Published monthly for CC employees by Clinical Center Communications November 1999 Sickle cell anemia study Awards honor CC staff Quality of worklife HHS Secretary Shalala visits New patient rep appointed Artwork donated Gallin receives flu shot News briefs

Study points to role for nitric oxide in sickle cell anemia       At left, healthy, normal red blood cells. At right, the misshapen red blood cells characteristic of sickle cell anemia. The hereditary disease affects about 1 in every 500 African-Americans, causing pain described by some as "a sledgehammer slamming bone." (Photos courtesy of Drs. Noguchi, Rodgers, and Schechter of NIDDK.) A study headed by Dr. Mark T. Gladwin, of the Clinical Center's Critical Care Medicine Department (CCMD), found that increasing levels of nitric oxide in the blood may offer new options for treating sickle cell anemia, the most common inherited blood disorder in the country. In the study, described in last month's "Journal of Clinical Investigation," Dr. Gladwin and colleagues in CCMD, NIDDK, and NHLBI examined how nitric oxide acts on hemoglobin, the oxygen-carrying molecule in red blood cells. Nitric oxide, a gas produced in many parts of the body, relaxes the smooth muscle cells in blood vessels. As the muscles relax, the vessels expand and allow more blood to pass through. Improving blood flow is a critical aspect in treating the painful and potentially deadly complications associated with sickle cell anemia. The study demonstrates that when nitric oxide is inhaled, it binds to hemoglobin. Once attached, the gas hitches a ride through the bloodstream, and may dilate vessels as it passes through. "This study is the first clinical demonstration of how nitric oxide binds to hemoglobin and that hemoglobin carries the gas as blood moves through the body," noted Dr. Frederick Ognibene of CCMD. In sickle cell anemia, hemoglobin molecules cluster into rigid spikes as oxygen is lost. The result is misshapen blood cells that slow blood flow and can block vessels entirely. When blood flow is disrupted, oxygen can't be delivered to the body. That causes painful and potentially deadly damage to organs and tissues. "Without oxygen, tissues die, and dying tissue hurts," Dr. Gladwin explained. "Some patients describe the pain as like a sledgehammer slamming bone." The research team hopes that these early studies will lead to new treatments for the life-threatening complications of this yet-incurable disease. The next step is to use magnetic resonance imaging to map changes in blood flow to certain muscle groups following nitric oxide inhalation therapy, researchers say. "Sickle cell anemia is a painful and debilitating disease that affects thousands of Americans," said Dr. John I. Gallin, CC director. "The Clinical Center's investigations in this area reflect our commitment to developing new and better therapies through innovative clinical research." Sickle cell anemia is most prevalent in African-Americans. About 1 in every 500 African-Americans has the disease; 1 in 12 carries the sickle cell trait. -by Sara Byars index Awards honor CC staff At the NIH Clinical Center Director's Annual Address and Awards Ceremony, held on Oct. 4, numerous CC employees were honored for their service and dedication to the mission of the hospital. "Collaboration is a key concept at the Clinical Center," said CC Director Dr. John Gallin. "It drives not only the science conducted here, but also every aspect of management and operations. Our dedicated staff members conduct the critical collaborations that bring success. It is the contributions of these individuals we honor today and we look to them for future growth." A reception in the Visitor Information Center followed the ceremony. In the category of administration, awards went to the following: Elaine Ayres, Office of Administrative Management and Planning, for significant contribution to the Clinical Center's goal of operational effectiveness and efficiency. Alberta Bourn, Nutrition Department, for outstanding long-term leadership of the Clinical Center Nutrition Department. Laura Cearnal, Office of the Director, for providing exemplary staff support to Clinical Center Grand Rounds and RoundTable presentations; for coordinating Clinical Center efforts to create a Pain and Palliative Care Service; and for providing exemplary support to the establishment and maintenance of the Clinical Center's Board of Scientific Counselors. Charles E. Daniels, Pharmacy Department, for sustained leadership of the Pharmacy Department. Bradley Henry, Sodexho-Marriott, for performance of duties above and beyond the call of duty in the maintenance of the South Entry lobby. David R. Kohler, Pharmacy Department, for the creative use of technology to disseminate information on handling of hazardous drugs in the protection of the safety of NIH staff. Francis A. LaBosco, Materials Management Department, for achievements exemplified by his notable and exceptional initiative and resourcefulness in reinventing the Materials Management Department. Barbara Merchant, NIDDK, for leadership and innovative administrative efforts to support the newly initiated organ transplant program. Gracie A. Millender, Outpatient Department, for achievements in administrative support which exemplify the mission of the Clinical Center and the NIH. Stephen Rosenfeld, Information Systems Department, for leadership during a time of transition in the Information Systems Department. Maureen L. Sampson, Clinical Pathology Department, for achievement in teaching as exemplified by contributions to train others in the computer-assisted generation of slides and posters, and for the design and implementation of the Clinical Pathology website. Jane M. Thurber, Office of Human Resources Management, for great skill and diligence in developing management reports regarding human resources status and trends. Ellen Williams, Equal Employment Opportunity Office, for leadership and extraordinary service to support diversity and equal employment opportunity in the Clinical Center. ITAS Implementation Group - Nicole M. Butler, Office of Administrative Management and Planning; Warren J. Moyer, Office