Armed Forces Institute of Pathology
The Armed Forces Institute of Pathology, a tri-service organization on the Walter Reed campus, is the nation’s leading laboratory for pathology. The AFIP’s wide-ranging mission includes research, consultation, and education to serve the military and the civilian community worldwide.

The AFIP is an international resource in the field of diagnostic pathology in medicine, dentistry, and the veterinary sciences, with a combined staff of almost 800 military, federal civilian, and contract employees. It is the reference center in pathology for the Departments of Defense and Veterans Affairs.

AFIP’s Directorate for Advanced Pathology, the heart of the institute, includes 27 departments and four groups. Each year, the institute receives more than 50,000 difficult cases for second-opinion consultation. More than half are from active-duty service members or their family members. AFIP’s pathologists make major or minor changes in diagnosis in nearly half these cases, many of which present potentially high-risk medico-legal problems.

The directorate’s other departments study aspects of pathology from molecular levels to skin (dermatopathology) and everything in between. The center leads or collaborates on many Department of Defense Health Affairs-directed medical programs. This involvement reflects the staff’s world-class reputation in the world of pathology. Further evidence is the numerous honors, lectureships, and special awards they receive, and the offices they hold in national and international societies.

The largest department in the AFIP is the Armed Forces Medical Examiner System. The AFMES is responsible for conducting forensic medico-legal death investigations for the Department of Defense and other federal agencies. Specialty divisions include the Forensic Toxicology Division, the Mortality Surveillance Division, and the DoD DNA Registry. The Forensic Toxicology Division is also responsible for providing quality assurance and quality control for the entire Department of Defense Drug testing program.

In education, the AFIP staff is devoted to teaching physicians worldwide about emerging diseases, the various tumors they encounter, toxic agents in the environment and the molecular components of disease. The AFIP offers nearly 70,000 hours of continuing medical education annually and in 2003 offered more than 62,000 contact hours, including distance-learning programs. Additionally, almost all the radiology residents in the United States and even some from overseas attend our six-week radiology pathology correlation course.

In research and development, AFIP experts examine or develop new technologies and procedures to deliver the best possible patient care in diagnostic pathology. Much of the approved research is in collaboration with other healthcare entities in government, academia and industry.

The AFIP evolved from the Army Medical Museum, which was founded in 1862 to undertake a systematic collection and study of the anatomical and disease-related specimens produced as a result of the Civil War.

From 1893 to 1902, the museum’s curator was Maj. Walter Reed while he was also a faculty member of the Army Medical School. During its first session, he taught clinical and sanitary microscopy and was the director of the pathological laboratory. The museum became the National Museum of Health and Medicine in 1989. While always located in Washington, D.C., it has moved several times and is now on the campus of Walter Reed.

Today the museum – the ‘‘soul” of the institute and the successor to the founding Army Medical Museum – preserves, collects and interprets the objects, specimens, photographs, and documents chronicling the history and practice of medicine over the centuries. Among the most popular anatomical specimens and historical artifacts on display are those related to President Abraham Lincoln. These include the bullet that ended his life, the probe used to locate the bullet, the bloodstained cuffs from the museum surgeon who attended the autopsy and bone fragments from Lincoln's skull. The Museum also highlights the evolution of military medicine in its public programs and exhibitions.

The museum’s interactive exhibits and historical collections document the history and practice of medicine over the centuries. It hosts health fairs on the first Saturday of every month and offers guided tours to walk-in visitors at 1 p.m. on the second and fourth Saturday of each month and many other public programs throughout the year. The museum is in Bldg. 54 on the Walter Reed main campus and is open from 10 a.m. to 5:30 p.m. every day of the year except Dec. 25. Phone 202-782-2200 or visit its Web site at www.nmhm.washingtondc.museum.

For more information about the AFIP, visit the Web site at www.afip.org, or contact the AFIP Public Affairs Office at (202) 782-2113 or 2115.

Armed Forces Pest Management Board
The Armed Forces Pest Management Board, or AFPMB, is a Department of Defense function under the direction of the Office of the Deputy Under Secretary of Defense for Installations and Environment. AFPMB ensures deployed combat forces have the most effective disease vector control and pest management capabilities to prevent adverse effects on troops, weapons systems, supplies, equipment and installations, using environmentally sound techniques to reduce risk.

