April 4, 2008
NIH Podcast Episode #0055
Balintfy: Welcome to the 55th episode of NIH Research Radio with news about the ongoing medical research at the National Institutes of Health-the nation's medical research agency. I'm your host Joe Balintfy. Coming up in this episode: a look at what happened during Brain Awareness Week; we’ll get an “African Tutorial” from the National Library of Medicine; but first, how prostate tumors act differently in different men. That's next on NIH Research Radio.
(BREAK FOR PUBLIC SERVICE ANNOUNCEMENT)
Biological Factors that Drive Prostate Tumors
Balintfy: Are there biological factors that may drive prostate tumors more aggressively in African-American men than European-American men? Here’s a report from Wally Akinso to address that question.
Akinso: Researchers, at the National Cancer Institute, identified differences in gene expression, the degree to which individual genes are turned on or off, between African American and European-American men that show the existence of distinct tumor microenviroments, which are the areas that includes the tumor and surrounding non-cancerous tissue, in these two patient groups. Dr. Tiffany Wallace, lead author of the study, and her colleagues analyzed differences in gene expression in prostate tumor from 33 African-American and 36 European-American men.
Wallace: Well there's a huge health disparity that's associated with prostate cancer. Social economic factors do contribute to some of these differences but they don't completely explain the increased aggressiveness, mortality rates that exist for African American men when dealing with prostate cancer. And so we investigated the hypothesis that there are differences in tumor biology that exist between African American men and European American men.
Akinso: Researchers analyzed the expression of genes in non-cancerous prostate tissue from African-American and European-American men. They found that differences in the expression of genes related to immune system function were more prominent in the tumor microenvironment than in non-cancerous prostate tissue. Dr. Wallace talks about what the results suggest and the implications of the research.
Wallace: Well it seems that there could be differences in tumor biology that can contribute to the increased aggressiveness and incidence in prostate cancer specifically with the African American population. As far as implications for this research, although these are preliminary we think that the differences in immune response could have important implications for prostate cancer therapy approaches.
Akinso: She adds that in future studies, researchers hope to investigate why gene expression profiles in prostate tumors from African-American men contain changes associated with immune responses. This is Wally Akinso at the National Institutes of Health, Bethesda, Maryland.
Balintfy: Recently Wally and I had a great time covering Brain Awareness Week for Eye-on-NIH, our monthly Vodcast. Here’s a taste of the fun that was had:
Michael Jones: We had a lecture about brain, how to keep your brain healthy and safe.
Female Speaker: It was real interesting. And I got to hold the brain.
Amber Rawls: I liked the drunken brain.
Female Speaker: My favorite part was the visual part.
Balintfy: Several busloads of students took a special, spring trip to the National Museum of Health and Medicine at Walter Reed Army Medical Center for more than a tour:
Andrea Schierkolk: This week we're hosting Brain Awareness Week, and it's for middle school students and so what we do is we had invite partners in education to come to the Museum, and provide hands-on activities for the students.
Balintfy: Andrea Schierkolk, Public Programs Manager of the National Museum of Health and Medicine says a long list of partners includes several institutes from the National Institutes of Health.
Andrea Schierkolk: The National Institute on Neurological Disorders and Stroke actually organized the National Institutes of Health who are participating this year, and they have done a fabulous job of bringing everyone together and sharing our brain studies and the vast amount of knowledge in these Institutes with the public.
Balintfy: Of the seven special exhibits from five difference NIH institutes, one of the most popular was sponsored by the National Institute of Alcohol Abuse and Alcoholism.
Dr. Dennis Twombly: …the basic premise is to explain some of the things that are going on in the brain when somebody becomes intoxicated, as well as some of the processes involved in the addictive process with long-term heavy alcohol abuse.
Balintfy: Dr. Dennis Twombly, a program director at NIAAA, describes his display:
Dr. Dennis Twombly: Well first off, I have a model brain that's created out of chicken wire and flashing Christmas lights, and I use that to explain different regions of the brain and how they are affected by alcohol, as well as how brain cells communicate with one another, and how alcohol changes firing rate and distribution of signals in different areas of the brain.
