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26. Houghton JA, Houghton PJ, and Wooten RS: Mechanism of induction of gastrointestinal toxicity in the mouse by 5-fluorouracil, 5-fluorouridine, and 5-fluoro-2-deoxyuridine. Cancer Res 39: 2406, 1979. Blumenkranz MS, Hajek A, Hernandez E, and Hartzer M: Fluorouridinc: A second generation ocular antimctabolite. Invest Ophthalmol Vis Sci 28 Suppl ; : 285, 1985. 28. Currie VE, Burchenal JH, Sykes MP, Clarkson BD, and Krakoff 1H: Animal and clinical studies of 5-fluorouridine FUR ; . Proceedings of American Association for Cancer Research Suppl ; : l88, 1975. 29. Gleason M and Fraenkcl-Conrat H: Biological consequences of incorporation of 5-fluorocytidine in the RNA of 5-fluorouracil-treated eukaryotic cells. Proc Natl Acad Sci U S A 73: 1528, 1976. Myers CE: The pharmacology of the fluoropyrimidines. Pharmacol Rev 33: 1, 1981. Ardalan B and Glazer R: An update on the biochemistry of 5-fluorouracil. Cancer Treat Rev 8: 157, 1981. Maybaum J, Ullman B, Mandcl HG, Day JL, and Sadcc W: Regulation of RNA-and DNA-directed actions of 5-fluoropyrimidines in mouse T-lymphoma S-49 ; cells. Cancer Res 40: 4209, 1980. Skuta GL, Assil K, Parrish II RK, Folbcrg R, Weinreb RN: Filtering surgery in owl monkeys treated with the antimctabolite 5-fluorouridinc 5-monophosphate entrapped in multivesicular liposomes. J Ophthalmol 103: 714, 1987. Cohen SS, Flaks JG, Barner HD, Loeb MR, and Lichtcnstcin J: The mode of action of 5-fluorouracil and its derivatives. Proc Natl Acad Sci U S A 44: 1004, 1958. Heidelberger C, and Ansfield FJ: Experimental and clinical use of fluorinated pyrimidines in cancer chemotherapy. Cancer Res 23: 1226, 1963. Miller E: The metabolism and pharmacology of 5-fluorouracil. JSurg Oncol 3: 309, 1971. Krakoff IH: The present status of cancer chemotherapy. Med Clin North 55: 683. 1971. Balch CM, Urist MM, Soong SJ, and McGregor M: A prospective phase II clinical trial of continuous FUdR regional chemotherapy for colorectal metastascs to the liver using a totally implantable drug infusion pump. Ann Surg 198: 567, 1983. Daly JM, Kemeny N, Oderman P, and Botct J: Long-term hepatic arterial infusion chemotherapy. Arch Surg 119: 936, 1984. Bosch L, Harbcrs E, and Heidclberger C: Studies on fluorinated pyrimidines. V. Effect on nucleic acid metabolism in vitro. Cancer Res 18: 335, 1958. Paul J and Hagiwara A: A kinetic study of the action of 5fluoro-2-deoxyuridinc on synthetic processes in mammalian cells. Biochem Biophys Acta 61: 243, 1962. Jampel HD, Lcong KW, Dunkclburger GR, and Quiglcy HA: Glaucoma filtration surgery1 in monkeys using 5-fluorouridine in polyanhydride disks. Arch Ophthalmol 108: 430, 1990.
Abbott Amgen, Inc. Fresenius Medical Care Genzyme Corporation Watson Pharmaceuticals Astellas Pharma US IPHA Sigma Tau Baxter Healthcare American Society of Transplantation ViraCor
Institute of Pathology, Washington, D.C., P. H. Bartels, DepartSciences, University of Arizona, Tucson, Aniz. and G. L. Wied, Departand Gynecology, University of Chicago, Chicago, Ill. Automated Cell and Measurement. M. M. Salpeter, Department Applied Physics, Cornell University, Ithaca, N.Y. Quantitative Electron Microscopic Cytochemistry by Autoradiography. Coffee Break F. M. Matchinsky, Department of Pharmacology, Washington University Medical School.
