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Antidepressants Recently the rate of publications of controlled clinical trials demonstrating significant pain relief with several drugs has accelerated. Nevertheless, the symptomatic pharmacological treatment of chronic painful diabetic neuropathy remains a challenge. A survey of physicians experienced in treating neuropathic pain demonstrated that only a minority would rate results of analgesic treatment as excellent or good using antidepressants 40% ; , anticonvulsants 35% ; , opioids 30% ; or simple analgesics 18% ; [27]. For 30 years, psychotropic agents, among which antidepressants have been evaluated most extensively, constitute an important component in the treatment of chronic pain syndromes. Several authors consider the tricyclic antidepressants TCAs ; to be the drug treatment of choice for neuropathic pain. However, their use is limited by relatively high rates of adverse events and several contraindications. Thus, there is a need for agents that exert efficacy equal to or better than that achieved with TCAs but have a more favourable side effect profile. Because selective serotonin re-uptake inhibitors SSRIs ; have been found to be less effective than TCAs, recent interest has focused on antidepressants with dual selective inhibition of serotonin and noradrenaline, such as venlafaxine and duloxetine. In a 6 week trial among 244 patients the analgesic response rates were 56, 39 and 34% in patients given 150225 mg of venlafaxin, 75 mg of venlafaxin and placebo, respectively. Because patients with depression were excluded, the effect of venlafaxin 150225 mg ; was attributed to an analgesic, rather than antidepressant, effect. The most common adverse events were tiredness and nausea [28]. Duloxetine was effective in reducing neuropathic pain in diabetic patients at doses of 60 and 120 mg day in a 12 week trial [29]. The most frequent side effects included nausea, somnolence, dizziness and constipation each in 1028%. In a recent trial, venlafaxine was as effective as imipramine in reducing neuropathic pain, but tolerability was more favourable with venlafaxine [30]. Although duloxetine has not been formally compared with TCAs, the rates of adverse effects appear to be lower. Both venlafaxine and duloxetine have not yet been licensed for the treatment of neuropathic pain. Anticonvulsants Gabapentin is an anticonvulsant structurally related to g-aminobutyric acid, a neurotransmitter that plays a.
He term `congenital cranial dysinnervation disorders' or CCDDs was derived in 2002 at a European Neuromuscular Centre ENMC ; international workshop for a group of congenital neuromuscular diseases reflecting the belief that these disorders resulted from developmental errors in innervation.1 The conditions under consideration were characterised by abnormal eye, eyelid, and or facial movement. The group includes Duane syndrome, congenital fibrosis of the extraocular muscles CFEOM ; , congenital ptosis, horizontal gaze palsy, congenital facial palsy and Mbius syndrome, but this is not an exhaustive list. The current list of clinical phenotypes, genetic loci and genes is certainly incomplete. It is envisaged that other congenital dysinnervation disorders such as Marcus Gunn Jaw winking ptosis accompanied by elevation of the ptotic eyelid on movement of the lower jaw, due to aberrant trigeminal nerve innervation of levator palpebrae superioris ; and Crocodile tears food provokes excessive tearing, due to aberrant facial salivary fibres innervating the lacrimal gland ; and disorders of afferent pathways will also be included. The purpose of this classification is to study the genes underlying the CCDDs which should enhance our understanding of human brain stem and cranial nerve development, with common functional pathways likely to emerge, as well considering potential treatments for these disorders.
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Irritable bowel syndrome IBS ; is a very common diagnosis in gastroenterology that is done on the basis of the Rome symptomatic criteria. The basic clinical pattern is characterized by abdominal pain and changes in bowel habit, on the basis of which three different variants of IBS are recognized IBS with stipsis, IBS with diarrhea or IBS with alternated stipsis and diarrhea ; . No matter which variant is diagnosed, 92% of the patients with IBS complain of abdominal bloating, flatulence and meteorism, three symptoms that are, however, more probably related to a small intestine bacterial overgrowth SIBO ; rather than to IBS. A close relationship exists between the changes in pattern and distribution of gastrointestinal GI ; bacterial flora, and the altered GI motility changes in bowel habit ; and sensorial physiology abdominal pain and bloating ; observed in patients with IBS. It has been demonstrated that the mioelectric activity of intestinal loops are deeply modified by the presence of SIBO, leading to the hypothesis that many of the sensorial and motorial symptoms of IBS are really determined by changes in the GI bacterial flora[1]. Moreover, it is well known that both an acute GI infection[2, 3] and the use of systemic antibiotics[4, 5] lead to profound changes in GI bacterial flora, and that both the conditions may result in symptoms such as abdominal bloating and changes in bowel habit ; , which look like those of IBS[6-9]. Finally, it has been reported that even one single cycle of systemic antibiotics may provoke long-time sustained alterations of GI physiology[10], while a treatment with antibiotics specifically addressed to correction of intestinal.
