What does a bar of soap have to do with health care marketing?

In today's competitive health care market, product/service marketing will become the key to survival. This article introduces a new way of using an established marketing concept. Product/service marketing is based on promoting services that fulfill a number of requirements, including being highly visible and a foundation for the later development of an overall marketing plan. Choosing the products/services to be marketed and developing the marketing program are discussed.

Antigenic variation among members of the tick-borne encephalitis complex

The antigenic relationships between seven members of the tick-borne encephalitis complex of flaviviruses (group B arboviruses) were examined by raising a library of 16 monoclonal antibodies against one of them and examining their biological and antigenic properties. These clones reacted with only one of two intracellular, virus-specific polypeptides. One polypeptide [mol. wt. 58 X 10(3) (58K)] is related to the major envelope protein E, but the identity of the other is at present unknown, even though it is a major immunogen in experimental infections and vaccinations. Only those clones specific for the 58K polypeptide contain either neutralizing or haemagglutinin-inhibiting activity, but these epitopes are not identical. In general, epitopes on the 51K polypeptide were more heavily conserved than those on the 58K polypeptide, although both conserved and variant epitopes were found on both polypeptides. One epitope was present on the 51K polypeptide which was conserved on all seven isolates studied and another epitope on the same polypeptide was specific for all the western isolates including one isolate of louping-ill virus. Using the monoclonal antibodies raised in the study, it was shown that louping-ill virus was closely related antigenically to isolates of the Western subtype of tick-borne encephalitis virus.

The glutaraldehyde-stabilized porcine aortic valve xenograft. I. Tensile viscoelastic properties of the fresh leaflet material

The tensile viscoelastic properties of radial and circumferential strips of fresh porcine aortic valve leaflets have been examined and compared with the fiber architecture of the leaflets as seen in the scanning electron microscope. The leaflet material showed nonlinear viscoelasticity, largely independent of strain rate, and dependent on the degree of preconditioning by cyclic loading. Preconditioning to a stable stress-strain response could only be accomplished on 1-cm-long strips above a minimum width of 4 mm (circumferential) and 6 mm (radial). Preconditioning yielded a more elastic and extensible material with reduced hysteresis. The leaflets were markedly anisotropic. Circumferential strips were up to 8 times stronger and stiffer than radial strips, and displayed greater stress relaxation and less creep. The circumferential mechanical properties were due to well-aligned circumferential collagen bundles reinforcing the composite structure, while radial properties were due to a more random collagenous support throughout the leaflet. Despite the presence of a septal shelf on the right coronary leaflet, no mechanical differences could be discerned between leaflets.

Cyclo(Leu-Gly) has opposite effects on D-2 dopamine receptors in different brain areas

Cyclo(Leu-Gly) (cLG), a diketopiperazine analog of Pro-Leu-Gly-NH2 (MIF), affects a number of physiological and behavioral responses to the endogenous neurotransmitter, dopamine (DA). In the present series of experiments, the effect of in vivo administration of cLG (8 mg/kg) was investigated five days following subcutaneous administration. It was found that cLG administration of cLG (8 mg/kg) was investigated five days following subcutaneous administration. It was found that cLG administration caused a supersensitive behavioral response, measured by increased stereotypic sniffing, to the DA agonist, apomorphine (APO). At the same time, an increase was found in the affinity for dopamine (DA), as measured by dopamine inhibition of 3H-spiroperidol binding to D-2 DA receptors in striatum (nigro-striatal DA tract). In contrast, the same peptide treatment caused a subsensitive physiological response to APO-induced hypothermia, concomitant with a decrease in affinity for dopamine, as measured by DA inhibition of 3H-spiroperidol binding to D-2 DA receptors in hypothalamus (incerto-hypothalamic DA tract). These results suggest that a single neuromodulatory agent, the peptide cLG, can elicit diametrically opposite effects on D-2 DA receptors and on the corresponding physiological endpoints in two different brain areas.