A senior officer selected from one of the military service branches directs AFPMB; duty rotates among the services. Army, Navy, and Air Force officers and scientists staff it jointly. The AFPMB offices, located at Forest Glen, include two sections: the Directorate and the Defense Pest Management Information Analysis Center.

The AFPMB Web site is www.afpmb.org.

Center for Prostate Disease Research
The Center for Prostate Disease Research Clinical Trials Research and Treatment Center at Walter Reed provides the most advanced clinical research and treatment for patients with prostate cancer and disease. This direct patient-care facility enhances the center’s ability to conduct clinical research, expand its database, and continue its education and training programs.

Congress established the CPDR in 1991 to help combat the increasing rate of prostate disease. The program now manages the largest, most comprehensive prostate cancer database in the country and has made several landmark research findings that have helped to improve diagnosis and treatment in the past decade.

This Department of Defense program is affiliated with the Uniformed Services University of the Health Sciences, the Armed Forces Institute of Pathology, the Henry M. Jackson Foundation for the Advancement of Military Medicine, and Army, Navy, and Air Force medical centers throughout the United States.

For more information about the CPDR and its programs, visit our Web site, www.cpdr.org.

Comprehensive Breast Center
The Walter Reed Comprehensive Breast Center, located on Ward 55 of Bldg. 2 (main hospital), is an outgrowth of the Clinical Breast Care Project, a congressionally mandated military-civilian collaboration. The Breast Center provides breast cancer screenings, diagnostic procedures, comprehensive serviBroad in scope and research-centered, the Breast Center provides all patients with the opportunity to participate in clinical studies aimed at understanding the genomic (genetic) changes that occur in all breast cancers. Breast cancer patients receive treatment from all their health care providers in the center, avoiding unnecessary multiple visits and clinic appointments. The center’s Risk Reduction Program specializes in identifying women who are candidates for its prevention approaches.

The most modern conference and video-teleconferencing facilities in the Breast Center link its health care providers to its off-site research locations, ensuring strong collaborations between the people treating the patients and the researchers looking for new approaches in the cure for breast cancer.

Defense and Veterans Brain Injury Center
The Defense and Veterans Brain Injury Center is a group of seven traumatic brain injury programs in Department of Defense and Department of Veterans Affairs hospitals and a civilian TBI rehabilitation program. DVBIC sites collaborate to provide services and support to help active-duty service members, veterans and their eligible beneficiaries with TBI return to duty, work and community. Our goal is to provide expert case management and to ensure individualized, evidence-based treatment for each patient to maximize function and decrease or eliminate disability.

Traumatic brain injury is a major cause of life-long disability and death. In earlier wars, TBI accounted for at least 14 percent of surviving combat casualties; preliminary information from Operation Iraqi Freedom suggests this number is now much higher. Blast injuries are a growing cause of TBI in combat.

In addition to its headquarters at Walter Reed, DVBIC sites are located in California, Florida, Minnesota, Texas and Virginia, with additional research programs in California, New York and North Carolina.

Visit www.DVBIC.org for updates on clinical treatment, research and educational programs⁄materials available from DVBIC.

Deployment Health Clinical Center
The Deployment Health Clinical Center is a comprehensive, tri-service outpatient program which serves returning service members and family members who are experiencing post-deployment health concerns. It works with its patients, their families and their doctors to find answers, improve health care and enhance the quality of life after military deployments.

The center offers a caring program that includes medical evaluation and treatment, veteran and clinician education, and strategies for improving the quality of post-deployment health care delivered within all Department of Defense health care facilities.

The skilled DHCC health care team of internists, nutritionists, occupational and physical therapists, psychologists, social workers, psychiatrists, chaplains, and other specialists operates the nation's only Specialized Care Program for service members returning from deployments. This intensive, three-week, outpatient program offers a multidisciplinary treatment approach in a comfortable small group setting to those affected by persistent and often unexplained symptoms.

The center’s Web site, www.pdhealth.mil, provides the most up-to-date deployment health information available for service members, family members, health care providers and everyone who cares about veterans.