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9: 44AM LH.00005 Reverse Dynamo-Flow Generation , SWADESH MAHAJAN -- The "reverse dynamo" mechanism, the amplification generation of the fast plasma flows by microscale turbulent ; magnetic fields via magneto-fluid coupling is recognized and explored. It is shown that macroscopic magnetic fields and flows are generated simultaneously and proportionately from microscopic fields and flows. The stronger the microscale driver is, the stronger the macroscopic products will be. A detailed calculation based on the double Beltrami driver fields is carried out to illustrate the general features of the system. 10: 10AM LH.00006 Entropy conservation in dynamic plasma simulations , JOACHIM BIRN, Los Alamos National Laboratory, MICHAEL HESSE, NASA Goddard Space Flight Center, KARL SCHINDLER, Ruhr-University Bochum, Germany -- The one-fluid magnetohydrodynamic MHD ; equations are the most common tool in investigating plasma behavior on temporal and spatial scales that are large compared to typical particle scales, such as gyroperiods and gyroradii. One of the frequent assumptions is that of adiabatic, i.e., entropy conserving, transport. In general, non-isotropic, plasmas this assumption may be violated, in addition to the possible break-down of the frozen-in flux approximation of ideal MHD. Here, entropy conservation is investigated for the dynamic field evolution associated with fast magnetic reconnection, based on a comparison between resistive MHD and particle-in-cell PIC ; simulations. Specifically, the entropy and mass integrated along magnetic flux tubes are compared between the simulations. It is shown that there is very good agreement between the conservation of these quantities in the two simulation approaches, despite the effects of dissipation, provided that the resistivity in the MHD simulation is strongly localized. This follows from the fact that dissipation is highly localized in the PIC simulation also, and that slipaage and heat flux across magnetic flux tubes have negligible effect. This result lends support for using the entropy-conserving MHD approach not only before and after reconnection but even as a constraint connecting the two phases.
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Although some statistically significant differences between patients being treated with EPOGEN and placebo-treated patients were noted, the overall safety profile of EPOGEN appeared to be consistent with the disease process of advanced cancer. During double-blind and subsequent open-label therapy in which patients n 72 for total exposure to EPOGEN ; were treated for up to 32 weeks with doses as high as 927 Units kg, the adverse experience profile of EPOGEN was consistent with the progression of advanced cancer. Three hundred thirty-three 333 ; cancer patients enrolled in a placebo-controlled double-blind trial utilizing Weekly dosing with EPOGEN for up to 4 months were evaluable for adverse events. The incidence of adverse events was similar in both the treatment and placebo arms. Surgery Patients Adverse events with an incidence of 10% are shown in the following table: Percent of Patients Reporting Event Patients PlaceboPatients Treated treated Treated With Patients With EPOGEN EPOGEN 100 U kg 600 U kg n 101 ; a n 103 ; a n 73 ; 50% 60% 47
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Note that in terms of the relationship between marker compounds and label claims, federal regulations 21 CFR part 101.9 g ; 3 ; , 101.9 g ; 4 ; , and 101.36 f ; 1 ; require that products be truthfully labeled with respect to their contents. The FDA has established two different minimum levels that label claims must meet depending on the type of ingredient. Fortified or fabricated Class I ; nutrients, whose content has been controlled in some fashion must meet 100% of label claim. Naturally occurring Class II ; nutrients, whose constituents occur naturally in an ingredient and whose level is not controlled must meet at least 80% of label claim. For DSVP, a botanical or "other dietary supplement" extract with declared chemical marker constituents on the label is considered a Class I standardized ; nutrient, whereas a powdered botanical or "other" dietary supplement is considered a Class II nonstandardized ; nutrient. In both cases, the rule applies to the product throughout its shelf life. Reference to the USPNF, other Pharmacopeias and standards on labels or labeling must be completely accurate. Other marks or seals cannot be used on the label without USP approval. Labeling must comply completely with all federal labeling regulations. The current edition of Herbs of Commerce, published by the American Herbal Products Association AHPA ; , should be consulted regarding the proper Latin Binomial and Standardized Common Name for each botanical species.
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A software package SFS Speech File System, from UCL ; was used as the UI for C-ToBI transcribing. Speech signal and fundamental frequency contour were shown to the transcriber, and associated with the phone and word boundary segmented by IBM ASR system. Those boundaries need to be modified manually sometime. To do labeling, first step is to label the intermediate phrase boundary, and the transcription on the prosodic structure tier is closed then; second step is to mark the break indices in different layers; the last step is to mark the stress indices in different layers. Figure 1. gives an example of C-ToBI annotation.
From The Leukemia Service and the Laboratory of Hematopoietic Cell Kinetics, Division of Hematologic Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, I C Submitted December 24, 1991; accepted Februaiy 11, 1992. Address reprint requests to Ellin Berman, MD, Memorial Sloan Kettering Cancer Center, 1275 YorkAve, New York, NY10021. The publication costs of this article were defrayed in part by page charge payment. This article must therefore be hereby marked "advertisement" in accordance with 18 U.S.C. section 1734 solely to indicate this fact. 0 1992 by The American Society of Hematology and ertapenem.