The glutaraldehyde-stabilized porcine aortic valve xenograft. II. Effect of fixation with or without pressure on the tensile viscoelastic properties of the leaflet material

We have examined the tensile viscoelastic properties of circumferential and radial strips of porcine aortic valve leaflets following fixation in glutaraldehyde and formaldehyde, with or without pressure. After aldehyde treatment, the radial strips remained weaker and less stiff than circumferential strips and responded slightly differently to the treatment. After fixation, with or without pressure, the radial strips showed large changes in stress-strain and hysteresis responses due to initial loading, and there was a twofold reduction in tensile strength and final stiffness. For strips in both directions, fixation without pressure produced doubled extensibility and a ramping stress-strain curve. Permanent (plastic) deformation of 5-20% occurred as a result of cyclic loading, stress relaxation, and creep experiments. Pressure fixation, however, produced little change in stress-strain results other than a simple shift to lower strain and produced no plasticity. Both methods of fixation reduced stress relaxation and creep. Mechanical test results are consistent with a loss of ground substance matrix during fixation. Reductions in tensile strength after fixation may be due to "riveting" of collagen geometry, producing local stress concentrations.

[Anesthesia for transsternal thymectomy in myasthenia gravis]

Twenty-seven patients with generalized myasthenia gravis (moderate, severe and acute fulminating forms) who underwent thymectomy were studied. The effects of several anesthetic agents were analyzed with special attention being given to immunologic considerations. The authors conclude that the association of ketamine, tiapride, droperidol, fentanil and nitrous oxide allowed fast recovery of consciousness and spontaneous respiration, and made safe extubation possible before leaving the operating room.

A model for design of health administration curriculum and instruction

Faculty members in health administration programs as in other professional programs tend to be trained in content appropriate to their field rather than as educators. Enhancement of the teaching skills of faculty will potentially improve the quality of the students' educational experience. Of particular note is the tendency of faculty to teach at the basic knowledge level and expect students to perform at the application and problem-solving levels. The purpose of this paper is to aid faculty in health administration improve their teaching activities and student evaluation. This goal will be accomplished through presentation of a model for systematic design of curriculum application of this model at the course and lesson levels.

Alcohol dehydrogenase isozymes in grain sorghum (Sorghum bicolor): evidence for a gene duplication

Two sets of alcohol dehydrogenase (ADH) bands are regularly observed in grain sorghum (Sorghum bicolor): set I is a permanent triplet; set II is variable, as either two or three bands. A faint set III is detected only when extracts from seeds subjected to anaerobiosis are run in neutral pH gels. Dissociation-reassociation experiments reveal that the central band of the set I triplet is a heterodimer of the other two. Full-sib progeny analysis from self-fed plants shows that the set II bands are doublets, with heterozygotes having only three apparent bands instead of four because of the similar mobilities of the fast-migrating isozyme specified by the slow allele and the slow isozyme specified by the fast allele. We propose a three-locus model as the best explanation of these patterns. Set I consists of the products of two loci and their intergenic heterodimer. Set III is specified by a third locus. Set II isozymes are the intergenic heterodimers of the two set I loci and the set III locus. This explanation is similar to that of Schwartz and Freeling for maize but suggests that the evolution of Sorghum includes a gene duplication of the homologue of the Adh-1 locus in Zea.

Cyclo(Leu-Gly) attenuates the striatal dopaminergic supersensitivity induced by chronic morphine: agonist binding to D2 dopamine receptors correlates with stereotypic behavior

We have previously shown that MIF and its structural analog, cyclo-(Leu-Gly), block analgesic tolerance and some signs of physical dependence following chronic opiate administration. The mechanism of action of these peptides has not been clearly elucidated. The data presented here suggests that chronic opiate administration causes a behavioral supersensitivity to dopamine (DA) agonists which is highly correlated with an increase in D2-Hi receptor affinity for DA agonists, but not antagonists. Both the behavioral and receptor changes are blocked by prior administration of cyclo(Leu-Gly). This suggests that the ability of cyclo(Leu-Gly) to block the development of opiate addictive states may involve DA synaptic elements.

