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55. Steggerda, S. M., and Paschal, B. M. 2002 ; Regulation of nuclear import and export by the GTPase Ran. Int. Rev. Cytol. 217, 41-91 56. Cronauer, M. V., Schulz, W. A., Burchardt, T., Anastasiadis, A. G., de la Taille, A., Ackermann, R., and Burchardt, M. 2003 ; The androgen receptor in hormone-refractory prostate cancer: relevance of different mechanisms of androgen receptor signaling Review ; . Int. J. Oncol. 23, 1095-1102 57. Wilce, J. A., Leedman, P. J., and Wilce, M. C. 2002 ; RNA-binding proteins that target the androgen receptor mRNA. IUBMB Life 54, 345-349 58. Mulholland, D. J., Read, J. T., Rennie, P. S., Cox, M. E., and Nelson, C. C. 2003 ; Functional localization and competition between the androgen receptor and T-cell factor for nuclear beta-catenin: a means for inhibition of the Tcf signaling axis. Oncogene 22, 5602-5613 59. Chesire, D. R., and Isaacs, W. B. 2002 ; Ligand-dependent inhibition of betacatenin TCF signaling by androgen receptor. Oncogene 21, 8453-8469 60. Benten, W. P., Becker, A., Schmitt-Wrede, H. P., and Wunderlich, F. 2002 ; Developmental regulation of intracellular and surface androgen receptors in T cells. Steroids 67, 925-931 61. Faure, J., and Dagher, M. C. 2001 ; Interactions between Rho GTPases and Rho GDP dissociation inhibitor Rho-GDI ; . Biochimie 83, 409-414 62. Gosser, Y. Q., Nomanbhoy, T. K., Aghazadeh, B., Manor, D., Combs, C., Cerione, R. A., and Rosen, M. K. 1997 ; C-terminal binding domain of Rho GDP-dissociation inhibitor directs N-terminal inhibitory peptide to GTPases. Nature 387, 814-819 63. Yeung, K., Seitz, T., Li, S., Janosch, P., McFerran, B., Kaiser, C., Fee, F., Katsanakis, K. D., Rose, D. W., Mischak, H., Sedivy, J. M., and Kolch, W. 1999 ; Suppression of Raf-1 kinase activity and MAP kinase signalling by RKIP. Nature 401, 173-177 64. Ojika, K., Mitake, S., Tohdoh, N., Appel, S. H., Otsuka, Y., Katada, E., and Matsukawa, N. 2000 ; Hippocampal cholinergic neurostimulating peptides HCNP ; . Prog. Neurobiol. 60, 37-83 65. Fu, Z., Smith, P. C., Zhang, L., Rubin, M. A., Dunn, R. L., Yao, Z., and Keller, E. T. 2003 ; Effects of raf kinase inhibitor protein expression on suppression of prostate cancer metastasis. J. Natl. Cancer Inst. 95, 878-889 66. Corbit, K. C., Trakul, N., Eves, E. M., Diaz, B., Marshall, M., and Rosner, M. R. 2003 ; Activation of Raf-1 signaling by protein kinase C through a mechanism involving Raf kinase inhibitory protein. J. Biol. Chem. 278, 13061-13068.
46. British Pharmaceutical Conference Group Discussion Sessions: How pharmacy might operate in the future including the switch from POM to P Pharmaceutical Journal 1994: 253: 575-577 Oct 22 ; 47. Nine POM to P changes for Dec 30. News ; Pharmaceutical Journal 1994: 253: 869 Dec 17 ; 48. OTC topical hydrocortisone for eczema. News ; Pharmaceutical Journal 1995: 254: 50 Jan 14 ; 49. Anusol Plus HC first OTC haemorrhoid product with hydrocortisone. News ; Pharmaceutical Journal 1995: 254: 353 Mar 18 ; 50. Society suggests more POM-to-P changes Society ; Pharmaceutical Journal 1995: 254: 433 Apr 1 ; 51. Adcortyl in Orabase moves over the counter for treating mouth ulcers. News ; Pharmaceutical Journal 1995: 254: 572 Apr 29 ; 52. Five POM to P changes at the end of June. News ; Pharmaceutical Journal 1995: 254: 786 Jun 10 ; 53. Topical minoxidil now available over the counter for treating hair loss. News ; Pharmaceutical Journal 1995: 255: 267 Aug 26 ; 54. OTC fluconazole for vaginal candidiasis launched. News ; Pharmaceutical Journal 1995: 255: 609 Nov 4 ; 55. Changes to POM order for budesonide nasal and beclomethasone dipropionate for allergic rhinitis. News ; Pharmaceutical Journal 1995: 255: 869 Dec 23 30 ; 56. Consumers' Association to oppose all POM to P switches until it has found "conclusive evidence that pharmacists are giving the advice that ensures safe use of medicines by consumers". Pharmaceutical Journal 1996: 256: 8-9 Jan 6 ; 57. Two new POM to P proposals: azelastine and nizatidine News ; Pharmaceutical Journal 1996: 256: 114 Jan 27 ; 58. POM to P for Perinal Spray ? News ; Pharmaceutical Journal 1996: 256: 180 Feb 10 ; 59. Nizoral shampoo goes from POM to P. News ; Pharmaceutical Journal 1996: 256: Feb 24 ; 60. Two new POM to P changes azelastine and nizatidine; and Perinal spray exempt from POM control. News ; Pharmaceutical Journal 1996: 256: 848 Jun 22 ; 61. Latest MCA proposals include mebeverine and six other named products. News ; Pharmaceutical Journal 1996: 257: 174 Aug 10 ; 62. Consumers' Association to oppose all POM-to-P switches News ; Pharmaceutical Journal 1996: 256: 8-9 Jan 6.
