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With the improved ability of managing other chemotherapyrelated toxicities such as myelosuppression, oral mucositis is more and more frequently becoming the dose-limiting toxicity of intensive regimens. Currently, no intervention exists that is completely successful in preventing and treating chemotherapyinduced stomatitis. The observation of a beneficial effect of subcutaneous administration of CSF dates back to 1988, when Gabrilove et al. [9] demonstrated a decrease in the overall incidence of mucositis from 44% to 11% with patients receiving M-VAC methotrexate 30 mg m2, vinblastine 3 mg m2, doxorubicin 30 mg m2, cisplatin 70 mg m2 ; for transitional cell carcinoma of urothelium and randomized to receive G-CSF support. Other investigators have retrospectively observed that the duration and severity of oral mucositis can be decreased significantly by adding G-CSF or GM-CSF [13, 14]. The first prospective study to assess the potential efficacy of colony-stimulating factors on mucositis was reported by Chi et al. [10]. Twenty patients with metastatic squamous cell carcinoma of head and neck were randomized to receive cisplatinum, infusional fluorouracil and leucovorin with or without subcutaneous GM-CSF from day 5 to 14 each cycle. The incidence of grade III mucositis, according to the Radiation Therapy Oncology Group criteria, was reduced from 73% to 11% with the addition of GM-CSF. In the transplant setting the benefits of myeloid growth factors have been less impressive however. Nemunaitis et al. [15] noted a reduction in mucositis in patients undergoing a human leukocyte antigen HLA ; -matched sibling allograft, whereas Atkinson et al. [16] did not show any difference in the incidence and severity of mucositis in patients receiving an HLA-matched sibling transplant with high-dose busulfan and cyclophosphamide. Preliminary data resulting from very small studies published in abstract form suggested that mouthwashing with GM-CSF might improve oral mucositis induced by chemotherapy [17, 18]. However, these expectations were not completely confirmed later. Cartee et al. [19] conducted a double-blind, placebo-controlled, doseranging study in patients with breast cancer during the first treatment cycle of a combination chemotherapy regimen, which has historically produced a 39% rate of grade 34 mucositis. Patients underwent prophylaxis with topical GM-CSF in a liquid mouthrinse. They did not observe a reduction in the maximum severity of mucositis between placebo and GM-CSF. Karthaus et al. [11] performed a prospective, randomized, placebo-controlled study using topical oral G-CSF in high-grade lymphoma patients to prevent chemotherapy-induced stomatitis. Eight patients were treated with 32 courses of chemotherapy. The administration of G-CSF mouthrinse significantly reduced the number of days in hospital, but the reduction in maximum severity of stomatitis was of borderline significance. A larger trial was carried out by van der Lelie et al. [20], who performed a double-blind, placebocontrolled study of 300 g GM-CSF in a 2% methylcellulose gel daily versus a 2% methylcellulose gel alone in 36 consecutive patients undergoing stem cell transplantation. No differences were found in the median subjective pain scores, WHO scores, and oral assessment scores between the placebo and the GM-CSF groups.
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Introduction: CCHF is a viral zoonotic disease. The virus is from Nairovirus genus and Bunyaviridae family. The disease is transmitted to humans by infected tick bite or contact with virus contaminated tissues, blood or discharges of mammals. The mortality rate could be up to 50%. Method: From June 2000 to August 2006, serum samples of Iranian suspected butchers for CCHF have been collected and analyzed with specific ELISA for detecting antibodies IgM and IgG ; , and also with RT-PCR to investigate the genome of the virus. Results: Our results show that among 51 suspected butchers, 42 were positive serologically and molecularly. Between the 42 cases, 39 were IgM positive and 3 cases RT-PCR positive and IgM negative. Between the 39 IgM positive, 9 persons ere also RT-PCR positive. Between the 42 positive cases, 6 died. 66.7% of the positive cases were in the age range 21-40 years. The provinces of infected cases were, SistanBaluchestan 38.1% ; , Isfahan province 23.8% ; and Fars province 19% ; Discussion: The results show that among the studied group, 82.4% of butchers were infected with CCHF, so more precautions must be taken by professionals in relation with livestock during slaughtering of domestic animals and handling of their carcass. Considering the obtained results, the most infected province was SistanBaluchestan.
The emergence of multidrug-resistant MDR ; tumor cell populations is a common impediment to cancer therapy. Simultaneous resistance to structurally unrelated chemotherapeutic agents in cultured multidrug-resistant mutants correlates with reduced accumulation of these agents 1-5 ; . To study this problem we isolated MDR human KB carcinoma cell lines by initially selecting with either colchicine KB-C4 ; 6 ; or vinblastine VBL ; KB-V1 ; 7 ; . These MDR cell lines are resistant to colchicine, VBL, vincristine, adriamycin, and actinomycin D 6, 7 ; and accumulate these drugs 5 ; at reduced levels. Both the decreased drug accumulation and the multidrug resistance are reversed by exposure of the cell lines to verapamil 5, 6 ; . We have investigated the biochemical basis of reduced drug accumulation using membrane vesicles from the drug-sensitive parental KB-3-1 cell line, a highly MDR cell line KB-C4 ; , and a drug-sensitive revertant KB-Ri ; and demonstrated that membrane vesicles from MDR cells bound more VBL than vesicles from the parental or revertant cell lines 8 ; . The specificity, saturability, trypsin sensitivity, and temperature dependence of the binding process, as well as the inhibition of [3H]VBL binding by some drugs to which the cells are cross-resistant 8 ; , suggested that a specific molecule might be responsible for increased drug binding to vesicles from MDR cells. To identify the molecule s ; responsible for increased VBL binding, we examined the labeling of membrane vesicle.
1 These studies were supported by grants from the National Institutes of Health AI31583, AI38375 ; to D.L. This is Manuscript 12171-IMM from the Scripps Research Institute. 2 Address correspondence and reprint requests to Dr. Mary Crowley or David Lo, Scripps Research Institute, IMM-25, 10550 North Torrey Pines Road, La Jolla, CA 92037. E-mail address: mtcwoof san.rr 3 Abbreviations used in this paper: DC, dendritic cells; BCR, B cell receptor; SLC, secondary lymphoid tissue chemokine; ELC, EBV-induced molecule 1 ligand chemokine; MZM, marginal zone macrophages; FDC, follicular DC.
