NLM Newsline 1997 January-February; Vol. 52, No. 1
The NLM Newsline is published 6 times a year by the National Library
of Medicine (National Institutes of Health, Department of Health and Human
Services).
In addition to electronic access, the printed NLM Newsline is mailed
without charge to institutions and individuals interested in health
sciences communications. For further information, contact the NLM Newsline
Editor, Melanie Modlin; e-mail address: mm354i@nih.gov
- NLM Director, Donald A.B. Lindberg, M.D.
- Chief, Office of Public Information, Robert B. Mehnert
- Editor, Melanie Modlin, Office of Public Information
- Fran Beckwith, Writer
- Karlton Jackson, Photographer
Contents:
Higher Profile Has Increased Use of Services
Without question, National Library of Medicine projects have received
an unusual amount of attention from the print and electronic media in the
past year.
- Dan Rather discussed the National Center for Biotechnology
Information's Human Gene Map on the "CBS Evening News," the same day CNN
aired a piece about it.
- The February 1997 issue of LIFE featured a cover story and stunning
photos based on the Visible Human Project. The Visible Humans were also
covered on combination cable TV- online news station, MS-NBC, and in a
front- page story in the Washington Post "Health" section.
- Ann Landers devoted her entire column to MEDLINE and Internet
Grateful Med. And an Associated Press story on the NLM's new
telemedicine contracts ran in dozens of newspapers nationwide.
The Library has always taken its 1987 congressional mandate to
"publicize the availability of its products and services" seriously. But
four major events of the past months turned the media spotlight on the
Library and raised its visibility like never before. As intended, NLM's
higher profile has meant an increase in the use of its services.
Last April 16th, at a conference on health care applications of the
information superhighway, NLM launched Internet Grateful Med, a program
for searching MEDLINE and other databases via the World Wide Web. Dr.
Michael E. DeBakey of Baylor University (and a member of the Library's
Board of Regents) presided over a special press event, along with Sen.
Bill Frist (R-TN), a surgeon and long-time user of Grateful Med.
Before the new system was demonstrated by Dr. Frist, two families whose
lives have been positively affected by the ability to search the medical
literature presented their stories. Jean Hoffmann-Anuta, a Maryland
pharmacist, spoke about her series of puzzling miscarriages, a problem she
was able to solve with the help of MEDLINE. She and her husband were
accompanied at the press conference by the result of their bibliographic
enterprise, their healthy baby, Sam.
The story of baby Sam and his family's search for medical information
continues to interest the public. To date, more than 244 newspapers in 22
different states, with a combined readership of about 24 million, have
carried stories about Internet Grateful Med's positive impact on the
family.
The second story was told by Michaela Odone, who, with her husband,
Augusto, told how they put MEDLINE to use to help their son, Lorenzo, who
suffers from a rare genetic illness. The family's story was recounted in
the film "Lorenzo's Oil," starring Nick Nolte and Susan Sarandon.
Lorenzo's parents spent endless hours searching for, retrieving and
reading journal articles from around the world. What they found led to the
development of what is now an accepted preventive therapy for
presymptomatic adrenoleukodystrophy (ALD), the disease afflicting their
son.
The press event was extremely well covered by national and local
electronic and print press, and demonstrated the public's intense interest
in obtaining credible health information from the National Library of
Medicine.
Headlines echoed this common theme. For example, a Washington Post
article bore the heading, "Doctors Herald Access to Vast On-Line Library";
The Wall Street Journal read, "Patients Delve Into Databases to Second
Guess Their Doctors"; The Los Angeles Times observed, "Web Sites, CD-ROMs
Give a Boost to Patients Seeking Medical Advice"; and Gannett News
Services said, "More Patients Turning to Internet for Health Information."
Reporters from Newsweek, TIME, The New York Times, UPI, Reuters, National
Journal, Science, Nation's Health, and USA Today, among others, covered
the press event in a similar fashion, highlighting the urgent need for
reliable consumer health information.
And publicity about IGM received another huge boost in July, when Ann
Landers' nationally syndicated column included a laudatory letter about it
from Dr. Michael DeBakey. The letter ran in hundreds of daily papers,
along with Ann's approving words that the new system could "help with
health problems and save many lives." New users flocked to IGM as a result
of this publicity, raising the number of total user codes to NLM database
services to 150,000. (For information on Internet Grateful Med, visit the
Web site: http://igm.nlm.nih.gov/)
One of the most dazzling enterprises of the Library's High Performance
Computing and Communications office is the Visible Human Project. This
enterprise has resulted in computer-generated images of two cadavers, one
male and one female. In October of 1996, the Library hosted a two- day
conference on the NIH campus, to examine how medical researchers, computer
scientists, medical illustrators and others are using the datasets. A
press conference held in connection with the conference attracted
widespread national and local TV coverage.
At this first-of-its-kind conference, researchers from the State
University of New York, Stony Brook, demonstrated how they use the Visible
Human datasets to screen for colon cancer, Baltimore researchers discussed
how they validated the existence of a new facial muscle with the database,
Mayo Clinic surgeons showed how they're using the data to rehearse
prostate surgery, and California researchers explained how the results of
reconstructive surgery can be viewed on computer before an operation.
Others explained how the Visible Humans will revolutionize the future of
medical education in our country.
NLM's press conference was attended by a diverse range of media. LIFE
magazine editors attended and devoted 36 pages to a cover story about the
Visible Human Project in their February 1997 issue, calling it "A
Fantastic Voyage Through the Human Body -- A 21st Century Look at How
Doctors Will Se Us -- and Heal Us." LIFE described how "Just as pilots now
use flight simulators to practice before they take off with real
passengers aboard, doctors are now using the Visible Human database to fly
through patients' bodies before embarking on life or death operations."