Balintfy: Roger Sorensen, a colleague at the National Institute on Drug Abuse had a similarly fun set-up, called “Roger’s Party”...
Dr. Roger Sorensen: So at my booth, I just try to point out certain brain regions that are responsible for the affects of, the rewarding affects of drugs and alcohol, for those who choose to use drugs or alcohol. And then their ability, the brain region, to make a decision on whether they should, indeed, try to use drugs and alcohol. Then we have a little game, since this is my party, and a party should have games. And at my game and my party we have goggles. The goggles distort vision, such that to mimic on whether you have taken too much alcohol, for example. I always tell the kids that, although it distorts the vision, they still can think clearly. They do not have alcohol in their brain, so they can think. And we walk through a maze with the distorted vision on and they have a lot of fun with that.
Balintfy: Vanessa Kalter-Long, a middle school middle school science teacher in Washington D.C. says that the combined event was an enlightening experience.
Vanessa Kalter-Long: I think that this exhibit allows the kids to do something they would never be able to do. They just held a brain, and to those students, we don't have all the resources necessarily for me to be able to have someone bring a brain to them. So for them to come here, hold a brain, experience what it's like to see how things influence the brain, to be able to look at optical illusions, all the high-tech equipment to be in this environment, it's not something that we necessarily have access to on an everyday level, so I highly recommend people bring in their students here.
Balintfy: Brain Awareness Week is every year in March. For more information on it, visit brainweek.dana.org. To visit the museum, go to nmhm.washingtondc.museum. And for the latest on brain research, visit ninds.nih.gov.
Also to see the video of this report, go to www.nih.gov/news and look for the link on the left that says NIH Vodcast.
When we come back, an interview about how efforts here at NIH, reach all the way to Africa…
When we come back, an interview about how efforts here at NIH, reach all the way to Africa…
(BREAK FOR PUBLIC SERVICE ANNOUNCEMENT)
Balintfy: For an Eye-to-Eye interview, we sat down with Julia Royall of the National Library of Medicine. We asked about the Medline Plus African tutorial. Specifically, why did the National Library of Medicine decide to undertake this ambitious project?
Royall: For a while, NLM has been interested in consumers - end users - how they get their information. If they use it, do they use it to really make behavior change and have better health as a result?
So the thought was, since we do a lot of outreach work in Africa, why don’t we make a tutorial that would work there? But rather they make something here for Africa, the idea was to make something in Africa collaborating with folks there. So, we worked with the medical school at Makerere University in Kampala, Uganda, and also Ugandan artists who were in Kampala, and made a version of a Medline Plus tutorial about malaria, which is quite different from the Medline Plus malaria tutorial that you see on the web site that’s geared for American audiences going abroad, about how not to catch malaria and how to treat it. Well this one, in Africa, had to be geared for people in villages being able to understand that the mosquito is the vector, and take precautions against getting malaria so they can prevent it, as well as when they do get treated for it, following the treatment properly.
So, it was a big challenge for everyone, and the medical students deserve huge amounts of credit for going into villages, talking with people, finding out what their concerns about malaria were, thinking, for example, that mangoes caused malaria, or maize – corn - causes malaria. Well, mangoes come during the rainy season and so that’s -- and when it rains there’s a lot of water that’s not absorbed that stays around in puddles, and that’s where mosquitoes can breed. So, it does make sense as part of the process, but it’s not like if you eat a mango you get malaria.
So, it was a long process and a very iteratative kind of process of going back and forth with the team here at NLM that makes Medline Plus and the team in Africa and Uganda that was working on the ground. So we’d go back and forth with various versions, various questions, and then the one in Uganda was also translated into Luanda, Rukiga, and Luo, as well as English. So, there are several versions that can be used, played on radios, played in clinics. We’re finding a lot of uses for it because we’re looking at a proactive kind of outreach approach.
Balintfy: Can you describe the tutorial in greater detail?