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27. Tortoriello, A., Facchini, G., Caponigro, F., Santangelo, M., Benassai, G., Persico, G., Citarella, A., Carola, M., Marzano, N., and Iaffaioli, R. V. Phase I II study of paclitaxel and vinorelbine in metastatic breast cancer. Breast Cancer Res. Treat., 47: 9197, 1998. Keren-Rosenberg, S., and Muggia, F. M. Response to estramustine phosphate and paclitaxel in patients with advanced breast cancer: a Phase I study. Semin. Oncol., 24: S26 S29, 1997. 29. Hudes, G. R., Nathan, F., Khater, C., Haas, N., Cornfield, M., Giantonio, B., Greenberg, R., Gomella, L., Litwin, S., Ross, E., Roethke, S., and McAleer C. Phase II trial of 96- hour paclitaxel plus oral estramustine phosphate in metastatic hormone-refractory prostate cancer. J. Clin. Oncol., 15: 3156 3163, Kavallaris, M., Kuo, D. Y-S., Burkhart, C. A., Regl, D. L., Norris, M. D., Haber, M., and Horwitz, S. B. Taxol-resistant epithelial ovarian tumors are associated with altered expression of specific -tubulin isotypes. J. Clin. Investig., 100: 12821293, 1997. Balog, A., Meng, D., Kamenecka, T., Bertinato, P., Su, D-S., Sorensen, E. J., and Danishefsky, S. J. Total synthesis of ; -epothilone A. Agnew. Chem. Int. Ed. Engl., 35: 28012803, 1996. Su, D-S., Meng, D., Bertinato, P., Balog, A., Sorensen, E. J., Danishefsky, S. J., Zheng, Y-H., Chou, T-C., He, L., and Horwitz, S. B. Total synthesis of ; -epothilone B: an extension of the Suzuki coupling method and insights into structure-activity relationships of the epothilones. Agnew. Chem. Int. Ed. Engl., 36: 757759, 1997. Meng, D., Bertinato, P., Balog, A., Su, D-S., Kamencka T., Sorensen, E., and Danishefsky, S. J. The total syntheses of epothilones A and B. J. Am. Chem. Soc., 119: 1007310092, 1997. Chen, X-T., Zhou, B., Bhattacharya, S. K., Gutteridge, C. E., Pettus, T. R. R., and Danishefsky, S. J. The total synthesis of eleutherobin: a surprise ending. Agnew. Chem. Int. Ed. Engl., 37: 789 792, Smith, A. B., III, Kaufman, M. D., Beauchamp, T. J., LaMarche, M. J., and Arimoto, H. Gram-scale synthesis of ; -discodermolide. Org. Lett., 1: 18231826, 1999. Haber, M., Burkhart, C. A., Regl, D. L., Madafiglio, J., Norris, M. D., and Horwitz, S. B. Altered expression of M 2, the class II -tubulin isotype, in a murine J774.2 cell line with a high level of Taxol resistance. J. Biol. Chem., 270: 31269 31275, Chou, T. C., and Talalay, P. Quantitative analysis of dose-effect relationships: the combined effects of multiple drugs or enzyme inhibitors. Adv. Enzyme Regul., 22: 2755, 1984. Ojima, I., Chakravarty, S., Inoue, T., Lin, S., He, L., Horwitz, S. B., Kuduk, S. D., and Danishefsky, S. J. A common pharmacophore for cytotoxic natural products that stabilize microtubules. Proc. Natl. Acad. Sci. USA, 96: 4256 4261, Cabral, F. R., Wible, L., Brenner, S., and Brinkley, B. R. Taxolrequiring mutant of Chinese hamster ovary cells with impaired mitotic spindle assembly. J. Cell Biol., 97: 30 39, Hyams, J. S., and Lloyd, C. W. eds. ; . Microtubules. New York: Wiley-Liss, Inc., 1994. 41. Giannakakou, P., Villalba, L., Li, H., Poruchynsky, M., and Fojo, T. Combinations of paclitaxel and vinblastine and their effects on tubulin polymerization and cellular cytotoxicity: characterization of a synergistic schedule. Int. J. Cancer, 75: 57 63, Giannakakou, P., Sackett, D. L., Nogales, E., Downing, K. H., and Fojo, T. A -tubulin mutation confers epothilone resistance in human cancer cells. Proc. Am. Assoc. Cancer Res., 40: 1885, 1999. Longley, R. E., Gunasekera, S. P., Faherty, D., Mclane, J., and Dumont, F. Immunosuppression by discodermolide. Ann. N. Y. Acad. Sci., 696: 94 107, Haux, J., Johnsen, A. C., Steinkjer, B., Egeberg, K., Sundan, A., and Espevik, T. The role of interleukin-2 in regulating the sensitivity of natural killer cells for Fas-mediated apoptosis. Cancer Immunol. Immunother., 48: 139 146 and vincristine.