National Capital AreaMulti-Service Market Office
The National Capital Area Multi-Service Market Office is a staff agency for the Walter Reed commander in his role as the senior market manger of the National Capital Area. The office is responsible for developing a single, integrated business plan for the many military medical treatment facilities in the National Capital Area. The commands that compose the National Capital Area include Walter Reed Army Medical Center, National Naval Medical Center, Malcolm Grow Medical Center, DeWitt Army Community Hospital, Kimbrough Ambulatory Care Center,

11th Medical Group and Naval Medical Clinics in Annapolis, Patuxent River and Quantico. The MSMO's business planning includes integrated plans for appointing services in the National Capital Area, resource sharing among the military services and with contractor support, optimization initiatives and sharing opportunities between the Department of Defense and Department of Veterans Affairs.

The office was activated in September 2004 and is part of the TRICARE revisions in governance established with the next generation of TRICARE contracts. It is located in Wing C on the second floor of Bldg. 1 (old hospital).

Naval Medical Research Center
The Naval Medical Research Center’s mission has remained the same since it was established in 1942 as the Naval Medical Research Institute: to enhance the health, safety, readiness and performance of Navy and Marine Corps personnel. NMRC and its subordinate laboratories conduct basic and applied biomedical research in infectious diseases, biological defense, combat casualty care, bone marrow, and military operational medicine. In addition, NMRI and its overseas laboratories support global surveillance, training, research and response to emerging infectious disease threats as part of the expanded Department of Defense Mission.

The original research institute was a tenant command of the National Naval Medical Center in Bethesda, Md. It was disestablished on Oct. 1, 1998, and the Naval Medical Research Center was established as a headquarters command with responsibility for the Navy Dental Research Institute at Great Lakes Naval Base, Ill.; the Navy Infectious Disease Research Commands in Cairo, Egypt, and Jakarta, Indonesia; and the Navy Infectious Diseases Detachment in Lima, Peru.

From the beginning, the institute’s research focus included heat stress and exposure limits for hot and humid shipboard environments. It also studied safety equipment, including protective clothing, flight goggles, safety belts, and repellents for sharks and for insect vectors of disease. NMRI studied the Japanese survivors of the atomic bomb and became deeply involved in developing methods for treatment of radiation exposure. These efforts led to the establishment of the Armed Forces Radiobiology Research Institute.

During the 1950s and 1960s, the institute became involved in training monkeys, and later human astronauts, for space flight. It also developed a telemetry suit for transmitting astronauts’ physiological data. The Navy Tissue Bank was established at NMRI, developing freeze-drying techniques for preserving tissue for grafting and other reconstructive surgery. During the Vietnam War, thousands of wounded Soldiers were treated with tissue that was collected, preserved and shipped from the Navy Tissue Bank.

The National Marrow Donor Program was established in 1986 with the Navy as lead contracting agent. In 1990, the C. W. Bill Young Marrow Donor Recruitment and Research Program became a permanent part of the NMRI scientific regimen. In 1990-91, NMRI scientists became involved in biological defense research. In 1995, USA Combat Developer selected biological defense rapid assays developed by NMRI as its technology of choice. The institute’s biological defense scientists helped UNSCOM inspectors determine evidence for Iraqi weaponization of biological threat agents.

In 1995, a space shuttle Discovery payload included an experiment developed by NMRI Immune Cell Biology Program scientists investigating the growth and development of bone marrow stem cells. That same year the Endeavor included a second set of experiments developed by NMRI scientists. In 1997, NMRI immune cell biology scientists collaborated with university and private-sector partners to test novel medical therapy to prevent rejection of transplanted organs.

Our research continues in the Daniel K. Inouye Building, co-located with the Walter Reed Army Institute of Research in the Forest Glen section of Silver Spring, Md.

North Atlantic Regional Dental Command
The North Atlantic Regional Dental Command is responsible for providing dental care to active-duty beneficiaries in 21 states and the District of Columbia. It also coordinates dental readiness and wellness and provides professional fillers to the Active and Reserve Components and to multi-component units throughout the region. The command provides dental support at nine power-projection platforms in the region as part of mobilizing and demobilizing Soldiers of the Army Reserve and National Guard. It also provides dental services in 33 dental clinics on 22 installations in the region.

