{"69841":{"#nid":"69841","#data":{"type":"news","title":"Researchers are Developing Technologies to Improve the Treatment for Premature Fusion of Skull Bones in Children","body":[{"value":"\u003Cp\u003EEngineers and surgeons are working together to improve the treatment of babies born with craniosynostosis, a condition that causes the bone plates in the skull to fuse too soon. Treating this condition typically requires surgery after birth to remove portions of the fused skull bones, and in some cases the bones grow together again too quickly -- requiring additional surgeries.\u003C\/p\u003E\n\u003Cp\u003EResearchers in the Atlanta-based Center for Pediatric Healthcare Technology Innovation are developing imaging techniques designed to predict whether a child\u0027s skull bones are likely to grow back together too quickly after surgery. They are also developing technologies that may delay a repeat of the premature fusion process. \n\u003C\/p\u003E\n\u003Cp\u003E\u0022Babies are usually only a few months old during the first operation, which lasts more than three hours and requires a unit of blood and a stay in the intensive care unit, so our goal is to develop technologies that will simplify the initial surgery and limit affected babies to this one operation,\u0022 said center co-director Joseph Williams, clinical director of craniofacial plastic surgery at Children\u0027s Healthcare of Atlanta at Scottish Rite and clinical assistant professor in the Department of Plastic and Reconstructive Surgery at Emory University.\n\u003C\/p\u003E\n\u003Cp\u003ECraniosynostosis affects approximately one in every 2,500 babies in the United States. The condition is caused by the premature closure of sutures with bone. Sutures, which are made of tissue that is more flexible than bone, play an important role in brain growth by providing a method for the skull to increase in size. If the sutures close too soon and get replaced with bony tissue, the skull may limit the normal expansion of the brain.\n\u003C\/p\u003E\n\u003Cp\u003EIf untreated, craniosynostosis can cause a range of developmental problems. If treated using the standard treatment course, surgeons remove the fused skull bones, break them up, reposition them, and hold them in place with plates and screws. This usually slows bone growth between the bone pieces, allowing room for expansion of the brain. However, studies show that more than six percent of babies need a second operation to separate the bones again and 25 percent of those require a third operation.  \n\u003C\/p\u003E\n\u003Cp\u003E\u0022Following the first surgery, there\u0027s a clinical need to be able to screen children on a regular basis to predict when their skull bones are going to fuse together again so that the surgeons can determine if additional intervention will be required,\u0022 said center director Barbara Boyan, the Price Gilbert, Jr. Chair in Tissue Engineering in the Wallace H. Coulter Department of Biomedical Engineering at Georgia Tech and Emory University and associate dean for research and innovation in the Georgia Tech College of Engineering.\u003C\/p\u003E\n\u003Cp\u003ETo address this need, the researchers have developed a non-invasive technique to monitor bone growth with computed tomography images. They created software that identifies bone in the images, quantifies the distance between the bones, the mass of bone in the gap, and the area and volume of the gap. The research team has demonstrated the utility of this \u0022snake\u0022 algorithm using a mouse model of cranial development and recently presented their findings at the 2011 Plastic Surgery Education Foundation conference.  \n\u003C\/p\u003E\n\u003Cp\u003E\u0022Using our snake algorithm to analyze computed tomography images of developing skulls in mice, we were able to monitor different types and speeds of bone growth on a daily basis for many weeks,\u0022 said Chris Hermann, an M.D.\/Ph.D. student in the Coulter Department. \u0022While one suture fused between 12 and 20 days and then significantly increased in mass for the next 20 days, another came closer together and increased in mass but remained largely open.\u0022\n\u003C\/p\u003E\n\u003Cp\u003EThe research team recently adapted the technology for use in children and began a clinical study to determine the effectiveness of the algorithm to diagnose cases of craniosynostosis. The researchers hope this technology will improve the ability of physicians to diagnose and determine the severity of craniosynostosis.\n\u003C\/p\u003E\n\u003Cp\u003EIn addition, the researchers are studying the biological basis of the condition and developing technologies they hope will delay bone growth and eliminate the need for additional operations. In one project, Coulter Department research scientist Rene Olivares-Navarrete and Williams are examining individuals with craniosynostosis to identify genes that influence suture fusion. Determining the genes that control suture closure may help the researchers identify potential therapeutic targets to prevent premature suture fusion.\u003C\/p\u003E\n\u003Cp\u003EThe research team has also designed a gel to be injected into the gap created between skull bones during the first surgery. The material -- called a hydrogel because it contains a significant amount of water -- would deliver specific proteins to the area to delay, but not prevent, bone growth. \n\u003C\/p\u003E\n\u003Cp\u003E\u0022The hydrogel cross-links spontaneously because of a reaction between a polyethylene-glycol monomer and a cross-linking molecule, allowing for polymerization without the use of chemical initiators or the production of free radicals,\u0022 explained Hermann.