich, 

Switzerland. October 18-19, 2002. 

GRANTS 

S. Myers, MD - PI 

The Diagnosis and Genotropin Treatment of 

Growth Hormone Deficiency in Adult Prader-Willi 

Syndrome Patients 

Pharmacia and Upjohn 

1/1/02-12/31/03 

$58,446 

S.E. Tollefsen - PI 

A Multi-center Trial of Genotropin Treatment of 

Children Born Small for Gestational Age (SGA): 

Evaluation of Predictors of / Correlates with First Year 

Growth Response 

2/1/02 - completion 

$4,500/subject x 10 subjects 

S.E. Myers and B.Y. Whitman - PI 

Clinical Quality Assessment Project: The 

Examination of the Characteristics Related to 

Disease Control and Compliance Issues in Patients 

with Congenital Hypothyroidism 


5/1/01-4/30/03 

$50,000 

S.E. Myers, A.L Carrel - PI 

The Metabolic Effects of Growth Hormone on 

Body Composition in Infants and Toddlers with 

Prader-Willi Syndrome 


5/3/02-8/31/03 

$6,877/subject x 12 subjects 

S.E. Tollefsen - PI 

A Phase IIIb, Open-Label, Randomized Trial to 

Compare Weekly Nutropin Depot with Daily 

Nutropin AQ for the Treatment of Short Stature due 

to Growth Hormone Deficiency in Pediatric Subjects 

Genentech 

2/15/00 - completion of phase 1 $3,375/subject 

phase 2 - $3,200/subject 

S.E. Tollefsen is also the PI, Saint Louis University, of 

the following contracts: 

Genentech 

National Collaborative Growth Study: Post-Marketing 

Surveillance Program 


KABI International Growth Study: Post-Marketing 

Surveillance Program 

Lilly Research Laboratories 

GeNeSIS (The Genetics and Neuroendocrinology of Short 

Stature International Study) 

19

20 

G ENERAL A CADEMIC P EDIATRICS 


Through quality patient care, innovative education, creative research, and vigorous advocacy, the 

Division of General Academic Pediatrics of the Saint Louis University School of Medicine partners with 

patients, parents and the community to assure that the physical, emotional, and spiritual needs of this 

and future generations of children will be met with competence, dignity, justice and compassion. 

Division members provide a wide variety of medical services to patients at SSM-Cardinal Glennon 

Children’s Hospital. University Pediatrics is the primary care practice of the Department of Pediatrics, 

serving as the medical home for approximately 6,000 patients with 15,000 visits per year. The 

patients cared for at University Pediatrics have more serious acute and chronic medical problems, 

and more social/economic problems than patients in a typical community practice. 

The General Academic Pediatrics faculty are actively involved in inpatient care of patients at Cardinal 

Glennon, accounting for one half of the inpatient faculty attending positions on the ward services. 

The Medical Director of the Rehabilitation Services is a member of the division. 

The Medical Diagnostic Clinic, a consultation service offered to referring physicians, is operated by 

the General Academic Pediatrics faculty. Division members have broad expertise, with special 

interest in failure to thrive; adoption medicine; community pediatrics; advocacy; urinary tract 

infections; voiding dysfunction; adolescent health care; sports medicine; the effect of media on 

children; health care needs of gay and lesbian youth; international child health; endocrinology; 

developmental delay; attention deficit hyperactivity disorder; and care of the child with special health 

care needs. 

Members of General Academic Pediatrics are recognized for their interest and expertise in the 

education of students at all levels of pediatric education: PA students; medical students; residents 

(Pediatrics, Med-Peds, Family Medicine, and others); and community physicians. Dr. Jay Noffsinger, 

the Medical Student Education Coordinator, has been awarded the last four Golden Apple Awards by 

the graduating classes from the School of Medicine, and the Division has won six of the last seven 

such awards. Members of the Division have been awarded innumerable teaching awards by the 

residents in pediatrics, and have been cited as excellent teachers by several other disciplines. 

Teaching is provided at University Pediatrics; on the general ward services; through formal and 

informal conferences for students and residents; in specialty clinics staffed by General Academic 

Pediatrics faculty; and through coordination of Continuing Medical Education seminars for 

community physicians. 

Advocacy for the needs of all children, but particularly for the underserved, is a major focus of the 

Division of General Academic Pediatrics. Division members serve on countless community boards, 

including the State of Missouri Child Abuse and Neglect Review Board, Vision for Children at Risk, 

Catholic Charities, Missouri Chapter of the American Academy of Pediatrics, Special School District, 

Headstart, and many others. Dr. Sarah Legett has developed a model program for immersion of 

residents in the community, through the Community Health Elective.

FACULTY 

Timothy J. Fete, MD, MPH, Professor 

of Pediatrics and Director of the 

Division of General Academic Pediatrics 

Shahnaz Ahmad, MD, Assistant 

Clinical Professor of Pediatrics 

David P. Dempsher, MD, PhD, 

Assistant Professor of Pediatrics 

Mark C. Eddy, MD, Assistant 

Professor of Pediatrics 

Kenneth A. Haller, MD, Assistant 


M. Susan Heaney, MD, MPH, 

Associate Professor of Pediatrics 

Jennifer S. Ladage, MD, Assistant 


Sarah M. Legett, MD, Assistant 


Shahida R. Naseer, MD, Associate 


Jay E. Noffsinger, MD, Professor of 

Pediatrics 

Douglas Nozaki, MD, Assistant 


Adrinne White, Medical Secretary 


The Division of General Academic 

Pediatrics is involved in a broad array 

of research projects, collaborating with 

investigators from other divisions 

within the Department of Pediatrics, 

other disciplines within Saint Louis 

University, and with researchers from 

other institutions. 

Jennifer S. Ladage, MD is involved in 

a multicenter study, investigating the 

prevalence of infection with Hepatitis B 

and C in international adoption. 

Timothy J. Fete, MD, MPH is 

participating in two studies related to 

patients affected with ectodermal 

dysplasia (E.D.). The first study is in 

collaboration with the Pediatric 

Gastroenterology division at Saint 

Louis University and with investigators 

from Baylor University. This study is 

evaluating growth, nutrition, exercise 

and self-esteem in children with E.D. 

The second study is in collaboration 

with the Division of Developmental 

Pediatrics, and is investigating the 

prevalence of learning disabilities in 

children with E.D. 


Sarah M. Legett, MD is investigating 

the etiologies of conjunctivitis in 

children, in conjunction with the 

Department of Pediatric 

Ophthalmology. She is studying the 

impact of medical practitioner spiritual 

and religious beliefs on the care of 

patients, in collaboration with the 

Department of Psychology. A third area 

of investigation for Dr. Legett is the 

health status of Bosnian refugee 

children, a study on which she is 

working with the Division of 

Neonatology. 

M. Susan Heaney, MD, MPH is 

working with Chief Resident Jean 

Wagner, MD, presented a poster at the 

Pediatric Academic Societies Meeting 

in May of 2002, “Adolescent Health 

Care in a University-Based Resident 

Continuity Clinic.” She is also pursuing 

an interest in Data Base Management 

of Resident Continuity Clinics. 

Mark C. Eddy, MD is a coinvestigator 

on several studies related 

to the management of short stature 

with growth hormone, including small 

for gestational age children and 

growth hormone deficient children. 

David P. Dempsher, MD, PhD is 

preparing background information for 

research projects related to 

medications in Type II Diabetes 

Mellitus and related to long-term 

outcomes of gender assignment. 

Shahida R. Naseer, MD is actively 

involved in several studies related to 

voiding dysfunction syndromes, 

particularly evaluation of vesicoureteral 

reflux in infants. These studies 

are in collaboration with the Saint Louis 

University Department of Urology. 

HONORS 

1. Fete, TJ: Featured for excellence in 

teaching in “Grand Rounds”, a 

publication for Saint Louis 

University Medical Alumni in 

“Teaching to Learn”; Reviewer 

National Foundation for Ectodermal 

Dysplasias research fund. 

2. Heaney, MS: Co-Chairperson, 

Region VI Ambulatory Pediatric 

Association; Listed in the 2002 

America’s Top Doctors Guide, 

published by Castle Connelly 

3. Medical Ltd., Featured on the cover 

of St. Louis Magazine; Reviewer 

Pediatric Academic Societies 2002 

Annual Meeting, General Pediatrics 

and Preventive Pediatrics. 

4. Legett, SM: Community Service 

Award, St. Louis Children’s 

Home Society. 

5. Noffsinger, JE: Golden Apple 

Award, Saint Louis University 

School of Medicine School of 

Medicine (4th consecutive year!); 

Inducted into the Saint Louis 

University Chapter of the Alpha 

Omega Alpha Honorary Medical 

Society, Faculty Member; Keynote 

speaker Saint Louis University 

School of Medicine Class of 2005 

White Coat Ceremony; Listed in 

2002 America’s Top Doctors 

Guide, published by Castle 

Connelly Medical Ltd; featured for 

excellence in teaching in “Grand 

Rounds”, a publication for Saint 

Louis University Medical Alumni 

in “Teaching to Learn.” 

PRESENTATIONS 

1. Dempsher DP: “Glucocorticoid 

Therapy and Adrenal 

Suppression.” Cape Girardeau, 

MO. October 2001. 

2. Dempsher DP: “Ambiguous 

Genitalia and Gender Assignment.” 

Glennon Grand Rounds”. St. Louis, 

MO. March 2002 

3. Fete TJ: Host, Moderator, 

“Ectodermal Dysplasias, a Medical 

Symposium.” National Foundation 

for Ectodermal Dysplasias Annual 

Meeting. St. Louis, MO, July 2001. 

4. Fete TJ: “Growth and 

Development in Children and 

Adolescents.” Saint Louis 

University School of Medicine 

Physician Assistant Lecture Series. 

St. Louis, MO. July 2001. 

5. Fete TJ: Host, Moderator, 

“Practical Pediatrics”, CME 

program for SSM-Cardinal 

Glennon referring physicians. St. 

Louis, MO. October, 2001. 

6. Fete TJ: “Reading Promotion in 

the Primary Care Office.” 

Practical Pediatrics. Saint Louis, 

MO. April, 2002. 

21

22 


7. Fete, TJ: Host, Moderator, 

“Sports Medicine: Care for the 

Child Athlete.” Saint Louis, MO. 

April 2002. 

8. Fete TJ: “Maturation: Sex, 

Drugs and Rock ‘n Roll.” Sacred 

Heart School. Saint Louis, MO. 

May, 2002. 

9. Fete TJ: “Maturation: Sex, 

Drugs and Rock ‘n Roll.” Holy 

Infant School. Saint Louis, MO. 

May 2002. 

10. Fete TJ: Host, Moderator “Focus 

on Pediatrics.” Saint Louis, MO. 

June 2002. 

11. Haller KA: “Immunizations.” 

Healthy Baby Forum, SIDS Urban 

Outreach Council. Saint Louis, 

MO. July, 2001. 

12. Haller KA: “Media Matters.” Saint 

Louis University Department of 

Pediatrics Grand Rounds. Saint 

Louis, MO. January, 2002. 

13. Haller KA: “Media Matters.” 

Community Preceptors Annual 

CME Conference. St. Louis, MO. 

January, 2002. 

14. Haller KA: “Using the Media 

History Form to Assess 

Behavioral and School 

Problems.” Practical Pediatrics. 

St. Louis, MO. May, 2002. 

15. Haller KA: “The AAP Policy 

Statement on Coparent, Same Sex 

Adoption: Implications for Medicine, 

Law, and the LGBT Community.” 

National Coalition on LGBT Health, 

Annual Conference. Chicago, IL. 

May, 2002. 

16. Haller KA: “Health Care Needs of 

Gay and Lesbian Adolescents.” 

Focus on Pediatrics, St. John’s 

Medical Center. St. Louis, MO. 

June, 2002. 

17. Heaney MS: “Adolescent Eating 

Disorders.” Practical Pediatrics. St. 

Louis, MO. November, 2001. 

18. Heaney MS: “Health 

Assessment of the Adolescent.” 

Saint Louis University Pediatric 

Grand Rounds. St. Louis, MO. 


19. Heaney MS: Partnering with 

Residents in Research.” Faculty 

Development Series, 

Department of Pediatrics. St. 

Louis, MO. June, 2002. 

20. Legett SM: “Care of the Special 

Needs Child.” Children’s Home 

Society. Saint Louis, MO. 


21. Legett SM: “Faith, Human 

Nature and the Professions.” Saint 

Louis University Symposium, 

Ethics Across the Curriculum. 

Saint Louis, MO. April, 2002. 

22. Naseer SR: “Bedwetting-What’s 

New?” Program for Nurse 

Practitioners. Washington, MO. 

April, 2002. 

23. Naseer SR: “Practical Pediatrics.” 

Primary Nocturnal Enuresis. St. 

Louis, MO. May, 2002. 

24. Noffsinger JE: “Viral 

Exanthems and Immunizations.” 

Saint Louis University Physician 

Assistant Program. Saint Louis, 

MO. July, 2001. 

25. Noffsinger JE: “Knee Injuries in 

Athletes.” Saint Louis University 

Sports Medicine Special Interest 

Group. St. Louis, MO. 


26. Noffsinger JE: “Sports Medicine 

Workshop.” Saint Louis 

University Family Medicine 

Residency Program. Belleville, IL. 


