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Cloning method for determining HPRT mutant frequencies in lymphoblastoid cells has been previously described 14, 15 ; . Briefly, after 3 days of exposure of TK6 cells in medium containing 0, 33, 100, and 300 M AZT or ddI, or equimolar concentrations of each drug, cells n 5 flasks per group ; were washed and subcultured in nonselective medium for 7 days to allow phenotypic expression of HPRT mutations. Then cells were plated in microtiter dishes in the absence and presence of selective agent 6-thioguanine ; for determining cloning efficiencies and identifying HPRT mutants, respectively, 10 days after plating. HPRT mutant frequency was calculated as the ratio of mean cloning efficiency in selective medium to that in nonselective medium 14 ; . The method used for measuring HPRT mutant frequencies was used to determine TK mutant frequencies, except that the time allowed for phenotypic expression of TK mutations was 3 days, the selection agent was trifluorothymidine, and plated cells were scored at 28 days after plating 15.

New data from the ASCOT study on the management of hypertension has prompted the UK National Institute for health and Clinical Excellence NICE ; to undertake an early review of its clinical guidelines on this condition in adults in primary care. This review is in collaboration with the National Collaborating Centre for Chronic Conditions NCC-CC ; and the British Hypertension Society BHS ; . It comes after an expert advisory committee, set up by NICE and the BHS, considered new data, which evaluated combinations of new antihypertensive drugs compared with old regimens, and their potential impact on current NICE and BHS guidelines Scrip No 3087, p 6 ; . Professor Peter Littlejohns, NICE clinical and public health director, said the new data would have a significant influence on the pharmacological treatment of hypertension. The BHS and NCC-CC will begin the review work immediately, and a guideline development group will develop the review's recommendations, for example, pyrilamine maleate. BICNU . 13 BIDIL . 25 bisoprolol. 19, 22 bisoprolol hydrochlorothiazide . 19, 22, 23 bleomycin . 14 BLEPHAMIDE SOP oint 10% 0.2% . 38, 39 brimonidine 0.2% . 38 bromocriptine . 16, 35 brompheniramine pseudoephedrine 4 mg 45 mg per 5 mL. 40 brompheniramine pseudoephedrine ext-rel 12 mg 120 mg . 40 brompheniramine pseudoephedrine ext-rel 6 mg 60 mg. 40 bumetanide. 23 bumetanide inj . 23 BUPHENYL . 29 bupropion . 10 bupropion ext-rel . 10, 29 buspirone . 18 BUSULFEX . 13 BYETTA . 20 cabergoline . 35 CADUET. 22, 24 calcitonin-salmon spray . 33 calcitriol. 42 calcitriol inj . 42 CALCITRIOL inj. 42 CAMPATH. 13 CAMPRAL . 29 CAMPTOSAR. 14 CANASA . 37 CAPITROL . 28 captopril . 24 captopril hydrochlorothiazide. 23, 24 CARAC . 29 CARAFATE susp . 30 carbamazepine . 9 CARBATROL . 9 carbidopa levodopa . 16 carbidopa levodopa ext-rel . 16 carbinoxamine pseudoephedrine 1 mg 15 mg per mL . 40 carboplatin. 14 CARDIZEM CD 360 mg. 22 CARDIZEM LA. 22 carisoprodol . 42 CASODEX . 35 CATAPRES-TTS . 19, 21.