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She took so long in answering the door and was so breathless when she did so, that I immediately thought that Agnes should be in hospital. A brief chat and examination in her cramped sitting room confirmed that she was in severe left ventricular failure, which had been worsening for nearly a week. I had never met her before, and she was obviously distressed that my partner, who usually sees her, could not come. "I think we should send for an ambulance to get you into hospital for a few days, " I ventured. Her face froze with fear: "Oh, no. Hospitals are such awful places--noisy, dirty, and, of course, you read about so many mistakes being made and old people being so badly treated nowadays." She wouldn't hear of it. Sadly, this has been a common enough reaction from older patients in my experience for a long time. What followed, however, was completely new to me. "Never mind then, we'll try an injection of some medicine instead to get all this fluid off your lungs." I was already reaching for the ampoule when the look of horror flashed over her for a second time. "Isn't there a tablet I can have instead, doctor?" I seemed to read her mind and thought I could see her reading mine. "Well, I could give you the same medicine in tablets. Have you got anyone who can get it for you quickly?" I do not usually carry frusemide tablets with me ; . Her nephew was on his way, and she was expecting him in about 20 minutes, so I left her with the prescription. The next day her regular doctor went in to review her and told me she was much better. But I was not. Though his name was never mentioned, I was deeply troubled that Agnes might have worried that I could be another Harold Shipman when I wanted to inject her. Months later, I was still wondering if I wanted to carry on practising in a so called health service where elderly patients are not only alarmed by the standard of care they assume they will get in hospital but now also fear that any general practitioner they have not seen before cannot be trusted to give them an injection. What a sad commentary on the current climate in which we practise. As the Elijah mood grew upon me, I thought that this would make a good story for the BMJ. But first it was essential to find out if my hunch had been correct. My longsuffering partner agreed to visit Agnes once more and ask her about it. "Oh, no, " she smiled, "I've always had a mortal fear of needles. That was all." But, of course, it wasn't quite all. Though delighted to discover my interpretation of events was unfounded, I remain unsettled by this episode. It shows that, even though Shipman's legacy may not have destroyed the confidence of my patients in me, it has substantially reduced my confidence in treating them. Trevor Stammers general practitioner, London We welcome articles up to 600 words on topics such as A memorable patient, A paper that changed my practice, My most unfortunate mistake, or any other piece conveying instruction, pathos, or humour. If possible the article should be supplied on a disk. Permission is needed from the patient or a relative if an identifiable patient is referred to. We also welcome contributions for "Endpieces, " consisting of quotations of up to words but most are considerably shorter ; from any source, ancient or modern, which have appealed to the reader.
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CHART CHART 6B."Growth 6C."Growth curves curves of Ni-Si FUdr of Ni-Si T in medium in the presence No. 7i without added FUdr: Tdr ; 0 control 1.1 X 10' plus i01 M thymidine plus Tdr adenosine 0.