The magazine then presents a poignant story of Michael Jennings, a Rhode
Island fifth grader whose surgery for a brain tumor was made more precise
and therefore safer thanks to images from the Visible Humans. Other press
in attendance, including the Associated Press, The New York Times, The
Washington Post and numerous others, heralded the remarkable new uses of
the Visible Human data and reported how it is revolutionizing the practice
and study of medicine.
Also in October, another HPCC-related project made news as NLM
announced the funding of 19 telemedicine projects nationwide.
In making the announcement, HHS Secretary Donna Shalala said that
"telemedicine offers us some of our best and most cost-effective
opportunities for improving quality and access to health care." Vice
President Al Gore joined the Secretary in extolling the merits of
telemedicine.
"We want to put cutting-edge communications technology to work helping
improve health care for Americans," said the Vice President. "We are
joining with academic centers, communities and the health care sector to
move rapidly in developing the potential of telemedicine."
The multi-year telemedicine contracts, located in 13 states and the
District of Columbia, total some $42 million. Among the projects to be
studied are those providing care to center city elderly (Los Angeles),
linking health care providers with rural patients (West Virginia,
Washington, Missouri and Alaska) and improving care to high-risk newborns
and their families (Massachusetts). Announcement of the new contracts
received extensive print coverage in the localities where the 19 projects
are located.
Headlines like "Medicine, Technology Merge -- Hospitals Practice At a
Distance Through New Telemedicine Initiative," from The Montgomery Journal
(Montgomery County, Maryland), typified the coverage received in
communities affected by the new national telemedicine initiative.
Also in October of 1996, surely one of the Library's busiest months
ever, NLM's National Center for Biotechnology Information (NCBI) launched
its new Human Gene Map on the World Wide Web. A press conference, which
coincided with the release of an article about the Gene Map in the October
25, 1996 issue of Science, also received excellent coverage in
international, national and local electronic press. The New York Times,
The Washington Post, UPI, Reuters USA Today, and Medical Tribune, among
many others, reported that this NLM-coordinated project had resulted in
the biggest map to date of human genes, all of it visible on the Internet.
They also quoted experts who predicted the Gene Map would speed the
discovery of disease-related genes.
The Gene Map represents the most extensive effort so far to locate and
identify the 80,000 genes in the human genome. More than 16,000 are
included in the map, giving scientists roughly a 1 in 5 chance that a gene
they may be trying to find is on the map.
The map was a notable achievement for several reasons. It married solid
science with the clever application of technology so that a vast sum of
knowledge could be visually accessible on the World Wide Web in all its
detail. Now, the information -- pictures, text and graphics -- can be
viewed by anyone with access to the Internet, from the high school biology
student to the geneticist to the member of the general public who wants to
learn more about an illness that runs in the family.
And the Gene Map was the result of a unique collaborative effort by
some 18 leading research institutions around the world, coordinated by
NCBI.
The release of the article in Science, plus attendant publicity, has
helped direct more than 6,000 visitors daily to the new Human Gene Map Web
site. The Web address for the Human Gene Map is http://www.ncbi.nlm.nih.gov/science96
This marked increase in the amount of publicity for NLM may seem a
"chicken and egg" situation: Is the Library generating more press
attention because its programs and products are more exciting? Or is the
growing press attention the result of a more careful cultivation of media
contacts and better planning of press events, both of which heighten the
public's interest in NLM and use of its services, resulting in even better
programs and products?
Dr. Michael E. DeBakey chairs the NLM Board of Regents' Subcommittee on
Outreach and Public Information. He sees NLM's expanded efforts at
publicity and outreach as a way of bringing more people to its services.
"I believe that health care professionals and consumers should be able
to tap into the most recent medical information," Dr. DeBakey observed.
"Even with all our modern advances in health care, I still believe that
good information is the best medicine."
Helping Dr. DeBakey, his Subcommittee, the Office of Public Information
and other branches of NLM with press strategy is Kathleen Gardner Cravedi,
a Special Expert in the Public Information Office. She joined the NLM
staff in February of 1996.
Cravedi worked for more than 18 years on Capitol Hill, the majority
with the late Cong. Claude Pepper, longtime chairman of the House Select
Committee on Aging. At the Aging Committee, she orchestrated successful
national publicity efforts on such topics as elder abuse, mandatory
retirement, Medigap insurance fraud, and abuses in nursing homes, among
numerous others. Many of her press efforts led to reform legislation that
has benefited countless elderly. Interestingly, she helped draft
legislation creating the National Center for Biotechnology Information,
and establishing NIH's Institutes on Arthritis and Musculoskeletal and
Skin Diseases, and Deafness and Other Communication Disorders.
Ms. Cravedi sums up the Library's promising future, and her role in it,
this way:
"The National Library of Medicine, as the nation's largest
repository of biomedical information, plays a critical role in the current
and future delivery of health care. As we move into the next millennium,
quick access to the best biomedical information will be crucial. NLM
programs and projects are at the cutting edge of information transfer. It
is a privilege to help sensitize health professionals and the public to
the marvels of innovation developed daily here at the National Library."
LIFE cover -- w/credit, Alexander Tsiaras, LIFE (Time Inc.)
When he sat down at the long, glossy table in a Capitol Hill hearing
room February 26th, NIH Director Harold E. Varmus's job was to convince
key members of Congress of two things: that NIH has accomplished great
deeds with its current funding, and that, with sufficient appropriations,
it will produce even more impressive results in the future.