1 American Society of Health-System Pharmacists. ASHP guidelines on preventing medication errors with antineoplastic agents. J Health-Syst Pharm 2002; 59: 1648 Petros WP, Ericson S. In DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey ML eds. Hematopoiesis. Pharmacotherapy: a pathophysiologic approach , sixth edition. McGraw-Hill Co., 2005: 1793 804. Hutson PR. Hematology: red and white blood cell tests. In Lee M ed. Basic skills in interpreting laboratory data . American Society of Hospital Pharmacists, 2004: 441 47. Demetri GD, Anderson KG. Bone marrow failure. In Abeloff MD, Armiate JO, Lichter AS, Niederhuber JE eds. Clinical oncology. Churchill Livingstone Inc., 1995. 5 Maxwell MB, Maher KE. Chemotherapy-induced myelosuppression . WB Saunders Co., 1992. 6 Demetri GD. Evidence-based use of hematopoietic growth factors for optimal supportive care of patients with cancer. In Chang AE, Ganz PA, Hayes DF, Kinsella TJ, Pass HI, Schiller JH, Stone RM, Strecher VJ eds. Oncology: an evidence-based approach. Springer Science and Business Media, Inc., 2006: 1526 35. Balmer CM, Valley AW, Iannuci A. Cancer treatment and chemotherapy. In DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey ML eds. Pharmacotherapy: a pathophysiologic approach , sixth edition. McGraw-Hill Co., 2005: 2279 28. Ganong W. Review of medical physiology, fourteenth edition. Appleton & Lange, 1989. 9 Cairo M. Dose reductions and delays: limitations of myelosuppressive chemotherapy. Oncology 2000; Suppl 8: 21 29. Hoagland HC. Hematologic complications of cancer chemotherapy. Sem Oncol 1982; 9 1 ; : 95 101. 11 Perry MC. Chemotherapy, toxicity, and the clinician. Sem Oncol 1982; 9 1 ; : 1 Nirenberg A. Hematologic toxicities. Cancer Nurs 2003; 26 suppl 6 ; : 32S 37S. 13 Kintzel PE. Anticancer drug-induced kidney disorders: incidence, prevention and management. Drug Safety 2001; 24 1 ; : 19 38. 14 Brouwer KL, Dukes GE, Powell JR. Influence of liver function on drug disposition. In Evans WE, Schentag JJ, Jusko WJ eds. Applied pharmacokinetics: Principles of Therapeutic Drug Monitoring , third edition. Applied Therapeutics Inc., 1992: 6-1 6-59. Kirchain WR, Gil MA. Drug induced liver disease. In DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey ML eds. Pharmacotherapy: a pathophysiologic approach , sixth edition. McGraw-Hill Co., 2005: 713 20.
| M. A. Jordan and others Fig. 3. Microtubule, chromosome and centrosome arrangement in HeLa cells after 18-20 h incubation in vinblastine at the specified concentrations. A, a, B ; 0.8 nM; C, c, c' ; 3.2 nM; D, d, d' ; 6.4 nM; E, e ; 100 nM; F ; 1 M; G ; 10 100 [M vinblastine. A, C, D, E, F, G, H ; Anti-tubulin immunofluorescence; a, c, d, e ; DAPI stain of chromosomes; B, c', d' ; anti-centrosomal immunofluorescence. A, a ; Type I abnormal spindle induced by incubation in 0.8 nM vinblastine, arrows point to tufts of long astral microtubules and to chromosomes located near the spindle poles. B ; Fragmented centrosomal material induced by 0.8 nM vinblastine, the microtubules and chromosomes of these three spindles were in the normal metaphase configuration not shown ; . C, c, c' ; Types I, II and III abnormal spindles labelled I, II and III ; induced by 3.2 nM vinblastine. Arrows point to chromosomes located near the spindle poles. D, d, d' ; Type III abnormal spindles with accompanying peripheral punctate aggregates of tubulin in D ; and fragmented centrosomes induced by 6.4 nM vinblastine in d' ; . E, e, Absence of microtubules and presence of punctate aggregates of tubulin induced by 100 nM and 1 fjM vinblastine, respectively; the chromosomes of these cells type IV ; were mitotic-like condensed with no nuclear membrane ; except for the cell marked i which was in interphase; each cell had one or two compact centrosomes not shown ; . G, H ; Vinblastine-tubulin paracrystals induced by 10 JJM and 100 vinblastine, respectively; the nuclei of the cells in G ; were in interphase not shown the cells of H ; were judged to be dying from the pyknotic appearance of their chromatin and their inability to exclude trypan blue not shown ; . Bars, 10 m; bar in a gives magnification of A, a; bar in B gives magnification of all other panels and vinorelbine.
0.01 ; . The mean vinblastine clearance index in the maternalto-fetal direction 0.31 0.05 ; was significantly different P 0.017 ; from the vinblastine clearance index in the fetal-tomaternal direction 0.67 0.17 ; 95% CI of the difference, 0.61 to 0.11 ; Fig. 3B.
Transmuralant MI using equilibriumradionuclideventricu lography. The RWM of anteroseptal ant-sep ; , inf-posterior pos ; and apical LV segments segs ; was assessed by a 6 point WN score S ; : 6Rnormal, 1 severe dyskinesis. Results mean + SD ; were as follows: EE WMS fn seg number ; LV RY All ANT-SEP INF-POS Apical and viracept!