Inhibition of ara-C Cytotoxily by FUdR hr and, after its removal, the cells were exposed to the 2nd drug for 1 hr. After drug treatment the cells were placed in drug-free medium for 10 days. The number of colonies were counted after fixation with methanol and staining with Giemsa. The plating efficiency under these conditions was approximately 50%. Biochemical Studies. For biochemical studies the HeLa cells were grown in suspension. DNA synthesis was meas ured by following the incorporation of deoxynucleosides-3H into the acid-insoluble fraction of the cells. Approximately 1 x IO5cells in 1.0 ml of medium was mixed with 1.0 ml of fresh medium containing 4.0 iCiof deoxythymidinemethyl-3H 20 Ci mmole ; or 5.0 Ci of deoxyadenosine-3H 17 Ci mmole ; . The mixture was incubated at 37 20 for min and the cells were then trapped on 2.4-cm-diameter ni trocellulose Millipore filters 0.45 im ; . The filters were washed with 0.1 M NaCl, 5% cold trichloroacetic acid, and 75% ethanol. The dried discs were suspended in scintillation fluid and assayed for radioactivity. The metabolism of ara-C nucleotides was measured by incubating an asynchronous culture of HeLa cells 5 x IO8 cells ; in logarithmic growth in 150 ml of fresh medium containing 14 Ci of ara-C-3H 16 Ci mmole ; for 90 min at 37. he cells were then centrifuged and suspended in fresh T medium free of ara-3H. FUdR at a concentration of 3 iM was added to one-half of the culture. At various intervals 20-ml aliquots 5 x IO7cells ; of the culture were centrifuged and suspended in 100 I cold trichloroacetic acid. After 5% centrifugation at 2000 x g for 10 min, the acid-soluble supernatant was removed and neutralized with 25 il of 0.5 M Tris-actate pH 8.5 ; . The neutralized supernatant was spotted with cold carrier onto DEAE-cellulose-coated plates. The plates were developed in 0.05 N HC1 11 ; and the nucleoside mono-, di-, and triphosphate forms of ara-C-3H were detected with UV, scraped off the plate, and assayed for radioactivity. In order to measure the metabolism of ara-CTP-3H to ara-UMP-3H, we treated the neutralized supernatant with apyrase to convert ara-C-3H nucleotides to ara-CMP3H and thus permit easy separation between this latter nucleotide and ara-UMP-3H using DEAE thin-layer chromatography. The neutralized supernatant was incubated at 37or 10 min in a reaction mixture containing 1.0 mvi each f of UMP and CMP, 1.0 mMCaCl2, and apyrase, l.Omg ml. At the end of the incubation period the mixture was spotted on DEAE-cellulose-coated glass plates and developed in 0.05 N HC1. The spots containing ara-CMP-3H and araLiM P-3H were detected with UV, scraped off the plate, and assayed for radioactivity. In control studies the apyrase converted more than 90% of ara-CTP-3H to ara-CMP-3H under these experimental conditions and fulvestrant.
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Chocolate spa, and more. July 14 & 15, 2007, Fort Mason Conference Center, San Francisco. Tickets for adults, children 6-12, under 6 free. Saturday July 14th, 11: 00 a.m. - 6: 00 p.m, Sunday July 15th, 10: 00 a.m. - 4: 00 p.m. : SFChocolateSalon Press Contact: Gary Carr, Rising Moon Marketing & Public Relations, 925 ; 672-8717.
Was iodocytosine detected in any of the present sions may be reached regarding their potential clinical usefulness as adjuncts in the radiotherapy experiments after administration of ICdR as pre dicted by Welch 20 ; . On the other hand, the of cancer. Preliminary findings 1 ; indicate that in finding of both lUdR and IU in the plasma man the clearances of ICdR and lUdR from the after ICdR administration indicates that deami- blood are similar. With regard to their possible use nation of the latter to lUdR is a probable initial in radioactive form in the demonstration and lo obligatory step. A preliminary report by Cramer calization of tumors using external detectors, et cd. 4 ; states that ICdR is incorporated into ICdR-I126 or ICdR-I131 is likely to be found prefer DNA of mastocytoma cells in vitro as lUdRable to BCdR-Br82 because, for such purposes, Br82 5-phosphate. Evidence for an analogous incorpo possesses an undesirably high energy and short ration of BCdR as BUdR-5-phosphate has been life and because any released bromide is widely presented 4 ; . distributed and, unlike iodide, is difficult to elimi After injection of ICdR-I131 in