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Address for reprint requests and other correspondence: K. E. Meier, Dept. of Pharmaceutical Sciences, Washington State Univ., PO Box 646534, Pullman, WA 99164-6534 e-mail: kmeier wsu ; . 1 This editorial focus should have been printed in the same issue as the article in focus by Chen et al. We apologize for the oversight. : ajpcell.

COMBIVENT COMBIVIR COMTAN CONDYLOX COPAXONE CORDARONE COREG CORTEF CORTIFOAM COUMADIN COZAAR CREON CRIXIVAN CUPRIMINE CYCLESSA CYTOVENE CYTOXAN D DANTRIUM DAPSONE DAYPRO DECONAMINE SR DEPAKOTE DEPAKOTE ER DEPAKOTE SPRINKLE DEPO-PRO VERA DETROL DIASTAT DIFLUCAN DIFLUCAN 150 ORAL DILANTIN DILAUDID DIOVAN to be deleted 08 01 03 ; DIOVAN HCT to be deleted 08 01 03 ; DIPENTUM DOSTINEX DOVONEX DURAGESIC E EFUDEX EFFEXOR EFFEXOR XR ELDERPRYL ELMIRON EMCYT ENTOCORT EC EPINEPHRINE INJECTION EPIVIR EPIVIR-HBV EPPY N ERGAMISOL ESCLIM ESKALITH CR ESTRADERM ESTRATEST ESTRATEST HS ESTROSTEP-FE EULEXIN EVISTA EVOXAC EXELON F FARESTON FEMARA FEMHRT FLOMAX FLONASE FLORINEF FLOVENT 44, 110, 220 FLOVENT ROTADISK FLOXIN FLOXIN OTIC FLUOROPLEX FORADIL AEROLIZER FORTOVASE FOSAMAX G GLEEVEC GLUCAGON GLUCOTROL XL H HALDOL HELIDAC HERPLEX HEXALEN HIVID HUMALOG MIX 75 25 HYZAAR I IMITREX, all forms IMURAN INDERAL LA INFERGEN INTRON A INVIRASE K KALETRA, capsule and solution KEPPRA K-LYTE DS K-LYTE CL K-LYTE CL 50 KLOTRIX KYTRIL L LAMICTAL LAMISIL LANOXIN LANTUS LARIAM LESCOL LESCOL XL LEUKERAN LEVAQUIN LEVORA LEVOXYL LEVSIN LEXAPRO LIDODERM LIPITOR LITHOBID LOESTRIN LOESTRIN 1 20, 1, LOESTRIN FE LOPROX LOTEMAX LOVENOX LUMIGAN LUNELLE LYSODREN M MACROBID MALARONE MAXALT MEDROLS MEPHYTON METADATE CD METADATE ER METHERGINE METRODIN METROGEL VAGINAL MIDRIN MIGRANAL MIRAPEX MYCELEX TROCHE MYLERAN MYLOCEL N NARDIL NASACORT NASACORT AQ NASONEX NEUPOGEN NEURONTIN NEXIUM NILANDRON NITRO-DUR NITRODISC NITROSTAT NIZORAL SHAMPOO NORITATE NORVASC NORVIR NUTROPIN NUTROPIN AQ NUTROPIN DEPOT NUVARING O OCUFLOX ORTHO EVRA OMNICEF OVIDE OXSORALEN ULTRA OXYCONTIN P PARNATE PAXIL PEG-INTRON PENTASA PHOSLO PLAN B PLAVIX PLETAL POLY-HISTINE DM POLY-HISTINE-D PRADIN PRAVACHOL PRECOSE PRED MILD PREDNISONE 1MG PREMARIN PREMARIN CREAM PREMPHASE PREMPRO PREVEN PRILOSEC PRO-AMATINE PROCTOFOAM HC PROGRAF PROSCAR PROTOPIC PRO VIGIL PULMICORT RESPULES PULMICORT TURBUHALER PURINETHOL Q QUIXIN R RAPAMUNE REBETOL REBETRON REBIF RELPAX REMERON SOLTAB REMINYL REQUIP RESCRIPTOR RESTORIL--7.5 MG DOSE ONLY RETIN-A GEL, SOLUTION RETIN-A MICRO RETROVIR RHINOCORT RHINOCORT AQUA RIDAURA RISPERDAL ROCALTROL LIQUID ROWASA S SAIZEN SEREVENT SEREVENT DISKUS SEROQUEL SERZONE SINGULAIR SONATA SUSTIVA SYNTHROID T TARGRETIN TARKA TAZORAC TEGRETOL TEGRETOL XR TEMODAR TESLAC THEO-DUR THIOGUANINE1 TOBRADEX TOPAMAX TOPROL XL TREXALL TRILEPTAL TRI-NORINYL TRIZIVIR U ULTRASE ULTRASE MT UNIRETIC UNIVASC URECHOLINE URSO V VALCYTE VALTREX VASOCIDIN VEPESID VERELAN VESANOID VIAGRA VIDEX VIDEX EC VIOKASE to be deleted 08 01 03 ; VIRACEPT VIREAD VIVELLE VIRAMUNE VISICHOL VOLMAX VOLTAREN OPTHALMIC SOLUTION W WELCHOL WELLBUTRIN SR WESTCORT X XALATAN XELODA XENICAL Y YASMIN 28 YUTOPAR Z ZADITOR ZAROXOLYN ZERIT ZESTORETIC ZIAC ZIAGEN ZITHROMAX ZOFRAN ZOLOFT ZONEGRAN ZOVIRAX TOPICAL ZYBAN ZYPREXA.