27. Noffsinger JE: “Preparticipation 

Evaluation in Athletes.” Saint 

Louis University Sports Medicine 

Special Interest Group. St. Louis, 

MO. March, 2002. 

28. Noffsinger JE: “Pediatric 

Workshop.” Saint Louis University 

Family Medicine Residency 

Program. Belleville, IL. May, 2002. 

29. Noffsinger JE: “The Preparticipation 

Evaluation: 

Important or Just a Requirement?” 

Sports Medicine, Care of the Child 

Athlete. St. Louis, MO. April, 2002. 

30. Noffsinger JE: “Hot Topic: Heat 

Related Illness in Athletes.” Sports 

Medicine, Care of the Child 

Athlete. St. Louis, MO. April, 2002. 

31. Noffsinger JE: “Sudden Death in 

Athletes-Sports Medicine’s Worst 

Fear.” Sports Medicine, Care of 

the Child Athlete. St. Louis, MO. 

April, 2002. 

32. Noffsinger JE: “Female Athlete 

Triad-Old Bones in Young 

Women.” Sports Medicine, Care of 

the Child Athlete. St. Louis, MO. 

April, 2002. 

33. Noffsinger JE: “Heat Illness in 

Athletes.” Practical Pediatrics. 

May, 2002.

24 

D IVISION OF M EDICAL G ENETICS 


The Division of Medical Genetics provides genetic evaluation and counseling for families and 

individuals with a known or suspected genetic disorder. Genetic services are provided through the 

following clinics/services: 

Medical Genetics Clinic (CGCH) 

Multidisciplinary Clinics (CGCH) 

- Cleft Lip and Palate Clinic 

- Neurofibromatosis Clinic 

Outreach Clinics 

- Cape Girardeau, MO: St. Francis Center for Health and Rehabilitation Sikeston, MO: 

Missouri Delta Medical Center Edwardsville, IL: 

- Madison County Health Department 

Inpatient Genetic Consultation Service 

Prenatal and Post-Conceptional Genetics Clinic (SMHC) 

Primary reasons for referral to the Medical Genetics and Outreach Clinics include developmental 

delay, dysmorphic features, failure to thrive, suspected metabolic disorder, abnormal newborn 

screen, and genetic counseling for diagnosed genetic disorders. Referrals for evaluation of abnormal 

newborn screens are anticipated to increase significantly due to the recent expansion in the scope of 

the screens mandated by the states of Missouri and Illinois. While most patients evaluated in the 

Medical Genetics Clinics are children, adults are also seen for diagnostic evaluation/presymptomatic 

screening for genetic disorders such as Marfan Syndrome and Huntington Disease, in which 

symptoms may appear later in life. The Genetic Division also operates the Gaucher Disease 

Treatment Center in the Costas Center. 

The molecular cytogenetics laboratory at SSM-Cardinal Glennon Children’s Hospital offers a 

comprehensive, state of the art test menu, which includes testing on chorionic villus samples, 

amniotic fluid, products of conception, peripheral blood, bone marrow and solid tumors. The lab also 

offers fluorescence in situ hybridization testing. The laboratory currently completes approximately 

300 prenatal, 800 bone marrow and 500 blood and tissue analyses per year. The laboratory is staffed 

by seven full-time cytogenetic technologists. The director, Jacqueline Batanian, PHD., is board 

certified in clinical cytogenetics. 

Members of the Division of Medical Genetics are actively involved in education at many levels. The 

first year medical student lecture series on Genetics is primarily taught by members of the division. 

Medical students, pediatric residents and college students rotate through the Medical Genetics Clinic. 

Lectures are provided for the third year medical student pediatric clerkship, for the pediatric 

residency curriculum and for the neonatology fellows. Many presentations are provided throughout 

the year in the Bi-State area for students, health professionals and family support groups. Visits are 

made to referring physician offices in Madison County, IL and in Southeast Missouri, to promote 

outreach clinics and to educate staff regarding appropriate referrals to the clinics.

FACULTY 

Timothy J. Fete, MD, MPH, 

Professor of Pediatrics and Interim 

Division Director, Medical Genetics 

Jacqueline Batanian, PhD, 

Professor of Pediatrics, Director 

Molecular Cytogenetics 

Meg Hefner, MS, CGC, Assistant 


Kathy Morris, MS, CGC, Instructor 

of Pediatrics 

Laura Waldman, MS, CGC, 

Instructor of Pediatrics 


The Division of Medical Genetics is 

involved in a broad array of research 

projects. 

1. Jacqueline Batanian, PhD is 

currently investigating cancer 

breakpoints in Fanconi anemia; 

complex chromosome 

rearrangement in osteosarcoma, 

using regular G-banding plus 

FISH plus GH; and identification 

of the gene responsible for 

trisomy 8 in leukemia. 

2. Timothy J. Fete, MD, MPH is 

participating in two studies related 

to patients with ectodermal 

dysplasia syndromes. One is 

assessing growth parameters and 

the other is assessing cognitive 

function in children affected by 

ectodermal dysplasia. 

3. Meg Hefner, M.S., C.G.C. is 

involved with research on the 

natural history of CHARGE 

syndrome, with a new interest 

in growth and behavior in 

CHARGE syndrome. 

4. Kathy Morris, M.S., C.G.C. has 

recently been working on 

chromosome 8 deletion studies, 

as well as mosaic trisomy 16. 

PUBLICATIONS 

1. Batanian JR, Morris K, Ma E, 

Huang Y, McComb J. Familial 

deletion of (8) (q24.13q24.22) 

associated with normal 

phenotype. Clinical Genetics 2001 

Aug; 60: 371-373. 

D IVISION OF M EDICAL G ENETICS 

2. Batanian JR, Polski JM, Galambos 

C, Gale GB, Dunphy CH, Evans HL. 

Acute megakaryoblastic leukemia 

after transient myeloproliferative 

disorder with clonal karyotype 

evolution in a phenotypically 

normal neonate. Journal of 

Pediatric Hematology/Oncology 

2002 January; 24(1): 50-54. 

3. Batanian JR, JA Bridge, C Vogler, 

B Gadre, Y Huang. EWS/FLI-1 

fusion signal inserted into 

chromosome 11 in one patient 

with morphologic features of 

Ewing Sarcoma, but lacking 

t(11;22). Cancer Genetics and 

Cytogenetics 2001 July; 133: 72-75. 

4. Batanian JR, Vadlamani I, Ma E, 

Brink DS. Trisomy 15 in a case of 

pediatric hemangiopericytoma 

and a review of the literature. 

Accepted in Cancer Genetics and 

Cytogenetics, accepted 2002 April. 

5. Batanian JR 2 , Zahed L 1 , 

Darwiche N 1 , and Awwad J 1 . 

Homologous telomere association 

of 19q in a female with premature 

ovarian failure. Accepted in 

Clinical Genetics and 

Cytogenetics, accepted 2002 June. 

6. Hefner MA, Davenport SLH, 

editors. CHARGE syndrome:a 

management manual for parents. 

Version 2.1. CHARGE Syndrome 

Foundation, Inc; 2002. 250p. 

HONORS 

1. Batanian, JR: Reviewer: Nature 

Medicine; American Journal of 

Human Genetics; American 

Journal of Medical Genetics. 

2. Fete, TJ: Reviewer: National 

Foundation for Ectodermal 

Dysplasias research fund. 

3. Hefner, MA: Recognized at the 

International CHARGE Syndrome 

Conference for dedication and 

service, July 2001. Reviewer: 

Clinical Medicine and Research; 

Editor, CHARGE Accounts, the 

quarterly newsletter of the 

CHARGE Syndrome Foundation. 

PRESENTATIONS 

1. Batanian, JR: “From 

Chromosome Translocation to 

Drug Therapy: the Story of CML.” 

National Clinical Research 

Associates SWOG Meeting. 

Chicago, IL. 2001. 

2. Fete, TJ: Host, Moderator, 

“Ectodermal Dysplasias, a Medical 

Symposium.” National Foundation 

for the Ectodermal Dysplasias 

Annual Meeting. St. Louis, MO. 

July, 2001. 

3. Waldman, LM: “Impact of 

Genetic Information and the 

Human Genome Project.” 

American Dietetic Association 

Annual Conference. St. Louis, MO. 


4. Waldman LM, Batanian JR, 

Oizumi J: “Bilateral Cleft Lip and 

Palate Associated with a Familial 

Unbalanced (7;8) Translocation.” 

Poster. Annual American College 

of Medical Genetics Clinical 

Meeting. New Orleans, LA. 

March, 2002. 

GRANTS 

T. Fete, MD-PI 

Missouri Department of 

Health #502503 

Tertiary Genetic Center Grant 

02 yr $164,421 

T. Fete, MD-PI 

Illinois Department of Public 

Health #500441 

Genetic Counseling Clinical 

Services Program Grant 

02 yr $46,000 

25

26 

DIVISION OF GASTRONENTEROLOGY & HEPATOLOGY 


The Division of Pediatric Gastroenterology and Hepatology cares for infants, children, and 

adolescents with a variety of gastrointestinal and liver diseases. The largest percentage of our 

patients have various complications due to gastroesophageal reflux disease. Gastroesophageal reflux 

disease is a common reason for referral because of infants having intractable regurgitation or colicky 

pain or both. It is also a common reason for a referral because of recurrent abdominal pain in 

childhood and adolescence. Our Division also treats a wide variety of motility problems ranging from 

constipation in younger children to irritable bowel syndrome in older children and adolescents. We 

also have more than 150 patients with inflammatory bowel disease, Crohn’s disease and ulcerative 

colitis that are followed in our gastroenterology clinics. We have an active service caring for infants 

and children with short bowel syndrome, many of whom end up on long term total parenteral 

nutrition and some of whom have had small and liver transplants. We have a very active liver 

transplant program. 

Our Division has a very successful liver transplant program for infants and children with chronic liver 

disease as well as acute fulminant liver failure. In the past five years we have had a 95% survival in infants 

and children receiving their first liver transplant, which is one of the best success rates in the country. 

The Weight Management Program at Cardinal Glennon Children’s Hospital is a very novel 

multidisciplinary approach to the treatment of overweight children and adolescents. The Weight 

Management Programs includes an integrated approach to the care of these children with 

nutritionists and psychologists. Cardinal Glennon is one of the few children’s hospitals in the 

Midwest to have established the Weight Management Program. 

We also have very active outpatient services in South County, Kirkwood, St. Charles and 

Jefferson City. 

Kathleen Spranaitis, RN, PNP, has joined the Division as a Pediatric Nurse Practitioner, in June 

2002, she will significantly help expand our capacity to see outpatients with gastrointestinal 

problems. Mrs. Spranaitis has over 20 years of experience as a nurse and 8 years as a Pediatric Nurse 

Practitioner. This wealth of experience will serve her well in her new responsibilities caring for our 

gastroenterology patients at Cardinal Glennon.

DIVISION OF GASTRONENTEROLOGY & HEPATOLOGY 

FACULTY 

Robert E. Kane, MD, Professor of 

Pediatrics and Director of the 

Division of Pediatric Gastroenterology 

and Hepatology 

Thomas M. Foy, MD, Associate 


Sarah E. Barlow, MD, Assistant 


Chenitra Akridge, Medical Secretary 

Stefanie Moore, Senior 

Patient Coordinator 

Karen Avant, RN 

Kathleen Spranaitis, PNP 


Dr. Robert Kane has participated in a 

multicenter study on safety and 

efficacy of Prevacid in the treatment of 

gastroesophageal reflux disease in 

infants, children and adolescents. 

These studies which involved ten 

children’s hospitals validated the safety 

and efficacy of Prevacid. A series of six 

articles were published in the 

November issue of Pediatric 

Gastroenterology and Nutrition. 

Dr. Kane is one of the principle 

investigators in the studies for 

Pediatric Liver Transplantation. (SPLIT) 

This is a registry of Liver Transplant 

patients that includes collaboration 

from 38 Pediatric Liver Transplant 

Centers. The registry was used as a 

database to devise and validate a new 

priority system for allocation of livers 

for pediatric transplant patients. 

Dr. Thomas Foy has recently revised 

his chapter in the textbook “Pediatric 

Gastrointestinal Diseases”. This chapter 

deals with feeding disorders in infants 

and children. Dr. Foy is Chairman of 

the Nutrition Advisory Committee and 

directs the Nutrition Support Service at 

Cardinal Glennon Hospital. 

Dr. Sarah Barlow is a nationally 

recognized authority in the field of 

childhood obesity. She has been the 

senior author on a series of six articles 

that were published as a supplement 

to the journal of pediatrics. She has 

currently submitted an application to 

the national institute of health for a 

Mentored Career Award. 

PUBLICATIONS 

1. Trowbridge FL, Sofka D, Holt K, 

Barlow SE. Management of child 

and adolescent obesity: study 

design and practitioner 

characteristics. Pediatrics 

2002;110 Suppl:205-209 

2. Story MT, Neumark-Stzainer DR, 

Sherwood NE, Holt K, Sofka D, 

Trowbridge FL, Barlow SE. 

Management of child and 

adolescent obesity: attitudes, 

barriers, skills, and training needs 

among health care professionals. 