Peptide inhibition of morphine-induced dopaminergic supersensitivity

Injection of the peptide cyclo(Leu-Gly) into rats prior to chronic exposure to morphine, inhibits: 1) the development of analgesic tolerance; 2) some signs of physical dependence; and, 3) morphine-induced increases in behavioral responses to dopamine agonists. Although there was no change in the total number of high affinity striatal dopamine receptors, chronic morphine treatment did increase the affinity of the ligand at the receptor. The peptide blocked not only the affinity change, but the increased behavioral response to apomorphine as well. These behavioral changes correlate significantly with the neurochemical changes in dopamine receptors following chronic morphine treatment. Therefore, some of the pharmacological efforts of morphine may be mediated by changes in CNS dopamine receptors and that the peptides may act by inhibiting these neurochemical changes.

Stylohamular dissection: a new method for en bloc reaction of malignancies of the infratemporal fossa

This study is a description of the "stylohamular" dissection, a technique for the en bloc resection of the infratemporal fossa. The medial plane of this dissection extends from the styloid process to the hamulus of the pterygoid just lateral to the foramen lacerum, allowing the surgeon to spare the internal carotid artery. The foramen ovale and foramen spinosum are routinely exposed during this procedure. Medially, the pterygoid musculature serves as the margin of the cancer block. Posteriorly, the mastoid tip may be included in this resection. Anteriorly, the lateral pterygoid plate is resected making it the anterior vertical plane of the dissection. Laterally, skin and mandible are the block margins. In the last three years, this approach has been utilized in eight patients with advance malignancies involving the infratemporal fossa. The results are encouraging. Five patients have remained well and free of disease for a maximum of three years postoperatively. Two patients have had recurrence of their tumor from six months to one year postoperatively. Palliation in all patients was excellent. The literature on various infratemporal dissections and their results is reviewed.

Marketing ensures success of maternity care program

The development and effective functioning of a marketing department was a key to the success of a one-day maternity care program. The program reversed a downward trend in obstetrical deliveries.

Effects of surgical stress and corticotrophin on the peripheral metabolism of thyroid hormones in rabbits

The effect of surgical stress and ACTH injection on the peripheral monodeiodination of thyroxine (T4) was studied in the rabbit. These stimuli resulted in a switch from the peripheral formation of tri-iodothyronine (T3) to reverse T3 in normal rabbits and in rabbits whose thyroidal secretion was suppressed by administration of T4. This is analogous to the situation in man. These changes were not due to alterations in the serum binding capacity for thyroid hormones.

Computer algorithm for electron beam treatment planning

A computer algorithm has been developed for electron beam treatment planning. The method uses a limited amount of stored experimental dose distribution data, performs interpolation, and stores generated beam information on an optimized fan line-depth line grid. Experimental verification of the computer program showed agreement within +/-5% for beam generation and air gap correction.

An efficient patient data entry system for a busy computer

The authors describe an independent minicomputer consisting of a CRT and a cassette unit which was designed to store patient data and interact with the main computer at a convenient time. This system permits the computer to handle data entry and treatment planning functions simultaneously. The layout of the overall system, the function of the program and a time analysis of the system are discussed.

Physical aspects of electron-beam arc therapy

The effect of different parameters on dose distribution in electron-beam arc therapy was studied in order to develop a technique for routine clinical use. A special diaphragm was designed to facilitate telecentric rotation. Dosimetry was performed with an ion chamber, film, and LiF powder in cylindrical polystyrene phantoms and an Alderson Rando phantom. Dose distributions were evaluated with regard to dose homogeneity, and a method of sharpening the dose fall-off near the ends of the arc was proposed. Criteria for selection of isocenter depth and field size were developed. Methods of dose calculation, calibration, and treatment planning are discussed.