1. Peto J, Hodgson JT, Matthews FE, et al: Continuing increase in mesothelioma mortality in Britain. Lancet 345: 535-539, 1995 Peto J, Decarli A, La Vecchia C, et al: The European mesothelioma epidemic. Br J Cancer 79: 666-672, 1999 Price B: Analysis of current trends in United States mesothelioma incidence. J Epidemiol 145: 211-218, 1997 Bissett D, Macbeth FR, Cram I: The role of palliative radiotherapy in malignant mesothelioma. Clin Oncol R Coll Radiol ; 3: 315-317, 1991 Ong St, Vogelzang NJ: Chemotherapy in malignant pleural mesothelioma: A review. J Clin Oncol 14: 1007-1017, 1996 Leveque D, Quoiz E, Dumont P, et al: Pulmonary distribution of vinorelbine in patients with non-small cell lung cancer. Cancer Chemother Pharmacol 33: 176-178, 1993 Cros S, Wright M, Morimoto M, et al: Experimental antitumor activity of Navelbine. Semin Oncol 16: 15-20, 1989 suppl 4 ; 8. Depierre A, Lemarie E, Dabuis G, et al: A phase II study of Navelbine vinorelbine ; in the treatment of non-small-cell lung cancer. J Clin Oncol 14: 115-119, 1991 Le Chevalier T, Brisgand D, Douillard J-Y, et al: Randomized trial of vinorelbine and cisplatin versus vindesine and cisplatin versus vinorelbine alone in advanced non-small-cell lung cancer: Results of a European multicenter trial including 612 patients. J Clin Oncol 12: 360367, 1994 Rusch VW: A proposed new international TNM staging system for malignant pleural mesothelioma from the International Mesothelioma Interest Group. Lung Cancer 14: 1-12, 1996 Therasse P, Arbuck SG, Eisenhauer EA, et al: New guidelines to evaluate the response to treatment in solid tumors. J Natl Cancer Inst 92: 205-216, 2000 Byrne MJ, Davidson JA, Musk AW, et al: Cisplatin and gemcitabine treatment for malignant mesothelioma: A phase II study. J Clin Oncol 17: 25-30, 1999 de Haes JC, van Knippenberg FC, Neijt JP: Measuring psychological and physical distress in cancer patients: Structure and application of the Rotterdam Symptom Checklist. Br J Cancer 62: 1034-1038, 1990 Gehan EA: The determination of the number of patients required in a preliminary and a follow-up trial of a new chemotherapeutic agent. J Chronic Dis 13: 346-353, 1961 Fumoleau P, Delgado FM, Delozier T, et al: Phase II trial of weekly intravenous vinorelbine in first-line breast cancer chemotherapy. J Clin Oncol 11: 1245-1252, 1993 Vogelzang NJ, Herndon JE, Miller A, et al: High-dose paclitaxel plus G-CSF for malignant mesothelioma: CALGB phase II study 9234. Ann Oncol 10: 597-600, 1999 O'Reilly EM, Ilson DH, Saltz LB, et al: A phase II trial of interferon alpha-2a and carboplatin in patients with advanced malignant mesothelioma. Cancer Invest 17: 195-200, 1999 Millard FE, Herndon NJ, Vogelzang NJ, et al: Gemcitabine for malignant mesothelioma: A phase II study of the Cancer and Leukemia Group B CALGB 9530 ; . Proc Soc Clin Oncol 16: 475a, 1997 abstr 1710 ; 19. van Meerbeeck JP, Baas P, Debruyne C, et al: A phase II study of gemcitabine in patients with malignant pleural mesothelioma: European Organization for Research and Treatment of Cancer Lung Cancer Cooperative Group. Cancer 85: 2577-2582, 1999 Kasseyet S, Astoul P, Boutin C: Results of a phase II trial of combined chemotherapy for patients with diffuse malignant mesothelioma of the pleura. Cancer 85: 1740-1749, 1999 Middleton GW, Smith IE, O'Brien ME, et al: Good symptom relief with palliative MVP mitomycin-C, vinblastine and cisplatin ; chemotherapy in malignant mesothelioma. Ann Oncol 9: 269-273, 1998.
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15. Katsuta O, Hiratsuka H, Matsumoto J, Tsuchitani M, Umemura T 1996 ; . Cadmium-induced dental lesions in ovariectomized rats. Toxicol Pathol 24: 451 457. Kim HK 1982 ; . Experimental study on effect of 5- uorouraci l in rat mandibular incisors. J Osaka Dent Univ 16: 157 170. Kohgo T, Iizuka T, Shindoh M 1999 ; . Pathological evaluation of the effects of intentional disocclusion and overloading occlusion in odontogenesis disorders in N-methylnitrosourea-treate d hamsters. Toxicol Pathol 27: 226 232. Mikkelsen HB 1978 ; . Acute and protracted effects of vinblastine on odontoblasts and dentinogenesi s in rat incisors. Scand J Dent Res 86: 313 324. Moe H 1979 ; . Physiological cell death of secretory ameloblasts in the rat incisor. Cell Tissue Res 197: 443 451. Reichart PA, Althoff J 1980 ; . The effects of cyclophosphamide , nitrosomethylurea and benzo a ; pyrene on the rat incisor. Exp Pathol Jena ; 18: 288 296. Schour I, Massler M 1949 ; . The teeth. In: The Rat in Laboratory Investigation, Farris EJ, Griffth JQ eds ; . Hafner Publishing Company, New York, pp 104 165. 22. Smith CE, Warshawsky H 1977 ; . Quantitative analysis of cell turnover in the enamel organ of the rat incisor. Evidence for ameloblast death immediately after enamel matrix secretion. Anat Rec 187: 63 98. Yamamoto T, Sawada T, Onizawa T 1997 ; . Immuno-histochemica l demonstration of alpha-tubulin distribution in rat incisor ameloblasts after vinblastine administration. Bull Tokyo Dent Coll 38: 195 199 and viread.
The White Mazurka, 1905 Oil on canvas, 63 x 81 cm Signed bottom left: F. Ruszczyc Private collection Though Ferdynand Ruszczyc's paintings are most often associated with the epic type of heroised symbolic landscape, there was another, no less important side to his work, born of his love for his family estate: the lyrical views of Bohdanw, the manor house and environs. To some extent, they were also an expression of the artist's world-view, his attachment to the traditional morals and manners, and ethical and cultural values symbolised in Polish society by the life in the manor house of the gentry, a model that had taken centuries to shape. In the period 190507, Ruszczyc painted a series of pictures representing interiors in the Bohdanw buildings: the old wooden manor and the house erected later on, which was called `Mur' [Brick House]. The series embraced compositions entitled The White Mazurka and Hollyhocks 1905, National Museum in Warsaw ; , Fireplace in the Bohdanw Drawing Room 1906, lost ; , Interior of Bohdanw Manor House called Kantorek, 1906, private collection ; , Granny's Room 1906, lost ; , After the Ball 1907, lost or destroyed in 1944 ; . Related in.
1 wk versus 75 wk, with p response was observed after patients. A similar for BCMP-treated urinary M-protein and of serum 3 MP-treated M-protein delay and vistaril.
P. quercina has been recently associated with oak decline in Europe Vettraino et al., 2002 ; . In some cases, however, a relationship was not clearly established e.g. Hartmann and Blank.
Gether with aortico-sympathetic paragangliomas and adrenal 1 ; . Clinically detectable endocrine activity by these tumors is thought to occur only in a small percentage of head and neck paragangliomas; almost all cases reported to be hormonally active show secretion of norepinephrmne. Occasionally, secre and vivelle.