Royall: The tutorial exists in several forms. It exists as an online interactive tutorial that you access via the internet. It exists as a booklet, a hardcopy version, sort of laminated version that a health worker could use to go through with clients and explain to them how malaria works and how you prevent it, how you get it, how you treat it. There are also posters that can be used in health clinics. When i visit health clinics like the smallest ones at the end of the line, the health officer always tells me, “what we really need are visual aids.” Because people come, hundreds of them might come in the morning to wait around, and they wait around, you know, much of the day, waiting to see a doctor. And while they’re waiting around, you have all that time to have an educational moment. So we hope they’ll be used that way.
The illustrations and the text were -- and they’re very simple --- were actually agonized over so that everything in an illustration communicated the message. So, even if you couldn’t read the text, you could still look at the picture and get the message.
Balintfy: Can you describe the collaboration you started with librarians in Uganda to help students obtaining their master’s degrees and learn how to search the NLM databases?
Royall: As you know, NLM has fabulous resources. We have wonderful databases. We have access to full text articles, not everything, but certainly a lot of access to full text. There’s Medline, you know, the largest biomedical database in the world, all peer-reviewed. Medline Plus, it’s great information, it’s always being reviewed by people here. So not only is there a lot of information and it’s free, but it’s good, it’s been looked at, it’s been reviewed. So, unfortunately a lot of people even here don’t know about these riches and wonders. Oh, and then there are databases like clinicaltrials.gov, which has clinical trials from all over the world in it. Wonderful. Of surgery, videos of surgery. A whole database on surgeries.
So there’s just a lot of stuff. So you’ve got all of that, this kind of gold mine, and then you’ve got students who have come to get master’s degrees. And then you’ve got a library, which is a building. And the library might have a workshop where people come into the library or people are invited to come in and learn. But we found that that’s a very kind of passive way to train people or to show people what’s available.
So we, the librarians and I, went directly to one of these master’s students classes and there are 70 people in it. And we said, “how many of you have used Medline?” Well, not many. “how many of you know about Medline Plus? Or clinicaltrials.gov?” And so on. And very low numbers. And we said, “well, we’re here to tell you that we are happy to help you find out about these resources. When could you come to a workshop? And they said, “we could come on the weekend.” So we said, “okay, we’ll organize one this weekend and one next weekend. How many are coming this weekend? How many are coming next weekend?” And they came.
And then we would show them databases, but we would also say, okay, say one of them might be interested in sickle cell, really help them work through what we were showing them using sickle cell, so that they’re working on something they are really interested in and that they will use.
And then after that, we went back to the class and said, “how are you all doing?” And they said, “we’re doing okay.” And we said, “would you like to come back for more one-on-one instruction?” And some of them definitely wanted to do that. So, they started coming back at lunchtime, and the librarians would help them one-on-one.
Balintfy: This is the midpoint of your term as a Fulbright scholar and you’re heading back to Uganda. What has this experience meant to you personally?
Royall: I think it’s fabulous to be immersed in the field. Granted, i have a round-trip ticket, so I can never experience exactly what my colleagues in Uganda experience. But, I can get some of the experience. I am now very used to blackouts, power outages, internet fluctuations, internet that’s not very good, and those things make getting things done difficult from time to time. And i wanted to learn -- i wanted to experience that firsthand, so i could walk in their shoes if you will. That’s been a real privilege to do that.
And at the same time, the students, the doctors, the folks i work with have energy, they have creativity, they have hope, that’s inspiring.
Balintfy: For more information on the tutorials, visit www.nlm.nih.gov/medlineplus/africa.
For more information about the National Library of Medicine visit www.nlm.nih.gov
Balintfy: And that’s it for this episode of NIH Research Radio. Please join us again on Friday, April 18th when our next edition will be available for download. I'm your host, Joe Balintfy. Thanks for listening.
NIH Research Radio is a presentation of the NIH Radio News Service, part of the News Media Branch, Office of Communications and Public Liaison in the Office of the Director at the National Institutes of Health in Bethesda, Maryland, an agency of the US Department of Health and Human Services.