Pediatrics 2002;110 Suppl: 210-214 

3. Jonides L, Buschbacher V, 

Barlow SE. Management of child 

and adolescent obesity: 

psychological, emotional, and 

behavioral assessment. Pediatrics 

2002; 110 Suppl: 215-221 

4. Barlow SE, Dietz WH, Klish WJ, 

Trowbridge FL. Medical elevation 

of overweight children and 

adolescents: reports from 

pediatricians, pediatric nurse 

practitioners, and registered 

dietitians. Pediatrics 2002; 110 

Suppl: 222-228 

5. Barlow SE, Trowbridge FL, Klish 

WJ and Dietz WH. Treatment of 

child and adolescent obesity: 

reports from pediatricians, 

pediatric nurse practitioners, and 

registered dietitians. Pediatrics 

2002; 110 Suppl: 229-235 

6. Foy T, Barlow S, Kane R, 

“Multiple rubber-band ligator for 

treatment of esophageal varices in 

children. J Pediatric 

Gastroenterology Nutrition, 2001; 

33: 412 (abstract). 

HONORS 

1. Kane,RE: Listed in the 2002 guide 

and only one of a thousand “Best 

Doctors in America”; Dr. Kane 

was a member of the Medical 

Advisory Board of the St. Louis 

Chapters of the American Liver 

Foundation and the Crohn’s and 

Colitis Foundation of America. 

2. Barlow,SE: Advisory committee 

for the Commission on Dietetic 

Registration’s “Certificate of 

Training in Pediatric and 

Adolescent Weight Management”, 

American Dietetic Association 

2002; General Clinic Research 

Center Advisory Committee, Saint 

Louis University School of 

Medicine, 2002 

PRESENTATIONS 

1. Barlow, SE “Pediatric weight 

management for the primary 

provider” Pediatric Academic 

Societies annual meeting; May 

2002, Baltimore, MD 

2. Foy, TM “Feeding difficulties in 

infants and children” Spring 

Gastroenterology & Hepatology 

Symposium, Hyatt Regency; 

March 2002, St. Louis, Mo. 

27

28 

D IVISION OF H EMATOLOGY O NCOLOGY 


Members of the Division of Hematology and Oncology diagnose and treat children with cancer, sickle 

cell disease, other hematologic diagnoses, and disorders of platelets and granulocytes. Care ranges 

from outpatient consultation to stem cell transplantation. Members of the division participate in 

educational activities at multiple levels within the School of Medicine, Cardinal Glennon Children’s 

Hospital and a two hundred mile hospital referral area. 

The Division is a full member of the Children’s Oncology Group and actively participates in national 

protocols investigating new therapies as well as the biologic behavior of childhood malignancies. 

The Saint Louis Cord Blood Bank collects, processes and preserves cord blood derived stem cell for 

use in stem cell transplantations here and throughout the world. A regional co-operative program 

with other caregivers is being established to improve treatment and foster needed research for 

children with sickle cell disease. 

FACULTY 

Dennis M. O’Connor, MD, Professor 

in Pediatrics and Director Pediatric 

Hematology and Oncology 

Richard A. Cahill, MD, Associate 

Professor in Pediatrics 

Jen-Yih Chu, MD, PhD, Professor 

in Pediatrics 

Gordon B. Gale, MD, Professor 

in Pediatrics 

Michael E. Kelly, MD, PhD, 

Assistant Professor in Pediatrics 

John Puetz, MD, Clinical Assistant 

Professor in Pediatrics, Medical 

Director Oncology Long-term 

Michael H. Creer, MD, FASCP, FCAP, 

Professor of Pathology and Pediatrics 

Patricia Codden, RN, MSN, 

Clinical Specialist 

Jan Armstrong, RN, 

Transplant Coordinator 

Barry Friedman, RN, 

Administrative Director, The Bob 

Costas Center and Transplant 

Marsha Steffen, RN 

Karen Imperiale, RN, BSN 

Dawn Ebeling, RN 

Susan Fitzgerald, RN, BSN 

Peggy Schneider, RN 

Kristi Schulz, RN, BSN 

Kathleen Maxwell, RN, BSN 

Kathleen Houghton, RN, BSN 

Valerie Akerson, MSW 

J. Mario Alonso, MT (ASCP), 

Manager, St. Louis Cord Blood Bank 

Donna M. Regan, MT (ASCP) SBB, 

Quality Manager, St. Louis Cord 

Blood Bank 

Jonathan D. Wofford, MPH, 

Biostatistical Support, St. Louis Cord 

Blood Bank 

Kristine M. Wassmer, RN, BSN, 

Search Coordinator, St. Louis Cord 

Blood Bank 

Kathy A. Mueckl, RN, BSN, Nurse 

Coordinator, St. Louis Cord Blood Bank 

Lora McLemore, Medical Secretary 


Richard Cahill, MD - We are 

investigating a new method of bone 

marrow transplant. Our aim is to 

replace the bone marrow stroma, 

which is not replaced with a 

conventional bone marrow transplant 

or with cultured mesenchymal cells. 

Animal studies have demonstrated 

that bone fragments and/or 

osteoblasts like cells placed 

intraperitoneally or directly into bone 

can replace the stroma. The cells can 

enhance engraftment and tolerance. 

Also these cells have the potential to 

develop into cells of ectoderm and 

endodermal origin as well as 

mesoderm and therefore could 

potentially replace abnormal or 

damaged tissues. An IRB protocol is 

pending to treat children with fatal and 

deforming bone diseases (Osteogenies 

imperfecta, hypophosphatasia and 

osteopetrosis) with this new method. 

Cord blood has been used extensively 

to treat malignant and genetic 

diseases without increasing the 

incidence of GvHD. We have applied 

for an NIH grant to study the potential 

of cord blood to treat bone diseases 

using a mouse model (SCID/SCID). 

Our hypothesis is based on work that 

was done in part at the St. Louis Cord 

Blood Bank showing that cord blood 

contains more primitive 

osteoprogenitors than bone marrow. If 

they are placed directly into bone or IP, 

the primitive cells can migrate to bone 

and correct the osteoblast-osteoclast 

deficiency. Because they can develop 

into other tissues including endothelial 

cells this potentially could be used to 

treat other genetic diseases. 

Michael E. Kelly, MD, PhD - 

Clinical research projects focus on 

improving our understanding of 

hemoglobinopathies and the treatment 

of disease-related complications. In 

collaboration with Washington 

University we are establishing a 

regional approach to the care of 

patients with sickle cell disease with 

the goals of obtaining unique 

demographic information, providing 

community education and the 

standardization of care. Active 

interests include increasing cord blood 

donations from blacks as well as 

developing less toxic regimens for 

stem cell transplantation of patients 

with sickle cell disease. 

Michael Creer, MD - At the St. Louis 

Cord Blood Bank and at St. Louis 

University Coagulation Consultants, 

we are also actively involved in basic 

and applied clinical research in the 

areas of stem cell biology, general 

hematology and 

hemostasis/thrombosis. We are 

currently engaged in several 

collaborative projects to study the


processes of hematopoietic stem cell 

(HPSC) differentiation and engraftment 

kinetics in xenotransplant models, 

stem cell trafficking, atherogenesis, 

platelet-endothelial cell interactions 

and to develop and implement new 

laboratory approaches to the diagnosis 

of bleeding and thrombotic disorders. 

One of the primary goals of our 

research at the St. Louis Cord Blood 

Bank is to investigate the potential of 

hematopoietic stem cells in the 

treatment of chronic vascular diseases 

related to abnormal lipid metabolism 

such as atherosclerosis, to investigate 

the role of endothelial cells as stromal 

elements capable of supporting the 

hematopoietic stem cell compartment 

and the role of phospholipases and 

phospholipid-derived second 

messenger molecules in the unique 

biologyof stem cells. 

Jen-Yih Chu, MD, PhD - Children’s 

Oncology Group clinical pediatric 

ematology/oncology studies. Sickle 

cell clinical studies related to cerebral 

vascular accidents. 

Analysing published hematology data 

to probe the ethnic relationship 

between Taiwanese (aboriginal 

groups/Chinese immigrants), Chinese, 

and Southeast Asians. 

PUBLICATIONS 

1. Cahill RA, Klemperer M, Steele A, 

El-Badri N, Good RA. Successful 

transplantation to correct 

metabolic bone disease (infantile 

hypophosphatasia) using bone 

fragments plus cultured 

osteoblasts with T-cell depleted 

mismatched bone marrow without 

lymphohematopoietic 

engraftment. Blood 2001; 98:796. 

2. Cahill RA, Jones O* 1 , Steele A* 2 , 

Mueller T* 2 , El-Badri N 1 , Good RA 1 . 

Replacement of Recipient 

Stromal/Mesenchymal Cells 

(SC/MSCs) after Bone Marrow 

Transplant Using Bone Fragments 

and Cultured Osteoblast Like 

Cells. Blood 2002; 100: in press) 

3. Chu J-Y, Allotypes of 

Immunoglobulin and Ethnic 

Relationship in Taiwan.Taiwan 

Medical Journal 44 (9): 17-22, 2001. 

4. DJ Scothorn DJ, C Price, D 

Schwartz, C Terrill, GR Buchanan, 

W Shurney, I Sarniak, R Fallon, J- 

Y Chu, C Pegelow, W Wang, J 

Casella, L Resar, B Berman, T 

Adamkiewicz, L Hsu, K Ohene- 

Frempong, K Smith-Whitley, D 

Mahoney, JP Scott, G Woods, M 

Watanabe, & MR DeBaun.: 

Morbidity and Mortality in 

Children with Sickle Cell Disease 

Receiving Blood Transfusion 

Therapy for at Least Five Years 

Following Stroke: A Retrospective 

Cohort Study of 164 Patients. J 

Pediatr, 140: 348-354,2002. 

5. Chu J-Y, Not Every Anemic Child 

Needs Iron. Focus on Pediatrics. 

Medical News from Cardinal 

Glennon Children’s Hospital. 

Summer, 2001:7. 

6. Kelly M, and Taalal Chatila. 2002. 

Chronic Parvovirus B19-induced 

anemia in atypical X-linked hyper- 

IgM immunodeficiency syndrome. 

Submitted. 

7. Wang F, Morikawa, T, Biwa S, 

Oliver D, Creer MH., Hamaguchi 

Y and Hirai K, Monitoring 

Hematopoietic Stem and 

Progenitor Cells with Sysmex 

Automated Hematology 

Analyzers, Laboratory Hematology 

8:119-125, 2002. 

8. Hofling AA, Vogler C, Creer MH, 

Sands MS, Engraftment of Human 

CD34+ Cells Leads to Widespread 

Distribution of Donor-Derived 

Cells and Correction of Tissue 

Pathology in a Novel Murine 

Xenotransplantation Model of 

Lysosomal Storage Disease, 

Blood, (submitted). 

9. Meyerrose TE, Hoffling AA, 

DeUgarte DA, Manoj R, 

Cordonnier T, Rosova I, Bauer G, 

Eagon C, Creer MH, Johnson C, 

Herrbrich P, Hedrick MA, Sands 

MS, and Nolta JA, Human 

Adipose-Derived Mesenchymal 

and Adherent Cord Blood Stem 

Cell Trafficking Studies are 

Facilitated by Novel 

Xenotransplant Models, Blood 

(submitted, 2002). 

10. Polski JM, Galambos C, Gale G, 

Dunphy C, Batanian JR. Remission 

of Transient Myeloproliferative 

Disorder after Clonal Karyotype 

Evolution in a Phenotypically 

Normal Neonate. J Pediatr 

Hematol Oncol. 2002 Jan; 

24(1):50-4. 

11. Puetz JJ and Bouhasin JD, Use of 

recombinant factor VIIa 

(Novoseven) to control bleeding in 

the palliative treatment of an 

adolescent male with severe 

hemophilia A, HIV, 

thrombocytopenia, hepatitis C and 

end-stage liver disease. Am J 

Hospice Palliative Care 2002; 19: 

271-282 

12. Puetz JJ and Bouhasin JD High 

titre factor VIII inhibitor in 2 

children with mild hemophilia A. 

Haemophilia 2001; 7: 215-219 

13. Puetz J, Patty the Platelet 2001 

14. Puetz J, Factor 5 Leiden 2002 

15. Puetz J, and Thrower M, 

Thrombophilia, a guide for 

patients and their families 2002 

Cord Blood Bank 

1. Regan DM, JM Alonso III, CE 

Johnson, DA Wall. A simple and 

reliable procedure for cord blood 

banking, processing and freezing: 

St. Louis and Ohio Cord Blood 

Bank Experiences. Cytotherapy, 

Volume 3 Number 6, 2001. 

2. HS Goodwin, LM Grunzinger, DM 

Regan, KA McCormick, CE 

Johnson, DA Oliver, KA Mueckl, 

JM Alonso III, DA Wall. Long Term 

Cryostorage of Cord Blood Units: 

Ability of the Integral Segment to 

Confirm both Identity and 

Hematopoietic Potential. 

Cytotherapy, Volume 5, 2002. 

3. Alonso JM, DM Regan. Stem Cell 

Processing for the Technologist. 

Transportation of Human Cells for 

Transplantation Chapter (in press 

for December 2002 release). 

ABSTRACTS 

1. DM Regan, KA Mueckl, DA Oliver, 

JM Alonso, CE Johnson, DA Wall. 

Utilization of Cord Blood Banking 

Inventory: Impact on Banking 

Practices. International Society for 

Hematotherapy and Graft 

Engineering, Quebec City, June 2001. 