Evers et al. 26 ; demonstrated that sulfinpyrazone stimulates transport of GSH by MRP2 and that vinblastine transport is accompanied by GSH transport at an approximate ratio of 1: Sulfinpyrazone also stimulates transport of E217G by MRP2 Figure 2C ; . Compounds that stimulate E217G transport by MRP2 might therefore be co-transported with this substrate, as previously proposed 26 ; . We have tested this in vesicular and transepithelial transport assays. We did not detect vesicular transport of [3H]penicillin G at concentrations of up to either in the absence or presence of varying concentrations of E217G data not shown ; . Similarly, In vesicular transport assays we did not detect transport of [14C]indomethacin at concentrations up to 50 MRP2. Negative results in vesicular transport assays are not conclusive, however, as the substrate may leak out of the vesicles at high rate, preventing transport measurements. This is not a problem in transepithelial transport assays with MDCK-II MRP2 cells. Indeed, in these assays we detected marginal transport of indomethacin and probenecid by MRP2 data not shown ; . In the same assays, we did not detect transport of penicillin G or pantoprazole, another stimulator of E217G transport by MRP2 Figure 2, and data not shown ; . These results indicate that these compounds.
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Were diluted after doubling to give 2 liters of rapidly growing cells and were then assayed for 06MeG removal. Chromosome preparation and analysis. Chromosome preparation and identification methods were very similar to those of Farber and Davidson 9 ; . Cells were seeded at 105 cells per ml and harvested on day 3 after a 2-h treatment with Velban vinblastine sulfate ; at 0.08 Lg ml. Cells were treated with 0.075 M KCl for 15 min at 37C, fixed at least three times with Camoy fixative, and air dried on slides. Preparations were soaked in pH 4.1 Mcllvaine buffer for 4 min, stained in 50 pg quinacrine mustard dihydrochloride per ml for 8 to 10 min, and soaked for 4 min in pH 4.1 Mcllvaine buffer. After rinsing in water, slides were mounted in pH 7.0 Mcllvaine buffer and photographed. At least 10 cells were karyotyped, and the chromosomes of 40 additional cells were counted for each parent and hybrid clone analyzed. Removal of O'MeG. Two liters of cells grown in Spinner culture was centrifuged, washed, and suspended in 100 ml of phosphate-buffered saline. Cells were treated with various amounts of [methyl3H]MNNG at 37C for 10 min. The cells were then suspended in 100 ml of prewarmed RPMI 1640 plus l0o fetal calf serum and 4 mM L-glutamine and incubated for 2 h at 37C. Cells were collected, washed, and suspended in SSC 0.15 M NaCl plus 0.015 M sodium citrate ; , and the DNA was isolated as previously described 31 ; . This DNA was depurinated, and the purines were chromatographed along with a mixture of methylated markers on a 0.5-mm cellulose MN 300 thin layer chromatography plate prechromatographed with solvent and developed in 2-propanol28% NH40H-water 7: 2: 1 ; 16 ; UV-absorbing bands corresponding to the markers and guanine were circled, removed from the plate with a razor blade, placed in scintillation vials, eluted, and counted as described elsewhere 31 ; . The amount of guanine in the eluted band was determined spectrophotometrically. The amount of O6MeG removed was calculated as previously reported 31 ; and is expressed per mole of guanine since both O6MeG and guanine can be determined from the same chromatogram and vortex.
Review. This was done in the 1980s at the University of Arizona Medical Center, when an artificial heart, not yet approved by FDA, was used in a subject for three days as a "bridge" until a human replacement heart could be found. If a project carries no greater risk than having a routine physical examination, FDA regulations permit an IRB to use an "expedited review." This means that the research can be reviewed and approved by the chairman or senior members without convening the full IRB. Minor changes in an existing project also can be approved through an expedited review. Institutions engaged in research involving humans will generally have their own IRBs that review work done on the premises or elsewhere by the staff of the institution. However, the IRB need not be "onsite" at the institution as long as it is available to review that institution's research. An IRB in a hospital, for example, is not required to review studies done outside the hospital's jurisdiction, but the IRB may do so if the hospital is willing. IRB members usually are not paid for their services, but there is nothing in the regulations to prevent it. Any payment should be a fixed amount and not contingent upon a favorable review. Travel and other expenses may be reimbursed. The FDA relies upon the careful review by the responsible IRB to ensure that the research studies are not unnecessarily risky and are valid endeavors. The IRB also assures that the process for subject selection is fair and that the subjects are adequately informed about the anticipated risks and hoped-for benefits of participation. Together, these principles serve to protect the rights and welfare of research participants.
1708 After demonstrating feasibility and some success in a pilot study [117], Steuber et al. [118] conducted a randomized phase II trial comparing amsacrine 100 mg m2 day on days 15 and etoposide 200 mg m2 day on days 13 with the same regimen plus azacitidine 250 mg m2 day over 1 h on days 45. The overall complete response rate was 28% for the combination of amsacrine and etoposide and 39% when azacitidine was added. The difference was only statistically significant for the subgroup of patients with refractory but not relapsed disease. Unfortunately, no adequately powered randomized trial has explored azacitidine in the setting of relapsed pediatric leukemia. phase II study, Levi et al. [122] compared azacitidine to guanazole among previously treated patients with ANLL. Five CRs were seen among 18 patients receiving azacitidine 200250 mg m2 day bolus on days 15, while none were seen among the patients receiving guanazole. Two larger studies by Saiki et al. [123, 124] examined several single-agent schedules of azacitidine in patients with relapsed acute leukemia. The tolerable dose was a continuous infusion of 150200 mg m2 day for 510 days. Unfortunately, CR rates did not exceed 24% at best, and were extremely poor for patients with ALL. Studies of azacitidine in refractory and relapsed disease have also demonstrated activity in combination with several agents. Adding an amsacrine 150 mg m2 i.v. push to the same dose of azacitidine daily for 5 days, Kahn et al. achieved a CR in seven of 12 patients 58% ; who had previous remissions with daunorubicin and ara-C [125]. None of six ANLL patients without previous remission were successfully treated. Among patients with AML in first relapse, another small report noted seven CRs among 10 patients with this combination [126]. In a third study using this combination, Winton et al. [127] achieved 10 CRs in 52 patients 19% ; with relapsed AML, three CRs in 28 patients 11% ; with refractory AML and one of 12 patients with refractory ALL, with a cost of some added mucositis, hepatic and cardiac toxicity. While the higher tested doses of 200 mg m2 day CIVI azacitidine on days 14 and amsacrine 125150 mg m2 over 23 h on days 58 appeared optimal, the high remission rate of Kahn's study could not be replicated. Based on a pilot study demonstrating reasonable activity in patients with relapsed AML [128], Omura et al. [129] studied the combination of azacitidine 150 mg m2 day CIVI for 5 days and the purine analogue -2-deoxythioguanosine in patients with relapsed leukemia. Among 81 assessable patients with AML, 16 CRs were achieved 20% ; , while none of six patients with ALL had a CR. With toxicity being principally hematological, the authors concluded that the results were not superior to their experience with azacitidine alone. A study of 29 patients treated with 5 days of azacitidine 200 mg m2 day and 175 mg m2 day of the anthracycline zorubicin revealed some activity in this cohort who had received previous ara-C and anthracyclines [130]. Seven of 10 relapsed patients reached a CR as opposed to one of 19 patients with refractory disease. A number of trials have shown little benefit of combination therapy. Goldberg et al. [131] concluded that adding azacitidine to relapsed patients having an inadequate marrow response to mitoxantrone did not improve remission rates, although these patients would by definition be refractory. Adding pyrazofurin, an inhibitor of pyrimidine biosynthesis, to azacitidine has failed to improve outcomes and generated prohibitive mucositis and dermatitis [132134]. Three further studies have tested azacitidine with other agents. In studies with carboplatin, with methyl-GAG, and with vinblastine and and vytorin and vinblastine.