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P06 SQUAMOUS CELL CARCINOMA AND ANORECTAL FISTULAS IN CROHN'S DISEASE. C. Verbaandert 1 ; , R. Detry 2 ; , R. Fiasse 3 ; , Ch. Sempoux 1 ; . 1 ; Dept. of Pathology ; 2 ; Dept. of Surgery ; 3 ; Dept. of Gastroenterology, Clin Univ St Luc, 1200 Brussels, Belgium. A 44 year-old female with a 22 year history of colic Crohn's disease, was hospitalized for severe loss of weight and asthenia. She complained of diarrhea and feces incontinence. Clinical examination revealed erythematous perianal skin with fistulous tracts and extensive anorectal induration. Biopsies taken during the rectosigmoidoscopy demonstrated the presence of a minimally invasive squamous cell carcinoma. Abdominoperineal excision was performed. Histological analysis revealed a peculiar feature of massive colonization of fistulous tracts by a keratinizing squamous cell carcinoma. It was notably extending into a fistula to the posterior vaginal cul-de-sac. None of the 38 lymph nodes examined were metastatic. After 6 months, a massive recurrence of the tumor was found in the pelvis and the patient died 9 weeks later. Patients with inflammatory bowel disease are at increased risk for developing cancer. Anorectal Crohn's disease, which often induces fistulas, leads to a chronic perianal inflammatory status that is believed to be a long-term predisposing factor of the development of anal carcinoma. Recent literature 1 ; suggests a poorer prognosis of this type of malignancy in a context of Crohn's disease, as illustrated by our case report. One explanation is that the diagnosis may be delayed because cancer symptoms are usually attributed to the inflammatory disease, also by the patient himself. Regular follow-up and adequate treatment of Crohn's perianal disease could result in better prognosis of this rare event.

Summary of submission The Food Commission believes that policies on fortification should support national and international initiatives to promote healthy eating. The Food Commission believes that the addition of vitamins and minerals to foods should not be used for the purposes of "enrichment" of foods that also contain high levels of fat, salt and or sugar. Especially in the case of children's foods e.g. highly-sugared breakfast cereals, low-juice drinks, confectionery, etc. ; fortification may be used as justification for marketing and promoting products of questionable nutritional quality. The following pages show examples of products currently marketed for children in the UK which have high levels of sugar, fat and or salt and or low levels of healthy ingredients such as fruit juice ; , but which are also fortified. In 1999, the Food Commission conducted a survey of 260 food products containing added vitamins and minerals, which showed that the majority were of poor nutritional quality and propafenone, because side effects.

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By Robin Frank NARSAD turned the spotlight on the groundbreaking research of nine innovative scientists at its annual Klerman and Freedman Awards ceremony in New York City on July 26. The researchers, all of whom received NARSAD Young Investigator grants in 1997 or 1998, were recognized for outstanding achievement and work that is helping to shape the direction of psychiatric research in years to come. The prize-winning investigators, whose projects covered a wide range of intriguing topics in neuroscience, expressed their gratitude to NARSAD not only for the award, but for funding their research in the first place. Many of them pointed out that without the "seed" money provided by a NARSAD Young Investigator grant, they never could have gotten their projects off the ground. In many cases, their original NARSAD grant has led to major funding from the National Institutes of Health. Dr. Michael Quick, an associate professor at the University of California who received a Freedman Award honorable mention, noted, "The Freedman award illustrates NARSAD's commitment to basic science research. Our work could not have been done without this commitment by NARSAD." Dr. Quick, whose work has yielded important information on the basic biology of the serotonin transport process in the brain, has gone on to receive several grants from the NIH, including funding that will total $1.75 million over a ten-year period. He will also receive $750, 000 from the NIMH over a five-year period for a separate study. "The Klerman and Freedman Awards allow us the opportunity to recognize the vital contributions of young investigators who have received NARSAD grants, " said Constance Lieber, the organization's president. "The goal of these NARSAD grants is to give scientists who are just embarking on their careers a foothold in the research field, and it is so gratifying to see their work lead to major funding from the NIH!

