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Growth as early as 1959. Most recently the cat model was exploited by Hassell and Cooper156 and by Hassell and Page145 to demonstrate that the major PHT metabolite can also elicit gingival overgrowth when administered per os on a chronic daily regimen. This has led to the hypothesis, as yet untested, that the physiologic basis for "response" or "nonresponse" to PHT -- in terms of developing gingival overgrowth or not -- may be found in the genetically determined capacity of the host to deal metabolically with chronically administered PHT. The histopathology of the developing gingival overgrowth has also been studied using the feline model, both in response to PHT and in response to the major PHT metabolite, pHPPH.157 Using sequential biopsies from cat gingiva, stereologic methods were employed to quantitate the fibroblast component of feline gingival connective tissue over a 3-month period of drug administration. At weeks 6 and 8 after initiating the drug regimen, the number of fibroblasts per unit of tissue increased dramatically; however, by 3 months, as the lesions matured, the fibroblastto-matrix ratio returned to normal. The implication of this feline data, which supports previous observations in human tissues, is that the drug and or its major metabolite interact early on with resident gingival fibroblasts, causing a proliferation and an ensuing, if transient, true cellular hyperplasia. Cell division then appears to slow or cease, and rapid production of connective tissue matrix ensues, returning the cell-to-matrix ratio to normal in the mature, fibrous PHT-induced gingival lesions. The cat model is also being exploited to investigate the question of why not all individuals who ingest PHT develop gingival overgrowth. The underlying question is one of genetic susceptibility to the drug-induced pathology, which resides within the rubric of pharmacogenetics.158 In a series of cat breeding studies in which known ' 'responded' cats i.e., those that respond to PHT by developing gingival enlargement ; were mated to other responders and to nonresponders, Boughman and co-workers were attempting to decipher the inheritance patterns for this gingival pathology.159 Preliminary data from such breed cross-breed studies, which are inordinately laborious and time-consuming, indicated that the
Current literature suggests that ifosfamide is one of the most promising single chemotherapeutic agent in relapsed cases of gct and, therefore, it would be wise to keep this agent as a reserve; especially so since there is no survival advantage when it is used as a first-line agent.
References 1 Fenaux P, Chomienne C, Degos L. All-trans retinoic acid and chemotherapy in the treatment of acute promyelocytic leukemia. Semin Hematol 2001; 38: 1325. Lo Coco F, Nervi C, Avvisati, Mandelli F. Acute promyelocytic leukemia: a curable disease. Leukemia 1998; 12: 19661980. Tallman MS, Nabhan C. Management of acute promyelocytic leukemia. Curr Oncol Rep 2002; 4: 381389. Avvisati G, Lo Coco F, Mandelli F. Acute promyelocytic leukemia: clinical and morphologic features and prognostic factors. Semin Hematol 2001; 38: 412. Latagliata R, Petti MC, Fenu S, Mancini M, Spiriti MA, Breccia M et al. Therapy related myelodysplastic syndrome acute myelogenous leukemia in patients treated for acute promyelocytic leukemia: an emerging problem. Blood 2002; 99: 822824. Zompi S, Legrand O, Bouscary D, Blanc CM, Picard F, Casadevall N et al. Therapy-related acute myeloid leukaemia after successful therapy for acute promyelocytic leukaemia with t 15; 17 ; : a report of two cases and a review of the literature. Br J Haematol 2000; 110: 610613. Olney HJ, Mitelman F, Johansson B, Mrozek K, Berger R, Rowley JD. Unique balanced chromosome abnormalities in treatment-related myelodysplastic syndromes and acute myeloid leukemia: report from an international workshop. Genes Chromosomes Cancer 2002; 33: 413423. Ferrara F, Morabito F, Martino B, Specchia G, Liso V, Nobile F et al. CD56 expression is an indicator of poor clinical outcome in patients with acute promyelocytic leukemia treated with simultaneous all-trans-retinoic acid and chemotherapy. J Clin Oncol 2000; 18: 12951300.