Tid-000 1998-06-20 14: 30: 00 m 001 compld "fac-2-1, clnt: : trclevel j0, exptrc \"aaa\", trc \"aaa\", inctrc \"aaa\", trcmode man, trcformat 16-byte" ; errors are listed in table 7-32 on page 7-20.
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10. 11. 12. Duvic M, Lemak N, Valero V, et al. A randomized trial of minoxidil in chemotherapy-induced alopecia. J Acad Dermatol 1996; 35: 7478. Clamon GH. Extravasation. In: The chemotherapy source book, 2nd ed. Perry MC, editor. Baltimore: Williams & Wilkins; 1996. p.607611. Rudolph R, Larson DL. Etiology and treatment of chemotherapeutic agent extravasation injuries: a review. J Clin Oncol 1987; 5: 11161126. duBois A, Kommoss FG, Pfisterer J, et al. Paclitaxel-induced "recall" soft tissue ulcerations occurring at the site of previous subcutaneous administration of paclitaxel in low doses. Gynecol Oncol. 1996; 60: 9496. Dorr RT. Antidotes to vesicant chemotherapy extravasations. Blood Rev 1990; 4: 4160. Larson DL. Treatment of tissue extravasation by antitumor agents. Cancer 1982; 49: 17961799. Luedke DW, Kennedy PS, Rietschel RL. Histopathogenesis of skin and subcutaneous injury induced by adriamycin. Plast Reconstr Surg 1979; 63: 463465. Shamseddine AI, Khalil AM, Kibbi AG, et al. Granulocyte macrophage-colony stimulating factor for treatment of chemotherapy extravasation. Eur J Gynecol Oncol 1998; 19: 479481. Rentschler R, Wilbur D. Pyridoxine: a potential local antidote for mitomycin-c extravasation. J Surg Oncol 1988; 37: 269271. Scuderi N, Onesti MG. Antitumor agents: extravasation, management, and surgical treatment. Ann Plast Surg 1994; 32: 3943. Heitmann C, Durmus C, Ingianni G. Surgical management after doxorubicin and epirubicin extravasation. J Hand Surg 1998; 23: 666668. Bertelli G, Gozza A, Forno GB, et al. Topical dimethylsulfoxide for the prevention of soft tissue injury after extravasation of vesicant cytotoxic drugs: a prospective clinical study. J Clin Oncol 1995; 13: 28512855. Anderson CM, Walters RS, Hortobagyi GN. Mediastinitis related to probable central vinblastine extravasation in a woman undergoing adjuvant chemotherapy for early breast cancer. J Clin Oncol 1996; 19: 566568. Houtee PV, Danhier S, Mornex F. Toxicity of combined radiation and chemotherapy in non-small cell lung cancer. Lung Cancer 1994; 10: S271S280. Yeo W, Leung S, Johnson P. Radiation-recall dermatitis with docetaxel: establishment of a requisite radiation threshold. Eur J Cancer 1997; 33: 698699. Schweitzer VG, Juillard GJF, Bajada CL, Parker RG. Radiation recall dermatitis and pneumonitis in a patient treated with paclitaxel. Gould JW, Mercurio MG, Elmets CA. Cutaneous photosensitivity diseases induced by exogenous agents. J Acad Dermatol 1995: 33; 551573. Lowitt M, Eisenberger M, Sina B, Kao G. Cutaneous eruptions from suramin: a clinical and histopathologic study of 60 patients. Arch Dermatol 1995; 131: 11471153. Wooten RS, Smith KC, Ahlquist DA, et al. Prospective study of cutaneous phototoxicity after systemic hematoporphyrin derivative. Lasers Surg Med 1988; 8: 294300. Dougherty TJ, Cooper MT, Mang TS. Cutaneous phototoxic occurrences in patients receiving Photofrin. Lasers Surg Med 1990; 10: 485488. Johnson T, Rapini R, Duvic M. Inflammation of actinic keratoses from systemic chemotherapy. J Acad Dermatol 1987; 17: 192197. Hardwick N, Murray A. Inflammation of actinic keratoses induced by cytotoxic drugs. Br J Dermatol 1986; 114: 639640. Bataille V, Cunningham D, Mansi J, Mortimer P. Inflammation of solar keratoses following systemic 5-fluorouracil. Br J Dermatol 1996; 135: 478480. Weiss RB. Hypersensitivity reactions. In: The chemotherapy source book, 2nd ed. Perry MC, editor. Baltimore: Williams & Wilkins; 1996. p.595606. Harris RE, McCallister JA, Provisor DS, et al. Methotrexate L-asparaginase combination chemotherapy for patients with acute leukemia in relapse: a study of 36 children. Cancer 1980; 46: 20042008. Blumenreich MS, Needles B, Yagoda A, et al. Intravesical cisplatin for superficial bladder tumors. Cancer 1982; 50: 863865. Castleberry RP, Crist WM, Holbrook T, et al. The cytosine arabinoside Ara-C ; syndrome. Med Pediatr Oncol 1989; 9: 257264. Williams SF, Larson RA. Hypersensitivity reaction to high-dose cytarabine. Br J Haematol 1989; 73: 274275. Zuehlke RL. Erythematous eruption of the palms and soles associated with mitotane therapy. Dermatologica 1974; 148: 9092. Demircay Z, Gurbuz O, Alpdogan T, et al. Chemotherapy-induced acral erythema in leukemic patients: a report of 15 cases. Int J Dermatol 1997; 36: 593598. Hellier I, Bessis D, Sotto A, et al. High-dose methotrexate-induced bullous variant of acral erythema. Arch Dermatol 1996; 132: 590591. Baack BR, Burgdorf WHC. Chemotherapy-induced acral erythema. J Acad Dermatol 1991; 24: 457461. Kampmann KK, Graves T, Rogers SD. Acral erythema secondary to high-dose cytosine arabinoside with pain worsened by cyclosporin infusions. Cancer 1989; 63: 24822485. Jucgla A, Sais G, Navarro M, Peyri J. Palmoplantar keratoderma secondary to chronic acral erythema due to tegafur. Arch Dermatol 1995; 131: 364365. Zimmerman GC, Keeling JH, Burrris HA, et al. Acute cutaneous reactions to docetaxel: a new chemotherapeutic agent. Arch Dermatol 1995; 131: 202206. Vukelja SJ, Baker WJ, Burris HA III, et al. Pyridoxine therapy for palmar-plantar erythrodyesthesia associated with taxotere. J Natl Cancer Inst 1993; 85: 1432. Crider MK, Jansen J, Norins AL, McHale MS. Chemotherapy-induced acral erythema in patients receiving bone marrow transplantation. Arch Dermatol 1986; 122: 10231027 and abraxane.