of Financial Resources Management; James T. Pitts, Information Systems Department; Lynda N. Ray, Office of Administrative Management and Planning, for administrative excellence as demonstrated by the implementation of the Integrated Time and Attendance System in the Clinical Center. Nurse Recruitment Improvement Group - Marsha Brown, Ana Ferreira, Linda Linko, Sherry Meyers, Clarissa Mickle, Teresa Peduzzi, Jeanne Radcliffe, Carol Romano, Rosalie Smith, Susan Squires, Diane Walsh, Therese White, Lomar Yap, all of the Nursing Department; and Barbara Lang, Office of Human Resources Management, for diligent and untiring efforts to study and improve the process of hiring nurses in the Clinical Center. South Lobby Entry Group - Sara R. Byars, Office of Clinical Center Communications; Ann M. Ellis, Office of Facility Management; Adrienne R. Farrar, Social Work Department; Steven C. Groban, Outpatient Department; Henry D. Primas, Housekeeping and Fabric Care Department; Andrea Rander, Volunteer Office; Donald A. Sebastian, Division of Engineering Services; Terri Wakefield, Nursing Department; Janice H. Weymouth, Office of the Director; James H. Wilson, Office of Facility Management, for efforts resulting in the successful opening and operation of the Clinical Center's South Lobby. Jesse Ferguson Customer Service Awards went to the following: Mary Hall, Medical Record Department, in recognition of the outstanding customer service provided as a protocol specialist in the Protocol Coordination Service Center. Barbara B. Isom, Department of Transfusion Medicine, for constant, capable, and caring service to Clinical Center patients who require transfusions during the late night and early morning. Karen Kaczorowski, Outpatient Department, for achievement in customer service which exemplifies the mission of the Clinical Center and the NIH. Edna M. Lowe, Housekeeping and Fabric Care Department, for outstanding and dedicated customer service to the patients, visitors, and staff of the Clinical Center. Al Rexroad, Office of Clinical Center Communications, for long-standing contributions to the Clinical Center through leadership of the Special Events Section. Daniel Rinehuls, Office of Financial Resources Management, in recognition of outstanding performance, customer service, and timeliness in completion of the initial phases of the Activity-Based-Costing initiative. Cafeteria Hospitality Group - Elizabeth Appiah, Lynn Champ, Van Phan, of Guest Services, Inc., for excellent customer relations and efficient service in the ACRF cafeteria. Facilities Management Group - Scott Robinson, Dyal Sharma, Division of Engineering Services, for sustained cooperation in developing an excellent facilities management program in the Clinical Center. Nutrition Coordination Group - Elva Barrett, Sherry Parker, Grace Raye, Pattie Russell, Sandy Seubert, Kristin Stafford, Kimberly Williams, Maxine Wilson, all of the Nutrition Department, for surpassing program goals for the sustained delivery of superior customer service in the coordination of meal activities at the patient care unit level. In the category of patient care, awards went to the following: Barbara Bierer, NHLBI, for continued service and contributions in support of the Clinical Center programs. Helena L. Royster, Pharmacy Department, for sustained contributions to excellence in pharmacy patient care, through provision of drug information and product-related services as the night pharmacist. Jerry Sachs, for significant contributions as a member of the Clinical Center Patient Advisory Group. Anthony Suffredini, Critical Care Medicine Department, for being an outstanding clinician whose excellence and dedication to patient care exemplifies the qualities necessary for the Clinical Center to achieve its objectives to provide first-rate patient care. Benjamin Williams, Housekeeping and Fabric Care Department, for continued outstanding service to patients, staff, and visitors of the Clinical Center. Bereavement Assistance Group - Nancy Ames, Nursing Department; Margaret Bevans, Nursing Department; Richard Childs, NHLBI; Eileen Dominick, Social Work Department; Peter Eichacker, Critical Care Medicine Department; Liz Hale, Nursing Department; Karen Morrow, Spiritual Ministry Department; Rachelle Ramirez, Nursing Department, Renee Stubbs, Rehabilitation Medicine Department, for the innovative initiative shown as a team in developing a program to assist patients' families in the bereavement process. DTM Laboratory Information Systems Group - Janet Browning, Sherry L. Sheldon, Department of Transfusion Medicine, for extraordinary effort in developing and implementing the Laboratory Information Systems for the Department of Transfusion Medicine. In the category of science, an award went to the following: Joseph Kovacs, Critical Care Medicine Department, for developing important research initiatives in the areas of immunotherapy for HIV disease and management of pneumocystis pneumonia. In the category of strategic initiatives, awards went to the following: MRD Operational Review Group - Patricia S. Coffey, Kai E. Lakeman, Medical Record Department, for coordinating and conducting the internal operational review of a section and recommending and implementing operational improvements to optimize performance and assure efficiency and integrity of sectional operations. Suburban Hospital Neurosurgery Implementation Group - Elaine Ayres, Office of Administrative Management and Planning; Martin Brotemarkle, Outpatient Department; Hetty DeVroom, NINDS; Juanita Ellis, Department of Anesthesiology and Surgical Services; William Kammerer, Department of Anesthesiology and Surgical Services; Daniel Keravich, Pharmacy Department; Laura Lee, Office of the Director; Susan Martin, Department of Anesthesiology and Surgical Services; Beth Price, Nursing Department; Donna Simonton, Department of Anesthesiology and Surgical Services; Max Wilkerson, Diagnostic Radiology Department; Karen Williams, Department of Anesthesiology and Surgical Services, for outstanding planning efforts that contributed to a successful implementation of the neurosurgery project at Suburban Hospital. index