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Aim We have previously trialed an outpatient regimen of Vinorelbine, Gemcitabine and filgrastim VGF ; , with or without Ifosfamide F-GIV ; for advanced lymphomas. We have now evaluated these regimens incorporating Rituximab for advanced CD20 positive non-Hodgkin's lymphoma NHL ; . Method Patients were stratified into Group 1 G1-first relapse, follicular NHL 12 months, other NHL 6 months Group 2 G2-primary refractory, early relapse, or first relapse Group 3 G3-relapse 2 post-ASCT with PFS 6 months ; . G1 and G3 received R-VGF Rituximab 375mg m IV, 2 Vinorelbine 25mg m IV, Gemcitabine 1000mg m IV Day 1 and 8, Pegfilgrastim Day 9 ; every 21 2 days. G2 received R-FGIV same as R-VGF with addition Ifosfamide 3g m on Day 1 ; . Patients failing to achieve 50% reduction in disease and PET negativity after 2 cycles were escalated G1 and G3 to R-F-GIV; G2 to IVAC inpatient Etoposide, Ifosfamide, Cytarabine, with Pegfilgrastim ; for a further 2 cycles. Result Twelve patients have been accrued. Diagnoses are DLCL 10; FL 1, Mantle Cell 1, Nodal Marginal Zone 1. Eleven patients have received 2 cycles; 8 have completed 4 cycles. Median age for those beyond cycle 2 is 66y range 38-84 ; . Rates of grade 3 or 4 haematological toxicity with RVGF 18 cycles ; were: neutropenia 2 18; thrombocytopenia 3 18; with R-F-GIV 8 cycles ; : anaemia 1 8, neutropenia 6 8, thrombocytopenia 4 8. There were six grade 3 or 4 non-haematological toxicities. Response Cheson BD, 1999 ; after two cycles was achieved in 6 7 2CR, 1 2 in 1CR, 1PD 2 in G3 CR, 1 off study post cycle 1 due toxicity but in CR ; . final assessment, response in 6 8 5CR, ; . Conclusion R-VGF and R-F-GIV appear to be well tolerated outpatient salvage regimens for CD20 positive NHL. Early outcome data suggest the regimen has significant activity.
We are a multinational business operating in a number of countries and the US dollar is the primary currency in which we conduct business. The US dollar is used for planning and budgetary purposes and as the presentation currency for financial reporting. We do, however, have revenues, costs, assets and liabilities denominated in currencies other than US dollars. Consequently, we enter into derivative financial instruments to manage our non-US dollar foreign exchange risk. We use derivative financial instruments primarily to reduce exposures to market fluctuations in foreign exchange rates. We do not enter into derivative financial instruments for trading or speculative purposes. All derivative contracts entered into are in liquid markets with credit-approved parties. The treasury function operates within strict terms of reference that have been approved by our board of directors.
This was the only departure from my normal consultation notes and did not affect the MAKING of the consultation notes." Dr F advised that she uplifted Ms A's original medical records from Dr J in mid-November 2003 on the advice of her lawyer, following receipt of a letter from my Office notifying her of the complaint. A photocopy of the records was left with Dr J. In subsequent correspondence via her lawyer in November 2004, Dr F confirmed that she still had the original medical records. In addition, in a letter dated 1 December 2004, Dr F stated: "I writing to correct what I have earlier said in my letter to you of 11 December 2003. This is with respect to the allegation that I had amended the medical notes for [Ms A]. It is correct that I have made three additions to the notes. They are: a ; For the entry of 24 [May] 02 I have added the words `admits irregular eating patterns' b ; For the entry of 11 10 have added the words `Not keen on further Ix' c ; For the entry of 2 12 have added] the words `advised TCI for Ix if no success at colonic clinic.' I believe I made these additions to the notes on or about 17 January 2003. I do however want to emphasise that the additions are correct that is to say they record observations that did occur at the particular consultations and which I could remember on 17 January 2003. That was a date shortly after I had learned of [Ms A's] diagnosis. They were most certainly not made with the purpose of any `cover up'. They were issues that I had discussed with [Dr J] to whom I was transferring the notes and I highlighted them for him as I referred to in my letter to you of 11 December 2003. I do want to apologise for this and I sincerely regret having misled you in this regard in my report of 11 December [2003]. I should confirm that the remainder of what I have said in my report to you is true and correct to the best of my knowledge and belief. Again I sorry for not having drawn to your attention, when I wrote my report on 11 December, that these alterations had been made." Other matters Dr F advised that in January 2004 she decided to leave the first medical centre because she had a job offer overseas. After selling her share of the practice, Dr F left on 30 June 2004. In response to this investigation, Dr G advised the Commissioner and the Medical Council of her concerns about Dr F, and alleged, that in addition to altering Ms A's notes Dr F had "set up patient dependency", blurred doctor patient boundaries, and tended to "belittle and blame patients, get angry with them, and tell them off". Dr G stated that she was also concerned because Dr F had told her that when she moved overseas to work she "would and iloprost.