the rat, the incor poration of I131into the DNA of bone marrow ex nate from the body. ceeded that in other organs. Relatively high bone REFERENCES marrow concentration of Br82 and H3 were also 1. CALABRESI, .; PRUSOFF, W. H.; and WELCH, A. D. P found after administration of BCdR-Br82 and Clinical Pharmacological Studies with 5-Iodo-2'-deoxycyCdR-H3, respectively 13 ; . These findings are tidine. Proc. Am. Assoc. Cancer Res., 3: 309, 1962. CHANG, . K., and WELCH, A. D. Preparation of 5-Iodo-2'P probably adequately explained by the known deoxycytidine. Biochem. Pharmacol, 8: 327-28, 1961. presence of deoxycytidylic deaminase in adult rat 3. CRAMER, J. W.; PHUSOFF, W. H.; SARTORELLI, C.; A. marrows 16 ; . In the mouse, ICdR and lUdR ap DELAMORE, W.; CHANG, P. K.; VONESSEN, C. F.; and I. pear to be incorporated into DNA in approxi WELCH, A. D. Effects of 5-Iodo-2'-deoxycytidine ICdR ; mately equal amounts and with essentially similar in Vitro, in Culture and in Vivo. Proc. Am. Assoc. Cancer patterns of distribution in different organs, sug Res., 3: 312, 1962. CRAMER, . W.; PHUSOFF, W. H.; and WELCH, A. D. 5J gesting the possibility that in this species deoxy Bromo-2'-deoxycytidine BCdR ; . II. Studies with Murine cytidylic deaminase is more ubiquitously distrib Neoplastic Cells in Culture and in Vitro. Biochem. uted. Of interest in this regard was the relatively Pharmacol., 8: 331-35, 1961. high incorporation of ICdR into the rapidly grow 5. D ANNEBERG, B.; MONTAG, . J. ; and HEIDELBERGER, P. B ing mouse sarcoma, since neoplastic tissue may C. Studies on Fluorinated Pyrimidines. IV. Effects on Nucleic Acid Metabolism in Vivo. Cancer Res., 18: 239-34, also contain relatively large amounts of deaminase 1958. 16 ; . 6. DJORDJEVIC, ., and SZYBALSKI, Genetics of Human B W. The enhanced incorporation into DNA of both Cell Lines, III. Incorporation of 5-Bromo-, and 5-IodoI131and I125after the administration of IUdR-I131 deoxyuridine into the DNA of Human Cells and Its Effect and ICdR-I125 in animals pretreated with 5-FUdR on Radiation Sensitivity. J. Exp. Med., 112: 509-31, is also consistent with a prior deamination of ICdR 1960. to lUdR. However, although this effect of 5-FUdR 7. EIDINOFF, M. L.; CHEONG, L. ; GAMBETTA GURPIDE, E.; BENUA, R. S.; and ELLISON, R. R. Incorporation of 5was noted in animals killed 1 hour after injection lodouracil Labeled with Iodine-131 into the Deoxyriboof the labeled compounds, no such effect was ap nucleic Acid of Human Leukaemic Leucocytes Following parent when the animals were sacrificed after 24 in Vivo Administration of 5-Iododeoxyuridine Labelled with Iodine-131. Nature, 183: 1686-87, 1959. hours. Perhaps the failure to observe an effect of 5-FUdR at the later interval was due to inability 8. EIDINOFF, M. L.; KNOLL, J. E.; and KLEIN, D. Effect of 5-Fluorouracil on the Incorporation of Precursors into of the small dose used to maintain a sufficiently Nucleic Acid Pyrimidines. Arch. Biochem. Biophys., 71: high local concentration of FUdR for many hours. 274-75, 1957. Increased incorporation of exogenous thymidine or 9. FIELD, E. O.; KRISS, J. P. ; and TUNG, L. A. Turnover of thymidine analogs under the influence of 5-fluoThymidine in the DNA of Marrow and Intestinal Mucosa rouracil or 5-FUdR has been previously reported in Mice, and Its Response to Administration of 5-Fluorouracil. Cancer Res., 21: 2-8, 1961. from this and other laboratories 5, 8, 9, GEIGER, J. W., and WRIGHT, L. D., Liquid Scintillation 19 ; . Counting of Radioautograms. Biochem. Biophys. Re Because the amount of ICdR incorporated into search Communications, 2: 282-83, 1960. DNA is less than that of BCdR, there is probably 11. GITLIN, D.; COMMERFORD, L.; AMSTERDAM, and S. E.; HUGHES, W. L. X-rays Affect the Incorporation of 5no advantage to be gained in using ICdR over lododeoxyuridine into Deoxyribonucleic Acid. Science, BCdR as a radiosensitizing agent. On the con 133: 1074-75, 1961. trary, BCdR would seem to be the preferable drug. 12. KRISS, J. P., and RVSZ, L. Quantitative Studies of In However, studies of the relative fates of these two corporation of Exogenous Thymidine and 5-Bromodeoxycompounds and their relative radiosensitizing po uridine into the Deoxyribonucleic Acid of Mammalian Cells in Vitro. Cancer Res., 21: 1141-47, 1961. tencies in man are needed before definite conclu and fuzeon.