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Mutagenesis All SEC26 truncations and mutants were created in pRS315 [67] for evaluation of functionality in the sec26 tester strain RCY3130; MAT his30 leu20 ura30 lys20 SEC26KANR [pRC2374; pRS316 SEC21 SEC26] [16] ; after plasmid shuffling or dominant negative activity in a wild type strain RCY239; MATa ura3-52 leu2, 3112 ; . Non-essential KANR single knockout strains were obtained from Research Genetics, Inc., Huntsville, AL; other knockouts were created using standard techniques.
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The animal experiments were approved by the Animal Ethics Committee of the Government of Lower Saxony. The study was supported by grants from Rhne-Poulenc Rorer and Deutsche Forschungsgemeinschaft Na 165 22 ; . These data were presented, in part, at the ThirtySeventh Interscience Conference on Antimicrobial Agents and Chemotherapy, Toronto, Canada, 28 September 1 October, 1997. 93.
5 mg h may be appropriate for some patients. Compatibility: Diltiazem hydrochloride injection was tested for compatibility with three commonly used intravenous fluids at a maximal concentration of 1 mg diltiazem hydrochloride per milliliter. Diltiazem hydrochloride injection was found to be physically compatible and chemically stable in the following parenteral solutions for at least 24 hours when stored in glass or polyvinylchloride PVC ; bags at controlled room temperature 15 to 30C 59 to 86F ; or under refrigeration 2 to 8C 46F ; . dextrose 5% ; injection sodium chloride 0.9% ; injection dextrose 5% ; and sodium chloride 0.45% ; injection Physical Incompatibilities: Because of potential physical incompatibilities, it is recommended that diltiazem hydrochloride not be mixed with any other drugs in the same container. If possible, it is recommended that diltiazem hydrochloride not be co-infused in the same intravenous line. Physical incompatibilities precipitate formation or cloudiness ; were observed when diltiazem hydrochloride injection was infused in the same intravenous line with the following drugs: acetazolamide, acyclovir, aminophylline, ampicillin, ampicillin sodium sulbactam sodium, cefamandole, cefoperazone, diazepam, furosemide, hydrocortisone sodium succinate, insulin regular: 100 units mL ; , methylprednisolone sodium succinate, mezlocillin, nafcillin, phenytoin, rifampin, and sodium bicarbonate. Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration whenever solution and container permit. Transition to Further Antiarrhythmic Therapy. Transition to other antiarrhythmic agents following administration of diltiazem hydrochloride injection is generally safe. However, reference should be made to the respective agent manufacturer's package insert for information relative to dosage and administration. In controlled clinical trials, therapy with antiarrhythmic agents to maintain reduced heart rate in atrial fibrillation or atrial flutter or for prophylaxis of PSVT was generally started within 3 hours after bolus administration of diltiazem hydrochloride. These antiarrhythmic agents were intravenous or oral digoxin, Class 1 antiarrhythmics e.g., quinidine, procainamide ; , calcium channel blockers, and oral beta-blockers. Experience in the use of antiarrhythmic agents following maintenance infusion of diltiazem hydrochloride injection is limited. Patients should be dosed on an individual basis and reference should be made to the respective manufacturer's package insert for information relative to dosage and administration and hydromorphone.