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CARDIOVASCULAR SYSTEM Levosimendan `Simdax' Orion Heart failure 2002 3 Selective phosphodiesterase inhibitor. Levosimendan infusion vs dobutamine LIDO ; study found that levosimendan was superior to dobutamine with respect to haemodynamic improvement and tolerance in patients with decompensated heart failure. Mortality was also lower in the levosimendan-treated patients at 6 months and one year. Infusion approved in Sweden who will act as the reference member state in the EU. Recombinant form of the naturally occurring B-type natriuretic peptide BNP ; , a hormone secreted as one of the body's natural responses to heart failure. When compared to nitroglycerin, nesiritide was more effective and produced a more rapid improvement in haemodynamics. Levosimendan is likely to cost less than 500 per course. The incidence of heart failure is about one new case per 1000 population per year. Incidence increases with age to more than 10 cases per 1000 in people aged 85 years and over. An average GP list size 2000 ; will see about 20 patients with heart failure each year. Heart failure accounts for more than 4% of all general medical and cardiology admissions and more than 1% of the total NHS budget. In 1999 00 the number of hospital episodes with a primary diagnosis of heart failure was 10, 638 in this region, for example, methergine.
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Magnesium sulfate in mild preeclampsia Should magnesium sulfate be administered to women with mild preeclampsia? This is an enigmatic question that plagues obstetricians constantly. As previously mentioned, the primary objective of magnesium sulfate prophylaxis in women with preeclampsia is to prevent or reduce the rate of eclampsia and complications associated with eclampsia. Secondary benefits also include reduced maternal and perinatal mortalities and morbidities, even in women who do not develop convulsions. In addition, in women with mild preeclampsia, a secondary benefit could be a reduction in the rate of progression to severe preeclampsia 15 ; . The large Magpie Trial 9 ; showed that magnesium sulfate reduced the risk of eclampsia in women with preeclampsia, but it did not address mild preeclampsia. There are only 2 double-blind placebocontrolled trials evaluating the use of magnesium sulfate in patients with well-defined mild preeclampsia blood pressure of at least 140 90 mmHg taken on two occasions in the presence of new onset proteinuria ; . The first trial performed by Witlin et al 16 ; , women with a diagnosis of mild preeclampsia at term were randomized to receive standard therapy during labor and for 12 hours post partum with either magnesium sulfate n 67 ; or matching placebo solution n 68 ; . They found that no difference was observed in the progression to severe preeclampsia in both groups. The second larger trial was conducted by Livingston et al 17 ; They randomized total of 222 women with mild preeclampsia to receive intravenous magnesium sulfate n 109 ; or matched placebo n 113 ; . They found that there was no difference in the percentage of women who progressed to severe preeclampsia or in maternal or infant outcomes. However, the problem with these studies is that the number of patients enrolled was too few. The power, therefore, was too low for valid conclusions. There were no eclamptic seizures in either group, but the likelihood of eclampsia was low. A much large number of patients needs to be studied before the effectiveness or safety of magnesium sulfate for prevention of disease progression in women with mild preeclampsia can be stated with certainty. Therefore, the routine use of magnesium sulfate for seizure prophylaxis in women with mild preeclampsia is not recommended at present. Pharmacology and toxicology of magnesium sulfate, for example, pheniramine eye drops. Department of Psychiatry and Biobehavioral Sciences, 2Neuropsychiatric Institute and Brain Research Institute, University of California, Los Angeles, California 90095, USA; 3Stern College for Women, Yeshiva University, New York, New York 10016, USA Extinction of conditioned fear in animals is the explicit model of behavior therapy for human anxiety disorders, including panic disorder, obsessive-compulsive disorder, and post-traumatic stress disorder. Based on previous data indicating that fear extinction in rats is blocked by quinpirole, an agonist of dopamine D2 receptors, we hypothesized that blockade of D2 receptors might facilitate extinction in mice, while agonists should block extinction, as they do in rats. One day after fear conditioning mice with three pairings of a white noise conditional stimulus CS ; with moderate footshock, we injected the D2 antagonist, sulpiride, the D2 agonist, quinpirole, or vehicle, just before repeated CS presentations to generate extinction. We assayed fear by measuring behavioral freezing during extinction presentations and then drug-free during CS presentations 1 d later. We found that sulpiride injections before extinction training facilitated extinction memory 24 h later, while quinpirole partially blocked extinction memory compared with vehicle-injected controls. Notably, sulpiride treatment yielded significant extinction after spaced CS presentations, which yield no extinction at all in vehicle-treated mice. These findings suggest that dopamine D2-mediated signaling contributes physiological inhibition of extinction, and that D2 antagonists may be useful adjuncts to behavior therapy of human anxiety disorders and quinine.