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Trends in Cerebrovascular Disease Mortality in Singapore: 1970 1994 --Venketasubramanian N Dept of Neurology, Tan Tock Seng Hospital, Moulmein Rd, Singapore 1130 ; --Int J Epidemiol. 1998; 27: 15 International Epidemiological Association 1998. Background Cerebrovascular disease has been the third leading cause of death in Singapore for the last 25 years. This study was carried out to examine recent trends in cerebrovascular disease mortality in Singapore, and to study corresponding changes in stroke risk factors in our population. Methods The Registry of Births and Deaths, Singapore, publishes annual reports on births and deaths. The cause of death is coded using the International Classification of Diseases Revisions 8 1969 1978 ; and 9 1979 onwards ; . Data for this study were obtained using rubrics 430 438. Death rates were age- and sex-standardized to the World Standard Population, and separately for males and females. Cerebrovascular disease risk factor patterns were derived from national epidemiological health surveys conducted from 1970 and 1994. Results The absolute number of deaths annually from cerebrovascular disease rose from 1041 in 1970 to 1692 in 1994. Crude death rates remained stable at 50 60 per 100 000, accounting for 10 12% of all deaths. Standardized death rates showed a distinct fall from 99 per 100 000 in 1976 to 59 per 100 000 in 1994, 101 to 60 per 100 000 in males and 95 to 57 per 100 000 in females. National health surveys have shown a fall in the prevalence of undetected hypertension, smoking and hyperlipidaemia; the prevalence of obesity was unchanged, while that of diabetes mellitus rose over the same period. The mortality trends found in this study are unlikely to be due to changing fashions in coding or inadequate data collection and esmolol.
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61 ; Come, T.V. and Travis, D.M.: J. Hered. 60, 39-41 1969 ; 62 ; Schiff, J.A. et al.: Methods Enzymol. Part A ; 23, 143-162 1971 ; 63 ; Kawachi, T. et al. in: Montesano, R. et al. eds. ; : IARC Scientific Publications No. 27, Lyon 1980 pp. 323-330 64 ; Ishidate, M. jr. et al.: Gann. Monogr ncer Res. 27, 95-108 1981 cited in: IARC Monographs on the Evaluation of Carcinogenic Risk to Humans, Vol. 51, Lyon, France 1991 pp. 291-390 65 ; Ishidate, M. jr.: Data Book of Chromosomal Aberration Tests in Vitro, rev. ed., Amsterdam, 410 1988 cited in: IARC Monographs on the Evaluation of Carcinogenic Risk to Humans, Vol. 51, Lyon, France 1991 pp. 291-390 66 ; Thompson, E.D.: Environ. Mutagen. 8, 753-767 1986 ; 67 ; Ishidate, M. jr. et al.: Gann Monogr. Cancer Res. 27, 95-108 1981 cited in: IARC Monographs on the Evaluation of Carcinogenic Risk to Humans, Vol. 51, Lyon, France 1991 pp. 291-390 68 ; Slamenova, D. et al.: Neoplasma 33, 457 -463 1986 cited in: IARC Monographs on the Evaluation of Carcinogenic Risk to Humans, Vol. 51, Lyon, France 1991 pp. 291-390 69 ; Novick, A. and Szilard, L.: Cold Spring Habor Symp. Quant. Biol. 16, 337 -343 1951 cited in: Timson, J.: Mutat. Res. 15, 197 -201 1972 ; 70 ; Novick, A. and Szilard, L.: Nature 170, 926-927 1952 cited in: Timson, J.: Mutat. Res. 15, 197 -201 1972 ; 71 ; Greer, S.B.: J. Gen. Microbiol. 18, 543-564 1958 cited in: Timson, J.: Mutat. Res. 15, 197 -201 1972 ; 72 ; Sacks, L.E. and Mihara, K.: Mutat. Res. 117, 55-65 1983 ; 73 ; Ishidate and Kada: Environmental Mutagens Data Book, Vol. 1 1980 p. 389 74 ; Kihlman, B.: Symb. Bot. Ups. 11 4 ; , 1-96 1952 cited in: Grant, W.F.: Mutat. Res. 99, 273-291 1982 ; 75 ; Kihlman, B.A. and Levan, A.: Hereditas 35, 109-111 1949 cited in: IARC Monographs on the Evaluation of Carcinogenic Risk to humans, Vol. 51, Lyon, France 1991 pp. 291-390 76 ; Kihlman, B.A. and Sturelid, S.: Hereditas 80, 247 -254 1975 ; 77 ; Fries, N. and Kihlman, B.: Nature 162, 573-574 1948 cited in: BASF AG, Literature Review 1991 ; 78 ; Fries, N. and Kihlman, B.: Nature 162, 573-574 1948 166.
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