29

30 


2. Wall, Oliver, Alonso, Wassmer, 

Regan, Creer, Richart. Adult 

Recipients of Unrelated Donor 

Cord Blood Transplants for 

Treatment of Leukemia Have 

Similar Engraftment and Survival 

Compared to Children: St. Louis 

Cord Blood Bank Experience. 

American Society of Hematology 

43rd Annual Meeting, Orlando 

Florida, December 2001. 

PRESENTATIONS 

1. Cahill RA, “Bone Marrow 

Transplantation of Genetic 

Diseases “Cardinal Glennon Grand 

Rounds, October 2001. 

2. Cahill RA, “Importance of stromal 

cell in hematopoiesis.” Stem Cell 

Conference,Department of 

Hematology-Oncology, Saint Louis 

University School of Medicine, 

Nov 2001. 

3. Cahill RA, Successful 

transplantation to correct 

metabolic bone disease (infantile 

hypophosphatasia) using bone 

fragments plus cultured 

osteoblasts with T-cell depleted 

mismatched bone marrow without 

lymphohematopoietic 

engraftment. American Society of 

Hematology, (oral presentation) 

Orlando Florida, December 2001. 

4. Cahill RA, Treatment of bone 

diseases with novel bone 

marrow transplantation.Workin-Progress, 

Pediatric Research 

Institute, May 2002. 

5. Cahill RA, Treatment of 

hypophosphatasia with bone 

marrow transplantation. Shriner’s 

Hospital, Jan 02. 

6. Creer, M, “The Unique Biology of 

Umbilical Cord Blood Stem Cells 

and Potential Applications in Cell 

Therapy”, St. Luke’s Hospital 

Grand Rounds, September, 2002 

7. Creer MH, “Biology of Umbilical 

Cord Blood Stem Cells and Potential 

Applications in Cell Therapy”, St. 

Louis University Hospital, 

Department of Internal Medicine 

Grand Rounds, May 2002 

8. Chu JY, “Biomedical Aspect of 

Taiwanese Ethnicity” at San Jose 

Community Center to group of 

Taiwanese physicians, professors 

and others 11/10/01 

9. Chu JY, “ Early Taiwanese 

Bioscientist’s Studies in Europe and 

North America” San Diego, 

Convention Center at Taiwanese 

Bioscientists of America annual 

meeting during National 

Neuroscience Convention (as 

keynote speech after receiving 

Annual Service Award from 

Taiwanese Bioscientists of America) 

10. National Hemophilia Meeting: 

Comprehensive Care 2001 

11. NIH Hemophilia Region VII 

Meeting: Laboratory Analysis 

during Comprehensive Care 2002 

12. HTC First Steps Program: Factor 

Update; Von Willebrand Disease 

2001/2002 

13. APON: Von Willebrand Disease 2002 

Cord Blood Bank 

1. International Society for 

Hematotherapy and Graft 

Engineering, Quebec City, June 

2001. Utilization of Cord Blood 

Banking Inventory: Impact on 

Banking Practices. 

2. SSM Laboratory Director Annual 

Meeting, St. Louis MO, June 2001. 

Community Based Cord Blood 

Banking Program: Impact on & 

Contributions to the Field of 

Medical Technology. 

3. National Marrow Donor 

Program, Minneapolis MN, 

October 18 2001, Overview of 

Cord Blood Bank Activities, 

Indications & Selection for CBU, 

Customer Needs and 

Expectations. 

4. National Marrow Donor Program 

2001 Annual Council Meeting, 

Minneapolis MN, November 9-11 

2001, Cord Blood Transplant: 

Before and After. 

5. American Association of Blood 

Banks 2002 Annual Meeting & 

Expo, Orlando FL, October 29 

2002, FDA Good Tissue Practice 

Guidelines for Human Cellular and 

Tissue Products, Impact on Cord 

Blood Banking. 

GRANTS 

R. Cahill, MD - PI 

Potential of unrelated cord blood 

for repair or regeneration of 

skeletal tissue 

Fleur-De-Lis $10,000 

M. Kelly, MD, PhD - PI 

Increasing Blood and Cord Blood 

Donations in Blacks. R01 

DK062619-01 (Principle 

Investigator M. DeBaun) 

9/22/02 - 6/15/07 

NIH $ 150,000 

M. Kelly, MD, PhD - PI 

State of Missouri, Principle 

Investigator Michael DeBaun, 

Hemoglobinopathy (Sickle Cell) 

Resource Center, 

07/22/02 - 06/30/07 

$130,000 direct costs 

MH Creer - PI 

(30% effort), Mechanisms and 

Functional Coupling of a Ca- 

Independent PLA2 with Thrombin- 

Receptor Stimulation in 

Endothelial Cells, 2002-2004, 

American Heart Association 

(Heartland Affiliate) 

$130,000 

MH Creer. PhDCo-Investigator, 

(10% effort) 

Plasmalogen metabolism by iPLA2 

in Ischemic Myocardium 

10/1/01 - 9/30/06, 

National Institutes of Health 

$1,104,000 


(10% effort) 

Tryptase-stimulated 

phospholipase A2 in the bladder, 

4/1/02 - 3/30/96 


$1,036,000 


(5% effort) 

Novel PLA2 in Oxidant-Induced 

Renal Cell Oncosis. 

12/01/01 - 11/30/04 


390,989

32 

D IVISION OF H EMOSTASIS AND T HROMBOSIS 


The purpose of the Division of Hemostasis and Thrombosis is to provide multidisciplinary care and to 

facilitate clinical research for patients with the chronic disorders of inherited coagulopathies, 

thrombophilia, and HIV exposure/infection. A team approach utilizing a specialized staff of nurses, 

social workers, physical therapists, and physicians work with patients and their families to promote 

independence, understanding and prevention of long term disabilities. 

Types of treatments offered include care for the acute and chronic manifestations of the 

coagulopathies, thrombophilia and HIV/AIDS. Special services include a Comprehensive Hemophilia 

Clinic which provides the multidisciplinary care for patients with chronic disorders of inherited 

coagulopathies, and the HIV/AIDS clinic which provides comprehensive care including 

pediatrician/hematologist, immunologist and nursing coordination for the individual patient’s care. 

EDUCATIONAL PROGRAM 

The Division of Hemostasis and Thrombosis, being a tertiary specialty, relies on extramural as well 

as intramural referrals to maintain the scope of services necessary to maintain their center of 

excellence designation. 

Lecture series are given to the following groups 

1) Physical therapy students 

2) Nursing personnel 

3) Dental students (SIU Southern Illinois University Alton, Illinois Campus) 

4) Noon Conferences for house staff 

5) Lecture series for industry 

Conferences Outreach Programs, etc. 

1) Hemostasis Rounds (Pediatrics) 

2) Multiple Lectures to Lay and Professional groups on Hemostasis and AIDS 

3) Outreach Program Presentations to schools, parent groups, paternal organizations, and 

professional organizations, etc. on Hemophilia/AIDS 

4) Combined adult/pediatric Hemostasis Conference Weekly 

5) Quarterly Newsletter Re: Hemophilia Center Activities 

Student and Resident Electives for Hemophilia/AIDS Services Weekly 

Preceptorships 

1) Junior medical students 

2) Senior medical students 

3) Pharmaceutical and industry representatives


FACULTY 

John D. Bouhasin, MD, Clinical Professor in Pediatrics and 

Director of the Division of Hemostasis and Thrombosis 

John Puetz, MD, Assistant Clinical Professor in Pediatrics 


Therapy of Chronic Persistent Hepatitis: Chronic persistent 

hepatitis, due to hepatitis C, has been recognized in 

approximately 95% of hemophiliacs who were treated with 

factor concentrates prior to 1988. Therapy at the Division of 

Hemostasis and Thrombosis with Interferon had a very poor 

outcome giving a persistent improvement in only 6% of the 

patients treated. Subsequently, therapy including Ribavirin 

and Interferon Alpha was initiated through a study 

supported in part by Shearing Plow Pharmaceutical 

Companies and showed a marked increase in the resolution 

of the hepatitis on long term follow-up to approximately 

30%. Recent reports in the literature have shown that the 

use of pegalated Interferon without Ribavirin has been seen 

to give a sustainable response of between 40 to 52 percent. 

These studies have been performed primarily in adult males 

and not in pediatric or adolescent children. A post 

marketing stage four study has been initiated with the 

former patients who had no response to the Interferon and 

Ribavirin, with the combination of pegalated Interferon and 

Ribavirin. It is estimated that 60 to 70 percent of these 

individuals will have a beneficial response. an ongoing 

grant funded by the office of Maternal and Child Health and 

in combination with the Center for Disease Control relative 

to the benefits of comprehensive care of children with 

bleeding disorders and the prevention of complications of 

hemophilia has been ongoing since 1982. Data relative to 

hospitalizations and their length of stay, surgical 

procedures, outcomes of complications such as inhibitors, 

hepatitis and the arthropathies, and outcome data relative 

to HIV and deaths, sexual activities, heterosexual spread to 

significant others, number of pregnancies among HIV 

positive and at risk couples, and the number of HIV positive 

infants with their outcome were/are collected and collated. 

A recent report by J. M. Soucie of the Center for Disease 

Control has shown that those patients with hemophilia who 

had received care in a Hemophilia Treatment Center had a 

significantly decreased risk of death (40%) as compared to 

individuals who received their medical care in other setting 

including care given by hematologists. 

PUBLICATIONS 

1. Puetz, J. MD; Bouhasin, J. MD, High Titer Factor VIII 

Inhibitor in Two Children with Mild Hemophilia A. 

Hemophilia 2001: 7: 215-219 

2. Puetz, J. MD; Bouhasin, J. MD, Use of Recombinant 

Factor VIIa to control bleeding in an adolescent male 

with severe hemophilia A, HIV, Thrombocytopenia, 

Hepatitis C, and End Stage Liver Disease. American 

Journal of Hospice and Palliative Care 2002 July/August; 

Vol. 19, No. 4, pp. 277-282 

PRESENTATIONS 

1. Bouhasin JD. Hemophilia: “This is Your Life”. Presented 

at the Hemophilia First Steps Seminar, St. Louis, MO, 

July 2001. 

2. Bouhasin JD. “Factor Concentrates, Manufacturing 

Processes”. Presented at the Hemophilia First Steps 

Mini-Seminar, Cardinal Glennon Children’s Hospital St. 

Louis, MO, September 2001. 

3. Bouhasin JD, Miller P. “Physical Therapy and You”. 

Presented at a Hemophilia Seminar, Cardinal Glennon 

Children’s Hospital St. Louis, MO, September 29, 2001. 

4. Bouhasin JD. “Recognition of Bleeding Episodes, 

Appropriate Response”. Presented at the Hemophilia 

Update Seminar for Patients with Mild/Moderate 

Hemophilia or Patients on Prophylaxis, Cardinal Glennon 

Children’s Hospital St. Louis, MO, April 27, 2002 

5. Puetz JJ. “von Willebrand’s Disease 101”. Presented at a 

First Steps Seminar St. Mary’s Hospital, St. Louis, MO, 

July 2001. 

6. Puetz JJ. “Factor Concentrate Shortage”. Presented at 

the First Steps Hemophilia Seminar, Cardinal Glennon 

Children’s Hospital St. Louis, MO, September 2001. 

7. Puetz JJ. “Comprehensive Care”. Presented at the NHF 

53rd Conference Nashville, TN, November 2001. 

8. Puetz JJ. “Surgical Bleeding”. Presented at the Surgery 

Noon Conference, Cardinal Glennon Children’s Hospital, 

February 2002. 

9. Puetz JJ. “Inhibitors and Their Treatment”. Presented at 

the Novo Nordisk Dinner Meeting St. Louis, MO, 

February 2002. 

10. Puetz JJ. “Thrombosis in Infants and Children”. Presented 

at the 17th Hemostasis Conference, St. Louis University 

Health Sciences Center St. Louis, MO, March 2002. 

11. Puetz JJ. “Inhibitors and Their Treatment”. Presented at 

the Novo Nordisk Dinner Meeting Tulsa, OK, April 2002. 

12. Puetz JJ. “Comprehensive Evaluation”. Presented at the 

Regional VII Comprehensive Hemophilia Centers Annual 

Meeting St. Louis, MO, April 2002. 

13. Puetz JJ. “von Willebrand’s Disease 101”. Presented at 

the First Steps Mini-Seminar Cardinal Glennon 

Children’s Hospital St. Louis, MO, July 2002. 

