NATIONAL INSTITUTES OF HEALTH National Institute of Arthritis and Metabolic Diseases Program Purpose and Accomplishments Laboratory and Clinical Research (Public Health Service Act Activity: Purpose: The National Institute of Arthritis and Metabolic Diseases bears responsibility for a broad array of diseases characterized by their chronicity and long-term disabling effects rather than mortality: various arthritic diseases and related rheumatic and connective tissue disorders; diabetes and other inherited errors of metabolism; diseases of the gastrointestinal tract, including diseases of the liver and gallbladder; endocrine disorders; and diseases of the blood and bone. Explanation: The total intramural program necessarily includes studies of a fundamental nature as they are associated with the specific disease objectives described above. Thus, the Institute has an important stake in the pursuit or support of research in fundamental sciences which constitutes the foundation of knowledge pertinent to any of the above disease categories. The fundamental scientific disciplines include chemistry, biochemistry, enzymology, molecular biology, anatomy, histology, pathology, physiology, medicinal chemistry, pharmacology, and genetics. Accomplishments in 1971: Significant gains were made in the field of endocrinology where the determination of the complete structure of the parathyroid hormone has been determined and has led to its successful synthesis. In the field of hematology, the so-called Australia antigen in the blood has been related to both serum and infectious hepatitis. A possible new treatment for sickle cell anemia has resulted from basic research studies by an Institute investigator. Objectives for 1972: Projects underway in 1971 will be continued but no major new projects are planned. The program decrease of $357,000 includes reductions of $347,000 for non-recurring building renovations in 1971 and $10,000 in the Office of Information as part of a government-wide policy to reduce public relations activities. NATIONAL INSTITUTES OF HEALTH National Institute of Arthritis and Metabolic Diseases Program Purpose and Accomplishments Activity: Collaborative Research and Development (Public Health Service Purpose: This activity is designed to make use of the research and development contract as a mechanism to meet special needs where the kind and content of the work required is clear and direct collaboration is sought with specific scientific talent or resources to pursue specific goals. The use of research contracts permits a coordinated, focused, developmental effort to reduce the lag period between development of basic research information and its practical application to human welfare. The Explanation: Three separate programs are conducted within this activity. Artificial Kidney Chronic Uremia Program is focused upon improvement of repeated hemodialysis for patients with permanently impaired kidney function and upon making this therapeutic modality less expensive and more effective. The Endocrine and Diabetes Hormone Developmental Program currently supports the collection, fractionation and distribution of rare, pure hormonal fractions to selected investigators for research purposes. The Scientific Communications Program provides current-awareness publications and other similar materials, conducts retrospective literature searches and initiates conferences and workshops and publishes their proceedings in order to provide up-to-date research information to individual physicians and research scientists. Accomplishments in 1971: Among the achievements of the last year were the development of a new generation of compact artificial kidneys, the so-called "hollow fiber dialyzers". The first of these has been introduced into commercial production after having proven extremely effective and relatively simple and inexpensive in use. A new "envelope dialyzer" has been developed which decreases significantly the set-up time in home dialysis and eliminates the need for complicated sterilization of dialyzers by the patient. The new dialyzers have been very successful in clinical testing and will become available commercially in March 1971. A new selfcontained automatic peritoneal dialysis system has been developed and has been tested clinically. This new system, which will permit hospital center or home peritoneal dialysis, will soon see commercial production. Objectives for 1972: A decrease of $500,000 in the Artificial Kidney Program will reduce the number of active contracts from 65 in 1971 to 57 in 1972, a decrease of 8 contracts. NATIONAL INSTITUTES OF HEALTH National Institute of Arthritis and Metabolic Diseases Program Purpose and Accomplishments Activity: Biometry, Epidemiology, and Field Studies (Public Health Service Act Title IV Part D) Purpose: Epidemiology, the study of population and disease, is