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Effect on the synthesis of other proteins; the time lag before the effect is observed; the requirement for RNA and protein syntheses; the requirement for the steroid hormone; and the requirement for induced levels of glycerol phosphate dehydrogenase mRNA. Bt + AMP, 3-isobutyl-1-methylxanthine, and norepinephrine plus 3-isobutyl-1-methylxanthine were effective in increasing the induced specific activity of glycerol phosphate dehydrogenase whether added together with or after the steroid hormone in C6 cells Tables III and IV ; . However, norepinephrine was effective in C6 cells only when added after hydrocortisone, confirming previously published findings 17 ; . Two facts can be used to interpret these data. First, norepinephrine produces a transient rise in the level of CAMP. After the addition of norepinephrine to C6 cells, the concentration of CAMP rises to a maximum at 15 min then begins to rapidly decline and cannot be restimulated by norepinephrine for 24 h or longer 17, 34, 70 ; . Second, the time required to accumulate fully induced levels of glycerol phosphate dehydrogenase mRNA is 18 to Thus, the simultaneous addition of norepinephrine and hydrocortisone could stimulate the synthesis of the postulated "factor, " but the factor would have decayed before glycerol phosphate dehydrogenase mRNA had accumulated in response to hydrocortisone. This is in contrast to the effect of B&, or 3-isobutyl-1-methylxanthine, or norepinephrine together with 3-isobutyl-1-methylxanthine, which cause the level of CAMP and thus the postulated factor to remain elevated for a longer period of time. In contrast to C6 cells, the simultaneous addition of norepinephrine together with hydrocortisone is effective in potentiating the induction of glycerol phosphate dehydrogenase in dissociated rat cerebral cells in culture. The reason for the difference between primary cell cultures and the C6 cell line is not clear, but may be due to the fact that rat brain cells in culture3 and rat brain slices 71 ; do not exhibit refractoriness and in the presence of norepinephrine, continually produce CAMP. It appears that only low intracellular levels of CAMP are necessary to increase the induced specific activity of glycerol phosphate dehydrogenase. This is supported by the fact that 3-isobutyl-1-methylxanthine alone was effective in potentiating the induced level of glycerol phosphate dehydrogenase, yet 3-isobutyl-1-methylxanthine by itself causes only a 2-fold increase in the intracellular level of CAMP in C6 cells 72 ; ." In addition, low concentrations of norepinephrine 30 nM ; are very effective in potentiating the induction of glycerol phosphate dehydrogenase, whereas maximal stimulation of CAMP occurs with higher concentrations of norepinephrine around 300 nM ; 17, 34 ; . Immunocytochemical experiments at both the light and electron microscopic level, using a monospecific antiserum against rat glycerol phosphate dehydrogenase, have demonstrated that only one population of brain cells is positive for the presence of glycerol phosphate dehydrogenase 73 ; . These positive staining cells have been identified as oligodendroglia by classical morphological criteria 73 ; . Our results represent the first demonstration of the interaction of glucocorticoid hormones with a neurotransmitter norepinephrine ; , and with cyclic nucleotides, which affects the rate of synthesis of an enzyme in oligodendroglia. This neuroendocrine interaction may represent a general regulatory mechanism to control the synthesis of specific cellular constituents in oligodendroglia, and since these cells are responsible for the synthesis and.
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Before us, and we smote him and his sons and all his people. And we took all his cities the same season, and destroyed all the cities with men, women, and children and let nothing remain, save the cattle only we caught unto ourselves and the spoil of the cities which we took, from Aroer upon the brink of the river of Arnon, and the city in the river, unto Galaad: there was not one city too strong for us. The Lord our God delivered all unto us: only unto the land of the children of Ammon ye came not, nor unto all the coast of the river Jabock nor unto the cities in the mountains, nor unto whatsoever the Lord our God forbade us. [Chpt 3] Then we turned and went up the way to Basan. And Og the king of Basan came out against us: both he and all his people to battle at Edrei. And the Lord said unto me: fear him not, for I have delivered him and all his people and his land into thy hand and thou shalt deal with him as thou dealest with Sihon king of the Amorites which dwelt at Hesbon. And so the Lord our God delivered into our hands, Og also the king of Basan and all his folk. And we smote him until nought was left him. And we took all his cities the same season for there was not a city which we took not from them ; even three score cities, all the region of Argob, the kingdom of Og in Basan. All these cities were made strong with high walls, gates and bars, beside unwalled towns a great many. And we utterly destroyed them, as we played with Sihon king of Hesbon bringing to nought all the cities with men, women and children. But all the cattle and the spoil of the cities, we caught for ourselves. And thus we took the same season, the land out of the hand of two kings of the Amorites on the other side Jordan, from.