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ANTICOAGULANTS Coumarin derivatives warfarin, dicumarol ; : Relatively safe to use; only small amount in breast milk; check PTT Heparin: Does not cross into breast milk; check PTT ANTICONVULSANTS Phenytoin Dilantin ; , phenobarbital: Generally considered safe; if high doses of phenobarbital are ingested, may cause drowsiness; short-acting phenobarbiturates secobarbital ; preferred, because they appear in lower concentration in milk Magnesium sulfate: Lactogenesis may be delayed ANTIDEPRESSANTS SSRI class Fluoxetin, Fluvoxamine ; Effect on newborn unknown current concern. ANTIHISTAMINES Diphenhydramine Benadryl ; , pheniraine Dimetane ; , Claritin, Allegra: May cause decreased milk supply; infant may become drowsy or irritable ANTIMETABOLITES Unknown, probably long-term anti-DNA effect on the infant; potentially very toxic ANTIMICROBIALS Aminoglycosides: May cause ototoxicity or nephrotoxicity if given for more than 2 weeks Ampicillin: Skin rash, candidiasis; diarrhea Azithromycin: No risk to newborn Chloramphenicol: Possible bone marrow suppression; too low a dose for Gray syndrome; refusal of breast Methacycline: Possible inhibition of bone growth; may cause discoloration of the teeth; use should be avoided Metronidazole Flagyl ; : Possible neurologic disorders or blood dyscrasias; delay breastfeeding for 12 hours after dose Penicillin: Possible allergic response; candidiasis Quinolones synthetic antibiotics ; : Can cause arthropathies Sulfonamides: May cause hyperbilirubinemia; use contraindicated until infant over 1 week old Tetracycline: Long-term use and large doses should be avoided; may cause tooth staining or inhibition of bone growth ANTITHYROIDS Thiouracil: Contraindicated during lactation; may cause goiter or agranulocytosis BARBITURATES Propylthiouracil: Safe; monitor infant thyroid function Phenothiazines: May produce sedation BRONCHODILATORS Aminophylline: May cause insomnia or irritability in the infant Ephedrine, cromolyn Intal ; : Relatively safe CAFFEINE Excessive consumption may cause jitteriness or wakefulness CARDIOVASCULAR Methyldopa: Increase in milk volume Propranolol Inderal ; : May cause hypoglycemia; possibility of other blocking effects, especially if infant has renal or liver dysfunction Quinidine: May cause arrhythmias in infant Reserpine Serpasil ; : Nasal stuffiness, lethargy, or diarrhea in infant CORTICOSTEROIDS Adrenal suppression may occur with long-term administration of doses greater than 10 mg day DIURETICS Furosemide Lasix ; : Not excreted in breast milk Thiazide diuretics Esidrix, Hydrodiuril, Oretic ; : Safe but can cause dehydration, reduce milk production HEAVY METALS Gold: Potentially toxic; gold salts--compatible with nursing Lead: Excreted in breast milk; high maternal levels can effect neuropsychologic development Mercury: Excreted in the milk and hazardous to infant HORMONES Androgens: Suppress lactation Thyroid hormones: May mask hypothyroidism LAXATIVES Peri-Colaces Ducolax: Relatively safe Milk of magnesia, metamucil: Relatively safe NARCOTIC ANALGESICS Codeine: Accumulation may lead to neonatal depression Meperidine: May lead to neonatal depression Morphine: Long-term use may cause newborn addiction. Medical malpractice disease strongly paser the defendant an alcoholic accumbens and requip. GROUP- C Tablets ; Date of Opening : S.No. 1. 