recognized by medical scientists as indispensable to the advancement of biomedical knowledge. In essence it deals with the relationships of the various factors which determine the frequencies or distributions of a disease. Explanation: The Institute's Southwestern Field Studies Section, located in Phoenix, Arizona, initiated a long-term program in 1965 in which the development of manifestations of diabetes, arthritis, and gallbladder disease in selected population groups are being studied and evaluated. Various factors, including hereditary, environmental, dietary, and anthropological aspects that may have a bearing on the frequency and severity of these diseases will be investigated. Selected fundings are being contrasted with similar studies performed on other populations with different characteristics or environment. Accomplishments in 1971: Intensive studies of the Pima Indians of the Gila River Reservation, who have been found by Institute investigators to have a diabetes incidence 10 to 15 times greater than that of the country in general, have now made possible a valid separation of individuals with high blood sugar levels into those truly diabetic or latent diabetic, and others in whom high blood sugar levels are merely an expression of attendant obesity. This is a major step forward in investigations of the genetic and all possible environmental factors which could determine the emergence of frank diabetes in such a population. It has also been shown that the majority of Pima females develop gallstones before the age of 30. Thus, the 15- to 25-year age group can now be selected as a study group known to be at very high risk of developing gallstones within a relatively short time. This will permit a statistically valid critical analysis of factors precipitating gallstone formation--a disorder which affects literally millions of Americans. Objectives for 1972: Epidemiological research on the conditions noted above will continue. Obesity and diabetes rates will be studied and compared among the Pimas and other Indian tribes in Arizona. Collaborative studies at the Institute's clinical research unit in Phoenix will be undertaken and will include gallbladder disease, diabetes, and digestive diseases. NATIONAL INSTITUTES OF HEALTH National Institute of Arthritis and letabolic Diseases Program Purpose and Accomplishments Review and Approval of Grants (Public Health Service Act Activity: Purpose: This activity covers the centrally furnished services from the National Institutes of Health management fund and the direct costs of staff and outside advisors engaged in the administration of the Institute's several granting activities. Explanation: The staff participates in the planning and development of programs in research, training, and fellowships that will best serve to accomplish the desired results in the areas of disease interest for which this Institute is responsible; reviews and evaluates research and training grant applications for presentation to the National Advisory Arthritis Council; furnishes required Council staff assistance; maintains liaison with applicants, grantees, other components of NIH and the Department, advisory bodies, and interested organizations, maintains continuous surveillance of scientific activities and progress; and records and reports fiscal and scientific information relevant to all transactions. Accomplishments in 1971: During 1971 the staff reviewed approximately 3,301 grants for scientific merit and program relevance and maintained surveillance over 2,635 grants. Objectives for 1972: In 1972, a continuing effort will be made to strengthen the liaison and surveillance activities in order to obtain maximum benefit from the available grant funds. NATIONAL INSTITUTES OF HEALTH National Institute of Arthritis and Metabolic Diseases Program Purpose and Accomplishments Activity: Program Direction (Public Health Service Act Title IV Part D) Purpose: This activity is comprised of the Institute Director, his immediate staff and administrative management and service personnel who are responsible for the general direction, coordination and administration of the total Institute activities. WEDNESDAY, MAY 5, 1971. NATIONAL INSTITUTE OF NEUROLOGICAL DISEASES AND STROKE WITNESSES DR. EDWARD F. MacNICHOL, JR., DIRECTOR DR. ROBERT Q. MARSTON, DIRECTOR, NATIONAL INSTITUTES OF HEALTH DR. ELDON L. EAGLES, DEPUTY DIRECTOR, NATIONAL INSTITUTE OF NEUROLOGICAL DISEASES AND STROKE ECKART WIPF, EXECUTIVE OFFICER, NATIONAL INSTITUTE OF NEUROLOGICAL DISEASES AND STROKE ROBERT L. SITHENS, FINANCIAL MANAGEMENT OFFICER, NATIONAL INSTITUTE OF NEUROLOGICAL DISEASES AND STROKE JOHN E. SHARKEY, DIRECTOR OF FINANCIAL MANAGEMENT, NATIONAL INSTITUTES OF HEALTH LELAND B. MAY, ASSISTANT DIRECTOR OF FINANCIAL MANAGEMENT (BUDGET), NATIONAL INSTITUTES OF HEALTH CHARLES MILLER, DEPUTY ASSISTANT SECRETARY, BUDGET |