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Were collected over 12 2-h periods on days 1 and 5 on both arms, starting 2 h before the first dose of mesna and ifosfamide. On days 3 and 4, a single 2-h sample was obtained on all patients starting 2 h before the first dose of mesna and ifosfamide. Plasma PK parameters for mesna and ifosfamide were: maximum concentrations Cmax ; of mesna and dimesna after each mesna administration i.v. or oral ; on day 5; Cmax of ifosfamide at the end of infusion; time to reach maximum plasma concentration tmax ; after each oral mesna administration on day 5; area under the concentration-time curves AUC0-last and AUC0 24 h ; for i.v. and oral mesna on day 5 over all three mesna administrations; terminal half-lives t1 2 ; after the final mesna dose on day 5; and predose plasma levels on days 25. Urine PK parameters were: cumulative urinary excretion at times 0 12 h and 0 24 h amounts and as a fraction of the daily mesna dose; maximum urinary excretion rates Rmax ; after oral and i.v. mesna doses; time to reach maximum excretion rates tmax nadir excretion rates Rmin ; at 2224 h; and predose urine levels on days 25. The sample size was determined on the basis of PK considerations. The study was not powered to detect differences in hematuria
From the tentorium, attached to parenchyma of the left temporooccipital lobe. It was 36 x25 mm in size. Both tumors had marked contrast enhancement, cystic component, and peritumoral edema. Histopathologic examination of the frontal lobe tumor revealed gliosarcoma, while the temporo-occipital tumor was found to be malignant meningioma. The patient received chemotherapy consisting of vincristine, VP-16, carboplatin, ifosfamide cyclophosphamide, and mesna. A tumor recurrence was detected during chemotherapy, for which a second surgery was performed. Histopathologic examination was again compatible with gliosarcoma, and this time the patient was treated with paclitaxel. Another tumor recurrence was noted after 4 courses of chemotherapy, and the patient died of tumor progression 18 months after admission. Extensive review of the literature revealed occasional reports that mention the presence of meningioma in association with glioblastoma, oligodendroglioma, glioma, ependymoma, and adenoma, but not with gliosarcoma. Neither NF, irradiation, nor any other etiologic factors supposedly associated with multiple primary brain tumors was present in our case. Although the presence of a genetic dysregulation leading to the development of these tumors can be speculated, there is no specific cytogenetic abnormality reported that is common to both gliosarcoma and malignant meningioma. Although this may be a case of coincidental occurrence of two separate neoplasms, further investigations for aberrations of the tumor suppressor genes should be performed and indinavir.
Arterioles to neurohypophyseal hormones and catecholamines. J Pharmacol Exp Ther 1975; 193: 403-412 Brodde OE: Endogenous and exogenous regulation of human alpha and beta-adrcnergic receptors. J Receptor Res 1983; 3: 151-162 Jones SB, Bylund DB, RieserCA, Shekim WO, Byer JA, Carr GW: Alpha-2 adrenergic receptor binding in human platelets: Alterations during the menstrual cycle. Clin Pharmacol Ther 1983; 34: 90-96 Rosen SG, Berk MA, Popp DA, Serusclat P, Smith EB, Shah.
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Ics and some self-reported symptoms more effectively and with fewer adverse effects than intravenous nitroglycerin. This trial suggests that nesiritide, in addition to diuretics intravenous and or oral ; , is a useful addition to initial therapy of patients hospitalized with acutely decompensated CHF and infliximab.
Less, some groups have identified persistent, albeit small, amounts of 4-hydroxycyclophosphamide in the plasma of mice [8] and humans [9], proposing that low levels of 4-hydroxycyclophosphamide in plasma reflect intracellular trapping of this compound [8]. Other groups have argued that the mustard is the major transport form. Struck et al. [10] studied the activity of isophosphoramide mustard against murine tumours, found it comparable to ifosfamide, and postulated that isophosphoramide mustard acts by membrane alteration and or non-DNA alkylation. The authors demonstrated that extracellularly delivered isophosphoramide mustard is an effective agent, with antitumour activity and selectivity in vivo comparable to ifosfamide and 4-hydroxyifosfamide. Sladek has reviewed values of the ratio of phosphoramide mustard AUC to 4-hydroxycyclophosphamide AUC in the plasma of mice, rats and humans, following a dose of cyclophosphamide, and also the sensitivities of.
To elevate the intracellular levels of ceramide. As shown in Fig. 6 treatment of TBE cells with 100 M H2O2 produced an increase in ceramide levels. Production of ceramide was detectable after 1 minute of H2O2 exposure, reached a plateau at 3 minutes, and remained elevated for hours. The rise in ceramide levels was 2 fold: from 127 pmoles per 106 control and intal.
