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From January 1989 to December 1998, a total of 374 patients aged 60 years were diagnosed as having AML at the Haematology Department, University `La Sapienza' of Rome. Of these, 86 23.1% ; median age 65 years, range 6077 ; were eligible for intensive CT and were enrolled into protocols of the GIMEMA Cooperative Group, while 288 median age 72 years, range 6090 ; were considered not eligible for an intensive approach. Of these latter patients, 44 11.7% ; were referred to other centers close to their homes immediately after diagnosis, and were excluded from present analysis. The remaining 244 patients 65.2% ; were followed at our institution with conservative approaches, and constitute the basis of the present examination. In 192 244 patients 78.7% ; , the diagnosis was performed on bone marrow BM ; and peripheral blood PB ; smears, according to FAB criteria marrow blasts 30% ; . In the remaining 52 patients 21.3% ; , BM aspirate was not performed because of poor clinical conditions or patient refusal; in these cases the diagnosis was only made on the basis of PB blastosis 30%, in the absence of well-established diagnostic criteria. Clinical and haematological characteristics of the patients at disease onset are presented in Table 1; 53 out of 192 patients with evaluable BM examination 26.4% ; M F 36 17, median age 71 years, median WBC value 2.3109 l, median PLTS value 73.0109 l ; had oligoblastic AML, as defined by BM blastosis 30 and 40%. As regarding karyotype, 52 patients did not perform marrow aspirate at diagnosis, 107 patients diagnosed with marrow aspirate elsewhere and revised by us or diagnosed at our institution with a simple morphologic marrow aspirate ; did not repeat a second aspirate for bad general conditions, refusal or medical decision, 22 patients performed karyotype but the study failed. As a matter of fact, only 61 242 patients 25.2% ; had an evaluable karyotype and they were heavily selected when compared with the whole population: thus, data from karyotype were excluded from this study. As concerns concomitant diseases present at AML diagnosis, they consisted of a symptomatic heart impairment in 63 patients 25.8% ; , arterial hypertension in 32 13.1% ; , diabetes in 30 12.2% ; , chronic pneumopathy in 27 11% ; , renal and hepatic failures in eight 3.3% ; and seven 2.9% ; , respectively. M F Median age range ; Previous MDS PS according WHO ; 01 2 34 Median Hb value g dl ; range ; Median WBC value 109 l ; range ; Median PB blasts 109 l ; range ; Median PLT value 109 l ; range ; Table 1. Clinical patient characteristics at diagnosis, for example, athlete foot lamisil.

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The SAMJ is published on the first of the month by the Health and Medical Publishing Group Pty ; Ltd, Co registration 2004 0220 32 a subsidiary of SAMA. Suites 1-2, Lonsdale Building, Gardener Way, Pinelands, 7405 All letters and articles for publication should be addressed to the Editor, Private Bag X1, Pinelands, 7430. Tel. 021 ; 530-6520. Fax 021 ; 531-4126. E-mail: publishing samedical Website: samedical.
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Terbinafine 250 A, tablets 250 mg, has a proven chemical-pharmaceutical quality and is a generic form of Lamisil. Lamissil is a well-known medicinal product with an established favourable efficacy and safety profile. Bioequivalence has been shown to be in compliance with the CHMP guidance documents. The SPC is consistent with that of the reference product. Satisfactory chemical-pharmaceutical documentation has been provided assuring a consistent quality of the product. The MAH has provided written confirmation that systems and services are in place to ensure compliance with their pharmacovigilance obligations. The Board followed the advice of the assessors. No discussion in a Board meeting was deemed necessary. On the basis of the data submitted, the MEB considered that Apothecon had demonstrated bioequivalence for Terbinafine 250 A with the reference product, and has therefore granted a marketing authorisation. 5 of 7.