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1. Nathan P. The experimental and clinical pharmacology of St John's Wort. Mol Psychiatry 1999; 4: 333338 Bon S, Harlmann K, Kubn M. Johanniskraut: ein enzyminduktor? Schweizer Apothekerzeitung 1999; 16: 535536 Nebel A, Schneider BJ, Bader RK, Kroll DJ. Potential metabolic interaction between St John's Wort and theophylline. Ann Pharmacother 1999; 33: 502 Johne A, Brockmoller J, Bauer S, Maurer A, Langheinrich M, Roots I. Interaction of St John's Wort extract with digoxin. Clin Pharmacol 1999; 55: 79 [abstract] 5. Conney AH. Induction of microsomal cytochrome P450 enzymes. Life Sci 1986; 39: 24932518 Schmidt PC. Deutsche Apotheker Zeitung 1999; 139: 6366 Alexander Mandelbaum1 Franziska Pertzborn2 Meret Martin-Facklam3 Manfred Wiesel2 1Department of Internal Medicine-Nephrology 2Department of Urology 3Department of Clinical Pharmacology University of Heidelberg Heidelberg Germany. 1 Dore G, Li Y, McDonald A, Ree H, Kaldor JM for the National HIV Surveillance Committee. Impact of highly active antiretroviral therapy on individual AIDS-defining illness incidence and survival in Australia. J Acquir Immune Defic Syndr 2002; 29: 388395. Selwyn PA, Hartel D, Lewis VA, et al. A prospective study of the risk of tuberculosis among intravenous drug users with human immunodeficiency virus infection. N Engl J Med 1989; 320: 545550. Of therapy 23 ; and the results from a trial of risedronate showing a significant reduction in morphometric vertebral fractures after 12 months 5 ; . The fact that bisphosphonates are effective so quickly in reducing fracture risk, with only modest early effects on BMD, suggest that mechanisms other than BMD improvements, such as the rapid decreases in bone remodeling rates, play some role in fracture reduction. This study has a number of strengths. The decision to pool the data was prespecified. Clinical fractures especially hip and clinical spine ; were prespecified and were carefully adjudicated by a blinded endpoints committee. A very conservative intention-to-treat analysis was used to evaluate the risk reduction. However, despite its large size, this study has some important limitations. The study was not powered specifically to examine the effect of alendronate within subgroups--the sample sizes within femoral neck BMD subcategories are, in some cases, too small to adequately address within-subgroup efficacy. Furthermore, our power to detect significant differences in fracture reductions between the two.