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FIG. 1.-Fraction of cells forming colonies after 48-hr exposure to FUdR at low cell density.
ANY PROCEDURES performed by dermatologic surgeons are painful. Local anesthesia provides excellent relief in most cases. However, several clinical scenarios exist in which adjuvant sedation proves beneficial for patients and surgeons alike. A prime indication is procedures in which extensive local anesthesia is necessary and is associated with the pain of numerous injections. Facial laser procedures can cause significant discomfort, either during the procedure or during the administration of extensive regional nerve blocks and local anesthesia. In addition, patients with significant anxiety, including apprehensive children, may benefit from the sedative and anxiolytic effects of conscious sedation. Conscious sedation is defined as a medically controlled state of depressed consciousness in which patients retain their protective reflexes, maintain their airway independently, and respond to physical and verbal stimulation.1 Conscious sedation is intermediate in the spectrum of sedation, which ranges from anxiolysis and analgesia to general anesthesia. The key characteristics of conscious sedation are that it is and gabitril.
The Republic of Maldives consists of a group of atolls in the Indian Ocean, about 430 miles southwest of Sri Lanka. The country's land mass measures approximately 116 square miles and the population is 349, 106. According to a recent article in the Maldivian paper The Evening Weekly, 18% of the population carries the trait for thalassemia and 1 in every 30 marriages in Maldives is between trait carriers. 1 in every 120 children is born with a form of thalassemia and more than 500 patients are registered with the thalassemia center. By contrast, the United States has a population of more than 298, 000, 000 people about 855 times that of Maldives but the thalassemia community is estimated at only 1, 000-1, 500. ; Thalassemia patients in Maldives take advantage of the Maldives Blood Line, a community information service that makes information about blood donors available online. The service provides a helping hand to parents of thalassemic children and others in search of blood. Founded in 1984, the Maldivian Thalassaemia Society provides valuable help and assistance to patients and families and the Society for Health Education also educates the populace about thalassemia. Thalassemia was not diagnosed in Maldives until the 1970s and special clinics were first introduced in the 1980s; the National Thalassaemia Center opened in 1994, and a National Thalassemia Program was initiated in recent years. As a result of the increased attention paid to thalassemia over the last two decades, over 30% of the population has been screened, including more than 60, 000 adolescents. Reaching individuals in sparsely-populated areas is problematic. Cost of care runs to about 00 per year, a huge cost in a country in which the average per capita annual income is around 00 and may be much lower in rural areas ; . Providing ongoing care is a challenge for individuals in outlying atolls with no hospitals, who must travel significant distances by boat to reach a hospital. This frequently requires a parent to miss at least two days of work when a child needs transfusions. Even with many healthcare costs covered by the government, many families find themselves facing significant financial burdens. The people and government of Maldives have been very strong and resourceful in responding to thalassemia. Knowledge of thalassemia has increased to the point where most of the population is aware of it and screening of the population continues to progress. Patient care has also advanced but is held back by the significant financial costs associated with it. Most patients receive transfusions on a monthly basis, and adequate chelation therapy is rare.
