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A financial analyst for Procter & Gamble must report on the prospects and implications of a new teeth-whitening product. Beyond a realistic profit-and-loss forecast and baseline net present value, he must determine which pricing and marketing strategy is most likely to maximize value for shareholders. Excerpt UVA-F-1670 Rev. Dec. 7, 2016 The Procter & Gamble Company: Investment in Crest Whitestrips Advanced Seal It was May 2008, and Jackson Christopher, a financial analyst for the Procter & Gamble Company's (P&G) North America Oral Care (NAOC) group, hustled along a sunny downtown Cincinnati street on his way to work. NAOC's Crest teeth whitening group was considering the launch of an extension to its Whitestrips product, and the project had dominated most of his working hours. At least he avoided a long commute by living downtown. The week before, the group had met to consider the merits of the proposed product, known as Crest Advanced Seal. Although openly intrigued by the concept, Angela Roman, the group's general manager (GM), was reserving judgment until she had a clearer picture of the idea and risks. She had tasked Christopher with putting together the economic perspective on Advanced Seal, an effort that had required a lot of work amalgamating all the different considerations and thinking through the financial implications. In the process, he had had to manage a lot of different constituencies. In short, it had been an interesting week, and with the follow-up meeting the next day, Christopher knew he needed to present some conclusions. . . .

Study Design. Magnetic resonance discography using gadolinium as an intradiscal contrast agent was investigated in a prospective study. Objective. To evaluate the utility of magnetic resonance discography using gadolinium as an intradiscal contrast agent, as compared with the current standard of computed tomographic discography using intradiscal iodinated contrast agent. Summary of Background Data. Magnetic resonance arthrography with gadolinium has been used to evaluate shoulder, elbow, wrist, hip, knee, and other joints. Gadolinium has not been used as an intradiscal contrast agent. The authors’ preliminary results using gadolinium as an intradiscal contrast agent for magnetic resonance discography were reported previously. They report the results of their completed study. Methods. For this study, 42 disc levels were studied in 13 patients. Water-soluble iodinated contrast and gadopentetate dimeglumine were injected at each disc level. After discography, anteroposterior and lateral radiographs, computed tomography scans, and T1-weighted magnetic resonance imaging were performed. Six physicians interpreted the results from each disc level in a blinded fashion. Interscan and interobserver interpretation variability was determined for magnetic resonance discography and computed tomographic discography using the Pearson correlation-coefficient (r) test. Results. Interscan variability was highly correlated between computed tomographic discography and magnetic resonance discography when used to determine disc normality (r = 0.87), general degeneration (r = 0.87), anular fissure (r = 0.89), disc herniation (r = 0.92), and contrast leakage (r = 0.77). Interscan variability was assessed by the Pearson test, and all values of r for all the readers were noted to be statistically significant at P values less than 0.01. Interobserver variability was significantly correlated among the four more experienced readers (neuroradiologists and spine surgeons), but not among the spine fellows. Interobserver variability was also significantly correlated by computed tomographic (CT) and magnetic resonance imaging (MRI) discography for disc normality (CT r = 0.60; MRI r = 0.56), general degeneration (CT r = 0.76; MRI r = 0.71), anular fissure (CT r = 0.79; MRI r = 0.84), and disc herniation (CT r = 0.63; MRI r = 0.64). The readings for contrast leakage did not reach statistical significance for computed tomographic or magnetic resonance discography. Conclusions. The high interscan and interobserver correlation rates obtained for magnetic resonance discography using gadolinium, as compared with the standard computed tomographic discography technique, indicate that magnetic resonance discography may be an acceptable substitute for the imaging of disc pathology. Magnetic resonance discography with gadolinium can be recommended for patients allergic to iodinated contrast agents and for patients who wish to limit their radiation exposure.

The genomic DNA polymorphism of the beta chain of the T cell receptor was examined. The restriction fragment length polymorphism distribution was similar in systemic lupus erythematosus patients, their relatives, and normal controls. Our observations suggest that these genes are not coinherited with genes responsible for systemic lupus erythematosus.