Pathogenesis Infection is initiated by ingestion of the oocyst with subsequent excystation and release of sporozoites upon exposure to bile salts. Spontaneous excystation can occur, however. It is found primarily in the small bowel but, in contrast to the deep intracellular invasion observed with Isospora belli, it is located at the luminal surface of the epithelial cells and sometimes just within the brush border of the intestinal epithelium Clayton, Heller & Kotler, 1994 ; . The sporozoite undergoes asexual multiplication and develops into a trophozoite and then into two types of schizonts meronts ; . Type I schizonts release the merozoites, which can invade other epithelial cells and develop into either type I or type II schizonts. Type II schizonts can reinitiate schizogony or enter into the sexual phase of the cycle. The mature oocyst type II ; can be passed through faeces in the environment or can re-enter the host. This ability to cycle within the asexual phase explains the potential for autoinfection. Both cellular and humoral immunity play a role in infection. In a very elegant model Ungar et al. 1991 ; showed that in selectively depleted adult BALB c mice, both CD4 + T lymphocytes and interferon-y are required to prevent initiation of infection, while CD4 cells also can limit duration and IFN-gamma limits intensity Ungar et al., 1991; Chen, Harp & Harmsen, 1993 ; . In recent experiments, both colchicine and vinblastine inhibited C. parvum infection in a concentration dependent manner, suggesting that microtubules are important in host-cell invasion and may represent targets for development of new therapeutic drugs Wiest, Johnson & Flanigan, 1993.
Bile acid sequestrants, 953955, 954f for diarrhea, 996 for dyslipidemia, 933, 953955 interactions with ezetimibe, 959 with statins, 953954 therapeutic uses of, 955 in triple therapy, with statins and niacin, 953 Bile salt s ; , 1006 Bile salt export pump BSEP ; , 4445, 49t Bile salt-induced diarrhea, 996 Biliary excretion enhanced, for poisoning, 1749 probenecid and, 710 Biliary fistula, and vitamin K absorption, 1486 Biliary obstruction, and vitamin K absorption, 1486 Biliary spasm, opioid-induced, 562 Biliary tract drug excretion via, 1011 muscarinic receptor antagonists and, 194195 opioids and, 562 Bilirubin atazanavir and, 1307 indinavir and, 1303 metabolism of, 8081 transporters and, 4445 BILN 2061, 1267t BILTRICIDE praziquantel ; , 1088 Bimatoprost, for glaucoma, 17221723 Binaltorphimine, 551 Bioavailability, 4, 12, 1788 definition of, 4, 17 extent and rate of, 1718, 1788 first-pass effect and, 4 Bioequivalence, 7 Biofeedback, for hypertension, 866 Biofilms, and -lactam antibiotics, 1133 Biological response modifiers for cancer chemotherapy, 1318t, 1374 1380 dermatologic use of, 16971700, 1699f for inflammatory bowel disease, 1010t, 10161017 ophthalmic use of, 17261729 Biologic induction therapy, 14061407 Biotransformation, 2f, 1112 drug-metabolizing enzymes in, inhibition of, 122 in poisoning treatment, 1749 Biperidin, 197 Biphenylmethyl derivatives, 812f Bipolar disorder, 430, 454455 antipsychotics for, 490 antiseizure drugs for, 485, 489490 biological hypotheses of, 430431 lithium for, 488490 manic phase of, 461 treatment of, 452453 novel, 491 Birth control pill. See Oral contraceptives Bisacodyl, 994 Bisethylhexyloxyphenol methoxyphenyl triazine, 1700 Bismuth compounds for diarrhea, 996 for gastric cytoprotection, 976 for Helicobacter pylori infection, 980t, 996 Bismuth subsalicylate, 996 Bisoprolol, 285 with ACE inhibitors, 285 for congestive heart failure, 289, 883 884 for hypertension, 285 pharmacokinetics of, 283t, 286 pharmacological properties of, 283t receptor selectivity of, 271, 285 Bisphenol A, chemistry of, 1542t Bisphosphonate s ; , 16661668, 1667f absorption, fate, and excretion of, 1668 available agents, 1668 for cancer, 1668 chemistry of, 16661667, 1667f with glucocorticoid therapy, 1604 for hypercalcemia, 1663, 1668 mechanism of action, 16661668 for osteoporosis, 1668, 1671, 1671f for Paget's disease, 1673 therapeutic uses of, 16681669 Bites, antibiotic prophylaxis in, 1107t Bithionol, 1078 Bitolterol, 252 Bivalirudin, 1475 for angina, 841 Blackfoot disease, 1765 Blackouts, ethanol and, 612 Blackwater fever, 1039 Bladder acetylcholine and, 185, 186t anticholinesterase agents and, 208 autonomic regulation of, 144t epinephrine and, 246 irrigation of amphotericin B for, 1228 neomycin-polymyxin for, 11671168 muscarinic receptor agonists and, 185, 186t, 187 muscarinic receptor antagonists and, 194 opioids and, 562 overactive, muscarinic receptor antagonists for, 196 Bladder atony, anticholinesterase agents for, 211212 Bladder cancer BCG for, 1422 cisplatin for, 1334 gemcitabine for, 1346 mitomycin for, 1363 valrubicin for, 1359 vinblastine for, 1351 Bladder disorder s ; muscarinic receptor agonists for, 188 muscarinic receptor antagonists for, 196 Blastomyces dermatitidis. See Blastomycosis.