In testimony before the House Appropriations Committee's Subcommittee
on Labor, HHS and Education, Dr. Varmus termed these two categories
"culminations" and "inspirations." Chairman John Edward Porter (R-IL) and
his colleagues were then presented definitions and examples of each.
"Culminations are practical health benefits built upon many years of
research in which NIH has had a very significant role," he explained. "Let
me mention just a few examples of such culminations."
He then selected nine items from among the work done at NIH's 24
Institutes, Centers and Divisions, one of which was NLM's Visible Human
Project.
In a list that included "the first measured real declines in cancer
mortality for cancers of the lung, colon, gynecological cancers, prostate
cancers and breast cancer" and "the further validation of a real effective
treatment for stroke with tissue plasminogen as an activator", Varmus
mentioned "[t]he application of the Visible Human Project that you've
heard about in previous years to the teaching of medicine and the practice
of surgery" as an outstanding accomplishment.
Begun by NLM in 1986, the Visible Human Project has so far involved the
scanning and photographing of one male and one female cadaver, resulting
in datasets that create full-color, three-dimensional, computer-generated
images of the two bodies. The Visible Humans have proved to have hundreds
of applications, including CD-ROMs that let medical students carry out
dissection via computer and surgical simulators for physicians. To date,
NLM has awarded over 750 licenses for use of the datasets in 26 countries.
Next in his testimony, Dr. Varmus turned to inspirations, "the
important discoveries in basic science that may, we hope, be the
foundations for future culminations," he explained. "They are abundant.
Let me give you just a few examples from three areas of recent research,"
he continued.
"In genetics, the area that has attracted a great deal of press
attention, we've all read about the complete sequencing of the genomes,
the entire collection of genes, from a number of organisms, yeast and
several bacteria," the NIH Director reported. "Other genomes have been
fully mapped, for example, and some partially mapped, including the human,
and all this information made miraculously accessible to all investigators
and to the public through the gene bank at the National Library of
Medicine."
GenBank is the NIH's database of all known nucleotide and protein
sequences, including supporting bibliographic and biological information.
Since 1992, GenBank has been based at the National Center for
Biotechnology Information, created by Congress in 1988 and specifically
charged with developing automated information systems to support molecular
biology and biotechnology.
Dr. Varmus also cited as inspirations the remarkable pace of advances
in neuroscience and, in the area of cell biology, a burgeoning
understanding of blood vessel growth, signaling new strategies for
improving blood supply to the heart and brain. "[O]ur understanding of how
blood clotting occurs is even giving rise to the new strategies for
treatment of cancers," said Dr. Varmus.
African-American physician Charles R. Drew is revered as the father of
the blood bank and a pioneer in the use of blood plasma. During his brief
life, however, this extraordinary figure accomplished much more: as a
surgeon, researcher and teacher of a generation of medical students at
Washington's Howard University.
His character was widely admired, too, as reflected in the words of one
of his students: "He was the only person I had ever known who would be
fully capable of fetching the Holy Grail, due to [his] magnificent purity
of heart."
The Holy Grail wasn't the only myth to be associated with Dr. Drew,
according to Professor Spencie Love of the University of Oregon. In "'One
Blood': Charles R. Drew, M.D. and a Mythic Prescription for Our Time," a
special African-American History Month program at the Library February
19th, she explained.
"Quite tragically and unexpectedly, Dr. Drew died on April 1, 1950,
at the age of 45," she told the large crowd in the Lister Hill auditorium.
"He had an auto accident in rural North Carolina, when he was en route to
a medical conference in Tuskegee, Alabama."
"Almost immediately after he died, a story started to go around in
the black community, especially among medical people," Dr. Love related.
"That Drew, the father of the blood bank, bled to death because he was
refused blood when he needed it; that he was turned away from a
whites-only hospital. There were several versions of the story. They all
carried the same message: Drew had been mistreated and suffered an
unnecessary death."
However, Dr. Love, explained, "[the myth] is not literally true. Drew
was treated in the emergency room of a small segregated hospital . . . in
Burlington, North Carolina. Two young white surgeons, both of whom are
still alive today, worked hard to save his life, exhausting every measure
available to them."
The reasons for the myth's persistence were "far more complex than I
anticipated at the outset," said Dr. Love.
When the American Red Cross began its national program of blood
collection during World War II, it collected blood only from white
Americans. After a few months and considerable protest from the NAACP and
other groups, the policy was changed: black donors could give blood but
theirs was stored in a separate area.
As an expert on blood, Dr. Drew inevitably got involved in this blood
segregation controversy. "On one occasion he declared: 'As you know there
is no scientific basis for the separation of the bloods of different races
except on the basis of the individual types or groups,'" Dr. Love
recounted.
Because of his stance, Charles Drew became the subject of a number of
newspaper articles. "Wasn't it ironic, they said, that the pioneer of
blood plasma himself would have had his blood refused or segregated had he
wished to donate," Dr. Love recounted. "It was this moment in Drew's life,
I believe, that laid a critical piece of the foundation for the legend.
Drew was rightly perceived by the black community as having performed
humanitarian work and yet having been mistreated."
Another incident reinforced the Drew myth. On December 1, 1950 --
exactly eight months after Drew had died -- a young World War II veteran
named Maltheus "Sonny" Avery did die in the way Drew allegedly did. The
African American had his accident very close to where Dr. Drew had his.
"Badly injured," Dr. Love reported in her lecture, "he was taken to
Alamance General Hospital where Drew had been treated. After brief efforts
to stabilize him in the emergency room, Avery was sent on to Duke
Hospital, some 30 miles away: there was a neurosurgeon there who could
treat injuries," she continued. "Duke Hospital, however, refused to admit
Sonny Avery because the black beds were full. Of the 120 beds, only 14
could be used for black patients. Avery was sent on to Lincoln, the
smaller black hospital in Durham. He died a few minutes after his arrival
there."