2. 3. Name of the Item Tab. Aspirin 350 mg + Cal rbonate 105 mg + Anhydrous Citric Acid 35 mg soluble Aspirin ; Tab. Acetylsalicylic Acid 100 mg Tab. Baclofenac lOmg, 25 mg Tab. Antacid Dried Alum. Hydroxy Gel 300 mg + Mag. Alum. Silicate 50mg + Mag.Hydro.25 mg + Methyl polysiloxane 10 mg ; Tab. Amiodrone lOOmg. Tab. Amiodrone 200mg. Tab. Atenolol 50mg. Tab. Albendazole 400mg. Tab. Alprazolam 0.5mg. Tab. Activated Charcoal 250mg Tab. Amitryptyline 25 mg Tab. Amlodipine besylate 5mg Tab. Allyloestrenol 5 mg Tab. Alprazolam 0.25mg. Tab. Amoxapine 100 mg Tab. Amiloride HCL + Frusemide 40mg Tab. Multivitamin Therapeutic ; Tab. Etophylline 231 mg + Theophylline 69 mg Tab. Bisacodyl 5mg Tab. Bromocriptine 2.5mg Tab. Bromhexine HCL 3 mg Tab. Bromelain 40mg + Trypsin 48mg + Rutin lOOmg Tab. Carbamazepine 200mg Tab. Cinnarazine 25mg Tab. Clopidogrel 75 mg Tab. Tramodol Tab. Clomiphene 50mg Tab. Cyproheptadine 4mg Tab. Chlorpheniramine Maleate 4mg Tab. Chloroquine Phosphate 250mg. Tab.Dothitine Hcl 25 mg Tab. Chlorpromazine HCL 50mg Tab. Chlorpromazine HCL lOOmg Tab. Carbimazole 5mg Tab. Levocetrizine 5 mg, lOmg. Tab. Calcium Gluconate 500mg Tab. Calcium Carbonate 500mg Tab. Clonazepam 0.5mg Tab. Carbidopa 25mg + Levodopa 250mg A u Tab Tab Tab Tab Tab Tab Tab Tab Tab Tab Tab Tab Tab Tab Tab Tab Tab Tab Tab Tab Tab Tab Tab Tab Tab Tab Tab Tab Tab Tab Tab Tab Tab Tab Tab Tab Tab Tab Tab Approx Qty S.J.H. R.M.L. 3 Lac 1.5 Lac 2000 2 Lac 2 Lac.

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Zhihong Yang, MD, Dennis Diederich, MD, Kurt Schneider, MD, Robert Siebenmann, MD, Peter Stulz, MD, Ludwig von Segesser, MD, Marko Turina, MD, Fritz R. Biihler, MD, and Thomas F. Luscher, MD We investigated the release of endothelium-derived relaxing factor EDRF ; in response to serotonin and histamine in the human internal mammary artery and saphenous vein. The arteries and veins were obtained intraoperatively and were suspended in organ chambers to record isometric tension. In mammary arteries, histamine 10-8 to 3x10-6 M ; induced relaxations in rings with 705%, IC50, 6.5 0.2 ; but not without endothelium p 0.005 for rings with compared with those without endothelium, n 7-10 ; . The response was inhibited by methylene blue or hemoglobin, but not meclofenamate, and, therefore, EDRF was delineated as the mediator. Because chlorpheniramine but not cimetidine inhibited the response, EDRF was released by the H1-histaminergic receptor n 5-8 ; . In contrast, in saphenous veins, histamine caused only weak or absent endotheliumdependent relaxations, but contractions were enhanced in rings with endothelium p 0.05, n 6 ; . Serotonin did not induce endothelium-dependent relaxations, but contractions were markedly greater in veins compared with arteries p 0.005, n 6 ; . The endothelium inhibited the maximal contraction to serotonin in arteries p 0.034 ; but not in veins. Thus, EDRF protects against contractions induced by histamine and serotonin in the mammary artery but not in the saphenous vein. This may be important for improved graft function and patency of the artery compared with that of the vein. Circulation 1989; 80: 1041-1048.

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