Hans Gmnder, Andreas Hohn. Genedata AG, Maulbeerstrasse 46, CH-4016 Basel, Switzerland Micro array-based gene expression profiling is poised to play a central role in the field of toxicogenomics. Pinpointing the potential toxicity of unknown compounds by comparing their mechanisms of action MOA ; with those of known substances will lead to the rapid and reliable categorization of novel compounds and the prediction of potential, severe side effects at an earlier experimental stage. However, an effective and reliable use of microarray data in toxicology studies depends heavily on a well-designed strategy of streamlined and highly standardized data analysis procedures. Ultimately, the use of computational analysis in large-scale toxicological studies will result in the more cost-effective production of safer and more effective drugs. Genedata has developed an in-silico solution specifically developed to optimize gene expression data analysis for high-volume toxicological studies. Building and using a "reference compendium" is at the core of this solution. In an initial step, a collection of reliable, quality assessed mRNA signatures of relevant well-known compounds are used for building a "reference compendium". These data are collected along with additional, vitally important biological and experimental information. In a second step, the value or quality ; of this compendium is cross validated and, if necessary, statistical analysis is used to find the characteristic genes that indicate a distinct pattern. Finally, statistical analysis can be used to classify novel, uncharacterized compounds into the "reference compendium", allowing a prediction of their potential toxicity and their MOA and macrodantin. 19 , serious wound infection with high mortality and morbidity , Oliver Wendell Holmes America ; and Ignaz Philipp Semmelweiss Vienna ; " washing of hand and changing of clothing " 1848, Pasteur, discovery of bacteria 1867, Lister, "antiseptic principles " 1899, Kocher, more advanced antisepsis modern standard Problems in surgical infection performance of more complicated and longer operation increased operation of geriatric patients with chronic illness or debilitating disease implants of foreign materials expansion of immunosuppressed transplant patients utilization of more diagnostic tool supplied more bacteria unwarranted use of antibiotics cf ; classification of Surgical wounds according to Risk of infection Type Clean Cleancontaminated Contaminated Definition Nontraumatic, No break in technique Respiratory, alimentary, or GU tract not entered GI or respiratory tract entered without significant spillage Oropharynx, vagina, or noninfected GU or biliary tract entered Minor major break in technique, Traumatic wound Gross spillage from GI tract Entrance into GU or biliary tract in presence of infected urine or bile Unacceptable infection rate at 30 days 1.5% 3% 5, for example, lamisil for women.

In the epithelial layers of these corneas. Histologic sections obtained from control and steroid-treated groups after 72 hr of healing showed that one thin layer of epithelial cells covered the corneas of steroid-treated animals, while two or three layers of cells covered the control corneas Fig. 1 ; . Rate of incorporation of 3H-thymidine. The rate of DNA synthesis as measured by a 3 pulse labeling showed that 3H-thymidine was incorporated into the DNA-containing fraction of control cells at 4.3 0.8 pmoles ixg DNA n 4 ; , while steroid-treated corneas incorporated thymidine at 2.9 0.2 pmoles xg DNA n 4 ; . Despite the decreased rate of DNA synthesis, the rate of incorporation of 3H-thymidine into the acidsoluble pool was 13.1 1.1 and 15.9 1.0 pmoles , g of DNA for control and steroidtreated epithelial cells, respectively. Preliminary chromatography of the acid-soluble fractions indicated that less thymidine 5'-triphosphate was formed from the 3H-thymidine taken up in the presence of steroids. Rate of incorporation of 3H-leucine. The rate of RNA synthesis as measured by a 3 pulse of 3H-uridine into the RNA fraction of epithelial cells was 6.8 1.2 pmoles tg DNA n 6 ; in control corneas and 12.2 0.8 pmoles xg DNA n 6 ; in steroidtreated corneas. The difference was significant at p 0.01. Analysis of the acid-soluble fractions indicated that the rate of incorporation of uridine into the nucleotide pool was not altered in the steroid-treated epithelial cells. Rate of incorporation of 3H-leucine. The acid-precipitable protein obtained from control corneas after removal of the DNA and RNA showed that leucine was incorporated at a rate of 1.6 0.6 pmoles Ag DNA n 8 ; . Leucine was incorporated into the protein of steroid-treated corneas at 1.8 0.6 pmoles fxg DNA n 8 ; during a 3 hr pulse. Although there was no significant difference in the rate of protein synthesis, the rate of incorporation of leucine into the acid-soluble fraction of steroid-treated epithelial cells was twice as great as in control corneas i.e., 14.4 0.9 vs. 28.8 5 . 1 pmoles , g DNA, n 8 for each and miconazole.