Apparently the Drew and Avery stories blended, in the memories of many.
"The story of Drew bleeding to death thus, is -- I came to realize -- a
transcendent tale about the experience of being black in America. It is
generically true: many black people have bled to death at white hands over
a national history spanning four centuries," Dr. Love explained.
And there was another dramatic observation near the close of the
lecture. "Drew in a sense, both literally and metaphorically, did drive
himself to death because of segregation. He pushed himself to maintain an
almost impossible pace, most of his life."
"He and the doctors accompanying him [on the trip to Tuskegee] planned
to drive all night because there were so few places on the road for black
people to stay. The reason for the accident was that Drew fell asleep at
the wheel in the early morning hours of April 1 while the three doctors
with him dozed."
Despite the tragic elements in Dr. Drew's story, Dr. Spencie Love
closed her talk on a positive note.
"Charles Drew is a very special American hero by any measure and I want
to end by suggesting that he has left us with our most serviceable myth of
all: we are all one blood. What unites us is more powerful than what
separates us. So let us continue to celebrate his remarkable life and
unique character as we are doing today."
A special guest at the lecture was Dr. Drew's eldest daughter, Bebe
Price. Her first name was an abbreviation for "Blood Bank," she told the
crowd. After Dr. Love's lecture, she presented several anecdotes about her
famous father: for example, the time his wife discovered a mouse in the
family bathtub and asked him to take care of the situation. Rather than
drown the animal, Dr. Drew put a small amount of water in the tub and
initiated an experiment, timing the mouse's swimming speed and studying
its strokes.
She brought greetings from her family members and expressed the loss
they still feel at the death of Dr. Drew. "To this day, we would trade all
of the bridges, the stamps and the buildings [named or created in his
honor] if we could just have him back."
The African-American History Month Lecture was jointly sponsored by
NLM's History of Medicine Division and the Washington Society for the
History of Medicine.
(For additional information on the life of Dr. Charles Drew, look for
Dr. Spencie Love's book, One Blood: The Death and Resurrection of Charles
R. Drew, 373 pps., Chapel Hill: University of North Carolina Press, 1996.)
Dr. Spencie Love probed the facts and the myths surrounding Dr.
Charles R. Drew in "One Blood," her African-American History Month lecture
at NLM.
A Look at Technical Developments at the Library
New MeSH Home Page
In addition to the NLM Home Page (http://www.nlm.nih.gov), there are
several specific home pages of interest.
A recent addition is the MeSH Home Page, which provides easy access to
a variety of information about NLM's controlled vocabulary is now all in
one place. The MeSH Home Page and Web site (http://www.nlm.nih.gov/mesh) gives
an overview of Medical Subject Headings (MeSH) and provides links to
related topics including the UMLS (Unified Medical Language System).
The subject headings are arranged in both an alphabetic and a
hierarchical structure. For example, headings at the most general level of
the hierarchy include "diseases" and "organisms" with headings
representing specific groups of concepts such as "neoplasms" appearing
next, then individual headings at the more specific levels. There are more
than 18,000 MeSH terms with additional terms or subheadings used as
modifiers for the subject descriptors. Web site features include:
- MeSH Factsheet
- MeSH Publications -- list of titles and ordering information
with links to GPO and NTIS
- MeSH Suggestion Box -- the direct line to offer your
recommendations for new MeSH headings and other suggestions
- MeSH Staff -- meet the staff and use the e-mail links to
contact individuals
- UMLS Link -- link to information about the Unified Medical
Language System
- Browse MeSH 1997 Tree Structures -- display MeSH headings
online in hierarchical categories such as anatomical concepts or
diseases
The medical library community may be especially interested in the
download links on the MeSH Home Page. These allow immediate access to the
MeSH vocabulary in several formats. A simple online registration form is
required but there is no other license requirement or charge for the data.
MeSH is available in a variety of formats to meet specific requirements
of different applications. Versions of the entire MeSH vocabulary
available via FTP (file transfer protocol) include:
1997 MeSH Trees. List of MeSH main headings with the tree
numbers that place the heading in a hierarchical arrangement. It is sorted
by tree number and in ASCII format. Helpful files for using 1997 MeSH
Trees are the Sample Text and About MeSH Trees.
1997 MeSH in MARC format. MeSH vocabulary data in the USMARC
authority format. This is available in ASCII using a binary transfer.
Helpful files related to this data include the NLM Conversion
Specifications (WP 5.1), the USMARC Specifications for Record Structure,
Character Sets, and Exchange Media, and samples of the full file and
update file.
Other MeSH files and aids for FTP download include:
Pharmacologic Actions of a given drug.
Drugs with a given Pharmacologic Action.
New Headings with Scope Notes. List of main headings that are
new for 1997 with scope notes or definitions, cross- references, and other
information.
Replaced Headings. List of main headings with changed forms for 1997
and those deleted.
Stats Also Show Windows Grateful Med Rapidly Gaining Users
NLM provides user-friendly access to the MEDLARS online databases
through the Grateful Med family of programs. Versions have been released
for MS-DOS, for the Mac OS, for the World Wide Web and most recently for
Windows. The Web-based Internet Grateful Med (IGM) was released April 16,
1996.
IGM attained a major milestone in January, topping 100,000 searches in
a single month -- 107,069 to be exact.
User traffic for January revealed another interesting development:
Grateful Med for Windows (GMWin), released in the middle of January, 1997,
is rapidly finding its own user population, and a large one at that.