\n\u003C\/p\u003E\n\u003Cp\u003EPreliminary results in a mouse model of cranial development indicate that the gel, developed in collaboration with Coulter Department associate professor Niren Murthy, can be injected into a gap between skull bones, firm up rapidly and not injure underlying soft tissues or impair bone healing. These pre-clinical results were presented at the Society for Biomaterials Annual Meeting in April 2011. \n\u003C\/p\u003E\n\u003Cp\u003EBoth Boyan and Williams see promise in using these technologies to improve the treatment of children with craniosynostosis and eliminate additional operations sometimes needed to treat the condition. \n\u003C\/p\u003E\n\u003Cp\u003E\u0022During the initial surgery, injecting the gel may reduce the operation\u0027s severity if it eliminates the need for plates and screws to hold the skull bones in place afterward,\u0022 explained Boyan, who is also a Georgia Research Alliance (GRA) Eminent Scholar. \u0022After the surgery, if the computed tomography images tell us that the skull is closing too quickly, we may be able to inject the gel through the skin overlying the skull without surgery to further delay the bones from fusing.\u0022 \n\u003C\/p\u003E\n\u003Cp\u003EThe researchers are currently improving the protein release kinetics of the hydrogel and conducting pre-clinical experiments to determine which proteins successfully delay bone growth when included in the gel. Approval from the Food and Drug Administration will be required before this system and hydrogel can be used as a treatment for craniosynostosis.\n\u003C\/p\u003E\n\u003Cp\u003EThe Center for Pediatric Healthcare Technology Innovation is supported by Children\u0027s Healthcare of Atlanta, in collaboration with Georgia Tech.\n\u003C\/p\u003E\n\u003Cp\u003E\u003Cstrong\u003EResearch News \u0026amp; Publications Office\u003Cbr \/\u003E\nGeorgia Institute of Technology\u003Cbr \/\u003E\n75 Fifth Street, N.W., Suite 314\u003Cbr \/\u003E\nAtlanta, Georgia  30308  USA\u003C\/strong\u003E\n\u003C\/p\u003E\n\u003Cp\u003E\u003Cstrong\u003EMedia Relations Contacts:\u003C\/strong\u003E Abby Robinson (abby@innovate.gatech.edu; 404-385-3364) or John Toon (jtoon@gatech.edu; 404-894-6986)\n\u003C\/p\u003E\n\u003Cp\u003E\u003Cstrong\u003EWriter:\u003C\/strong\u003E Abby Robinson\u003C\/p\u003E","summary":null,"format":"limited_html"}],"field_subtitle":"","field_summary":[{"value":"\u003Cp\u003EResearchers in the Atlanta-based Center for Pediatric Healthcare Technology Innovation are developing technologies to better diagnose and treat children with craniosynostosis.\u003C\/p\u003E","format":"limited_html"}],"field_summary_sentence":[{"value":"Researchers work to improve treatment of those with craniosynostosis."}],"uid":"27206","created_gmt":"2011-09-06 00:00:00","changed_gmt":"2016-10-08 03:10:05","author":"Abby Vogel Robinson","boilerplate_text":"","field_publication":"","field_article_url":"","dateline":{"date":"2011-09-06T00:00:00-04:00","iso_date":"2011-09-06T00:00:00-04:00","tz":"America\/New_York"},"extras":[],"hg_media":{"69842":{"id":"69842","type":"image","title":"Barbara Boyan\/Joseph Williams","body":null,"created":"1449177275","gmt_created":"2015-12-03 21:14:35","changed":"1475894611","gmt_changed":"2016-10-08 02:43:31"},"69843":{"id":"69843","type":"image","title":"Chris Hermann","body":null,"created":"1449177275","gmt_created":"2015-12-03 21:14:35","changed":"1475894611","gmt_changed":"2016-10-08 02:43:31"},"69844":{"id":"69844","type":"image","title":"Barbara Boyan\/Joseph Williams","body":null,"created":"1449177275","gmt_created":"2015-12-03 21:14:35","changed":"1475894611","gmt_changed":"2016-10-08 02:43:31"}},"media_ids":["69842","69843","69844"],"related_links":[{"url":"http:\/\/www.bme.gatech.edu\/facultystaff\/faculty_record.php?id=48","title":"Barbara Boyan"},{"url":"http:\/\/www.bme.gatech.edu\/","title":"Wallace H. Coulter Department of Biomedical Engineering"},{"url":"http:\/\/www.cphti.gatech.edu\/","title":"Center for Pediatric Healthcare Technology Innovation"}],"groups":[{"id":"1188","name":"Research Horizons"}],"categories":[{"id":"145","name":"Engineering"},{"id":"146","name":"Life Sciences and Biology"},{"id":"135","name":"Research"}],"keywords":[{"id":"9548","name":"Barbara Boyan"},{"id":"530","name":"bone"},{"id":"397","name":"children"},{"id":"594","name":"college of engineering"},{"id":"14223","name":"computed tomography"},{"id":"14219","name":"Coulter Department of Biomedical Engineering"},{"id":"14220","name":"craniosynostosis"},{"id":"2585","name":"pediatric"},{"id":"171116","name":"skull"},{"id":"169511","name":"surgery"},{"id":"171117","name":"suture"}],"core_research_areas":[],"news_room_topics":[],"event_categories":[],"invited_audience":[],"affiliations":[],"classification":[],"areas_of_expertise":[],"news_and_recent_appearances":[],"phone":[],"contact":[{"value":"\u003Cp\u003E\u003Cstrong\u003EAbby Robinson\u003C\/strong\u003E\u003Cbr \/\u003EResearch News and Publications\u003Cbr \/\u003E\u003Ca href=\u0022http:\/\/www.gatech.edu\/contact\/index.html?id=avogel6\u0022\u003EContact Abby Robinson\u003C\/a\u003E\u003Cbr \/\u003E\u003Cstrong\u003E404-385-3364\u003C\/strong\u003E\u003C\/p\u003E","format":"limited_html"}],"email":["abby@innovate.gatech.edu"],"slides":[],"orientation":[],"userdata":""}}}