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51 Knox S, Hoppe RT, Maloney D et al. Treatment of cutaneous T-cell lymphoma with chimeric anti-CD4 monoclonal antibody. Blood 1996; 87: 8939. Foss FM, Raubitscheck A, Mulshine JL et al. Phase I study of the pharmacokinetics of a radioimmunoconjugate, 90YT101, in patients with CD5-expressing leukaemia and lymphoma. Clin Cancer Res 1998; 4: 2691700. Lundin J, Osterborg A, Brittinger G et al. CAMPATH-1H monoclonal antibody in therapy for previously treated low-grade nonHodgkin's lymphomas: a phase II multicenter study. European Study Group of CAMPATH-1H Treatment in Low-Grade NonHodgkin's Lymphoma. J Clin Oncol 1998; 16: 325763. Lundin J, Hagberg H, Repp R et al. Phase II study of alemtuzumab anti-CD52 monoclonal antibody, CAMPATH-1H ; in patients with advanced mycosis fungoides. Blood 2003; 101: 426772. Olsen EA, Duvic M, Frankel A et al. Pivotal phase III trial of two dose levels of denileukin diftitox for the treatment of cutaneous T-cell lymphoma. J Clin Oncol 2001; 19: 37688. Duvic M, Martin AG, Kim Y, Olsen E. Worldwide Bexarotene Study Group. Phase 2 and 3 clinical trial of oral bexarotene Targretin capsules ; for the treatment of refractory or persistent early stage cutaneous T-cell lymphoma. Arch Dermatol 2001; 137: 58193. Duvic M, Hymes K, Heald P et al. Bexarotene is effective and safe for treatment of refractory advanced-stage cutaneous T-cell lymphoma: multinational phase IIIII trial results. J Clin Oncol 2001; 19: 245671. Edelson R, Berger C, Gasparro F et al. Treatment of cutaneous T-cell lymphoma by extracorporeal photochemotherapy. N Engl J Med 1987; 316: 297303. Heald P, Rook A, Perez M et al. Treatment of erythrodermic cutaneous T-cell lymphoma with extracorporeal photopheresis. J Acad Dermatol 1992; 27: 42733. Fraser-Andrews E, Seed P, Whittaker S, Russell Jones R. Extra corporeal photopheresis in Sezary syndrome: no significant effect in the survival of 44 patients with a peripheral blood T-cell clone. J Arch Dermatol 1998; 134: 10015. Russell Jones R. Extracorporeal photopheresis in cutaneous T-cell lymphoma. Inconsistent data underline the need for randomized studies. Br J Dermatol 2000; 142: 1621. Evans AV, Wood BP, Scarisbrick JJ et al. Extracorporeal photo pheresis in Sezary syndrome: hematologic parameters as predictors of response. Blood 2001; 98: 1298301. Bekkenk MW, van Geelen FA, van Voorst Vader PC et al. Primary and secondary cutaneous CD30 + lymphoproliferative disorders: a report from the Dutch cutaneous lymphoma group on the long term follow-up data of 219 patients and guidelines for diagnosis and treatment. Blood 2000; 95: 365361. Vonderheid EC, Sajjadian A, Kadin ME. Methotrexate is effective for lymphomatoid papulosis and other primary cutaneous CD30positive lymphoproliferative disorders. J Acad Dermatol 1996; 34: 47081. Van Doorn R, Scheffer E, Willemze R. Follicular mycosis fungoides, a distinct disease entity with or without associated follicular mucinosis. Arch Dermatol 2002; 138: 1918. Griffiths CEM. The British Association of Dermatologists guidelines for the management of skin disease. Br J Dermatol 1999; 141: 3967. Cox NH, Williams HC. The British Association of Dermatologists Therapeutic Guidelines: can we AGREE? Br J Dermatol 2003; 148: 6215.