Cyanide can be found in a liquid solutions of cyanide salts ; , solid cyanide salts ; , or gaseous hydrogen cyanide ; form. In solid form, it is white with a faint almond odor 20% of the population are genetically unable to detect the odor ; . Hydrogen cyanide gas may be formed when acid is added to cyanide salt or a nitrite or when plastics burn. If there is a large amount of liquid or solid cyanide material on the victim's clothing or skin, there is a significant risk of exposure to rescuers. Exposure can occur through skin absorption, eye contact, inhalation, and ingestion and hydroxyurea.
Obtain adequate funding including CMP funds, at state and local level to support adequate staff including volunteers ; for number of beds in New York, and to have a full time coordinator for each program or cluster of programs as appropriate ; . NTSOFA LTCOP to aggressively pursue: New partnerships to bring new volunteers to the program e.g. Universities Schools of Social Work, Gerontology, Private industry- Target Corp., Associations- National Education Association NEA Prepare and generate on going publicity promotion to provide public information regarding LTCOP and to recruit volunteers To improve and increase LTCOP training resources in New York by: NYSOFA LTCOP will have a full time training coordinator who will develop and provide training and training resources for local programs Increase the use of technology- e.g. distance learning, Tele- and Video- conferencing, CD's Develop and maintain comp. modules with appropriate materials: o Program management o Volunteer management: training, supervision and retention o Basic, continuing education, advanced.
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Modifications in ring C are shown in Figure 5.116. Bromination to the 12-keto function generates the 11-bromo derivative, which on treatment with base gives the 12-hydroxy-11-ketone by a base-catalysed ketoenol tautomerism mechanism. The 12-hydroxyl is then removed by hydride displacement of the acetate using calcium in liquid ammonia. The new 11-keto sapogenin is subjected to the side-chain degradation used with other sapogenins, e.g. diosgenin see Figure 5.119 ; , to the 11-ketopregnane Figure 5.117 ; which can then be used for conversion into cortisone, hydrocortisone, and other steroid drugs. Of much greater importance was the discovery in the mid-1950s that hydroxylation at C-11 could be achieved via a microbial fermentation. Progesterone was transformed by Rhizopus arrhizus into 11-hydroxyprogesterone Figure 5.118 ; in yields of up to 85%. More recently, Rhizopus nigricans has been employed, giving even higher yields. 11-Hydroxyprogesterone is then converted into hydrocortisone by chemical means, the 11 configuration being introduced via oxidation to the 11-keto and then a stereospecific reduction step. Progesterone could be obtained in good yields about 50% ; from diosgenin extracted from Mexican yams Dioscorea species; Dioscoreaceae ; see page 239 ; or stigmasterol from soya beans Glycine max; Leguminosae Fabaceae ; see page 256 ; . Steroidal sapogenins such as diosgenin may be degraded by the Marker degradation.
Cardiac Arrhythmia Center, Department of Medicine Cardiovascular Division ; , University of Minnesota Medical School, Minneapolis, Minnesota, U.S.A and ibritumomab.
Abstract Use of NSAIDs has been associated with decreased risk of breast cancer in epidemiological studies. Thus, a high inflammatory response may be associated with increased breast cancer risk. It is thus possible that genetic variations leading to a modified inflammatory response will influence breast cancer risk. The purpose of this study was to determine if polymorphisms associated with an altered inflammatory response are associated with breast cancer risk, and to investigate the possible interaction with lifestyle factors such as alcohol use, smoking and NSAID use. We matched 361 female breast cancer cases with 361 controls, nested within the prospective "Diet, Cancer and Health" study. Carriers of the variant Ala-allele of PPAR2 Pro12Ala were at lower risk of breast cancer IRR 0.67, 95%CI 0.46-0.97 ; . This was primarily due to an interaction with alcohol consumption. Alcohol consumption was associated with a 1.21-fold increased risk of breast cancer pr 10 g alcohol day 95% CI 1.06-1.35 ; among homozygous wild type carriers, whereas alcohol was not associated with breast cancer risk among variant allele carriers P for interaction 0.005 ; . NSAID users, who were carriers of the variant allele of PPAR2 Pro12Ala, were at lower risk of breast cancer IRR 0.44; 95%CI 0.26-0.73 ; compared with non-users carrying wildtype alleles P for interaction 0.03 ; . No effects were found for IL6 G-174C, IL8 T-251A and COX2 T8473C. Our results suggest that PPAR2 Pro12Ala is an important determinant in alcohol mediated breast carcinogenesis. We also observe interaction between NSAID, alcohol consumption and PPAR2 Pro12Ala genotype in relation to breast cancer risk.
