* * * NEWSBRIEFS * * *

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Health System, Medical School form Johns Hopkins HealthCare
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     The Johns Hopkins Health System and the School of Medicine
have formed Johns Hopkins HealthCare LLC, a physician service
organization designed to offer a wide range of support services
to community-based physicians and physician groups associated
with Hopkins.
     Johns Hopkins HealthCare will serve as a vehicle for Hopkins
to coordinate relations with managed-care organizations.
Ultimately, it could coordinate the health care of large
populations of patients. 
     The new company, owned equally by the university and the
health system, is led by John D. Stobo, chairman of the board and
president/CEO, who also serves as vice dean for clinical sciences
in the School of Medicine and vice president of the health
system.
     "Our goal is not just to have patients come to Johns
Hopkins," said James A. Block, health system and hospital
president. 
     "Our goal is to provide affordable, easily accessible,
high-quality health care to an entire population," he said. "We
need to make it possible to maintain health and prevent disease
in a large segment of patients in Maryland. To do that, we need
to design a delivery system that reaches out beyond East
Baltimore by creating a network of physicians."
     "Johns Hopkins HealthCare is being formed in response to the
rapidly changing needs of health-care providers and consumers in
Central Maryland and the mid-Atlantic region," said Michael E.
Johns, dean of the School of Medicine and vice president for
medicine at the university. "This PSO will provide a mechanism
for Johns Hopkins medicine to contract with managed-care
organizations as well as with individual physicians in order to
help meet the health-care needs of large groups of individuals."
     Dr. Stobo said that Johns Hopkins HealthCare will offer the
payor community physician credentialing and quality control
through the development of practice guidelines. It also will
provide services such as assisting physicians in establishing
community-based, primary-care practices, training office staff,
providing management services and providing access to continuing
medical education, all in an effort to help physicians at a time
of increasing complexity in the delivery of health care, Dr.
Stobo said. 
     "As far as Hopkins is concerned, the [PSO] reduces previous
duplications of managed-care activities in the hospital and
School of Medicine," he said.
     "[This new venture] will serve as a vehicle for achieving a
closer relationship between Hopkins and primary-care physicians
in existing practices throughout the region," Dr. Johns said.


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Navy awards $429 million contract to Applied Physics Laboratory
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     The Navy's Space and Naval Warfare Systems Command signed a
one-year $429 million contract with the Hopkins Applied Physics
Laboratory. The agreement, which carries with it an option to
renew for two additional years, represents a preapproved funding
ceiling for defense research and development work. The purpose of
the contract is not to guarantee funds but to provide a mechanism
for Navy and other federal offices to fund individual programs. 
     APL's new contract, which runs from Oct. 1, 1994, through
Sept. 30, 1995, is similar in requirements, provisions and
funding level to previous contracts with the Navy. Although the
laboratory does conduct some research and development work for
government and private agencies outside the contract,
approximately 98 percent of its work will initially be covered
under the new agreement. 
     Typically, APL works on approximately 250 programs at any
one time, mostly in the area of research, development and
evaluation of submarine, surface and air defense systems. APL is
also a major space research and development facility and has
launched more than 50 spacecraft.


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Refining the treatment for women with unstable angina
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     Hopkins researchers report that an experimental drug greatly
reduces the formation of deadly blood clots in women at risk for
heart attacks and strokes.
     "We believe the drug Integrelin increases the efficiency of
traditional medicines in patients with unstable angina," said
Pascal Goldschmidt-Clermont, director of Hopkins' newly opened
Thrombosis Cen-ter.
     "When we gave it in addition to standard therapies, clot
formation dropped by 75 percent," he said. The study results were
presented at the American Heart Association's 67th Scientific
Session on Nov. 17.
     Integrelin mimics the action of a small segment of
fibrinogen, the molecule that clumps blood platelets, Dr.
Goldschmidt-Clermont said. The drug wiggles its way onto the
platelet's surface, taking up residence and blocking fibrinogen
access. Without a fibrinogen bond, platelets can't cluster or
produce clots that cause heart attacks and strokes.
     "Control of unstable angina in women may become easier with
new compounds like Integrelin," he said. "The next step is to
study long-term safety under all conditions." Integrelin is
currently available only through study protocols.
     In the study, both men and women with unstable angina were
randomized into two groups. Each group received standard
treatment that included heparin, a blood thinner. One group also
got Integrelin injections while the other group received aspirin.
     Researchers found that platelet clumping was six times less
likely to occur in women on Integrelin. Men, too, experienced a
reduction in platelet clumping, although the effect of the drug
compared with aspirin was less pronounced.
     "We don't understand why it had a different biologic
response in women," Dr. Goldschmidt-Clermont said. "Only further
research in a large patient population will help us explain the
gender bias."