Quality of worklife Cafeteria suggestions researched Recently, the Clinical Center Quality of Worklife Council (QWI) received a general comment in the CC Employee QWI Suggestion Box about the cost and quality of food in the cafeteria. It was unclear if the problems concerned the B1 or second floor cafeteria. Later, a second suggestion was submitted concerning the use of plastic utensils, which the employee believed are damaging to the environment. Since the cafeterias are not under CC management, suggestions about the cafeterias should go directly to GSI, the food-service contractor. Some QWI Council members met with cafeteria staff to learn about the most appropriate way for CC employees or other cafeteria patrons to submit suggestions. The Council contacted Vickie Clark, B1-level cafeteria manager, to find out if a mechanism was in place for patrons to utilize. She said that GSI customer comment cards are available and located at the cashier checkouts. These cards can be completed and returned to the cashiers. The cashiers will then forward all cards received to the manager. Clark mentioned that patrons may also request to speak to the manager on duty. By contacting the manager, a majority of concerns can be addressed immediately. Since most patrons may not know about the customer comment cards, GSI will arrange to post signs at the checkouts. The signs will also indicate whom to contact if there are any immediate problems or concerns. Plans are in the works to provide an e-mail account for GSI on the ORS LAN System that will allow patrons the ability to communicate and obtain responses from GSI management regarding their comments and concerns. If you are dissatisfied with GSI efforts to address your concerns, contact Pamela Jenkins, NIH cafeteria program manager, on 2-0878. Also, please remember that we all need to pick up trash that we drop, and contact the cafeteria managers if we observe spills. With regard to CC employee suggestions, please be specific about the exact nature of the suggestion so that the Council can adequately research the issues important to you.   Family care referral service offered Are you struggling with working and finding appropriate options for caring for your children or elders? It is time consuming and challenging to explore all the possibilities, especially if you are a new parent, new to the area, or simply haven't had to respond to these issues in the past. However, the CC Quality of Worklife Council has some ideas to ease the stress. The NIH now has a Child Care/Eldercare Referral Service to assist you in finding the right solution. Call 5-1619 or TTY 0-0690 to be connected with a specialist who will research available options. When you call and explain your needs, you will receive: Customized referrals for available area services. Personal guidance. Information to assess the child's or elder's physical, social, emotional, and intellectual development, and financial needs (in the case of elders). Tip sheets, handbooks, and other tools for evaluating options. The service is provided by LifeWork Strategies, Inc., and is made available through the NIH Work and Family Life Center. index