Clearance at these toxic concentrations. Analysis of metabolites in the media indicated that nefazodone underwent oxidative metabolism followed by conjugation with sulfate and glucuronide with only trace amounts of unconjugated hydroxylated metabolites detected in the culture media Fig. 8 ; . Collision-induced dissociation of the molecular ions at MH + 566 and MH + 662 which corresponded to the sulfate and glucuronide conjugates of monohydroxynefazodone indicated that conjugation had occurred on the hydroxyl group on the 3chlorophenyl ring in nefazodone. Incubation for 24 h with 10, 25, 50 and 100 M nefazodone demonstrated the saturation of metabolism as evident from the diminished capacity of the hepatocytes to produce conjugated metabolites at 25 M. Furthermore, there was a decrease in the amount of conjugates produced at 50 and 100 M, most likely due to cell toxicity resulting in compromised drug metabolizing enzyme activities Fig. 5, 8 ; . Thus, metabolism of nefazodone to conjugated products at 10 M resulted in recovery of protein synthesis. In contrast, insufficient metabolism at 25 M resulted in a sustained decrease in protein synthesis 40% at 25 M ; and cell death at 50 and 100 M by 24 hr. To further characterize the importance of metabolism in preventing nefazodone toxicity, we treated hepatocytes with the combination of 10 M nefazodone and 1 mM ABT, a non-specific inhibitor of P450 enzymes that has been shown previously to inhibit P450 activity in primary hepatocytes Harrel et al., 1994 ; . Treatment with ABT and nefazodone 10 M ; for 24 hr resulted in a 45% decrease in total protein synthesis Fig. 9A ; . In contrast, there was almost full recovery in hepatocytes treated with 10 M nefazodone alone Fig. 9A ; . Analysis of culture media from cells treated with ABT showed an increase in the concentration of unmetabolized nefazodone associated with a decrease in formation of, for example, lamisil jock itch. 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These tasks have enabled us to develop a stronger foundation from which a more unified team of Staff, Management and Board members can maximize Spectrum's potential. As a Board, we see the Agency continuing to maintain its high standards of service and customer satisfaction, despite the difficult pressures of decreased State and County spending. This is indeed a very difficult time for government funded agencies, but Spectrum is carefully maneuvering itself through these tightened fiscal constraints. The Board of Directors and I look forward to the year ahead with a fresh new energy that will help us carry out our new strategic plan. We salute the Management team and Staff of Spectrum for their hard work and dedication to providing the most effective and proactive solutions to a variety of difficult challenges. As we continue to work together to meet the needs of our community while providing the highest quality of care to our consumers, we embrace our Vision to become one of the finest Mental Health and Chemical Dependency Treatment Agencies in Western New York. Sincerely. The prevalence of type 2 diabetes mellitus is increasing in Vietnam as well as in other developing countries China, Indian subcontinent, and Africa ; . Searching for hypoglycemic agents with origin from domestic herbals was considered as a useful way to find novel therapy of the disease. After treatment i.p. or orally of normal mice with extract of Anemarrhena asphodeloides A.a. ; , Angiopteris evecta A.e. ; and Gynostemma pentaphyllum G.p. ; , blood glucose levels of the mice were decreased. All of those 3 extracts also suppressed the rise in blood glucose in normal mice during a glucose tolerance test. At both 3.3 and 16.7 mM glucose, 2, 4 and 8 mg ml Anemarrhena asphodeloides A.a. or TH2 ; increased the insulin release of Wistar W ; and GotoKakizaki GK ; rat islets. In perifusions of islets, A.a. also increased insulin secretion that returned to basal levels when A.a. was omitted from the perifusate. Thus, ethanol extract of the roots of A.a. contains a substance, TH2, that stimulates insulin secretion from islets of normal W and GK rats. The mechanism behind TH2-stimulated insulin secretion involves an effect on the exocytotic machinery of the B-cell, mediated via pertussis toxin-sensitive Ge-proteins. G.p. extract had a hypoglycemic effect in rats and mice. We have isolated the active compound, phanoside, a gypenoside with molecular mass of 914.5 Da. When given orally to rats, phanoside 40 and 80 mg kg ; improved glucose tolerance and enhanced plasma insulin levels. Phanoside stimulated insulin release at 3.3 and 16.7 mM glucose from isolated rat pancreatic islets of both W and GK rats. Interestingly, Bcell sensitivity to phanoside is higher at 16.7 mM than at 3.3 mM glucose, since significant insulin responses were observed with phanoside between 31.25 and 125 M only at the high glucose levels. When W rat islets were incubated at 3.3 mM glucose with 150 M phanoside and 0.25 mM diazoxide to keep K-ATP channels open, insulin secretion was similar to that in islets incubated in 150 M phanoside alone. At 16.7 mM glucose, phanoside-stimulated insulin secretion was reduced in the presence of 0.25 mM diazoxide. In W islets depolarized by 50 mM KCl and with diazoxide, phanoside stimulated insulin release 2-fold at 3.3 mM glucose but did not further increase the, for example, lamisil af. 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