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For a particular system at this time. Prostatic cancer should be graded by a system both informative and reproduc ible.5 The staging of prostatic cancer, in the U.S. and elsewhere, is undergoing fur ther study and revision. American urobo gists usually speak of occult cancer sub and taxol. 04 01 D059 SOLULEXIN TABLET 125mg Cephalexin Monohydrate equiv. to Cephalexin 125mg ; [Reg. No.: MAL19910194A] Colour: Light green Shape: Caplet Marking: d861 Scored Length: 11 mm 1 500.
Patent Abstracts John Woodruff The Indian Neem Tree Azadirachta indica A. Juss ; has been recognized as a promising source of a plurality of biologically active chemicals. Neem Oil is obtained mainly from its seeds and may be obtained by press or solvent extraction from Neem seeds kernels. Neem Oil consists primarily of fatty acids and bioactive meliacins. Neem Oil is reported to be effective for treatment of cuts, bruises, skin disorders and acne and to remove skin blemishes. Neem Oil also has a large number of medical applications and is reportedly effective for treating psoriasis. It has been shown to be antimalarial, antitubercular, antiviral, antiallergic, antiperiodonitic antiseptic, antimicrobial and antihyperglycemic. Neem Oil has been shown to be an effective analgesic, especially for earaches and headaches. Neem leaf is regarded as a traditional herb for treating diabetes and is also an effective insecticide. The applicants claim that current methods for delivering the benefits of Neem oil to consumers are unsatisfactory and compositions containing it are frequently unstable. They claim product benefits by providing Neem oil as a thermally stable microemulsion, which is co-solvent and alcohol free. The microemulsion requires the inclusion of a surfactant selected from the group of alkyl phenol ethoxylates, where the alkyl group contains 8 to 12 carbons and the ethoxylate contains an average of 4 to ethoxylate groups. The surfactant can be a nonyl phenol ethoxylate and the surfactant comprises 0.003 to 25% by weight of the composition. The surfactant to oil ratio is preferably at least 3: 1. To prepare a 10% Neem Oil microemulsion concentrate, 10 grams of the oil, 40 grams of the surfactant and water are blended together to form a nearly clear mass. When diluted in water a stable, clear, and transparent microemulsion of the desired strength is obtained. Introduction: Alpha and beta hydroxy acids are used in cosmetic compositions for the gentle exfoliation of the skin to improve skin clarity, colour, and tone, and reduce the appearance of wrinkles and fine lines. The exfoliating effect is due to the acidity of the materials but this acidity may also cause skin irritation and dryness. In general, the acidity of a hydroxy acid will depend upon the number of hydroxyl groups present on the molecule and placement of the hydroxyl and carboxylic acid groups, this glycolic acid tends to be more acidic than salicylic acid because the hydroxyl and carboxylic acid groups are closer to each other on the molecule. The following three patents describe different methods of achieving a balance between effectiveness and mildness. Title: Use of honey as keratolytic agent for improving the radiance and the complexion of the skin and treating wrinkles Publication No. USP 5, 965, 145 Application No. 901522 Date of filing 28 07 1997 Applicants: L'Oreal The patent describes a composition in which honey is the keratolytic agent in a cosmetic or dermatological composition for improving the radiance of the complexion, for smoothing the skin and for treating wrinkles and fine lines. Conventional anti-ageing active ingredients, such as retinoids and hydroxy acids, exhibit the major disadvantage of causing stinging, itching or tightness after they have been and taxotere.