The command has subordinate dental activities, or DENTACs, at Fort Bragg, N.C.; Fort Drum, N.Y.; Fort Eustis, Va.; Fort Knox, Ky.; Fort Meade, Md.; West Point, N.Y.; and at Walter Reed. In addition, there are three dental clinic commands, at Carlisle Barracks, Pa.; Fort Lee, Va.; and Aberdeen Proving Ground, Md.; and 12 U.S. Army Reserve annual training sites. The command headquarters is in Bldg. T-20.

North Atlantic Regional Veterinary Command
The North Atlantic Regional Veterinary Command is responsible for food inspection and animal care in Washington, D.C., and the same 21 northeastern states as the region’s medical and dental commands, plus a unit in the Azores.

As in the rest of the Army, the primary mission of the Veterinary Corps is food inspection for such activities as dining facilities, commissaries, and snack bars.

NARVC veterinarians also provide care for military working animals, such as bomb and drug detection dogs, the mascots of the Army and Navy military academies, and the horses that pull the caissons for traditional military funerals at Arlington National Cemetery. They also provide limited veterinary care to eligible beneficiaries at veterinary treatment facilities on Army, Navy, and Air Force installations in the 21-state region.

NARVC has four subordinate commands: the Allegheny District at Carlisle Barracks, Pa.; the Mid-Atlantic District at Fort Eustis, Va.; the National Capital District at Fort Belvoir, Va.; and the Northeast District at Fort Monmouth, N.J. The command’s headquarters is in Bldg. 1 (old hospital) on the main Walter Reed installation.

U.S. Army Dental Activity Walter Reed
The U.S. Army Dental Activity Walter Reed is a subordinate command of the North Atlantic Regional Dental Command and the U.S. Army Dental Command.

The DENTAC coordinates dental services for the National Capital Area, including Walter Reed, Fort Belvoir, Fort Myer, the Pentagon, and Fort McNair.

Priority of care goes to active-duty service members. Care for other beneficiaries is limited to treating emergencies and supporting Walter Reed inpatients and medically compromised patients. Limited resources do not generally allow DENTAC clinics to give standby or space-available care to otherbeneficiaries.

Dental care includes a full range of diagnostic, consultative and restorative dental services. Dental specialty support includes oral medicine, oral and maxillofacial pathology, comprehensive general dentistry, endodontics, periodontics, pedodontics, orthodontics, prosthodontics, and oral and maxillofacial surgery.

Teaching is an integral part of the DENTAC mission. The command provides residency training in oral and maxillofacial surgery through its affiliation with the combined Army-Navy Oral Maxillofacial Surgery Residency Program. It also offers an annual postgraduate dental continuing education course in oral diagnosis, oral medicine, and oral pathology; and a biennial postgraduate course in oral and maxillofacial surgery. It provides speakers for dental continuing education programs sponsored by the Navy Postgraduate Dental School in Bethesda, Md., and the Armed Forces Institute of Pathology on the Walter Reed campus. These programs, in conjunction with clinical research and consultation, enhance the clinical skills ofArmy Dental Corps officers and other dentists throughout the United States.

U.S. Army Physical Disability Agency
The U.S. Army Physical Disability Agency is a field agency of the U.S. Army Human Resource Command. It manages the Army’s physical disability evaluation system and provides prompt processing of Soldiers who must leave the Army because of a service-connected disability.

The agency develops and implements policies, procedures and programs related to physical disability issues and makes sure applicable laws, policies and directives are interpreted uniformly. By reviewing physical evaluation board proceedings, the USAPDA also ensures that Soldiers’ cases are decided fairly and are substantially the same as members of other services under similar conditions.