| Process guarantees a much better preservation of the initial aggregation state during sample fixation. Fig. 6 A presents a typical image of LH2 complexes at nonaggregated conditions cLH2 6 mM and cLDAO 15 mM ; . contrast to the pure LDAO buffer solution Fig. 6 B ; , dark spots can clearly be seen in the image. The diameter of the spots is ; 10 nm and there is, on average, one spot per area of 50 nm nm. The thickness of the sample is 50100 nm leading to an estimate of 10 mM LH2. The size and concentration match very well what would be expected for the well-separated LH2 complexes and support the conclusions drawn from ultrafast spectroscopy compare to Fig. 2, ; . For LDAO concentrations below the CMC, small cluster-like aggregates with varying shape and sizes of up to are obtained Fig. 6 E ; , but also very few rather huge assemblies Fig. 6 F ; . the special region of LH2 and LDAO concentrations where annihilation is slow see above ; , the formation of sheet-like aggregates is observed. For example, at cLH2 1.5 mM and cLDAO 5 mM, one can see several structured areas Fig. 6 C ; . Fourier transformation of the marked square Fig. 6 D ; reveals that in this area the LH2 aggregates form a hexagonal lattice in a two-dimensional layer. The formation of two-dimensional layers is indicated by the edge Fig. 6 C, lower area ; producing a line of intense contrast. These extended, sheetlike aggregates are different from the smaller, cluster-like ones obtained at LDAO concentrations below the CMC. To quantify these results in terms of different packing densities of the aggregates, the TEM resolution has not been sufficient. In particular for the tiny aggregates shown in Fig. 6 E, Fourier analysis is not possible. Simulations To establish the initial conditions of the simulations, we first analyzed the fast intra-ring annihilation at the beginning of.
Top ; A new stage adaptation of "Moby Dick" by the Perseverance Theatre in Douglas, Alaska, draws on native Alaskan whaling culture in its retelling of Melville's story. The theater is one of 32 U.S. arts and cultural organizations working to advance public dialogue on important civic issues with support from the Animating Democracy Initiative. The initiative was started in 1999 by Americans for the Arts, an alliance of local arts agencies throughout the United States. Bottom ; Musicians in Indonesia rehearse a composition in the gambang kromong tradition, an amalgam of Indonesian, Chinese and European sounds that originated in Old Jakarta. The ensemble receives support from Yayasan Asosiasi Tradisi Lisan the Association for Oral Tradition ; , which is working to revitalize traditional forms of music, theater and oral literature of the country's many different ethnic groups.
This chapter is a primer to help you learn how to use awk. The awk tool, along with sed, grep, and perl., are commonly used text processing tools based on regular expressions. For more detailed reference material, see the manual page for awk and the GNU AWK manual : gnu software gawk manual ; . This chapter uses the file poem.txt from "Regular Expressions Unfettered" page 51 ; as the basis for most of its examples. Be sure to create that file before attempting any of these examples and vincristine.
| 15. Finley, P. R., Hicks, M. J., Williams, R. J., et al., Rate nephelometric measurement of rheumatoid factor in serum. Clin. Chem. 25, 1909-1914 1979 ; . 16. Hewlett Packard 9845 B Clinical Laboratory Library, I, Hew.
Effective July 1, 2007, the M-CARE Preferred Drug List for M-CARE's HMO, POS, PPO, Open Access, and GradCare non-employed ; drug benefits will be revised to reflect the additions and deletions listed in the table that follows. Additions to the list.
Modulators of MDR of widely differing structure and biological activity share a common feature: they all enhance drug cytotoxicity in multidrug-resistant cells. It is now known that many of these modulators interact with P-gp, preventing anticancer drugs from binding to this protein 6-9 ; , yet virtually nothing has been reported on the structural requirements for this interaction. In a recent study 10 ; , we demonstrated that verapamil has three domains in common with vinblastine that appear to be important in its ability to interact with P-gp and modulate MDR: two aromatic rings and a basic nitrogen atom. However, the conformational flexibility of verapamil makes it unsuitable for a more detailed structural analysis that would lead to a definition of the MDR pharmacophore. The compounds tested in the present study represent a wide range of stereochemical and conformational possibilities related to the less flexible reserpine yohimbine carbon skeleton. Those having a pendant benzoyl function under certain conformational constraints were the most effective modulators of MDR in our cells; indeed, reserpine, rescinnamine, and trimethoxybenzoylyohimbine were twice as effective in enhancing drug cytotoxicity as any other agent, including verapamil 10, 13, 15 ; . The relative conformational rigidity of these molecules may influence their ability to modulate MDR.
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