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It is recommended that where more than one alternative topical corticosteroid is considered clinically appropriate within a potency class, the drug with the lowest acquisition cost should be prescribed, taking into account pack size and frequency of application. The TAG classifies the above guidance as Green suitable for GPs to prescribe. Where an employee becomes aware of a child-related allegation, charge or conviction concerning the employee of another Health Service, or the Chief Executive or senior member of staff of their Health Service, these matters should be immediately reported to ESRU and may also be reported to the Ombudsman's Child Protection Team. ESRU and the Ombudsman Child Protection Team can assist in determining the appropriate course of action, including assessing the immediate risk to patients, clients and other staff, assessing whether any other Health Services or external agencies may need to be notified, and whether an external investigator should undertake an investigation. 5.4 Assessing the risk to patients, clients and employees and tazorac. Spanish mortality rates due to lung cancer are among the lowest in Europe, with the exception of young adults, where an increase has been registered over the last decade. These have not changed for the last 40 years [Fig.4].

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The provisions of this Agreement including, without limitation, the provisions of paragraphs 7 and 8. 9.2 INJUNCTION - In the event of any dispute under paragraphs 7 and or 8, Mr. Duncan agrees that QLT USA will be entitled, without showing actual damages, to a temporary or permanent injunction restraining his conduct, pending a determination of such dispute and that no bond or other security will be required from QLT USA in connection therewith. ADDITIONAL REMEDIES - Mr. Duncan acknowledges and agrees that the remedies of QLT USA specified in this Agreement are in addition to, and not in substitution for, any other rights and remedies of QLT USA at law or in equity and that all such rights and remedies are cumulative and not alternative or exclusive of any other rights or remedies and that QLT USA may have recourse to any one or more of its available rights and remedies as it will see fit and telithromycin. This table is not intended to be comprehensive, but to give you an idea of the medical equipment that is eligible for benefits.

This prescription drug is not normally covered in a Medicare Prescription Drug Plan. The amount you pay when you fill a prescription for this drug does not count towards your total drug costs that is, the amount you pay does not help you qualify for catastrophic coverage ; . In addition, if you are receiving extra help to pay for your prescriptions, you will not get any extra help to pay for this drug. + See page vi for mail order procedure and temodar.

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Janury 31, 2008 Recently, we informed you about benefit changes we made to ensure your health plan complied with the requirements of a new Oregon law, Senate Bill 8. This legislation requires health benefit plans that provide coverage for cancer chemotherapy treatment to provide coverage for prescribed, orally administered anticancer medication no less favorably than IV administered or injected cancer medications. We listened to your feedback and made changes After carefully considering the potential unintended impact on some members, we are revising our oral chemotherapy drug coverage to ensure that all our members have the best possible benefit. To accomplish this, while still complying with the new law, we are implementing the following solutions: Participating Benefit The following medications can now be obtained through any participating Caremark retail pharmacy. Your plan includes a pharmacy benefit that is subject to your medical deductible. Using your PacificSource ID card at Caremark participating retail pharmacy allows PacificSource and your pharmacy to electronically update your deductible information daily. Until you meet your deductible, you will still pay 100 percent of your drug claim, and that amount will automatically accumulate toward your medical deductible. Once you meet your deductible, you will only have to pay your coinsurance amount, as