33

34 


GRANTS 

1. J. Bouhasin, M.D. PI. Prevention of Complications 

of Hemophilia 

Competitive Renewal 

10/01/01 - 09/30/02 ($60,642) 

10/01/02 - 09/30/03 ($60,642) 

2. J. Bouhasin, M.D. PI. Great Plains Regional Hemophilia 

Center (MCHB) 


06/01/01 - 05/30/02 ($58,063) 

06/01/02 - 05/30/03 ($58,063) 

3. J. Bouhasin, M.D. PI. Bi-State Hemophilia 

Association Grants: 

Award for ancillary laboratory charges ($50,000) funded 

and open-ended 

Habilitative and rehabilitative program for hemophiliacs 

($36,000) funded and open-ended 

4. J. Bouhasin, M.D. PI. Caremark Home Health 

Agency Grant: 

For salary and center support ($37,500) funded and 

open-ended 

5. J. Bouhasin, M.D. PI. Saint Louis Hemophilia 

Association Grant: 

Comprehensive hemophilia funding ($17,500) funded 

and open-ended 

6. J. Bouhasin, M.D. PI. National Hemophilia Foundation: 

HIV risk reduction ($3,000) funded and open-ended 

7. J. Bouhasin, M.D. PI. Hill Foundation: 


Hemophilia Center Grant for support and education, 

11/01/01 - 10/31/02 ($38,425) 

11/01/02 - 10/31/03 ($30,715) 

8. Nicholas Barr Foundation: (gift) 

10/16/00 ($7,136.92) 

5/13/02 ($150) 

9. Dana Brown Foundation: (endowment) 

09/16/97 - 09/16/99 ($600,000) funded 

Earnings from endowment to 6/30/02 ($98,481) 

10. Hemophilia Research 

Funded and Open-ended ($51,892) 

11. Bi-State Hemophilia Health Care for Hemophilia Patients 

Funded and Open-ended ($16,891) 

N. B. Grants 1, 2, and 7 are competitive renewal grants and 

rely on performance and application yearly. Grant 9 is a 

permanent endowment for which we receive the greater of 

5% of the principle or all income derived from investment of 

the endowment. The rest of the grants listed have all been 

funded and are open-ended until completely utilized (letter 

from grantors as to this fact on file).

D IVISION OF I NFECTIOUS D ISEASES 


The purpose of the Pediatric Infectious Disease Division is to provide state-of-the-art care to pediatric 

patients with acute and chronic infectious diseases, to educate medical students, residents, and 

community physicians on the latest advances in the field, and to perform leading edge research in 

our chosen areas of specialization. 

Treatment is offered for all varieties of pediatric infectious disease problems for patients ranging in 

age from the newborns to young adults. 

FACULTY 

Stephen J. Barenkamp, MD, Professor of Pediatrics; 

Director of the Pediatric Research Institute; Director of 

Pediatric Infectious Diseases; and Vice Chair for 

Academic Affairs 


Linda Winter, Laboratory Assistant 


Immunization with Nontypable Haemophilus influenzae (NTHI) 

High Molecular Weight (HMW) Adhesion Proteins Induces 

Opsonophagocytic Antibodies (Abs) against Both Homolgous 

and Heterologous Strains was presented by Stephen J. 

Barenkampat the 39th Annual Meeting of the Infectious 

Diseases Society of America, San Francisco, CA, 2001. 

PUBLICATIONS 

1. Ogra PL, Barenkamp SJ, DeMaria TF, Giebink GS, et al. 

Report of the microbiology and immunology panel: 

Seventh international otitis media research conference. 

Ann Otol Rhinol Laryngol 111:S62-S81, 2002. 

2. Giebink GS, Bakaletz LO, Barenkamp SJ, et al. Report 

of the vaccination panel: Seventh international otitis 

media research conference. Ann Otol Rhinol Laryngol 

111:S82-S94, 2002. 

3. Barenkamp SJ. Chancroid. In: Rudolph AM, Rudolph 

CD, Siegel NJ, Lister G, Hostetter MK (eds): Rudolph’s 

Pediatrics, 21st ed., Philadelphia, McGraw-Hill, 2002. 

HONORS 

Ad Hoc Manuscript Reviewer: Journal of Infectious 

Diseases, New England Journal of Medicine, Pediatrics, 

Pediatric Infectious Diseases Journal, Vaccine; Study 

Section Member, Integrative, Functional and Cognitive 

Neuroscience 6 (IFCN-6) Study Section [Hearing 

Research], National Institutes of Health; Ad Hoc Study 

Section Member, Special Emphasis Panel for NIDCD R21 

Grants, National Institutes of Health, November, 2001; Ad 

Hoc Study Section Member, Special Emphasis Panel for 

NIDCD R03 Grants, National Institutes of Health, March, 

2002; Ad Hoc Study Section Member, IFCN-4 Special 

Emphasis Panel, National Institutes of Health, April, 2002. 

PRESENTATIONS 

1. Barenkamp SJ. Immunization with nontypable 

Haemophilus influenzae high molecular weight 

adhesion proteins induces opsonophagocytic antibodies 

against both homologous and heterologous strains. 

Presented at the 39th Annual Meeting of the Infectious 

Diseases Society of America, San Francisco, CA, 2001. 

2. Barenkamp SJ. Haemophilus influenzae high molecular 

weight proteins: Adhesins and potential vaccine candidates. 

Presented at the 4th International Pasteurellaceae Society 

Conference, Banff, AL, Canada, 2002. 

GRANTS 

Stephen J. Barenkamp, MD - PI 

NIH R01 AI 48066-02 

Title: Role of Haemophilus influenzae HMW adhesion 

proteins in host immunity 

02 yr $175,00007/01/01-06/30/02 

03 yr $175,00007/01/02-06/30/03 

35

36 

DIVISION OF NEONATAL/PERINATAL MEDICINE 


The purpose of the Division is to provide exemplary neonatal care, continue to build outstanding 

programs of public and professional education, contribute a wide variety of productive research, and 

to help fulfill the mission of the Department of Pediatrics. 

Venues of neonatal care include the Neonatal Intensive Care Units at St. Mary’s Health Center and 

Cardinal Glennon Children’s Hospital, the Neonatal Transport Team of Cardinal Glennon Children’s 

Hospital, the pre and perinatal consultation services at St. Mary’s Health Center, consultation services 

at Forest Park, DePaul, St. Joseph’s Health Center; St. Charles, St. Joseph’s Hospital; Kirkwood and 

Belleville Memorial Hospitals and the Multidisciplinary High Risk Infant Follow-Up Clinics. The faculty 

lead and participate in quality improvement efforts for each of these clinical efforts. 

Education opportunities and/or didactic sessions are provided for Saint Louis University 

undergraduates, medical students, SLU residents in Pediatrics, Pediatrics, Pediatrics/Internal 

Medicine, Obstetrics and Neonatal Perinatal Medicine. Members of the Division participate in a 

variety of educational opportunities for undergraduate and graduate nurses and respiratory 

therapists. An important educational effort is the regional perinatal education program. In 

cooperation with faculty of Obstetrics and Cardinal Glennon/St. Mary’s nursing leadership, the 

faculty regularly engage members of the medical and nursing staffs of forty referring maternity 

services in educational and quality improvement exercises. 

Divisional research includes public health, clinical and bench research. Included are understanding 

mother’s motivation for and obstacles to prenatal care services, examination of language and other 

social barriers to effective care, defining obstacles to regional education and exploring important 

intensive care topics such as sedation, pain control, disturbances of respiratory rhythm and 

treatment of pulmonary hypertension. 

Currently major investments of time and effort are devoted to outcomes research with a major 

emphasis on long term well being of NICU survivors. Bench research including iron homeostatis and 

pulmonary development are key portions of the Divisional research profile. 

The residency program in Neonatal Perinatal Medicine deserves special attention. Currently there are 

four GME funded positions. These individuals will be key policy, educational and research leaders of 

the future. Formal courses in epidemiology, statistics and physiology, intensive bedside instructions in 

research and close mentoring relationship with the faculty are key ingredients in this preparation.


FACULTY 

William J. Keenan, MD, Professor of Pediatrics and 

Director of the Division of Neonatal-Perinatal Medicine 

Akihiko Noguchi, MD, Professor of Pediatrics 

Suzanne S. Toce, MD, Professor of Pediatrics 

H. Farouk Sadiq, MD, Professor of Pediatrics 

Gregory J. Mantych, MD, Associate Professor of Pediatrics 

Robert E. Fleming, MD, Associate Professor of Pediatrics 

Corinne Walentik, MD, Professor of Pediatrics 

Vijay K. Nama, MD, Assistant Professor of Pediatrics 

Ayoob Ali, MD, Assistant Professor of Pediatrics 

John Ahmann, DO, Fellow 

Nancy Apsey, MD, Fellow 

Vicki Shipp, Administrative Secretary 

Lisa McNeil, Medical Secretary 


F. Sadiq, MD - Research study of inhaled nitric oxide for 

persistent pulmonary hypertension in the newborn (PPHN) 

has been completed. The manuscript for the randomized 

portion of the study was submitted to the Journal of 

Pediatrics but was not accepted. It has been resubmitted 

with revisions to the Journal of Perinatology. Data for the 

rescue patients is in the process of being analyzed and 

should be ready for submission soon. 

S. Toce, MD - With our research team headed by Elena 

Andresen, PhD, I am completing the analysis and manuscript 

preparation for the following projects supported by RWJF: 

1. Provider’s perceptions of pediatric palliative care 

education and service needs. 

2. Conducting focus groups of bereaved parents. 

3. Bereaved parents perception of end of life care for 

their children. 

4. Hospital charges in the last 6 months of life for 

children. 

5. FOOTPRINTS model of pediatric palliative care. 

6. Assessment of care around the time of death: A 

physician and nurse survey. 

7. Results of post death interviews of bereaved parents. 

R. Fleming, MD performs laboratory-based research 

investigating the molecular basis for iron homeostasis. Iron 

is an important co-factor in the cellular injury associated 

with increased oxidant stress (e.g., inflammation, use of 

supplemental oxygen). His primary focus is characterizing 

the role for a recently discovered second transferring 

receptor (TfR2) in regulating the intestinal uptake of dietary 

iron and the distribution of tissue iron between sites of 

storage and utilization. His laboratory has generated a 

murine: knockout of the TfR2 gene.This transgenic mouse 

model is being studied and compared with mice in which the 

HFE gene (responsible for hereditary hemochromatosis) has 

been knocked out. Interactions between TfR2 and JFE are 

being studied in cell culture systems. The roles for TfR2 and 

the iron regulatory hormone hepcidin in the altered iron 

metabolism observed during inflammation are also being 

investigated. These studies will allow for a better 

understanding of the means by which the body regulates the 

dietary uptake and cellular distribution of iron in normal and 

pathologic states. Dr. Fleming’s laboratory in the Pediatric 

Research Institute works closely with the Iron Research 

Group at Saint Louis University. 

PUBLICATIONS 

1. Fleming RE, Holden CC, Tomatsu AW, Brunt EM, 

Britton RS, Bacon BR, Roopenium D and Sly WS. Mouse 

strain differences determine severity of iron 

accumulation in Hfe knockout model of hereditary 

hemochromatosis. Proc Natl Acad Sci USA 2001; 

98:2702-2711. 

2. Sproule TJ, Jazwinska EC, Britton RS, Bacon BR, Fleming 

RE, Sly WS and Roopenian DC. Naturally variant 

autosomal and sex-linked loci determine the severity of 

iron overload in beta 2-microglobulin-deficient mice. 

Proc Natl Acad Sci USA 2001; 98:5170-5104. 

3. Waheed A, Grubb JH, Zhou XY, Tomatsu S, Fleming RE, 

Costaldi ME, Britton RS, Bacon BR, Sly WS. Regulation 

of transferring-mediated iron uptake by HFE, the protein 

defective in hereditary hemochromatosis. Proc Natl 

Acad Sci USA 2002; 99:3117-3122. 

4. Singh B, Sadiq HF, Noguchi A, Keenan WJ. Efficacy of 

albuterol inhalation in treatment of hyperkalemia in 

premature neonates. J. Pediatr. 2002; 141:16-20. 

5. Brink DS, Fenton GA, Noguchi A, Manepalli AN, Vogler 

CA. Clinicopathologic conference: Neurologic 

dysfunction in a premature infant. J Peds 140:110-5, 2002 

6. Galambos C, Ng Y-S, Ali A, Noguchi A, Lovejoy S, 

D’Amore PA, deMello D. Defective pulmonary 

development in the absence of heparin-binding vascular 

endothelial growth cartor isoforms. Am J Resp Cell Mol 

Biol 27:194-203, 2002 



premature neonates. J Pediatrics 141:16-20, 2002 

8. Brink DS, Fenton GA, Noguchi A, Manepalli AN, Vogler 

CA. Clinicopatholic conference: Neurologic dysfunction 

in a premature infant. J Peds 140:110-5, 2002 



premature neonates. J. Pediatr 2002; 141:16-20. 

10. Toce SS. Meconium Happens! Delivery room 

intervention revisited. The Perinatal Times 2001; 16:2. 

11. Himelstein BP, Friebert S, Lewandowski J. Toce S, et al. 

Statement to the Institute of Medicine Committee on 

Children Who Die and Their Families. From the Pediatric 

Special Interest Group, representing the American 

Academy of Hospice and Palliative Medicine. 

September, 2001 

12. Toce SS. Difficult decisions for challenging children: 

Ethical decision making for the child with a life limiting 

condition. Supportive Voice 2001; 7(4):6-8 

13. Andersen EM, Nanda U, Toce S. Research on the 

quality of death of children. Quality of Life Newsletter, 

2002;28:17-18 

37

38 


14. Toce SS, Anderson E. The roles of data collection, 

evaluation and research in pediatric palliative care. 

Supportive Voice 2002;8(5-6):11-13 

15. Toce SS. Universal screening for congenital adrenal 

hyperplasia. Perinatal Times; 2002, (Summer)17:5. 

16. Walentik CA. Kernicterus resurrected. The Perinatal 

Times 2002; 17:2. 

PRESENTATIONS 

1. Fleming RE: “Hepatic Iron Loading: Lessons from a Murine 

Model of Hereditary Hemochromatosis” Gordon Research 

Conference on Oxidative Stress and Disease, 2001. 