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Thermore, it was shown in a later paper 1 ; that radioactivity from FIJDR C'4 is also incorpo rated into RNA, not DNA, as a result of the cleav age of FUDR to FTJ, which was then converted into nibonucleotides and incorporated. The in corporation of FU into tobacco mosaic virus RNA has been demonstrated by Gordon and Staehelin and garlic.
The Division of AIDS of the National Institutes of Health NIH ; in Bethesda has recently released the final report dated March 2003 ; from the reassessment of the trial procedures and results in the HIVNET 012 trial conducted in Uganda niaid.nih.gov daids Prevention ; . This trial, the first to demonstrate the safety and efficacy of nevirapine NVP ; to prevent mother-to-child transmission MTCT ; of HIV, was started in Uganda in 1997 and the results were published in 1999 Guay, et al. Lancet 1999; 354: 795-802 ; . A single dose of NVP given at onset of labor, plus a single dose to the newborn within 72 h of birth, reduced the risk of HIV transmission down to 13%, almost 2-fold lower than a short course of AZT started during labor. Concerns about the trial were raised when claims emerged that certain serious adverse events had not been properly reported. The Division of AIDS issued.
D. Raoult. Unit des Rickettsies--UMR 6020, MARSEILLE, France Free-living amoebae feed on bacteria, fungi and algae. However, some microorganisms evolved to become resistant to these protists. These amoeba-resisting microorganisms include established pathogens, such as Cryptococcus neoformans, Legionella spp., Chlamydophila pneumoniae, Mycobacterium avium, Listeria monocytogenes, Pseudomonas aeruginosa, and Francisella tularensis, and emerging pathogens, such as Bosea spp., Simkania negevensis, Parachlamydia acanthamoebae, Legionellalike amoebal pathogens and a giant virus: Mimivirus. Free-living amoebae represent an important reservoir of amoebae-resisting bacteria ARB ; that may, while encysted, protect the internalized bacteria from chlorine and other biocides. Free-living amoebae may act as a Trojan horses, that bring hidden ARB within the human Troy , and they may produce vesicles filled with ARB, increasing their transmission potential ee-living amoebae may also play a role in the selection of virulence traits and in adaptation to survival in macrophages.Thus, intra-amoebal growth was found to enhance virulence, and similar mechanisms seem to be implicated in the survival to both amoebae and macrophages. Moreover, free-living amoebae represent useful tools for the culture of some intracellular bacteria and new bacterial species that might be potential emerging pathogens.In this lecture pathogens associated with amoeba will be presented and gefitinib.
This metabolic abnormalities associated with hepatic arterial fudr heart by histological pattern could not associated with branchedchain to control due to be in hr, oras indicated.
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Create a "Glossary" to help establish a common terminology and to facilitate the understanding of this text. The "Glossary" should be revised and expanded and gemcitabine.
Urine NAE was the mean for each animal of a group on day 28. Net HCO3 reabsorption in microperfusion studies was transport during perfusions with the HCO3-containing solution 1, recognizing that tubule transport is bidirectional 11, 12 ; . Luminal HCO3 accumulation was HCO3 appearance collected initial ; for initially HCO3-free perfusions. Bicarbonate secretion was calculated using blood-to-lumen HCO3 transport for distal nephron perfusions with the HCO3-containing solution 1. "Passive" and "apparent" blood-to-lumen HCO3 permeability were calculated as above to yield "total" secretion 11 ; that is reported in these studies. Distal nephron H secretion was calculated for perfusions with solution 1 by subtracting calculated total secretion a negative value ; from measured net HCO3 reabsorption 11 and fudr.
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