HHS Secretary Shalala visits the Clinical Center

		HHS Secretary Donna Shalala paid a visit to NIH last month, which included a tour of the Clinical Center and presentations by several NIH researchers. At left, CC Director Dr. John Gallin, left, and Dr. Ronald Summers, center, greet the Secretary as she arrives at the CC. Dr. Summers, of the CC Diagnostic Radiology Department, then gave a talk on virtual bronchoscopy and virtual colonoscopy, noninvasive ways of examining the airway or colon by use of high-resolution CT scans.
At right, getting a bird's-eye view from high up in the ACRF, Secretary Shalala is briefed on the construction of the new Clinical Research Center. Yong-Duk Chyun, CRC project director, foreground, explains the new floor plan, while CC Director Dr. John Gallin, left, NIH Director Dr. Harold Varmus, and ORS Director Steve Ficca, far right, look on.

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New patient representative Laura R. Cearnal was recently appointed acting patient representative for the Clinical Center.     Laura R. Cearnal, R.N., M.S., was recently appointed acting patient representative for the Clinical Center. Louise Faehner left the position because of a move to California. Cearnal has been with the CC for over 6 years. Most recently she served as special assistant to the deputy director for clinical care in the Office of the Director. Prior to that, she was head nurse on the 4-West mental health procedure unit and the 4-East adult schizophrenia unit, and before that she worked 10 years with NIMH in clinical research. "Many things about the role of the patient representative appealed to me," said Cearnal. "I find direct interpersonal contact with patients and families and with clinical and research staff very rewarding. And it's a great pleasure to be working with a wonderful group of volunteers who staff the O.R. waiting room and visit new patients." The patient representative is best described as an advocate. Resolution of patient grievances, identification of areas for improvement, problem-solving to meet patients' needs (either individually or hospital-wide), answering questions, and identifying resources are all functions of the job. "The position serves as a direct link from the bedside to the director of the Clinical Center, and as an open communication channel between patients and their families and the institution," Cearnal said. "This position will continue to be an integral part of many other hospital departments and programs to create a seamless approach to patient concerns. Links to the Patient Recruitment and Public Liaison Office, to the new Hospitality Services Program, and to the Volunteer Service form a vital network." At a research hospital such as the CC, there is the added dimension of rights and responsibilities of patients who are participating in clinical research. "The patients ­ our partners in clinical research ­ can teach us how to be even better, and this position provides a voice for those lessons," she said. "I'd like patients and families to feel comfortable coming to me or calling, confident that I will listen to their ideas, complaints, concerns, and compliments. I truly enjoy meeting our patients, and I appreciate learning from them." The patient representative can be reached at 6-2626. index

Artwork donated Pictured from left to right are Inna Krymova, Dmitry Krymov, and Dr. John Gallin.     Dmitry Krymov, a Russian artist, recently donated his painting "Apples" to the Clinical Center's permanent art collection. Krymov's wife, Inna Krymova, is a CC patient, and the couple wanted to express their appreciation for the care she receives here. Krymov is a well-respected artist, stage designer, graphic designer, book and magazine illustrator, and sculptor, living and working in Moscow. Several of his works are in the permanent collections of the National Russian Museum in St. Petersburg and the National Tretyakovsky Museum in Moscow. Krymov offered several of his works for the CC to select from. "This piece was the unanimous choice of the selection group," said CC Director Dr. John Gallin. Krymov created "Apples" in 1993, using paper, mixed media, and a type of water-based, opaque paint called gouache. The work hangs at the end of the visitor-side hallway that leads up from the South Lobby. index

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Big shot Last month, CC Director Dr. John Gallin rolled up his sleeve to receive his annual flu shot from Muriel Brenner, R.N., of OMS. Even if you missed your scheduled day, it's still not too late to get your flu shot. Doing so will help protect you, your colleagues, and our patients from getting the flu. The OMS clinic on the 6th floor will offer flu shots on a walk-in basis from 7:30 a.m. to 11 a.m. and from 1 p.m. to 5 p.m., on Nov. 19, 22, 23, and 24. After that, call 6-4411 to schedule an appointment.