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Fig 1. -- Patients' valuation of health states associated with transfusiondependence and transfusion-independence. This figure illustrates how MDS patients N 8 ; from an independent interview survey valued health states associated with being transfusion dependent and transfusion independent. The interview used the so-called time trade-off TTO ; method to value the health states on a scale anchored on 1 perfect health ; and 0 dead ; . Higher ratings represent better health states. These ratings, also called "health utilities, " were used in the cost-effectiveness model as a quality adjustment to calculate QALYs in each arm of the model and idarubicin.
Acknowledgements. We thank Mrs Krystyna Wilczewska and Mrs MaBgorzata Zak for helpful technical assistance. Our study was supported by grants from The Medical University of Gdansk ST28 and ST4 and hydrocortisone.
1968 13. FISHER RA: Statistical Methods for Research Workers. Edinburgh and London, Oliver and Boyd, 1948 14. LOWN B, WOLF M: Approaches to sudden death from coronary heart disease. Circulation 44: 130, 1971 CORONARY DRUG PROJECT RESEARCH GROUP, REPORT OF THE: The prognostic importance of premature beats following myocardial infarction: Experience in and ifex.
Function respiratory burst and phagocytosis ; remained intact, indicating that lowdose hydrocortisone did not suppress innate defense mechanisms. Our results are in agreement with recent reports of hydrocortisone-induced attenuated systemic inflammatory response, evidenced by reduced phospholipase A2, neutrophil elastase, C-reactive protein, and interleukin-6 plasma concentrations.25; 59 Overall, hydrocortisone did not induce immunosuppression. Several markers like interleukin 10 and soluble tumor necrosis factor receptors decreased during hydrocortisone therapy. Moreover, the inhibition of interleukin 6 synthesis attenuated the antiinflammatory response, since this cytokine is increasingly recognized as an antiinflammatory mediator60 A switch from TH1 to TH2 cells and overproduction of antiinflammatory cytokines promote the risk of infection and may worsen outcome.6163.
Indications: An adjunct in the treatment of nonspecific inflammatory diseases involving the rectum, sigmoid and left colon such as idiopathic ulcerative colitis, ulcerative proctitis, regional enteritis granulomatous colitis ; with left side involvement, proctitis, proctocolitis, and radiation proctitis. Contraindications: Local contraindications to the use of intrarectal steroids include obstruction, abscess, perforation, peritonitis, fresh intestinal anastomoses, extensive fistulas and sinus tracts. Active tuberculosis active, latent or nonpositively healed ; , ocular herpes simplex, and acute psychosis are usually considered absolute contraindications to the use of corticosteroids. Relative contraindications include active peptic ulcer, acute glomerulonephritis, myasthenia gravis, osteoporosis, diverticulitis, thrombophlebitis, psychic disturbances, pregnancy, diabetes, hyperthyroidism, acute coronary disease, hypertension, limited cardiac reserve, and local or systemic infections, including fungal, viral or exanthematous diseases. Where these conditions exist, the expected benefits from hydrocortisone retention enema must be weighed against the risks involved in its use. If there is no evidence of clinical or proctologic improvement within 2 or 3 weeks after starting hydrocortisone retention enema therapy, discontinue the drug. Warnings: No data supplied by the manufacturer. Precautions: Hydrocortisone retention enema should be administered with caution in patients with severe ulcerative disease because these patients are predisposed to perforation of the bowel wall. In the advanced stages of chronic ulcerative colitis, where there is loss of mucosa, and thickening and fibrosis of the bowel wall, steroid therapy theoretically might hasten deterioration, although this has not been proved with steroids in actual practice. In severe cases, such as acute fulminating ulcerative colitis, where surgery is imminent, in the absence of marked clinical improvement, it is hazardous to wait more than a few days for a satisfactory response to medical treatment. Of particular importance is the complication of adrenal insufficiency caused by suppression of the adrenal cortex by glucocorticoids, especially after prolonged therapy. It is therefore important that therapy be withdrawn gradually. If the patient is subjected to unusual stress, while on therapy or up to year after discontinuation of steroids, adequate supportive measures and increased or reinstated systemic steroid therapy are indicated. In the case of surgery, these measures should be continued throughout the pre- and the postoperative recovery periods, bearing in mind the possible deleterious effects of corticosteroids on fresh intestinal anastomoses. Steroid therapy might impair the prognosis in surgery by