shown on your member benefit summary, for the rest of the year. Once you meet your out-of-pocket maximum, we will pay your covered prescription claims in full for the rest of the year when you use a participating pharmacy. Alkeran Arimidex Aromasin Casodex CEENU Cyclophosamide Cytoxan Droxia Emcyt Etoposide Eulexin Fareston Femara Flutamide Hexalen Hydrea Hydroxyhydrea Iressa Leukeran Lysodren Matulane Megace Megestrol acetate Mercaptopurine Myleran Mylocel Nilandron Nolvadex Purinethol Soltamox Tamoxifen citrate Targretin Tasigna Teslac Thioguanine Tykerb VePesid and targretin. Lawfullie use some means for the maintenance of ane doctor to the schole out of the kirk box. Anserit he might do so, seeing it is pious uses. Appoynts the kirk of Portmook to be visited the nixt Thursday, and Mr Frederik Carmichell to preache thair. Junii 19. The visitation of the Kirk of Portmook holden within the paroshe kirk of the samyne be the whole brethren of the Presbytrie, except the Parson of Dysert, whose absence being both lawfull and necessarie, was excused. Mr Frederik Carmichell preached the said day ; Text I , Cor. 4, I . Ruleing elders all present except John Colyear who was in Cuper at the meitting thair. Edict was returned indorsat with the names of the heretors and elders. All persones being thryse called at the kirk durr who had anything to object aganest aither minister or elders to compeire and be hard, none compeired. The minister being removed for his tryell, the elders praised God for him, and approved him heartilie, both in his calling, doctrin, and in his lyff and conversatioun. The Elders also being removed the Minister praised God for them and approved them both in thair callings and in thair concurrence with him and in thair conversatiouns. The whilk day a letter being sent from Edinburt for chuseing commissioners for the Generall Assemblie to be halden at Aberdein the last Tysday of Julii as also for a publik fast to be intimate the nixt Sabbath in all kirks and celebrate the Sabbath following thairafter for the blissing of God on this expedition etc. : appoyntit to be obeyit. The Minister and Elders of the paroshe of Portmook regrateing the uncommodiousnes of the Kirk of Portmook both in respect of the place as is notour ; as also in respect of the quantitie whilk is so litill that it cannot conteyne the parochiners and the ruinousnes thairof the brethren taking the samyne to thair consideratioun referrs the samyne to the first Assemblie whidder Generall or provincial of Fyfe. Compeired David Moreis, witness anent Margaret Douglas, admittit and deiple sworne, deponed that his Umquhill Master David Turnbull and he being goeing in the morning to the feild to spread mukk hee wakened the said Margaret at his Masters command and that he fell not sick ten dayes afterhead and that the said Margaret com niver to him nor tuke him be the hand [as was reported ; and that he niver drank with hir bot that she com in one day to ane houss of Kirkcaldie where he was and sate doun upon hir bear knies aud prayed him to tell the truth whilk was a long tyme afterhand. The commissioners who wer appoynted to speak with the Generall when he was heir declaired that they knew not that he was heir till he was gone. Mr Mungo Law and Mr Georg Gilespie reported that they went to the meitting at Cuper and shew that anent the voluntar contribution. They desyred onlie to borrow so much of it and to give band for it as to supplie a present necessitie viz, 3600 Merks to pay these Officiars of fortoun heir in Fyfe to whom they wer obliged so much. The brethren agrees thairto and tenex.

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16. Chruscinski AJ, Link RE, Daunt DA, Barsh GS, Kobilka BK. Cloning and expression of the mouse homolog of the human alpha 2-C2 adrenergic receptor. Biochemical and Biophysical Research Communications 1992; 186: 12801287. Cotecchia S, Kobilka BK, Daniel KW, Nolan RD, Lapetina EY, Caron MG, Lefkowitz RJ, Regan JW. Multiple second messenger pathways of alpha-adrenergic receptor subtypes expressed in eukaryotic cells. Journal of Biological Chemistry 1990; 265: 6369. Link R, Daunt D, Barsh G, Chruscinski A, Kobilka B. Cloning of two mouse genes encoding alpha 2-adrenergic receptor subtypes and identification of a single amino acid in the mouse alpha 2-C10 homolog responsible for an