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The Symposium on "Protein Metabolism: Infiuence of Growth Hormone,
Anabolie Steroids, and Nutrition in Health and Disease" is the
fourth in the series of International Symposia sponsored by CIBA
Limited, Basle. As in the case of the previous conferences, it was
planned and organised with the help of experts in the field
concerned. Special thanks are due to Prof. A. QuERIDO and Dr. A. A.
H. KAssENAAR who, once the idea of the Symposium had been conceived
in the course of joint discussions, embarked upon the project with
enthusiasm and inspiration, although they must have known full weil
what a great deal of time and trouble the organisation of such a
meeting would inevitably cost them. For their untiring efforts, for
the judicious manner in which they contrived to select precisely
those subjects on which interest is chiefiy centred today, and-last
but not least-for their success in finding competent specialists to
participate in the proceedings, we wish to assure them of our
sincere gratitude. To all the members of the Department of Clinical
Endocrinology and Diseases of Metabolism, at the University
Hospital in Leyden, who helped in preparing the meeting, we would
likewise extend a warm vote of thanks. The fact that the present
volume, featuring the papers and discussions of the Symposium, has
been published only a few months after the event, was made possible
thanks to the co operative help of all who participated.
Hypertension has certainly been one of the topics most fre quently
discussed at symposia, meetings, and congresses during recent
years. There may be several reasons for this; three of them are
obvious: firstly, the fact that a large proportion of the world's
population is suffering from various forms of hypertensive disease;
secondly, increasing knowledge of the pathogenesis of hypertension
and of the disturbances underlying it; and, thirdly, the marked
progress which has been made in antihypertensive therapy over the
past fifteen years. When plans for the present symposium were being
drawn up, it was felt that it should not simply bring forth just
another meeting on hypertension, but should place particular
emphasis on those aspects which had not been adequately discussed
at previous symposia of this kind. Curiously enough, the topic
which appeared to have received least attention in the past was
therapy, although from the practical point of view this is by far
the most important. The choice of therapy as the main theme of the
whole symposium also seemed to be warranted in view of the
relatively long period that had elapsed since effective antihyper
tensive treatment became available; the time had in fact come now
to pass judgement on the benefits as well as the shortcomings of
drug treatment as available today.
The pharmacokinetics of digitalis glycosides have been the subject
of extensive re view (IISALO, 1977; ARONSON, 1980; PERRIER et ai.,
1977). Research on glycoside kinetics has progressed at a rapid
pace, requiring continuing reevaluation of the state of our
understanding of this problem. The present article focuses on the
effect of disease states (renal, gastrointestinal, thyroid, and
cardiac) on the absorption, distribution, and clearance of a number
of digitalis glycosides. Evidence is critically reviewed, and
interpreted with respect to possible clinical implications. A.
Renal Insufficiency I. Strophanthin Strophanthin disposition in
renal failure has been evaluated in only two studies. KRAMER et ai.
(1970) determined an elimination half-life of 14 h in normals as
com pared to 60 h in anuric patients. Similar results were reported
by BRASS and Pm LIPPS (1970) using tritiated strophanthin. They
found a half-life value of 18 h in healthy individuals as compared
to 68 h in anuric patients. The findings clearly in dicate that the
elimination half-life of strophanthin is prolonged in renal
failure."
Between 1950 and 1960, remarkable advances were made in the
develQpment Qf antihypertensive drugs, but since then, prQgress has
been less rapid. This dQes nQt mean that no. new drugs have been
intrQduced: Qn the cQntrary, their number has increased sharply;
but since the advent Qf the beta-adrenergic blQckers no. new
pharmacQdynamic principle has been discQvered that CQuid be applied
widely as an antihypertensive. This has nQt been fQr want Qf
effQrts, because many attempts have been made to. find new ways and
means Qf influencing blQQd- pressure regulatiQn Qr the mechanisms
invQlved in the pathQgenesis Qf hypertensiQn. HQwever, the results
Qf these endeavQrs have mQstly been disapPQinting. Even thQugh high
blQQd pressure can be treated mQre satisfactQrily tQday than many
Qther diseases, the success achieved in cQmbating Qne Qf man's mQst
frequent ailments shQuld nQt induce cQmplacency, but rather
stimulate research tQwards further imprQvements. The present
standstill affQrds an QPPQrtunity to. review the field Qf antihy-
pertensive agents, fQr it is unlikely that fundamentally new drugs
will appear in the near future. AlthQugh greater knQwledge has been
gained Qf the mechanisms Qf blQQd-pressure regulatiQn and Qf the
pathQgenesis Qf hypertensiQn, these ad- vances have had no. direct
cQnsequences in the search fQr new therapeutics.