Second, and inexorably related to the point raised above, history educators and textbook writers must consider their application of curriculum content and avoid the damaging effects of "mentioning" in which limited and ad hoc elements of the history and culture of minority groups are included without altering the central Anglo-centric story line. The third issue of importance is the need to ensure that relevant scholarship on the experiences of people of colour penetrates the educational system. Addressing and implementing these three recommendations poses a difficult challenge. In terms of understanding the Second World War it will require greater attention to the histories of ethnic groups within Britain and to peoples from the Empire, Commonwealth and beyond. Broader than this it will involve a reconceptualization of British identity, critical consideration of curriculum, pedagogy and instructional resources and a fierce commitment on the part of policy makers, the education establishment and, above all, teachers. If history education can go some way to embracing these three recommendations it will undoubtedly result in students having a more inclusive, more responsible, more exciting, and more worthwhile appreciation of our shared history.
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We thank Randall Kinnick and Raymond Phelps for the help in fabricating the custom tissue bath and Jennifer Milliken for secretarial assistance. DISCLOSURES This study was supported by an American Society of Echocardiography Grant-in-Aid Research Award to T. P. Abraham ; . M. Belohlavek receives partial research funding from GE Medical Systems. REFERENCES 1. Abraham T, Nishimura R, Holmes D Jr, Belohlavek M, and Seward J. Strain rate imaging for assessment of regional myocardial function: results from a clinical model of septal ablation. Circulation 105: 14031406, 2002. Abraham TP and Nishimura RA. Myocardial strain: can we finally measure contractility? J Coll Cardiol 37: 731734, 2001. Belohlavek M, Bartleson VB, and Zobitz ME. Real-time strain rate imaging: validation of peak compression and expansion rates by a tissue-mimicking phantom. Echocardiography 18: 565571, 2001. Bland JM and Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1: 307310, 1986. Greenberg NL, Firstenberg MS, Castro PL, Main ML, Travaglini A, Odabashian JA, Drinko JK, Rodriguez LL, Thomas JD, and Garcia MJ. Doppler-derived myocardial sys and invirase.
Low technological and financial inves-tment. The amount of technology per worker in schools is relatively low. From 70 to 90 per cent of the budget ordinarily goes to salaries, with a fraction for equipment and materials. The consequence is that social transactions, rather than socio-technical transactions, come to be the major working technique 1381. Sussman says: 'A school system which must house pupils in old, unsafe buildings, which can barely supply them with the minimum necessities in terms of textbooks, paper and chalk, which has a shortage of teachers - n o t speak of specialists like testers and remedial reading staff can hardly be expected to innovate. Even if an innovation promises to save money eventually, the process of instituting it is likely to be expensive'. The author also recalls Galbraith's observation that market economy countries have a tendency to affluence in the private sector and to underspending in the public sector.
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Table IV. Laboratory Results of Patients Group A Laboratory Test CBC FB$ CR BUN Total Chol. Total Trig. Sodium Potassium Urinalysis Normal No. % 15 12 14 Abnormal No. % 0 3 0 20.00 13.33 14.29 Normal No. % 15 14 15 Group B Abnormal No. % 0 1 6.67 0 2 13.33 3 0 0 and iressa.
Direct reactions of GSH with ifosfamide metabolites and or mesna. Our results indicate that mesna is a modulator of GSH precursors and that a prolonged infusion of mesna may be required to achieve GSH precursor starvation and the consequent GSH depletion in cells and ifosfamide.
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Received November 15, 2004; revision received January 20, 2005; accepted February 18, 2005. From the Medical Faculty of the Charit A.F., E.S., G.H., N.A.-S., R.D., M.W., S.M., F.C.L., D.N.M. ; , HELIOS Klinikum-Berlin, Franz Volhard Clinic, Berlin, Germany; Max Delbrck Center for Molecular Medicine F.C.L., D.N.M. ; , Berlin-Buch, Germany; Medical School of Hannover S.R. ; , Hannover, Germany; Novartis Institutes for Biomedical Research A.Y.J., R.L.W. ; , East Hanover, NJ; Centre Hospitalier Universitaire Vaudois J.N. ; , Hypertension Division, Lausanne, Switzerland; and University of Heidelberg C.M.-G. ; , Institute of Pharmacology, Heidelberg, Germany. * Drs Fiebeler and Nussberger contributed equally to this article. Correspondence to Anette Fiebeler, MD, Franz Volhard Clinic, Wiltberg Strasse 50, 13125 Berlin, Germany. E-mail fiebeler fvk-berlin 2005 American Heart Association, Inc. Circulation is available at : circulationaha DOI: 10.1161 CIRCULATIONAHA.104.521625 and irinotecan.
| Ifosfamide msds sheetAll participants will receive at least 2 cycles of adriamycin and ifosfamide chemotherapy ai.
The attribute binds a field, a property, or an indexed item containing a function pointer to the specification method see Section 3.13 for details ; . The EarlyBoundOpt variant allows adding a condition under which the binding is optional and isdn.
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