increasing the hazard of infection. If infection is suspected, appropriate antibiotic therapy must be administered, usually in doses larger than those customarily employed. General precautions common to all corticosteroids therapy should be observed during treatment with hydrocortisone retention enema, including those pertaining to growth suppression in children during prolonged use. Patients should be kept under close observation, for, as with all drugs, rare individuals may react unfavorably under certain conditions. If severe reactions or idiosyncrasies occur, steroids should be discontinued immediately and appropriate measures instituted. Pregnancy: If it is necessary to use hydrocortisone retention enema in pregnant patients, the infants of these mothers should be closely observed following delivery for signs of hypoadrenalism and appropriate measures, including administration of corticosteroids, should be instituted if such signs are seen. Corticosteroid therapy may cause hyperacidity or peptic ulcer, and may aggravate diabetes mellitus or precipitate manifestations of latent diabetes mellitus. When hydrocortisone retention enema is used in the presence of glaucoma, intraocular pressure should be measured frequently and optic nerve heads and visual fields observed. Patients should be advised to inform subsequent physicians of the prior use of corticosteroids. Adverse Effects: Hydrocortisone retention enema may produce adverse effects known to occur with other forms of hydrocortisone therapy. These include moon face, buffalo hump, fluid retention, excessive appetite and weight gain, abnormal fat deposits, mental symptoms, hypertrichosis, acne, striae, ecchymosis, increased sweating, pigmentation, dry scaly skin, thinning scalp hair, thrombophlebitis, decreased resistance to infection, negative nitrogen balance with delayed bone and wound healing, menstrual disorders, neuropathy, peptic ulcer, decreased glucose tolerance, hypopotassemia, adrenal insufficiency, necrotizing angiitis, hypertension, pancreatitis and increased intraocular pressure. In children, suppression of growth may occur. Increased intracranial pressure may occur and possibly account for headache, insomnia and fatigue. Subcapsular cataracts may result from prolonged usage. Long-term use of all corticosteroids results in catabolic effects characterized by negative protein and calcium balance. Osteoporosis, spontaneous fractures and aseptic necrosis of the hip and humerus may occur as part of this catabolic phenomenon. Where hypokalemia and the other symptoms associated with fluid and electrolyte imbalance call for potassium supplementation and salt-poor or salt-free diets, these may be instituted and are compatible with the diet requirements for ulcerative colitis. Overdose: For management of a suspected drug overdose, CPhA recommends that you contact your regional Poison Control Centre. See the CPS Directory section for a list of Poison Control Centres. Treatment: No known antidote but gastric lavage should be performed and ifosfamide.
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This report is the largest to describe 192Ir HDRB for vaginal cancer using both intracavitary and interstitial techniques. The results suggest that this is a reasonable approach for continued investigation, with good tumour response and acceptable toxicity. Of those patients who had measurable disease at the initiation of brachytherapy, 91% 10 11 ; experienced a complete response. The crude recurrence rate for patients with early-stage tumours that were not melanomas was only 11% 1 9 ; . Patients with late-stage disease and melanomas faired predictably worse, decreasing the overall 2 year PFS and OS to 39.9% and 66.1%, respectively. Conventional brachytherapy has long played a critical role in the treatment of vaginal cancer. In a review of 49 cases treated between 1970 and 1988 at Memorial Sloan-Kettering Cancer Centre, Stock et al [11] found that 38 patients had some sort of brachytherapy incorporated into their treatment regimen 78% ; . Chyle et al [12] reviewed the 301 patients who received radiation therapy for vaginal cancer between 1953 and 1991 at M.D. Anderson Cancer Centre and found that brachytherapy predominated for early disease, with EBRT playing a more prominent role for more advanced disease. Brachytherapy was used in 100% of cases of Stage I tumours, compared with 70% of Stage II and 25% of Stage III tumours. In a more recent review, Perez [13] also discussed the use of EBRT and conventional brachytherapy for the treatment of vaginal cancer. He found the 10 year PFS to be 80% for Stage I, 55% for Stage IIA, 35% for Stage IIB, 38% for Stage III and 0% for Stage IV patients. The incidence of distant metastasis was 13%, 3052%, 50%, and 47% for Stages IIV, respectively. These three large studies form a context in which to compare our above results. Of note and iloprost.
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