Hypertension has certainly been one of the topics most fre quently
discussed at symposia, meetings, and congresses during recent
years. There may be several reasons for this; three of them are
obvious: firstly, the fact that a large proportion of the world's
population is suffering from various forms of hypertensive disease;
secondly, increasing knowledge of the pathogenesis of hypertension
and of the disturbances underlying it; and, thirdly, the marked
progress which has been made in antihypertensive therapy over the
past fifteen years. When plans for the present symposium were being
drawn up, it was felt that it should not simply bring forth just
another meeting on hypertension, but should place particular
emphasis on those aspects which had not been adequately discussed
at previous symposia of this kind. Curiously enough, the topic
which appeared to have received least attention in the past was
therapy, although from the practical point of view this is by far
the most important. The choice of therapy as the main theme of the
whole symposium also seemed to be warranted in view of the
relatively long period that had elapsed since effective antihyper
tensive treatment became available; the time had in fact come now
to pass judgement on the benefits as well as the shortcomings of
drug treatment as available today.
Im grundlegenden Wandel von der Industrie- zur
Informationsgesellschaft suchen Unternehmen nach einer neuen
Identitat. Strategische Identitat ist das schlussige Konzept von
Vision und Kompetenz, das zu verteidigungsfahigen
Wettbewerbsvorteilen fuhrt. Das Buch zeigt dafur den Weg: Auf der
Basis der Planungsforschung der SIEMENS AG, die vor allem die
Erfolgsursachen exzellenter Unternehmen erforscht hat, wird ein
umfassender Transformationsprozess entworfen. Die systematische
Ursache-Wirkungs-Kette zwischen Basiskompetenzen, Angebotskompetenz
und Angebotsvorteilen ist der Weg zur Marktfuhrerschaft.
Wenn wir uns mit dem mild en oder leichten Hochdruck befassen,
miissen wir uns be- wuBt sein, daB es sich dabei flir den einzelnen
urn eine verhaltnismaBig leichte Erkran- kung handelt, die nur ein
geringes Risiko darstellt. 1m Hinblick auf die Gesamtbeurtei- lung
stellt der leichte Hochdruck eher ein bedeutsames
sozialmedizinisches Problem dar. Von allen Patienten mit hohem
Blutdruck fallen etwa 80-85% in die Kategorie des leichten
Hochdrucks. Wenn wir annehmen, daB von den iiber Vierzigjahrigen
jeder flinfte einen erhohten Blutdruck hat, so bedeutet ein Anteil
von 80-85% eine ganz be- trachtliche Zahl. Wir miissen damit
rechnen, daB in Deutschland vier Millionen Pa- tienten einen
leichten Hochdruck haben, ohne daB sie etwas von dieser Erkrankung
wissen miissen und ohne daB sie dadurch Beschwerden haben.
Andererseits miissen wir uns im klaren sein, daB diese Erhohung des
Blutdrucks ein gesteigertes kardiovas- kulares Risiko bedeutet. Wie
wird der leichte oder milde Hochdruck definiert? Die
Weltgesundheitsorganisation hat mehrfach Expertengruppen
zusammengerufen, die sich mit dieser Frage befaBt ha- ben (siehe z.
B. Technical Report Nr. 628 von 1978). 1m vergangenen Jahr, also
vier Jahre spater, ist diese Definition leicht modifiziert worden
(Tabelle 1), besonders im Hinblick auf die endgiiltige Diagnose.