interspecies variation in antagonist binding. Molecular Pharmacology 1992; 42: 1627. Lorenz W, Lomasney JW, Collins S, Regan JW, Caron MG, Lefkowitz RJ. Expression of three alpha 2-adrenergic receptor subtypes in rat tissues: implications for alpha 2 receptor classification. Molecular Pharmacology 1990; 38: 599603. Takano Y, Yaksh TL. Characterization of the pharmacology of intrathecally administered alpha-2 agonists and antagonists in rats. Journal of Pharmacology and Experimental Therapeutics 1992; 261: 764772. Tallarida R, Harakal C, Maslow J, Geller E, Adler M. The relationship between pharmacokmetics and pharmacodynamic action as applied to in vivo pA2: application to the analgesic effect of morphine. Journal of Pharmacology and Experimental Therapeutics 1978; 206: 3845. Ruffolo RR. Review: Important concepts of receptor theory. Journal of Autonomic Pharmacology 1982; 2: 277295. Yaksh TL, Rudy TA. Analgesia mediated by a direct spinal action of narcotics. Science 1976; 192: 13571358. Moron MA, Stevens CW, Yaksh TL. The antiseizure activity of dihydropyridine calcium channel antagonists in the conscious rat. Journal of Pharmacology and Experimental Therapeutics 1990; 252: 11501155. Buerkle H, Yaksh TL. Comparison of the spinal actions of the mu-opioid remifentanil with alfentanil and morphine in the rat. Anesthesiology 1996; 84: 94102. Tallarida RJ, Murray RB. Manual of pharmacologic calculations with computer programs. New York: Springer Verlag, 1986. 27. Ruffolo RR. Alpha2 Adrenoceptor agonists and antagonists. Neurotransmissions 1990; 4: 15. Kalso EA, Poyhia R, Rosenberg PH. Spinal antinociception by dexmedetomidine, a highly selective alpha 2-adrenergic agonist. Pharmacolotogy and Toxicology 1991; 68: 140143. Takano Y, Yaksh TL. Relative efficacy of spinal alpha-2 agonists, dexmedetomidine, clonidine and ST-91, determined in vivo by vising N-ethoxycarbonyl-2-ethoxy91, 2-dihydroquinoline, an irreversible antagonist. Journal of Pharmacology and Experimental Therapeutics 1991; 258: 438446. Saeki S, Yaksh TL. Suppression by spinal alpha-2 agonists of motor and autonomic responses evoked by low- and high-intensity thermal stimuli. Journal of Pharmacology and Experimental Therapeutics 1992; 260: 795802. Eisenach JC, Shafer SL, Bucklin BA, Jackson C, Kallio A. Pharmacokinetics and pharmacodynamics of intraspinal dexmedetomidine in sheep. Anesthesiology 1994; 80: 13491359. Ruffolo R Jr., Yaden EL, Ward JS. Receptor interactions of imidazolines. Influence of ionization constant on the diffusion of clonidine and a series of structurally related imidazolidines into and out of the central nervous system. European Journal of Pharmacology 1982; 81: 367375. Schwinn DA. Adrenergic receptors: unique localization in human tissues. Advances in Pharmacology 1994; 31: 333341. Uhlen S, Wikberg JE. Rat spinal cord alpha 2-adrenoceptors are of the alpha 2A-subtype: comparison with alpha 2A- and alpha 2B-adrenoceptors in rat spleen, cerebral cortex and kidney using 3H-RX821002 ligand binding. Pharmacology and Toxicology 1991; 69: 341350. Lawhead RG, Blaxall HS, Bylund DB. Alpha-2A is the predominant alpha-2 adrenergic receptor subtype in human spinal cord. Anesthesiology 1992; 77: 983991. Correa-Sales C, Reid K, Maze M. Pertussis toxin-mediated ribosylation of G proteins blocks the hypnotic response to an alpha 2-agonist in the locus coeruleus of the rat. Pharmacology Biochemistry and Behavior 1992; 43: 723727. Hayes AG, Skingle M, Tyers MB. Alpha-adrenoceptor-mediated antinociception and sedation in the rat and dog. Neuropharmacology 1986; 25: 391396. Pertovaara A, Kauppila T, Jyvasjarvi E, Kalso E. Involvement of supraspinal and spinal segmental alpha-2-adrenergic mechanisms in the medetomidine-induced antinociception. Neuroscience 1991; 44: 705714.

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We performed a randomized, double-blind study at three centres after obtaining approval from the Local Ethics Review Committees. Written informed consent was obtained from patients in early labour requesting epidural analgesia and who had not received parenteral opioids in the preceding 4 h. All patients were ASA I or II with a full term 36 weeks ; singleton fetus, aged 1840 yr, height 150 cm and weight 115 kg. Exclusion criteria were and teniposide.

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