News briefs Health forum NIH wants to "Share the Health" with its neighbors on Saturday, Nov. 6, from 8 a.m. to 12 noon, at the Natcher Conference Center. The event features health seminars, exhibits, free health materials, presentations by elected officials, interactive computer and WebTV demonstrations, tours, volunteer opportunities, and more. For more information, call Terry LaMotte or Jessica Harrison of Palladian Partners at 301-650-8660, or visit the web site at http://health.info.nih.gov/forum99/ ClinPath auction Join in the fun Dec. 3, at the 27th annual Clinical Pathology holiday auction in Bldg. 10, Room 2C310. A bake sale starts at 9 a.m., and the silent auction and white elephant sale start at 11 a.m. Have a slice of pizza while you browse. The event will benefit the Patient Emergency Fund and the Friends of the Clinical Center. Over $2000 was raised last year. To donate items for sale, call Norma Ruschell at 6-4473. Studies open Call the Patient Recruitment and Public Liaison Office at 1-800-411-1222 for information on the following studies: Uveitis: NEI researchers seek women in their first 6 months of pregnancy who have uveitis or history of uveitis. NEI provides eye examinations, evaluation, and treatment as needed at no cost to participants. Psoriasis: NCI researchers seek adults who have psoriasis on at least 10 percent of their skin for a study of a new medication. The study will last 3 months, and there is no cost to participants for the new medicine Transport week The Patient Escort Service celebrates National Transport Week, Nov. 1­5, with a display on the first floor from 9 a.m. until 2 p.m. daily. Try your luck in the 5th annual transport raffle. The winner will receive exclusive transport service for 8 hours to the patient care area of their choice. Last year over $1000 was donated to the Patient Emergency Fund. Raffle tickets cost $1, and are available from any member of the Patient Escort team. Tickets will also be sold in front of both cafeterias and at the display. Heart disease study The Heart Disease Risk Factors in African-Americans Study seeks new participants for a study of the relationship between obesity and heart disease risk factors in healthy, nondiabetic African-American men and women. Participants can be of normal weight, overweight, or obese and between the ages of 18 and 55. There will be a series of four outpatient visits to the Clinical Center, in which participants will have body fat analyses, an electrocardiogram, blood tests, including cholesterol profiles, and oral and intravenous glucose tolerance tests. All participants will be compensated. For more information, call 2-7119. fMRI study NIMH researchers seek volunteers for fMRI studies of the visual processing of faces. Volunteers should have no history of medical or psychiatric disorders and must have normal vision or wear contact lenses. A 2-hour screening interview, a follow-up visit, and a 3-hour visit for the fMRI scan are required. Participants will be reimbursed. Specifically needed are: men aged 56-73 and women aged 51-59 who are right-handed and currently married, and right-handed mothers aged 20-40 with nonadopted, firstborn children aged 5-12. For further details, call Lisa Kalik or Neil Santiago at 6-8381. Bring a friend November is "Bring a Friend" month in the Department of Transfusion Medicine. If you bring a friend to donate blood when you donate, you'll double the help you're providing to others. To schedule an appointment, call 6-1048. Clutter control Want to clean out your offices and labs for a fresh start in the new millennium? Visit a new web site, http://goodriddance.nih.gov, for information and instructions on how to dispose of unwanted computer equipment, laboratory equipment, hazardous materials, reagents, furniture, and more. For details, contact Rosamond Burns at 6-2346, or rrburns@helix.nih.gov   index

Editor: Sue Kendall   Staff Writer: Sara Byars Clinical Center News, 6100 Executive Blvd., Suite 3C01, MSC 7511, National Institutes of Health, Bethesda, MD 20892-7511. Tel: 301-496-2563. Fax: 301-402-2984. Published monthly for CC employees by the Office of Clinical Center Communications, Colleen Henrichsen, chief. News, article ideas, calendar events, letters, and photographs are welcome. Deadline for submissions is the second Monday of each month. top | cc home page | nih home page |