January statistics show 4,787 GMWin users, a number that climbed to 5,157
in February.
"I see the success of the two new programs as very good news,"
explained NLM's Dave Kenton, MEDLARS Database Administrator, who compiles
monthly data on use of Grateful Med in all its versions. "NLM has created
two new products that make it easier for the user to interact with our
databases. That's encouraging for us, for medicine and for science."
"We're delighted that NLM's users are finding the program helpful, and
look forward to providing more comprehensive and even easier access to the
important information in NLM's online systems," said Internet Grateful Med
project leader Dr. Lawrence Kingsland. "Look for a new version soon which
can search ten of NLM's databases!," he told NLM NEWSLINE.
The encouraging debut of Windows Grateful Med is due in part to the
ease with which people could sign up for it. Registered users of the older
MS-DOS version were sent request cards for Grateful Med for Windows.
"People who want access to our data have several good choices," Kenton
continued. "Internet Grateful Med runs on a gateway system at NLM and is
available to anyone with an Internet connection and a compatible Web
browser. Windows Grateful Med version and the earlier MS-DOS and Mac OS
versions run on the user's computer and can be used either over the
Internet or by dial-up modem connection through the FTS- 2000 telephone
system."
"We'll continue, as we always have, to be guided by users' needs in
delivering new searching capabilities," said Dave Kenton.
To register for IGM, go to the NLM home page
(http://www.nlm.nih.gov) and click on "MEDLINE," which will take
you to IGM. You can then register online for a password.
To download Windows Grateful Med, select it from the NLM home page.
Once on the GMWin page, you'll be asked if you need a user identification
code. By clicking on the hot link, you'll be able to register online or
have an application sent to you.
First NLM Publication With No Print Counterpart
Beginning with calendar year 1997, the NLM Current Bibliographies in
Medicine series may be obtained free-of-charge in electronic format from
the Library's Web site (http://www.nlm.nih.gov/pubs/resources.html).
This is the first NLM publication to be published without a print
counterpart. The CBM series had been available in paper copy on a paid
subscription basis from the U.S.Government Printing Office (GPO) since its
inception in 1988. Individual bibliographies have been accessible since
mid-1992 via FTP, but now all titles from that date forward are in HTML on
the Web.
Bibliographies in the CBM series are produced by staff of the Reference
Section in collaboration with subject specialists from the National
Institutes of Health (NIH) and elsewhere. The creation of each
bibliography begins with a strategy session held with the subject
specialist to define the scope and coverage. The reference librarian then
selects the online and CD-ROM databases which would likely contain
relevant citations on the topic, prepares the search strategies needed,
and downloads the search results; the subject specialist reviews the
results, eliminating any unwanted references. Altogether, Reference staff
expend over 100 hours in preparing a bibliography.
Each year's subjects are selected by a variety of means: to support
initiatives of the Department of Health and Human Services, to support NIH
and NLM conferences, and at the request of special groups. An example of
the latter is CBM 95-3, Asian/Pacific Islander American Health, which was
produced for the NIH Asian and Pacific Islander American Advisory
Committee.
Of the approximately ten bibliographies published each year, about half
are done for NIH Consensus Development Conferences or Technology
Assessment Conferences. These conferences are sponsored by the NIH Office
of Medical Applications of Research (OMAR), which has been charged with
bringing the results of research to the practicing physician. They are
held for the purpose of reaching consensus on a controversial subject,
usually the efficacy of specific treatment modalities or the application
of new technologies.
During each three-day conference, a panel hears presentations by a
number of experts on the topic under discussion, then meets to formulate a
recommendation. These recommendations are presented at a press conference
on the last day and are subsequently published by OMAR in print and on the
Internet (http://consensus.nih.gov/). Because
it is important for panelists and conference attendees to be aware of the
full range of publications on these controversial topics, Reference staff
will often search 20 or more databases for citations for their
bibliographies. Panelists receive a copy of the final bibliography about a
month ahead of the conference to assist them in preparation for their
role. Recognizing that the CBMs produced for NIH conferences have wide
appeal, GPO will continue to make available copies of these bibliographies
on an individual issue basis.
The following titles are the last to be produced in the 1996 CBM
series: 96-5 Breast Cancer Screening in Women Ages 40-49*; 96-6 American
Indian and Alaska Native Health; 96-7 Interventions to Prevent HIV Risk
Behaviors*; and 96-8 Unified Medical Language System( (UMLS(). The first
title for 1997 is 97-1 Management of Hepatitis C*. Other subjects in
preparation for this year include cystic fibrosis* and assessment of
domestic violence by health professionals.
Questions and comments on Current Bibliographies in Medicine may be
directed to the series editor, Karen Patrias (ref@nlm.nih.gov).
* CBMs for NIH conferences
Agreement Caps Years of Negotiation
On February 5, 1997 a Memorandum of Understanding was signed
establishing an International MEDLARS Center in Russia. The event
culminated several years of discussion and planning by representatives of
the National Library of Medicine and the State Central Scientific Medical
Library (SCSML) in Moscow.
MEDLARS, the MEDical Literature Analysis and Retrieval System, is NLM's
computerized system of databases and databanks. International MEDLARS
Centers assist health professionals in accessing MEDLARS databases, offer
search training, provide document delivery and perform other functions as
biomedical information resource centers.
"Russia is the 21st Center to be so designated by NLM since 1969,"
explained Dr. Elliot Siegel, NLM Associate Director for Health Information
Programs Development. "This agreement provides a contextual framework
around which the NLM and the SCSML will collaborate in a variety of
research, development and service activities intended to improve access to
medical information resources in the two countries."