2. Fleming RE: “Characterization of a Second Transferrin 

Receptor” Pediatric Grand Rounds-University of Missouri 

School of Medicine, 2001. 

3. Fleming RE: “Intestinal and Placental Iron Transport: 

Parallels and Peculiarities” Washington University 

School of Medicine 2001. 

4. Keenan WJ. “Obstetrics & Gynecology Grand Rounds. 

“Contemporary Perinatal Mortality and Morbidity”. St. 

Mary’s Health Center 2002. 

5. Keenan WJ. Maternal & Fetal Health Seminar. “Kernicterus 

Revisted”. SSM St. Joseph’s Health Center 2002 

6. Mantych G. “Care for Infants of HIV Positive Mothers”. 

AWHONN Regional Meeting, 2001. 

7. Mantych G. “Neonatal Resuscitation Program”, Medical 

Staff/Nursing Staff Educational Program, Kennett, 

Missouri, 2001. 

8. Galambos C, Ali A, Noguchi A, D’Amore P, deMello DE. 

“The role of vascular endothelial growth factor (VEGF) 

isoforms in fetal mouse lung development. Scientific 

Conference on Therapeutic Angiogenesis and 

Myocardial Laser Revascularization. 2001. 

9. Galambos C, Ali A, Ng Y-S, Noguchi A, D’Amore P, 

deMello DE. Vascular endothelial growth factor (VEGF) 

isoforms mediate early events in lung development. 

Pediatric Academy Meeting. 2001. 

10. Legett S, Karahodzie E, Hemley K, Klie M, Kleeper N, 

Klutho R, Homan S, Noguchi A.. Health status of 

Bosnian children in St. Louis, Missouri. Society for 

Pediatric Research 2001. 

11. Noguchi A, Fleming R, Thorpe C, deMello DE. Impaired 

pulmonary vascular development in patients with PPHN. 

Pediatric Research 51:334A 2002. 

12. Gloeb J, Noguchi A. Impact of humanitarian support on 

the stillbirth and neonatal mortality rates in Kosovo 

since the end of the conflict. Pediatric Research 51:405 

A, 2002. 

13. Noguchi A, Gloeb J. Neonatal and perinatal mortality rates 

in Kosovo year 2000. Pediatric Research 51:414A, 2002. 

14. Cheng C, Bommarito K, Noguchi A, Holcomb W, Leet T. 

Changes in body mass index (BMI) during interpregnancy 

period and the risk for small for gestational 

age (SGA) infants. Society for Maternal Fetal Medicine. 

15. Toce S. “To Cure Sometimes, To Comfort Always.” 

Advances in Pediatric Palliative Care Conference, 

Naperville, IL 9/19, 9/20/01. 

16. Toce S. “Total parenteral nutrition in children”. 

Hannibal, MO 10/25/01. 

17. Toce S. “Respiratory distress in the term newborn”. 

Practical Pediatrics, 3/13/02. 

18. Toce S. “The role of the child in decision making”. 

Resident lecture series 4/4/02. Noon ethics forum 

8/12/02. 

19. Toce S. “Neonatal pain”. St. Mary’s Health Center, 7/2/02. 

20. Walentik CA: Presentation on early intervention to 

Illinois 0-3 program personnel through the Perinatal 

outreach grant, 2001. 

21. Walentik CA: Cardinal Glennon critical care course 

presentation, 2001. 

22. Walentik CA: Presentation on perinatal substance 

abuse and consequences to the infant. Southern Illinois 

Perinatal Conference, 2001. 

23. Walentik CA: Presentation on health care access at St. 

Louis Ethical Society, 2002. 

24. Walentik CA: Perinatal in-service lecture at St. Joseph’s 

Health Center, St. Charles, “Kernicterus”, 2002. 

25. Walentik CA: Law school lecture in health care 

access, 2002. 

26. Walentik CA: Practical pediatric lecture on 

“Kernicterus”, 2002. 

27. Walentik CA: Housestaff orientation lecture - 

Managed care


GRANTS 

R. Fleming, MD 

RO1-DIC 53405-01, Co-Investigator 

Principal Investigator: William S. Sly 

Functional Studies of the Gene Defective In 

Hereditary Hemochromatosis 

25% effort, $927,787 (total awarded) 

3/1/98-2/29/03 


R01 HL 62491-01, Subcontract 

Principal Investigator: David Carlton 

Lung Epithelial Transport After Premature Birth 

$316,605 

9/1/99-8/31/03 


R01 HL 6625-01, Principal Investigator 

Iron Transport in a Murine Model of Hereditary 

Hemochromatosis 

7/2/00-6/30/05 

$750,000 (direct costs) 

W. Keenan, MD 

Southern Illinois Perinatal Education and 

Administration - Illinois 

Department of Health - $358,000/year 

Southeastern Missouri Perinatal Outreach Education 

1987-Present 

W. Keenan, MD 

Co-Investigators Greg Mantych, MD, Carol Hoeman, 

Jeff Mayer 

Development and Evaluation of an Intervention to 

Improve Utilization of Prenatal Care 

Source: March of Dimes 

$50,612 

W. Keenan, MD 

Principal Investigator 

Source: Fleur de Lis 

Non-Pharacologic Interventions for Procedural Pain 

in Neonates 

2002 - 2003 

$3,000 

S. Toce, MD 

Robert Wood Johnson Foundation, 2001. $15,000 

Communications grant, “Promoting Excellence in Endof-Life 

Care: Project 

P.A.T.H.S. (Pediatric Approach to Hospice Support) 2001 

39

40 

D IVISION OF N EPHROLOGY 


The Division of Pediatric Nephrology in the Department of Pediatrics of Saint Louis University 

provides comprehensive care for infants, children, and adolescents with various forms of kidney or 

urologic disorders. Care is provided for both acute and chronic disorders with a multidisciplinary 

team, including physicians, renal nursing, renal dietician, renal social worker, and play therapist. 

Members of the division are involved in teaching of medical students, residents, community 

physicians, and families, and participate in various clinical research studies. The division is housed at 

Cardinal Glennon Children’s Hospital. 

Types of treatment offered include renal biopsy, acute and chronic hemodialysis, acute and chronic 

peritoneal dialysis, including a peritoneal training program, acute hemofiltration, renal 

transplantation, and ambulatory blood pressure monitoring, in addition to inpatient and outpatient 

care and consultative services. 

Services are provided for a variety of kidney disorders, including congenital and hereditary disorders 

involving the kidney and urinary tract, urinary tract infections, kidney stones, hypertension, acute 

and chronic glomerular and tubular disorders and renal diseases that occur secondary to a variety of 

systemic diseases, such as systemic lupus erythematosus, diabetes mellitus, and vasculitis. The 

division provides primary management of renal transplant recipients along with members of the 

Transplant Surgery service 

The division began a renal transplant program in 1983. Since that time, approximately 90 

transplants have been performed. The division currently follows approximately 40 renal transplant 

recipients of cadaver/living donation. Cadaveric, living related and living unrelated donation is 

currently performed. 

The division has a special interest in hypertension, and has a weekly clinic for patients with 

primary hypertension. 

Educational programs address training of pediatric residents, family practice residents, and medical 

students, as well as community programs for families of children with renal disease and CME 

activities for community physicians.

FACULTY 

Ellen G. Wood, MD, Professor of Pediatrics, Director of 

Pediatric Nephrology 

Craig W. Belsha, MD, Associate Professor of Pediatrics 

Marjorie Jones, Medical Secretary 

Amy Hogoboom, RN 

Barb Champion, RN 


The division participates in the Southwest Pediatric 

Nephrology Study Group, a multicenter group of institutions 

with the purpose of improving care of infants and children 

with kidney disease. During the past year, the division has 

participated in 2 clinical studies: (1) A Randomized, 

Placebo-Controlled Multicenter Trial Evaluating A) 

Alternate-Day Prednisone vs B) Fish Oil Supplements in 

Young Patients with IgA Nephropathy: (2) Pilot Study of 

Mycophenolate Mofetil in Children with Steroid-Dependent 

Nephrotic Syndrome. 

The division participates in the North American Pediatric 

Renal Transplant Cooperative Study, a registry for 

Transplant, Dialysis, and Chronic Renal Insufficiency 

patients. Numerous studies are ongoing from registry data. 

The division also participates in the International Pediatric 

Hypertension Association Study Group. 

PUBLICATIONS 

1. Belsha CW. Systemic hypertension: Management in 

children and adolescents. Curr Treat Options Cardiovasc 

Med 2002;4:351-360. 

2. Sorof J, Belsha C, Flynn J, Hogg R, Harshfield G, Koch V, 

Seeman T, Portman R. Ambulatory BP in Children: 

Collaborative data from the International Pediatric 

Hypertension Association. Pediatr Nephrol2001;18:P157. 

3. Wood, EG, Belsha, CW. Ovarian pathology in 

adolescent renal transplant recipients. Ped. Research 

2002;51:437A. 

4. Cole BR, Johnson MC, Houser M, Wood E, Beck AM, 

Hmiel SP: Cardiovascular (CV) Risk Factors in Pediatric 

Renal Transplant Recipients. Pediatr. Nephrol. 

2001;16(8):P527A. 

D IVISION OF N EPHROLOGY 

HONORS 

1. Belsha,CW: Reviewer for Pediatric Nephrology, 

American Journal of Hypertension; Community service: 

renal camp for children with end stage renal disease 

and post renal transplant; patient education day for 

families of children with kidney disease, cosponsored 

with St. Louis Children’s Hospital and the National 

Kidney Foundation. 

2. Wood EG: Best Doctors in America; Reviewer for 

American Journal of Kidney Disease, Pediatric 

Nephrology; Community service; renal camp for children 

with end stage renal disease and post renal transplant; 

patient education day for families of children with 

kidney disease cosponsored with St. Louis Children’s 

Hospital and the National Kidney Foundation. 

PRESENTATIONS 

1. Belsha, CW: “Fluid and Electrolytes in Pediatrics” and 

“New Advances in the Diagnosis and Treatment of 

Hypertension.” American Academy of Pediatrics, Annual 

Meeting. San Francisco, CA, October, 2001. 

2. Wood EG: “Chronic Dialysis in Neonates: An 

Outcomes Analysis” and “Case Studies of Neonates 

with ESRD.” 22nd National Dialysis Conference. 

Tampa, FL, March, 2002. 

GRANTS 

E Wood, MD - PI 

A Pilot Trial of Mycophenolate Mofetil (MMF) in Children 

with Steroid - 

Dependent Nephrotic Syndrome 

Medical City Dallas Hospital/Merck 

4/6/01 - 4/6/03 $4200.00/patient 

41

42 

P EDIATRIC E MERGENCY M EDICINE D IVISION 


The Division of Pediatric Emergency Medicine has primary responsibility for the care of patients at 

Cardinal Glennon Children’s Hospital Emergency Department and is a Level I Pediatric Trauma 

Center. In the past year over 37,000 children were seen in our Emergency Room including 181 

trauma stats. 12% of our visits result in 50% of the yearly admissions to the hospital including 439 

PICU admissions. The PEM Division coordinates and is responsible for medical control to our 

transport team for all referrals that need our team’s assistance. 24 hours a day a member of the 

department is on site and available for assistance in patient care, discussion for the need to transfer, 

and needed transport team support. 

As an institution of medical education numerous trainees of varying levels of pediatric exposure 

receive training in our Emergency Room. We are proud to have offered over 16 years of PACTS/PALS 

courses to over 4788 physicians, nurses, EMT’s, paramedics, respiratory therapists. Most recently we 

have initiated a WEB PALS course, making onsite time commitment and access to this educational 

venue much more user friendly to the health care provider. It should be noted that observational 

experiences are available in our emergency room. 

FACULTY 

Richard C. Barry, MD, Professor of Pediatrics, Director of 

Pediatric Emergency Medicine, Director of Pediatric 

Residency Training Program 

Faye E. Doerhoff, MD, Assistant Professor of Pediatrics, 

Associate Director of Pediatric Emergency Medicine 

James M. Gerard, MD, Assistant Professor of Pediatrics 

Steven P. Laffey, MD, Associate Professor of Pediatrics 

Albert K. Nakanishi, MD, Associate Professor of 

Pediatrics, Co-Director of Pediatric Emergency Medicine 

Fellowship Program. 

John R. Peter, MD, Associate Professor of Pediatrics, Co- 

Director of Pediatric Emergency Medicine Fellowship 

Program, Associate Director Emergency Medicine 

Transport Team 

Ann D. Ricci, MD, Assistant Clinical Professor 

Anthony J. Scalzo, MD, Professor of Pediatrics, Medical 

Toxicologist & Medical Director of the Regional Poison 

Control Center, Director of Toxicology 

Scott O. Davis, MD, Fellow 

Asha Kumar-Verraswamy, MD, Fellow 

Diliane C. Pelikan, MD, Fellow 

Danette Kurtzeborn, Medical Secretary 


Dr. James Gerard’s research into Web Based PAL’s is an 

internet-based course designed to teach the didactic portion 

of the AHA’s Pediatric Advanced Life Support Course via the 

internet. Students who complete the on-line portion of the 

PALS course must then complete a 1-day practical skills and 

testing session at Saint Louis University School of Medicine. 