The agency operates three Physical Evaluation Boards: at Walter Reed; at Fort Sam Houston, Texas; and at Fort Lewis, Wash. The board at Walter Reed is co-located with the USAPDA and is on the second floor of Bldg. 7. More information about the USAPDA is available by clicking on ‘‘Physical Disability Evaluation System” at the agency’s Web site, https:⁄⁄www.perscomonline.army.mil⁄tagd⁄pda⁄pdapage.htm

U.S. Military Cancer Institute
The United States Military Cancer Institute is a tri-service, collaborative endeavor to enhance patient care and research among military beneficiaries. The headquarters is in Bldg. 1 (old hospital) at Walter Reed. The institute is composed of military cancer specialists and civilian scientists from the medical departments of the Army, Navy and Air Force. They are working together to answer important questions about the cause and treatment of cancer.

A particular interest of the institute is the area of cancer epidemiology, prevention and control. It chose this focus because prevention of cancer is better than its treatment, even when the treatment is successful. Prevention lessens suffering, preserves the wellness of the military, and decreases the economic costs of this disease.

For further information, consult our Web site, www.usmci.org.

Walter Reed Army Institute of Research
The Walter Reed Army Institute of Research is the oldest and largest of the laboratories in the U.S. Army Medical Research and Materiel Command. It was founded in 1893 as the first school of preventive medicine in the United States and has evolved into the military’s premier biomedical research laboratory. Its primary focus is on research that delivers life-saving products to the war fighter.

Today WRAIR pursues a research program extending from basic research through product development. This includes research on military-relevant infectious diseases, combat casualty care, operational medicine, field medical and dental care, and equipment development and medical defense against chemical and biological agents.

In the study of infectious diseases, basic research is aimed at understanding the molecular biology of agents that causemilitarily important diseases such as malaria, hepatitis, and dysentery. Research in epidemiology and immunology complements these studies. The goal is to understand these mechanisms and then to rationally design products and strategies that will prevent exposure and infection.

Basic studies in neurophysiology and behavioral psychology seek to discover determinates of behavior and response to stress and sleep deprivation. The object is to understand and prevent combat psychiatric injuries and to enhance performance.

Since its inception, the institute has sought practical answers to military medical problems through its range of research capabilities. This range extends from basic exploratory efforts to advanced development capability in collaboration with units of the Army’s Medical Research and Materiel Command, academia, and the pharmaceutical and biotechnology industries.

Medical research in genomics and proteomics for modern vaccine development is immediately applicable to disease prevention measures. For example, work continues in the development of genetically engineered vaccines to prevent diseases such as malaria and shigellosis. Much of this work also has application in the civilian world.

Also in active development or testing are vaccines for dengue fever, hepatitis-E, malaria, shigellosis, and AIDS. Each of these vaccines has been at some stage of human testing trials. Field tests of drugs and vaccines in military and civilian populations provide important final evaluations of their ability to prevent disease.

Much of WRAIR’s work takes place in its main laboratory in Bldg. 503 at the Walter Reed Army Medical Center’s Forest Glen section in Silver Spring, Md. Collocated with it is the Naval Medical Research Center (see separate listing above). Elements of the institute have operated beyond the main campus since Maj. Walter Reed led the Yellow Fever Commission to Cuba from 1900 to 1901. WRAIR special field activities are currently in Thailand, Kenya, and Germany. Research in these laboratories provides critical knowledge to protect war fighters deployed overseas.

WRAIR is also responsible for scientific and administrative oversight of laboratories that focus on directed energy bio-effects, military dentistry, and operational stress. The directed energy detachment is co-located with the Air Force at Brooks City Base in San Antonio, Texas. The Dental Detachment is co-located with the Navy at Great Lakes Naval Base.

Complementing the successful in-house research produced by WRAIR is its responsibility for managing a broad program of external research. Contracts with leading university and industrial laboratories greatly expand the Medical Research and Materiel Command’s capability in neuropsychiatry, combat care, and infectious disease and drug development research.

The Walter Reed Army Institute of Research, through a combination of teaching, research, and product development, exemplifies preventive medicine in its broadest context: identifying potential medical threats, developing specific prevention and treatment methods, instructing others in their application, and constructing drugs and vaccines which simplify the task of conserving the fighting strength.

The institute still maintains an educational mission by hosting residencies and fellowships in military preventive medicine, military medical research, clinical pharmacology, and others. High school and middle school science programs educate local students about scientific research through hands-on activities and laboratory participation. Phone (301) 319-9259 or 7195 for more information.