In a ceremony held at the NIH in Bethesda, MD, the Memorandum of
Understanding was signed by NLM Director Dr. Donald A. B. Lindberg and by
Dr. Boris Loginov, SCSML Director. Looking on were Donna E. Shalala,
Secretary, Department of Health and Human Services, and Dr. Tatyana
Dmitrieva, the Russian Minister of Health. Dr. Siegel and Lois Ann
Colaianni, Associate Director for Library Operations, were instrumental in
moving events forward to this successful outcome.
The ceremony took place in conjunction with the fifth meeting of the
Health Committee of the Gore-Chernomyrdin Commission, an initiative by
U.S. Vice President Al Gore and Russian Prime Minister Viktor Chernomyrdin
that seeks to identify long-term goals for federal level cooperation
between the U.S. and Russia. 
NLM Director Donald A. B. Lindberg (seated, left) shakes hands with
SCSML Director Boris Loginov at NIH signing ceremony which made Russia
NLM's 21st International MEDLARS Center. Others in attendance were (l. to
r.) HHS Secretary Donna Shalala; Dr. David Hohman, Director, Office of
International Affairs, HHS; Russian Minister of Health Dr. Tatyana
Dmitrieva; and Prof. Oleg Maliugin, interpreter for Minister
Dmitrieva.
NLM Publications Redesigned to be "All in the Family"
What do the NLM home page, copies of Index Medicus, the NLM annual
report, the Grateful Med marketing brochure, NLM employee business cards,
NLM mugs, the pocket folders distributed at press events, and NLM fact
sheets have in common?
If you guessed that all emanate from the National Library of Medicine,
you're right, of course. What these diverse items don't have is a unifying
design or look.
Colors and typefaces vary, as do representations of the Library itself
and its programs and products. And there's been no single vocabulary of
colors, typefaces and images.
That's starting to change, however, now that NLM has moved to develop a
unified "image" for itself.
A signature element of the new look is the emblem that appears in the
masthead of this publication, at the top of page one. This emblem was
designed to represent several aspects of the Library. It had to embody
NLM's long history along with its proactive role in the present and
future. The Library's mission also had to be represented. ![]()
The visually dynamic rays represent enlightenment. The descending
arrows pointing to the center of the rays illustrate locating or finding.
What the arrangement serves to do is to visually communicate that the
National Library of Medicine is about helping people gain access to
knowledge.
The new symbol also needed to be historical and contemporary in its
feel. The type has a classical style while the box and rays feel more
modern and technical. The result is an emblem that is distinctive and
visually powerful, and that captures the Library.
The application of NLM's new identity is almost as important as the
revolutionary new emblem. Typefaces, colors and image treatment have been
specially selected for the Library's use.
By using this palette of graphic tools consistently, the Library will
have a unified presentation across all of its outreach activities and
materials. People will eventually be able to identify all programs,
projects and publications of the Library more easily.
NLM's Chief of Graphics, Joe Fitzgerald, said, "We're all excited about
this. It will allow us to give NLM's public face a distinct graphic
identity -- an institutional personality, so to speak. The designs and
formats are very cleverly constructed," he continued, "to allow for
individual creativity and flexibility while at the same time preserving a
visual unity."
Dr. Daniel Le, a research electronics engineer in NLM's
Communications Engineering Branch, recently received the first patent ever
awarded to an NLM employee. His invention is a technique to improve the
accuracy and versatility of automated document scanners and optical
character recognition.
His "Automated Portrait/Landscape Mode Detection on a Binary Image,"
U.S. Patent Number 5,592,572, permits automated scanning machines to
"read" a piece of paper and store its contents in an electronic format
even if the page is laid out sideways (in "landscape" format) or is
slightly at an angle when the scanning is performed. 
Dr. Daniel Le
The National Library of Medicine was one of four agencies that received
the National Health Information Silver Award "Honoring the Nation's Best
Consumer Health Information Programs and Materials" of 1996. The award was
for "HIV/AIDS Clinical Trials: Knowing Your Options," a video produced
jointly by the Centers for Disease Control, the Food and Drug
Administration, the National Institute of Allergy and Infectious Diseases,
and NLM as part of the AIDS Clinical Trials Information Service (ACTIS).
The video was distributed to the approximately 4,500 libraries that
comprise the National Network of Libraries of Medicine. Gale
Dutcher, Specialized Information Services Division, is the NLM project
officer for ACTIS.
Former Board of Regents member (1990-94) Robert E. Kahn was
recently selected to receive the Alexander Graham Bell Medal from the
Institute of Electrical and Electronics Engineers. Kahn, an IEEE fellow,
is founder and president of the Corporation for National Research
Initiatives, Reston, VA. The award is for "conceiving the Internet
architecture and protocols, and for the vision and sustained leadership
that led to the current Internet."
Some of you may remember Oliver Smith, who worked in the History
of Medicine Division in the late 1980s while attending Bowie State. Oliver
was a personable young man of 19 whose soft-spoken manner and cooperative
nature endeared him to the reference crew -- Margaret Kaiser, Anne Toohey
and me. Last August, Oliver's pal Guy Walker, who worked summers for Sarah
Richards, stopped by for a visit and reported that Oliver had become a
D.C. cop, good news since Oliver had been interested in law enforcement.
Oliver was the police officer who was murdered in the early morning
hours of February 26th after being robbed in front of his home in
Forestville, MD. In the Washington Post, his police colleagues recalled
him as reserved and reliable, a hard worker who always made a good
impression. That describes the Oliver we remember. He had a quiet charm
that made us smile. He was without doubt one of the best.