Dr. James Gerard is participating in a joint study to be 

carried out at Saint Louis University School of Medicine and 

Washington University School of Medicine. The purpose of 

the study is to collect data on School Bus Related Injuries in 

the St. Louis area. The information will be used to create a 

database of collision and injury data. Data will be analyzed 

for trends in conditions correlated with collisions, for types 

and outcomes of injuries related to school buses, and for 

cost of associated medical care. Finally, collision locations 

will be geographically mapped in order to identify high 

incidence areas. The study is currently under IRB review at 

both institutions. Upon IRB approval, subject enrollment into 

the study will commence in the ED’s at both Cardinal 

Glennon Children’s Hospital and St. Louis Children’s 

Hospital. 

Diliane Pelikan, MD, Anthony Scalzo, MD, Albert 

Nakanishi, MD, John Peter, MD, Jim Gerard, MD, are 

conducting a feasibility study for Universal Screening of 

Lead Poisoning in about 200 patients/children aged 6 

months to 6 years.

P EDIATRIC E MERGENCY M EDICINE D IVISION 

PUBLICATIONS 

1. Lowry J, Vandover J, DeGreeff J, Scalzo A. An unusual 

presentation of iatrogenic phenytoin toxicity in a 

newborn. IJMT 2001;4(1):1 

2. Klasner AE, Luke DA, Scalzo AJ. Pediatric orogastric 

and nasogastric tubes: a new formula evaluated. Ann 

Emerg Med 2002;39:268-272. 

3. Tominack R, Weber J, Blume C, Madhok M, Murphy T, 

Thompson M, Scalzo A. Elemental mercury as an 

attractive nuisance: multiple exposures from a pilfered 

school supply with severe consequences. Pediatr Emerg 

Care 2002;18:97-100. 

4. Scalzo AJ. Toxicology. Chapter 12, In: Pediatric 

Advance Life Support Provider Manual. American Heart 

Association, 2002; pp. 305-335. 

5. Scalzo AJ., Laffey, SP., Gerard JM., Case Scenarios. 

In: Pediatric Advanced Life Support Instructor Manual. 

American Heart Association, 2002, pp. 1-51. 

HONORS 

Barry, RC: Faculty Recognition Award; for outstanding 

contribution to the Housestaff by a Faculty Physician. 

PRESENTATIONS 

1. Laffey, SP: “EMSC - Past, Present, and Future”, Saint 

Louis University Department of Pediatrics Grand Rounds 

- September 12, 2001 

2. Barry, RC: “Cold Weather Injuries”, Saint Louis 

University Department of Pediatrics Pre-Grand Rounds - 

January 2002 

3. Davis, SO: “Radiographs for the Primary Care 

Physician”, Saint Louis University Department of 

Pediatrics, Pre-Grand Rounds - February 2002 

4. Peter, JR: “Management of Concussions”, Saint Louis 


January 2002 

5. Pelikan,DC: “Pediatric Office Emergencies” Saint Louis 


January 2002 

6. Scalzo AJ: Toxic Glycol and Glycol Ether Poisonings. 

North American Congress of Clinical Toxicology. 

Montreal, Canada, October, 2001. 

7. Scalzo AJ: Web Based PALS Program. American Heart 

Association, Emergency Cardiovascular Care Committee 

Fall Conference, Dallas, Texas, October, 2001. 

8. Laffey, SP: “The Septic Appearing Infant” Resident 

Noon Conference, Cardinal Glennon Children’s Hospital 

GRANTS 

J. Gerard, MD 

Web PALS 

HRSA grant awarded March 2000 3-year /$300,000 

An Additional stipend of $20,000 to test the educational 

efficacy of the Web-PALS program has been provided by 

the AHA 

43

44 

D IVISION OF P ULMONARY M EDICINE 


The Division of Pulmonary Medicine cares for children with a variety of acquired and congenital 

respiratory disorders. The members of the division are actively involved in educational teaching 

activities for CME programs locally and nationally, medical students, residents, and students in other 

disciplines including nursing and respiratory therapy. An active clinical research program is an 

integral part of the activities of the division and includes work in SIDS, asthma, and cystic fibrosis. 

Members of the division have active leadership roles in administrative responsibilities for the 

hospital, university, and national organizations including the American Thoracic Society (ATS) and 

the SIDS Alliance. 

The division has an active outpatient program with multidisciplinary clinics caring for children with 

cystic fibrosis, asthma, sleep disorders, and for children who are “dependent” on technology (e.g. 

children receiving home mechanical ventilation). In addition, children with more routine pulmonary 

disorders are seen as outpatient consultations. Finally, division members see patients in very busy 

outreach clinics located in Centreville, Illinois (Southern Illinois Healthcare Foundation), Poplar Bluff 

and Jefferson City, Missouri. 

FACULTY 

Blakeslee E. Noyes, MD, Associate Professor of Pediatrics 

and Director of the Division of Pulmonary Medicine 

Gary M. Albers, MD, Associate Professor of Pediatrics, Codirector 

of the Asthma Center for Children and Director of 

Broncoscopy 

James S. Kemp, MD, Associate Professor of Pediatrics and 

Interim Director of Clinical Research 

Anthony J. Rejent, MD, Clinical Professor Pediatrics and 

Director of the Cystic Fibrosis Center 

Robert W. Wilmott, MD, IMMUNO Professor of Pediatrics 

and Chair for the Department of Pediatrics. 

Michele White, Medical Secretary 

Judy Consolino, CNS 

Mary Howell, CNS 

Susan Mason, CNS 

Diane Roth, RN 


Dr. James Kemp’s research into SIDS and the relationship 

of sleep environment and positioning as risk factors for SIDS 

has continued to be a source of considerable importance in 

the scientific community as well as in the lay press. Recent 

work this past academic year has focused on the incidence 

of crowding and the availability of “safe” (as recommended 

by the Consumer Products Safety Commission) cribs to 

African-American infants born to mothers of lower 

socioeconomic status at high risk for dying from SIDS. An 

additional aspect of the study was to provide safe cribs to 

these mothers at no cost. Preliminary work in this area has 

assessed the acceptability of this intervention and the 

ultimate use of cribs provided to families. This work has 

been the subject of two presentations at national meetings. 

A corollary to this work has been investigation into the rate 

of infant death in adult beds and the recognition that this 

rate has increased over the past decade. This research has 

also demonstrated the very high risk for sudden death 

among infants who do not sleep in cribs. 

In conjunction with the Neonatology division, Dr. Kemp has 

teamed with Drs. Keenan and Apsey to pilot a project 

examining the mechanisms of severe hypoxemic spells in 

neonates recovering from hyaline membrane disease. This 

research is ongoing and will be presented in national forums 

this coming academic year. 

Dr. Gary Albers has participated as the local principal 

investigator in a study of an agent that blocks IgE in children 

with asthma; that study has recently been completed. He has 

also been involved in the study of the use of high dose 

aerosolized tobramycin in cystic fibrosis. 

Dr. Blake Noyes is the local P.I. for a Phase I/II study in 

children and adults with cystic fibrosis analyzing the impact 

of gamma-interferon administered subcutaneously on a 

variety of serum and sputum inflammatory markers. 

Dr. Anthony Rejent remains involved in an ongoing data 

collection protocol sponsored by Genentech, Inc. in cystic 

fibrosis patients. 

Dr. Robert Wilmott is involved in ongoing studies 

examining the use of a new delivery device for high dose 

tobramycin aerosols in cystic fibrosis and is completing 

publication of studies for the CF Therapeutic Development 

Network.


PUBLICATIONS 

1. Albers GM, Fifty Years Ago in 

The Journal of Pediatrics, Dargeon 

et al.: Hemangioma of the larynx 

in an infant (invited editorial). 

2. Flick L, White DK, Vemulapalli C, 

Stulac B, Kemp JS. Sleep position 

and the use of soft bedding during 

bedsharing among 218 African- 

American infants at increased risk 

for sudden infant death syndrome. 

J Pediatr 2001; 138:338-343. 

3. Flick L, Vemulapalli C, Stulac BB, 

Kemp JS. The influence of 

grandmothers and their senior 

caregivers on sleep position used 

by African-American infants. 

Arch Pediatr Adolesc Med 2001, 

155: 1231-7. 

4. Kemp JS, Grady KC, Vemulapalli 

C. Sleep practices and SIDS risk: 

crowding and availability of safe 

cribs among African American 

infants who bedshare. Platform 

session, Pediatr Res Vol 51, A 

1127, May, 2002. 

5. Vemulapalli CFE, Grady KC, 

Kemp JS. Sleep practices and 

SIDS risk: crowding d availability 

of safe cribs among African 

American infants who bedshare. 

ASIP Meeting, Cambridge, MA, 

March 16, 2002. 

6. Apsey NB, Keenan WJ, Kemp JS. 

Spontaneous movement precedes 

the majority of spontaneous 

hypoxemic episodes in neonates 

recovering from respiratory 

distress syndrome. Submitted, 

60th Mead Johnson Perinatal and 

Developmental Medicine 

Symposium, March 23, 2002 

7. Noone PG, Ramsey B, Wilmott 

RW. Safety of aerosolized INS 365 

in patients with mild to moderate 

cystic fibrosis: Results of a phase I 

multi-center study. Pediatr 

Pulmonol 2001 Aug 32(2): 122-8. 

8. Rosenfeld M, Gibson R, 

McNamara S, Emerson J, McCoy 

K, Shell R, Borowitz D, Konstan 

M, Retsch-Bogart G, Wilmott RW, 

Burns JL, Vicini P, Montgomery B, 

Ramsey B. Serum and lower 

respiratory tract drug 

concentrations produced by 

tobramycin for inhalation in 

young children with cystic fibrosis. 

J Pediatr 2001; 139:572-7. 

9. Bucuvalas JC, Chernausek SD, 

Alfaro MP, Krug SK, Ritschel W, 

Wilmott RW. Effect of insulin like 

growth factor - 1 treatment in 

children with cystic fibrosis. J 

Pediatr Gastroenterol Nutr. 2001 

Nov; 33 (5): 576-81. 

10. Quan JM, Tiddens HA, Sy JP, 

McKenzie SG, Montgomery MD, 

Robinson PJ, Wohl MEB, Konstan 

MW, Pulmozyme Early 

Intervention Trial Study Group. A 

two-year randomized, placebocontrolled 

trial of dornase alfa in 

young patients with cystic fibrosis 

with mild lung function 

abnormalities. J.of Pediatrics 2001; 

139 (6):813-820. 

11. Britto MT, Kotagal UR, Hornung 

RW, Atherton HD, Tsevat J, 

Wilmott RW. Impact of recent 

pulmonary exacerbations on 

quality of life in cystic fibrosis. 

Chest 2002;121:64-72. 

HONORS 

1. Albers, GM: Midwest Cystic 

Fibrosis Consortium Meeting April 

26-27, 2002, Organization and 

Elected Director, St. Louis, 

Missouri; Facilitator Pediatric 

Asthma Poster Review 98th 

International Conference 

American Thoracic Society, 

Atlanta, Georgia, May 22, 2002; 

Chair, Patient Care Committee, 

Medical Staff Cardinal Glennon 

Children’s Hospital, 1999 - 

present; Advisor to Resident 

Brandon Triplett, MD; Reviewer 

Journal of Pediatrics. 

2. Kemp, JS: Interim Director of 

Clinical Research, Pediatric 

Research Institute, Saint Louis 

University, April 1998 - present; 

Medical Director, Respiratory 

Care, Cardinal Glennon Children’s 

Hospital, April 1998 - present; 

Member, Saint Louis University 

Institutional Review Board for 

Human Studies, September 1999 - 

present; Voting member, 

University General Clinical 

Research Advisory Committee, 

February 2002 - present: Program 

Committee SIDS Alliance National 

Conference, September 2000 - 

present: Chair of Medical Track, 

June 2001 - present. 

