APL awarded Navy Certificate of Merit for contributions to CEC

The Navy Certificate of Merit, the Navy's highest institutional award, was given Nov. 6 to The Johns Hopkins University Applied Physics Laboratory for its contributions to the Cooperative Engagement Capability program, an anti-air warfare system that continuously links radars and other cooperating sensors and weapons in a battle group, creating a single composite radar track picture available instantly to all units of the group.

The Certificate of Merit is presented to corporations, associations or other groups for outstanding services to the Department of the Navy in connection with a single project or program.

APL's involvement in the CEC program began in 1987, and it has since grown to one of the laboratory's most significant research and development efforts. Conrad Grant, who heads APL's CEC activities, says, "CEC gives the Navy a level of capability unattainable with any other system. It enhances the performance of existing sensor and weapon systems."

The system allows the battle group to engage targets that are at greatly extended ranges beyond a ship's radar horizon and targets that were previously considered difficult to detect and track. CEC also makes it possible for a ship or other battle group component to use targeting data from another unit and automatically determines who will shoot at what target and when. The information is merged into a common picture on all CEC ships and aircraft in the battle group so each unit can see what any single unit sees, no matter where it is.

In 1987 APL proposed the CEC concept to the Navy as a way to extend the Navy's current capabilities. After initial approval to proceed, the laboratory conducted critical experiments, and developed and fabricated advanced development models, including more than 2 million lines of computer program code. Today APL functions as technical direction agent, developing and demonstrating new concepts and supporting contractors by monitoring the technical work of industry. The laboratory also serves as test conductor for ongoing test activities.
--Helen Worth

Strokes associated with heart surgery exact high costs

One in five people who have a stroke associated with heart surgery dies before leaving the hospital, and only one in four is able to return straight home after hospitalization for their surgery, according to a study by Johns Hopkins physicians. These stroke victims also required hospital stays more than twice as long as those of other heart surgery patients.

"Stroke associated with cardiac surgery also has serious economic repercussions in terms of longer hospital stays and higher hospital bills. These findings emphasize the need for further improvements in stroke prevention and management," says Jorge D. Salazar, lead author of the study and a resident in the Department of Surgery.

Results were presented Nov. 10 at the American Heart Association's annual Scientific Sessions in Orlando, Fla. The study's other authors were Maura Goldsborough, John R. Doty, Elaine E. Tseng, Robert J. Wityk, and William A. Baumgartner.
--Karen Infeld

Depression lessens likelihood of behavioral changes in cardiac patients

Nearly one in four people suffers from depression after a heart attack, according to a study by Johns Hopkins researchers, who found that these patients are less likely to comply with their doctors' advice to modify their diets and exercise more often.

Results of the study were presented Nov. 11 at the American Heart Association's annual Scientific Sessions in Orlando, Fla.

"We know from previous studies and from our own findings that people with depression are at greater risk of dying within the first few months after a heart attack," says Roy C. Ziegelstein, the study's lead author and an assistant professor of cardiology at Johns Hopkins Bayview Medical Center. "Our findings suggest that heart attack patients with depression have greater difficulty making recommended changes to lower their risk of having another heart attack. Further study is necessary to determine if this difficulty in making recommended lifestyle and behavior changes is related to the increased risk of death among depressed heart attack patients."

The study's other authors were James A. Fauerbach, David E. Bush and Sandra Sordo.
--K.I.

New ways to prevent brain damage during cardiac surgery

An unlikely team of heart surgeons and brain chemistry experts at Johns Hopkins has experimental evidence that some common drugs including anti-seizure medications may reduce or eliminate the most feared risk to people facing heart bypass surgery--inevitable, if often subtle, brain damage.

Five years into an eight-year National Institutes of Health grant, the Hopkins team has conducted laboratory tests with chemicals that dramatically protect animal brains from the kind of damage that occurs during heart surgery. Patient trials are expected to start in early 1998.

"The truth is that surgeons have gone about as far as they can go to indirectly protect the brain from injury by both decreasing operating time and refining cardiopulmonary bypass [the heart-lung machine]," says William A. Baumgartner, chief of cardiac surgery. "Since satisfactory methods have been developed to protect the heart during open-heart operations, the next challenge is to protect the brain.

"Our goal has been twofold. We want to define the cellular and biochemical mechanism of nerve cell injury and then develop pharmacological strategies to reduce the injury."

Baumgartner likened the neuroprotective strategy to newer tactics in the battle to reduce death and injuries from auto accidents. "The first approach years ago was driver education-- getting people to avoid accidents and reduce their frequency. But accidents persisted, so the next phase was to build a more protective car, with better brakes, air bags and seat belts. If you know that every time people get behind the wheel some accidents are inevitable, then the goal becomes making those accidents less harmful, regardless of the cause."

The apparently protective drugs tested at Hopkins inhibit overproduction of the neurotransmitter glutamate (an excitatory amino acid), glutamate receptors like N-methyl-D-aspartase and nitric oxide. The team has shown in several published studies that, when administered, these medications result in far less brain cell damage and document better neurologic outcomes after undergoing bypass surgery.

In a paper presented Nov. 8 at the annual meeting of the Southern Thoracic Surgical Association in Naples, Fla., the researchers reported that 17477AR, an inhibitor of the enzyme nitric oxide synthase, significantly reduced brain cell death in a model of open-heart surgery, where brain damage is known to occur. The particular areas of the brain affected are those that involve memory and learning.
--K.I.

Adenovirus may play life-threatening role in heart inflammation

Adenoviruses, viruses that cause common upper respiratory infections, may also cause life-threatening heart muscle inflammation in adults, according to a study led by Johns Hopkins researchers.

The finding contradicts previous evidence that the enterovirus Coxsackie B was the major cause of the inflammation, known as viral myocarditis. Enteroviruses enter the body through the gastrointestinal tract.

In data presented Nov. 11 at the American Heart Association's annual Scientific Sessions in Orlando, Fla., investigators at Hopkins and Baylor College of Medicine in Houston reported on tests of autopsied heart tissue from 13 patients, seven of whom had myocarditis.

Virus was detected in five of the case hearts (71.4 percent) but in none of the control hearts. Genetic material from adenovirus was identified in afflicted hearts as frequently as that from enterovirus. Also, genetic material from both types of viruses was detected in three of the case hearts. No other types of viruses were found.

"Our results suggest that adenovirus is a causative agent in a significant proportion of the adult cases of viral myocarditis that we studied," says Robert E. McCarthy III, the study's lead author and a cardiology fellow. "They also suggest that adenovirus and enterovirus could work together to cause this condition."

The study's other authors from Hopkins were Joshua M. Hare, Chi-Long Chen, Ralph H. Hruban, Edward K. Kasper and Kenneth L. Baughman.
--K.I.