Diese ist davon abhlingig, daB die erhOhten Druckwerte zu
wiederholten Malen in bestimmten zeitlichen Abstanden festgestellt
werden. Danach ist der milde Hochdruck auf diastolische Werte
zwischen 90 und 105 mmHg definiert.
Die Hochdruckerkrankungen sind im letzten Jahrzehnt im besonderen
MaBe in den Blickpunkt des arzdichen und wissenschaftlichen
Interesses geriickt, da stati- stische Untersuchungen ergaben, daB
jeder 5. Erwachsene an einem Hochdruck er- krankt und zunehmender
Anstieg des diastolischen Blutdruckes iiber 80 mm Hg mit einem -
gegeniiber Normotonikern - logarithmischen Anstieg der Mortalitat
einhergeht. Aktualitat und Bedeutung der Hochdruckerkrankungen
werden durch die Entdeckung neuer Hochdruckformen, die Fortschritte
in der Diagnose und Differentialdiagnose der Hochdruckerkrankungen
und die Entwick1ung wirksamer Antihypertonika sowie der
GefaBchirurgie unterstrichen. Die zunehmenden Erkenntnisse der
Pathogenese der primaren und sekundaren Hypertonie fiihrten zum
Ausbau und zur Aufwertung der ambulanten Untersu- chungsmethoden
der Hochdruckdiagnostik in der Praxis; die komplizierteren klini-
schen Untersuchungsmoglichkeiten wurden diagnostisch treffsicherer
und verfei- nert. 1m Rahmen einer sinnvoll durchdachten
Stufendiagnostik konnen daher heute in der Praxis haufig, in der
Klinik fast immer die bisher bekannten Ursa- chen der sekundaren
Hypertonien abgeklart werden. Die Fortschritte unserer Kenntnisse
in der Pathogenese der Hypertonie haben im Zusammenhang mit der
Entwicklung effektiver und besser vertraglicher Anti- hypertonika
zwangslaufig zu einem grundlegenden Wandel der operativen, diate-
tischen, medikamentosen, allgemeinen und speziellen
Behandlungsprinzipien in der Hypertonie gefiihrt. In Anbetracht der
ernsten Prognose der unbehandelten Hyper- tonie und der
iiberzeugenden Erfolge einer modernen Hochdruckbehandlung ist es
ein folgenschweres Versaumnis, eine Hypertonie diagnostisch -
soweit sich hier- aus therapeutische Konsequenzen ergeben - nicht
abzuklaren oder nicht sofort effektiv zu behandeln bzw. sorgfaltig
zu iiberwachen. Fiir das Schicksal des Hypertonikers sind
Friihdiagnose und Friihbehandlung seines Leidens von eminen- ter
Bedeutung.
"If you pit a good person against a bad system, the system will win
every time." --Geary Rummler Is it possible to raise the teaching
competence of an entire faculty quickly and cost effectively? Now,
the answer is YES The graduate training most faculty receive
focuses on conveying the content of their discipline-with an eye to
teaching them how to produce research. If an individual receives
any training in how to teach, it is usually as a teaching
assistant-and often less than holistically. Most newly minted
instructors arrive on campus and are observed by someone who is
senior to them-but who has received exactly the same preparation.
To improve faculty observation outcomes for the institution, it is
time to consider a new paradigm. Our approach is based on a norming
process that identifies areas of strength and areas of training
opportunity within a sampled population of teaching faculty. The
norming process has two particularly useful features: 1. Because
faculty selected represent a cross-college or cross-department
sample, it becomes quickly obvious where critical deficiencies may
exist across the institution. Since we work at a basic level of
pedagogy, opportunities for a large number of faculty to improve
become almost immediately obvious-and the data are not tied to
discipline, type of faculty member, or type of class taught. 2.
