In Brief
Medical News

Brain damage that occurs during certain heart surgeries may be reduced by stopping a natural chemical from overstimulating brain nerve cells to the point of self-destruction, a Hopkins animal study suggests.

Scientists likened the process to a gatekeeper blocking flood waters from breeching the cell walls and triggering cellular "suicide."

Brain damage sometimes occurs during cardiac surgery when the heart is stopped for a long period using hypothermia, or greatly lowering the patient's body temperature to reduce the need for oxygen and then draining the blood from the body. Some of the damage occurs through apop-tosis, a form of programmed cell death in which the brain cells follow built-in instructions to kill themselves.

"Our results provide the first evidence that a toxic overload of the chemical glutamate plays a role in the development of programmed brain cell death when the heart is stopped during hypothermia, and indicate that blocking glutamate receptors on the cell surface reduces this kind of cell death," said Elaine Tseng, a surgery fellow and the study's lead author.

The results were presented at the recent American College of Surgeons annual meeting in San Francisco.

High-risk GI patients do better at major centers

Patients undergoing high-risk, complex gastrointestinal surgeries are far less likely to die if they are in hospitals that do a lot of them, a recent Hopkins study reveals. Moreover, patients won't pay any more for the added safety.

"These results are the latest in a series of related studies that demonstrate the value of major medical centers in providing superior care that is cost-effective as well as the importance of having experienced physicians and staff treat high-risk patients," said Toby Gordon, associate professor of surgery, a Hopkins vice president and the study's lead author.

The operations surveyed are among the most difficult performed by surgeons, and include removal of the esophagus, the stomach and large parts of the liver, as well as biliary tract anastomosis (surgically connecting bile ducts) and radical pancreati-coduodenectomy (removal of the head of the pancreas along with the encircling loop of the duodenum).

"Patients at lower-volume hospitals were at least twice as likely to die while hospitalized than similar patients treated in the highest-volume center, suggesting that major academic medical centers are 'centers of excellence' for certain conditions," Gordon told those gathered at the recent American College of Surgeons annual meeting in San Francisco.

Gordon noted that the researchers were aided in their outcomes study by the state of Maryland's unique medical data collection system. "Maryland has one of the most complete hospital admissions databases in the United States," she said. "In terms of having access to data and the availability of true cost data, Maryland is probably unique."

Other News

The Welch program in scientific writing and editing has expanded to include the consultation services of a specialist with expertise in grants writing and the mechanics of peer-review. Wendy Sanders, newly appointed to the faculty of the Division of Biomedical Information Sciences, provides fee-based consulting for members of the JHMI.

Formerly affiliated with the Department of Radiology, Sanders has more than seven years' experience as a full-time proposal writer.

Sanders will work with investigators to help them compete successfully for peer-reviewed funding, conferring with investigators on planning their application before they begin writing the proposal, and working with them as they draft proposals.

After investigators have drafted their proposals, Sanders can provide a written "prereview" critique of the application before its submission, the component of the service she thinks may be of greatest benefit to clients.

Sanders works on a "first-come, first-served" basis. Potential clients should allow for a turn-around time of seven to 10 days at a minimum. The charge for the consulting service is $50 per hour, but Sanders will provide an initial free, brief (no more than 30 minutes) consultation to discuss a project and its scope. Sanders can be reached by phone at (410) 955-3751 or by e-mail at ws@welch.jhu.edu.

MSX infrared observations of the galactic center

The Science Team for the Midcourse Space Experiment has released two sets of images from the Ballistic Missile Defense Organization satellite launched in April.

The first set is the highest resolution mid-infrared maps of the central 1 degree by 3 degree region of our galaxy. The resolution of the MSX mid-infrared observation is about 15 times better than the previous best infrared observation taken by the Infrared Astronomical Satellite.

The other set is two unique images of the Small Magellanic Cloud, a small companion galaxy to our own Milky Way. The images represent at least a fivefold improvement in resolution and sensitivity over previous experiments.

The observatory-class MSX satellite was launched on April 24 from Vandenberg Air Force Base, Calif., into a high-inclination, circular, near sun-synchronous Earth orbit at 561 miles (903.5 kilometers) altitude. Round-the-clock operations are being conducted from the Applied Physics Laboratory.

The images are available on the World Wide Web from the official MSX homepage at http://msx.nrl.navy.mil/, under the "Program News & Info: Press Releases" section. They are also available on the Johns Hopkins University Applied Physics Laboratory (JHU/APL) homepage at http://www.jhuapl.edu/ under the "PR" section. Color prints of the images can be obtained from the JHU/APL Public Affairs Office.