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Finding the Linchpin
Children's Hospital & Research Center Oakland's First Pediatric Surgery Clinical Research Fellow Receives Prestigious UCSF Research Award

May, 2013 – For the past three years, CHORI and Children’s Hospital Oakland have been working with Clinical Scientist and Pediatric Surgeon Wolfgang Stehr, MD, and CHORI Senior Scientist Frans Kuypers, PhD, to develop a translational research program in the pediatric surgery department at the hospital. Those efforts have culminated with the department’s very first surgical research fellow, Robert Bell, MD, receiving first prize for Best Presentation at the University of California, San Francisco’s Department of Surgery’s 26th Annual Resident Research Symposium, held on April 5, 2013.

Dr. Bell, a resident in the UCSF East Bay Surgery Program, joined the Children’s Hospital & Research Center Oakland pediatric surgery lab in July, 2011 for two years of basic science and clinical research. Working under the mentorship of Drs. Stehr and Kuypers, Dr. Bell has been investigating necrotizing enterocolitis (NEC), a common disease in premature babies born as early as 25 or 26 weeks of gestation.

“There is nothing more heartbreaking or more motivating for a pediatric surgeon than coming across one of these children whose entire small bowel has died from this disease.”



Premature babies of this gestational age weigh about one pound, as opposed to full-term babies who can weigh anywhere from six to ten pounds. When these premature infants first start eating, their intestines can be too underdeveloped to handle the food. As a result, they develop NEC, and the entire intestinal system begins to fail.

"There is nothing more heartbreaking or more motivating for a pediatric surgeon than coming across one of these children whose entire small bowel has died from this disease. There is nothing you can do but artificially feed them until they can have an intestinal transplant or they die," says Dr. Stehr.

During the course of his fellowship at Children's, Dr. Bell developed a clinical project analyzing specimens from premature babies at the hospital for certain factors that might contribute to NEC. He then established an animal model of the disease at CHORI, and used it to investigate the role of the stress hormone, corticotropin-releasing factor (CRF), in NEC's development and progression.

“What Dr. Bell found is that inhibiting CRF prevented the rats from developing NEC. The research is truly remarkable and suggests that CRF may be the linchpin manipulating everything that goes on in NEC.”

"While Dr. Kuypers and I provided oversight and laboratory space, Dr. Bell demonstrated incredible initiative. He is a very scientifically oriented surgery resident and a very powerful first fellow for our clinical surgery research program," continues Dr. Stehr.

The UCSF Department of Surgery Annual Resident Research Symposium was open to all residents within the UCSF surgery department, but only 20 residents were selected to give presentations, which covered basic science, clinical outcomes, global health, and surgical innovation projects.

"I really appreciate the award for Best Presentation," says Dr. Bell. "It feels great to be recognized. It's especially rewarding to represent CHORI, Children's Hospital Oakland, and the East Bay Surgery Program in front of our colleagues across the bay, and to give them a small example of the spectacular work being done here in Oakland."

Drs. Bell and Stehr are continuing to investigate CRF's subcellular effects in newborns, and hope to secure additional funding to fully elucidate the critical role that CRF may play in NEC.

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Tuesday, May 21, 2013 8:48 AM

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