Oliver was 27 years old. He was married and the father of a
five-year-old son. It was a pleasure to have known him.
Donations can be sent to the Oliver W. Smith, Jr. Family, c/o 2nd
District Police Headquarters, 3320 Idaho Ave., NW, Washington, DC 20016.
(contributed by Betsy Tunis, History of Medicine Division, NLM)
Fact Sheets Get Facelift
NLM has recently updated 30 of its fact sheets, all of which are
accessible from the NLM home page (http://www.nlm.nih), under the heading,
"NLM Publications." Here are the titles of the revised fact sheets:
- AIDS Information Resources
- AIDSLINE
- AIDSTRIALS and AIDSDRUGS
- Chemical Carcinogenesis Research Information System (CCRIS)
- ChemID
- CHEMLINE
- Developmental and Reproductive Toxicology
- Database (DART)
- DIRLINE
- Environmental Mutagen Information Center (EMIC) Database
- Fixed-Fee Agreement (Request for Proposal)
- GENE-TOX Program of the U.S. Environmental Protection Agency, The
- Hazardous Substances Data Bank (HSDB)
- Health Services/Technology Assessment Text (HSTAT)
- Integrated Risk Information System(
- Lister Hill National Center for Biomedical Communications
- Microfilm Sales Program
- Registry of Toxic Effects of Chemical Substances (RTECS)
- SPECIALIST Lexicon
- Telemedicine Related Programs
- Toxic Chemical Release Inventory (TRI)
- Toxic Chemical Release Inventory Facts (TRIFACTS)
- Toxicology and Environmental Health Information Program (TEHIP)
- Toxicology Data Network (TOXNET)
- TOXLINE
- UMLS Information Sources Map
- UMLS Knowledge Source Server
- UMLS Metathesaurus
- UMLS Semantic Network
- Unified Medical Language System (UMLS)
- Visible Human Project, The
A Look at Historical Acquisitions for 1996
The History of Medicine Division reports on items added to the
collection in 1996.
Especially interesting acquisitions included a copy of a very early
printed work on hospital management and history. Joannes Gilinus's Ia.
Antiquar, Arx Erat hic Quondam Domus Est ubi & Hospita Virgo qua: Data
Pauperibus Munera Cuncta Vides... (Milan, 1508) is a work on the Ospedale
Maggiore of Milan, established in the mid-15th century and influential for
its design.
Two extremely rare editions of works by Galen were acquired.
Dissectionis Venarum Arteriarumque Commentarium. Eiusdem de Nervis
Compendium (Paris, 1526) are the first separate editions of Galen's
treatises on dissection of veins and arteries, and of nerves and muscles.
These editions were translated by Antonius Fortolus, whose versions were
often reprinted and highly regarded. De la Raison de Cvrer par Euacuation
de Sang (Lyon, 1542) is the rare separate French edition of Galen's work
on bloodletting, translated by Pierre Tolet, court physician and friend of
Rabelais.
An extremely rare work on cerebral anatomy was acquired. In his
Discours de Monsieur Stenon, sur l'Anatomie du Cerveau (Paris, 1669),
Nicolaus Steno criticizes Descartes' theory of brain function, arguing
that a knowledge of the anatomy of the brain must precede theories about
its function. Steno recommends a new method of dissection which is less
damaging to the specimen. Steno is also known for his work on the
glandular and lymphatic system, muscles, embryology and comparative
anatomy.
Other interesting acquisitions included Juan Valverde's Anatomia del
Corpo Human (Rome, 1559), the first edition in Italian of this
"plagiarism" of Vesalius. Valverde admitted taking his illustrations from
Vesalius, but also added observations of his own. The first edition, which
was printed three years earlier, is considered the first great medical
book in Spanish. Scevole de Sainte-Marthe's Paedotrophiae Libri Tres
(Paris, 1584) is the rare first edition of his poem on the care and
feeding of children. The poet Sainte-Marthe was inspired to write the poem
after his infant son survived a serious illness. The first part of the
poem deals with prenatal care, the second with infancy and the third with
the common diseases of childhood. Giovanni Aldini's Essai Theorique et
Experimental sur le Galvanisme (Paris, 1804) is the extremely rare folio
first edition of this work on the effects of Galvanic electricity on the
animal system. It includes sections on experiments with both humans and
animals, illustrated with colored folding plates.
For additional information on these titles or on the Library's
historical acquisitions, please contact Elizabeth Fee, Ph.D., Chief,
History of Medicine Division, 301-496-5405, e-mail elizabeth_fee@occshost.nlm.nih.gov.
You may also contact the HMD reference desk at the same phone number,
e-mail hmdref.nlm.nih.gov 
Title page illustration from Joannes Gilinus's Ia. Antiquar... (Milan,
1508). The book discusses hospital management and history.
Important Dates
May
24-28, 1997
Medical Library Association
Meeting, Seattle, WA:
The MLA annual meeting provides a rare opportunity to learn about the
latest products, exciting technical developments, new strategies for
information management, and much more. NLM will offer several programs,
including "NLM Update," a National Network of Libraries of Medicine
"Outreach Session" and a "Lunch & Learn" online users meeting. For
more information, call 312- 419-0994, or e-mail info@mlahq.org. To see the preliminary
program and for online registration, go to the MLA Web site: www.kumc.edu/mla/preprog.html
May 28-31, 1997
American Medical Informatics Association (AMIA)
Spring Congress, San Jose, CA:
"Information Technology in Community Health" is the theme of this
conference. For more information, call 301-657-1291, e-mail mail@mail.amia.org or visit Web site
http://www.amia.org/
October 25-29, 1997
American Medical Informatics Association
(AMIA) Fall
Symposium, Nashville, TN:
This year's themes are "The Emergence of 'Internetable' Health Care"
and "Systems That Really Work." For more information, call 301-657-1291,
e-mail mail@mail.amia.org, or
visit Web site http://www.amia.org/
The White House,
the Capitol, the Air
and
Space Museum
Isn't it Time You Toured the NLM, Too?