3. Blakeslee E. Noyes, MD: “Best 

Doctors in America”; Reviewer: 

Chest, Am J Resp Crit Care Med; 

Member, Medical Executive 

Committee, Cardinal Glennon 

Children’s Hospital, 1997 - 

present; Member, Compensation 

Committee, University Medical 

Group, 2000 - present; Chairman, 

Quality Improvement Committee, 

Cardinal Glennon Children’s 

Hospital, 2001 - present; Co-Chair, 

Clinical Chest Rounds, American 

Thoracic Society, 2001 - 2002; 

Member, Governing Board, 

University Medical Group, 2002 - 

present; Member, Executive 

Committee, University Medical 

Group, 2002 - present; Co-Chair, 

Post Graduate Course, ATS “The 

Impact of Environmental Tobacco 

Smoke Exposure on Children”, 

2002; Chair-Elect, Pediatric 

Program Committee, ATS, 2002 

4. Robert W. Wilmott, MD: Award 

of Endowed Chairman, IMMUNO 

Professor, Department of 

Pediatrics, Saint Louis University 

Health Sciences Center, 2001; “Hall 

of Honor” Award, Historyical 

Committee Society of the 

Children’s Center Medical Center, 

Cincinnati, Ohio, 2001; Award of 

Appreciation, Cystic Fibrosis 

Foundation, Cincinnati, Ohio, 2001 

PRESENTATIONS 

1. Albers, GM: Instructor/Invited 

Lecturer Seventh International 

European Pediatric Flexible 

Bronchoscopy Course, Davos, 

Switzerland (November 12 - 16, 

2001) 

2. Albers, GM: “Multidisciplinary 

Management of Children with 

Airway Problems”, Saint Louis 

University Department of 

Otolaryngology Grand Rounds - 

April 24, 2002 

3. Albers, GM:“Upper Airway 

Lesions and their Evaluation by 

Flexible Bronchoscopy”, Saint 

Louis University Department of 

Pediatrics “Pre-Grand Rounds”, 

April 2002 

4. Kemp, JS: Invited Speaker, 

2001 Northeast Regional 

Convention for SIDS and 

unexpected Death, Secaucus, NJ, 

November 9 - 10, 2001 

45

46 


5. Noyes, BE: “Treatment Recommendations for the 

Pediatric In-patient with Respiratory Disorders”, Good 

Samaritan Hospital Grand Rounds, Mt. Vernon, IL, 2001 

6. Noyes, BE: “Clinicopathologic Conference”, Cardinal 

Glennon Children’s Hospital Grand Rounds, 2001 

7. Noyes, BE: “BPD and Other Wheezing Illnesses”, 

Ranken-Jordan Children’s Home, 2001 

8. Noyes, BE: “The Impact of Environmental Tobacco 

Smoke Expose on Children’s Respiratory Health”, 

Cardinal Glennon Children’s Hospital Grand Rounds, 2002 

9. Wilmott, RW: “Results of Phase 3 Tobi(r) Study Using 

New Delivery Device”, Saint Louis University School of 

Medicine Clinical Research in Progress, April 2002 

10. Wilmott, RW, Goss CG, Kulish M, Rosenfeld M, Waltz 

DA: “Understanding Cystic Fibrosis: New Findings, New 

Approaches:, Mini-Symposium, American Thoracic 

Society 2002 International Conference, Atlanta, George, 

May 2002 

11. Wilmott, RW, “Infection and Inflammation in the Cystic 

Fibrosis Lung”, Highlights of a Symposium from The 

North American CF Conference, October 2001. 

Sponsored by Chiron. Chaired symposium and narrated 

Highlights CD-Rom provided to all CF Centers. 

12. Wilmott RW, Chatfield B, Dyson M, Geller D, Milgram L, 

Noone PG, Rodman D, Rosenfeld M, Waltz DA, 

Schaeffler B, Challoner P. Aerodose Improves TOBI 

Delivery in Cystic Fibrosis (CF). The Fifteenth Annual 

North American Cystic Fibrosis Conference, Orlando, 

Florida, October 2001. (Poster Presentation) 

13. Brody AS, Klein JS, Molina PL, Quan J, Bean J. High- 

Resolution CT in Young CF Patients with Mild Lung 

Disease: Distribution f Abnormalities and Correlation 

with PFTs. The Fifteenth Annual North American Cystic 

Fibrosis Conference, Orlando, Florida, October 2001. 

(Oral Presentation) 

14. Britto MT, Hornung RW, Kotagal UR, Tsevat J, Wilmott 

RW. Factors Associated with Changes in Health-Related 

Quality of Life in Patients with Cystic Fibrosis. The 

Fifteenth Annual North American Cystic Fibrosis 

Conference, Orlando, Florida, October 2001. (Poster 

Discussion) 

15. Byczkowski TL, Kotagal UR, Britto MT, Wilmott RW. An 

Exploration of Disease Related Education Preferences 

Among Families of Patients With Cystic Fibrosis. The 

Fifteenth Annual North American Cystic Fibrosis 

Conference, Orlando, Florida, October 2001 (Poster 

Discussion) 

GRANTS 

G. Albers, MD - PI 

Airway Secretion Clearance in Cystic Fibrosis 

Cystic Fibrosis Foundation and The Children’s Hospital 

of Denver 

$25,000 


A Multicenter, Randomized, Controlled, Open-Labeled 

Study to Evaluate the Safety of XolairTM in Moderate to 

Severe, Persistent Asthma Subjects Already Treated with 

other Therapies (ALTO) 

Genentech, 

$60,000 


An Open-Label Extension Study of Xolair (Omalizumab) 

in Moderate to Severe, Persistent Asthma Subjects Who 

Completed Study Q2143g” 

Genentech, 

$60,000 


An Open-Label Randomized Trial with Tobramycin 

Solution for Inhalation (Tobi(r)) in Cystic Fibrosis 

Patients with Mild Lung Disease. PC-TNDS-009 

Chiron Corporation 

$30,000 

J. Kemp, MD - PI 

Available Space for Safe Beds in Sleep Environment 

Used by African American Infants 

Group Health Foundation 

$30,000 yr. current 

B. Noyes, MD - PI 

A Phase I/II Study of Interferon-gamma-1b by 

Subcutaneous Injection for the Treatment of Cystic Fibrosis 

Intermune, Inc. 

$15,000

48 

D IVISION OF T O XICOLOGY 


The Division of Toxicology is composed of two physician toxicologists (Dr. Anthony Scalzo, Dr. 

Rebecca Tominack), a forensic and environmental toxicologist (Dr. Christopher Long PhD) and two 

clinical pharmacists (Michael Thompson, Julie Weber). 

The main purposes of the division are: 1) to assist the Missouri Regional Poison Center in providing 

quality-assured triage and treatment information on toxic exposures and poisonings to all the 

hospitals, practitioners and public in the state of Missouri; 2) to provide direct or telephone 

consultation to physicians caring for poisoned patients; and 3) to educate health care professionals 

and the public about toxicology and related issues. 

The Missouri Regional Poison Center provides poisoning information, treatment strategies, and 

followup-management 24 hours a day. It is directed by Michael Thompson with the assistance of 

Julie Weber. The Center is staffed by pharmacists, Pharm Ds and nurses who are Certified Specialists 

in Poison Information. In addition to advice on virtually any type of exposure, over 190 full 

management guidelines are available for facsimile or computer fax transmission to all hospitals in 

the state of Missouri including Saint Louis University and SSM Cardinal Glennon Children’s Hospital. 

Medical toxicology consultation is accessed by first calling these specialists at the Poison Center. 

They will then contact one of the physician toxicologists as appropriate. Consultation ranges from 

simple triage advice to complex toxicology information and medical management. The two medical 

toxicologists have complementary fields of expertise. Dr. Scalzo is board certified in Pediatrics and 

Pediatric Emergency Medicine in addition to Medical Toxicology and Dr. Tominack is boarded in 

Internal Medicine and Medical toxicology. She also has much experience in industrial and 

occupational toxicology. 

Forensic and analytical toxicology services can be obtained either at contracted reference 

laboratories or through Dr. Chris Long. He is also director of the Forensic and Environmental 

Toxicology Laboratory at Saint Louis University. 

The Division of Toxicology maintains a strong commitment to education. For Saint Louis University 

School of Medicine, we provide 13-hours of toxicology lecture and case discussions in the first year 

curriculum, teach toxicology in a lecture cycle throughout the year for third year medical students, 

and provide one-month toxicology rotations at the Poison Center for selected senior students. Onemonth 

electives are also provided to the Pediatric Emergency Medicine Fellows from Saint Louis 

University and Washington University and to selected externs and residents in the fifth and sixth 

years at St. Louis College of Pharmacy. Each of 12 Emergency Medicine residents per year from 

Washington University is given a 1-day introduction to the function and capabilities of a Regional 

Poison Center. Finally, we teach the entire masters level course in human toxicology at the SLU 

School of Public Health each year.

FACULTY 

Anthony J. Scalzo, MD, FAAP, FACMT, Professor of 

Pediatrics and Internal Medicine, Director, Division of 

Toxicology, Full-time faculty, Division of Emergency 

Medicine, Medical Director, Missouri Regional Poison Center 

Rebecca L. Tominack, MD, FAACT, FACMT, Clinical 

Assistant Professor of Pediatrics Division of Toxicology, and 

Internal Medicine Adjunct Associate Professor of Community 

and Family Medicine, Assistant Professor of Community 

Health, School of Public Health, Assistant Medical Director, 

Missouri Regional Poison Center 

Christopher Long, PhD, DABAT, Assistant Professor of 

Pathology, Saint Louis University School of Medicine, Director, 

Forensic and Environmental Toxicology Laboratories 

Julie B. Weber, BS Pharm, Poison Information Pharmacist, 

Coordinator of Professional Education, Missouri Regional 

Poison Center at Cardinal Glennon Children’s Hospital and 

Division of Toxicology, Adjunct Clinical Instructor in 

Pharmacy, St. Louis College of Pharmacy 

Barb Austermann, Secretary 

Patrice Seratti, Secretary 


Currently, we are conducting a feasibility study for universal 

screening of lead poisoning in children aged 6 months to 6 

years. Anthony Scalzo, MD, is working with Pediatric 

Emergency Medicine fellow, Diliane Pelikan, MD, Principal 

Investigator, to conduct this study of 200 patients. 

Currently, the Regional Poison Center is conducting a 

prospective study of outcomes of snake envenomation in 

Missouri and the use of antivenom. 

Completed a retrospective study of 596 snake 

envenomations over a 61/2-year period and reported results 

at annual scientific meetings in toxicology, the North 

American Congress of Clinical Toxicology, in October 2001 in 

Montreal, Canada. 

Dr. Scalzo is also involved in researching educational 

methods for teaching Pediatric Advanced Life Support. He 

has attended the American Heart Association Emergency 

Cardiovascular Care Committee (ECC) Fall Conference in 

Dallas Texas, October 2001 and participated in the Pediatric 

Subcommittee of the ECC. 

PUBLICATIONS 

1. Lowry J, Vandover J, DeGreeff J, Scalzo A. An unusual 

presentation of iatrogenic phenytoin toxicity in a 

newborn. IJMT 2001;4(1):1 

2. Klasner AE, Luke DA, Scalzo AJ. Pediatric orogastric 

and nasogastric tubes: a new formula evaluated. Ann 

Emerg Med 2002;39:268-272. 

3. Tominack R, Weber J, Blume C, Madhok M, Murphy T, 

Thompson M, Scalzo A. Elemental mercury as an 

attractive nuisance: multiple exposures from a pilfered 

school supply with severe consequences. Pediatr Emerg 

Care 2002;18:97-100. 

4. Scalzo AJ. Toxicology. Chapter 12, In: Pediatric 

Advance Life Support Provider Manual. American Heart 

Association, 2002; pp. 305-335. 

5. Scalzo AJ. Case Scenarios. In: Pediatric Advanced Life 

Support Instructor Manual. American Heart Association, 

2002, pp. 1-51. 

D IVISION OF T O XICOLOGY 

6. Tominack RL. Herbicides Chapter. In: Goldfrank’s 

Toxicologic Emergencies. 

PRESENTATIONS 

1. Scalzo AJ: Toxic Glycol and Glycol Ether Poisonings. 

North American Congress of Clinical Toxicology. 

Montreal, Canada, October, 2001. 

2. Scalzo AJ: Web Based PALS Program. American Heart 

Association, Emergency Cardiovascular Care Committee 

Fall Conference, Dallas, Texas, October, 2001. 

3. Tominack RL: Toxicity of Agricultural Chemicals: 

Formulations and the “Inerts.” Midwest Toxicology 

Conference. Indianapolis, November 2001. 

4. Tominack RL: Mold and Human Health. Conference on 

Indoor Mold Contamination. Sacramento, January 2002. 

5.. Splitter, L (Tominack RL): Finkelstein Test Positively in 

Asymptomatic Patients: Influence of Workers 

Compensation and DOT Certification as Secondary Gain 

Issues. Central States Occupational Medicine 

Association Meeting. Chicago, March, 2002. 

6.. Sun, S (Tominack RL): Occupational Hand Infection 

Caused by BCG Vaccine during Bladder Instillation. 

Central States Occupational Medicine Association 

Meeting. Chicago, March 2002. 

7. Tominack RL: “Toxic” Environmental Mold- A 

Physician’s Perspective. Healthy Indoor Environment 

Conference. Folsom, California, April, 2002. 

8. Tominack RL: Aspects of Lead Exposure in Adults. 

Missouri Department of Environmental Health 

Community Education Seminar. Hurculaneum, Missouri, 

June 2002. 

9. Tominack RL: Evidence-Based Medicine and 

Legislative Action on Mold- Is There A Match? 5th 

Annual Western Legislative Conference of Women in 

Government. Napa, California, June 2002. 

10. Weber JA: The ABCs of Toxicology - Case Studies about 

Tots and Teens. Annual Conference - School Tools for 

Nurses. St. Louis, Missouri, August 2001. 

11. Weber JA: Toxicologic Emergencies. 10th Annual 

Pediatric Pharmacy Advocacy Group Meeting. St. Louis, 

Missouri, October 2001. 

POSTER PRESENTATIONS 

Johnson P, Blume C, Thompson M, Tominack R, Scalzo 

A: Antivenom: It’s Not Just for Rattlesnakes Anymore. North 

American Congress of Clinical Toxicology. Montreal, Canada, 


SPECIAL SERVICES 

1. Tominack RL: invited member of scientific panel 

convened by Toxicology Excellence in Risk Assessment 

(TERA) for the U.S. Department of Defense for 

Quantitative Risk Assessment of Non-Lethal Weapons: 

the 66 mm non-lethal grenade. Cincinnati, May 2002. 

2. Scalzo AJ: Toxicology Liaison. Pediatric Subcommittee 

of the AHA Emergency Cardiovascular Committee Fall 

Conference, Dallas, Texas, October, 2001. 

49

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