When teaching "stars" are identified, we know exactly why they are
exceptional at what they do-so their expertise is transportable
across college and discipline borders. This information can be
particularly helpful for new fulltime or adjunct teaching faculty
and can serve as an excellent guide for mentoring. This exciting
new tool-the Teaching Observation Worksheet-is is available for
sale online at www.amazon.com and other channels. About the Author:
With a doctorate in adult and continuing education from Columbia
University's Teachers College, Dr. Eric F. Grosse Jr. has worked in
higher education for nearly 30 years. He has served as an adjunct
and full-time faculty member, a department chair, a division chair,
an academic dean and dean of academic development and training.
Grosse has worked in a variety of educational environments, from a
community college to a private Catholic liberal arts college to a
high-ranking research university. During his decades of
professional experience, he has observed or counseled nearly 700
faculty members. CONTACT Dr. Eric F. Grosse, Jr. Email:
[email protected] Phone: (301) 377-2674 Website:
www.efgassociatesinc.com
Structured self-study is a well known and widely accepted strategy
for postsecondary institutions seeking re-accreditation. However,
it is virtually unknown as a strategy for a Teaching & Learning
Center seeking to learn about itself-what it is, what it can be,
and the distance between these two points. The CTL Self-Study Tool
has been developed by EFG Associates, Inc. to address this critical
need. Whether you are starting a new (or recently re-opened)
Center, facing the need to efficiently and effectively downsize an
existing CTL, or simply desire a structured approach to improve
your overall operation, the CTL Self-Study Tool gives you a
step-by-step approach and the needed ancillary materials.
This scarce antiquarian book is a selection from Kessinger
Publishing's Legacy Reprint Series. Due to its age, it may contain
imperfections such as marks, notations, marginalia and flawed
pages. Because we believe this work is culturally important, we
have made it available as part of our commitment to protecting,
preserving, and promoting the world's literature. Kessinger
Publishing is the place to find hundreds of thousands of rare and
hard-to-find books with something of interest for everyone
Studies of American industry frequently cite Lowell,
Massachusetts, as an early model for business practices. Scholars
have sought to explain the city's rise to prominence, the impact of
its textile mills on workers and on commerce, and its part in
regional development and American prosperity. Laurence Gross looks
beyond these issues. Focusing on Lowell's Boott Cotton Mills, he
examines the industry's struggle to maintain its prominence, the
causes of its decline, and its ultimate flight south.
Gross puts much of the blame for the pattern of events on the
mill-owners themselves. They resisted reinvestment, so their
operations became less efficient. They kept antiquated machinery
running long after it was safe to do so, and they were slow to
respond to issues of worker safety. The increased textile demands
of World War II, Gross explains, only forestalled the mills'
inevitable demise.
Behrman's prolific career as a Broadway playwright and Hollywood
screenwriter spans a period from the 1920s to the mid-1960s. As a
writer for popular performance, he had to contend with commercial
influences and with producers and directors involved in the
dynamics of the collaborative process. Though eminently successful,
his works have not received adequate critical scrutiny. His ouevre
probably will never be fully determined because of collaboration,
numerous rewrites, and the many unpublished and unproduced plays
and scripts. Author Robert F. Gross here provides an immensely
detailed record of the primary materials, published and
unpublished, including plays, filmscripts, fiction, and essays, and
of the critical response, both reviews and analytical studies.
Focusing on Behrman as a dramatist, Gross has written extensive
plot summaries and critical overviews for each of fifty-one plays.
Where applicable, full production credits are given for premieres
and revivals, and references are made to reviews and commentary
about specific productions as well as to the plays in general. The
annotated secondary bibliography is divided into chronologically
organized sections for reviews and for books, parts of books, and
articles. Fully cross-referenced, the material is also accessible
through an author index to the secondary bibliography and a general
subject index. In an opening appraisal, Gross expresses his
appreciation for Behrman, whose high comedies he finds to be
informed by a probing ethical conscience and whose goal of
scrupulosity he emulates in his own work. This scrupulous
playwright is here given his due in a comprehensive sourcebook of
value for theatre historians and theatre professionals.
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