Planning a trip to NIH soon, or to the Washington, DC area? Why not
devote an hour to touring the National Library of Medicine?
Maybe you work at NLM but would like to learn more about the Library's
history, programs and services. You're a good candidate to take a tour,
too.
Every Monday through Friday at 1:00 (except federal holidays), NLM's
Visitors Center offers a free tour of the Library. The one-hour session
includes a videotaped overview of programs and services, a demonstration
of Internet Grateful Med, and a walking tour that includes the computer
room, reading room, audiovisual Learning Center, online public catalog and
History of Medicine Division.
If you'd like to arrange a group tour, please call in advance: Bob
Mehnert, Chief, Public Information Office, at 301-496-6309 (e-mail: mehnert@nlm.nih.gov). 
Caption: "Photo by Fran Beckwith"
Telehealth Planning Conference
Looks to
Technology as a Way of Improving
Health of Minority and Disadvantaged
Persons
On February 24th and 25th, delegates representing the member
institutions of the Minority Health Professions Foundation (MHPF) and
other Historically Black Colleges and Universities (HBCUs) met at the
National Library of Medicine to develop and strengthen telecommunications
linkages among these institutions.
Such links will be invaluable as information-sharing tools for a number
of potential applications in clinical care, distance education, medical
research, and administration. An extension of these links into underserved
urban and rural communities of the U.S. will help the two groups fulfill
their mission to improve the education and health status of minorities and
disadvantaged persons.
Featured speakers included Dr. Clay Simpson, Deputy Assistant Secretary
for Minority Health, U.S. Department of Health and Human Services, and Dr.
John Ruffin, Director of NIH's Office of Research on Minority Health. The
conference was chaired by Dr. Henry Lewis III, Dean of the College of
Pharmacy and Pharmaceutical Sciences at Florida A and M University and
MHPF President.
The HBCU Telehealth conference was made possible through support from
the National Library of Medicine and the Office of Research on Minority
Health of the National Institutes of Health.
Photo:
Attendees at the MHPF/HBCUs telehealth conference
examined the many applications of telecommunications and information
technologies for improving the health of minority and underserved
populations.
The following references cite works that discuss the products and
services of the National Library of Medicine. If you know of other
appropriate citations for this column, please send reprints or references
to the editor, NLM NEWSLINE, Public Information Office, National Library
of Medicine, Bethesda, MD 20894, or e-mail to mm354i@nih.gov. (Note: Some
of the articles below may be from publications that are out of the scope
of the NLM collection and therefore are not available from the Library on
interlibrary loan.)
- Bellack JP, Hill T, Welling P, Guilford S. The use of library and
information resources in three rural AHECs. S C Nurse 1996 Jul-
Sep;3(3): 12.
- Fonger GC. Toxicological and environmental health information from
the National Library of Medicine. Toxicol and Ind Health 1996
12(5):639-49.
- Lindberg DA. The NLM and Grateful Med: promise, public health and
policy. Public Health Rep 1996 Nov-Dec;111(6):552-5.
- Lindberg DA. Innovations Raise Visibility Of NLM. U.S. MEDICINE 1997
Jan;33(1-2):4-6.
- Long LR, Ostchega Y, Goh GH, Thoma GR. Distributed data collection
for a database of radiological image interpretations. Proc of SPIE:
Storage and Retrieval for Image and Video Databases V, San Jose, CA,
Feb. 8-14 1997;3022:228-37.
- Schell CL. A role in cyberspace for prospective indexing [letter].
Bull Med Libr Assoc 1996 Jul;84(3):437.
- Smithing RT, Wiley MD. Interesting resources from the Web. NP News
1996 Jul- Aug;4(4):2,5.
- Finding medical help online. Consumer Rpts 1997 Feb;28-31.
NLM regularly seeks the help of the medical library community in
filling gaps in its monograph and serial collections. If you can provide
any of these items, we would be most grateful. Kindly send to:
National Library of Medicine
TSD - MONOGRAPHS
Attn: L.
Turnage
Bethesda, MD 20894
- Bennett, Richard C. Second opinion: a holistic approach to treating
adults with ADD. Valparaiso, IN: ADD Resources, 1994.
- Hill, David and Leary, Martha R. Movement disturbance: a clue to
hidden competencies in persons diagnosed with autism and other
developmental disabilities. Madison, Wis.: DRI Press, 1993.
- Infection protocols for obstetrics and gynecology / edited by Philip
B. Mead and W. David Hager; prepared by the members of the Infectious
Diseases Society for Obstetrics and Gynecology. Montvale, NJ:
Contemporary Ob/Gyn, c1992.
- Issues and skills in relating primary medical care to the other
human services / Stephen P. Hersh, James E. Simmons, editors. Chicago:
American Medical Association, 1982.
- Non-insulin-dependent diabetes: its present and future: proceedings
of a UK symposium held at the Cavendish Conference Centre on 31st March,
1982 / edited by P.H. Suonksen, W.S. Phillips. London: Royal Society of
Medicine; Oxford: Oxford University Press, 1984. 1984. (International
congress and symposium series; no. 68).
Last updated: 23 July 1997
First published: 01 January 1997
Permanence level: Permanent: Stable Content
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