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The treatment of patients, who suffer with Pulmonary Arterial Hypertension PAH ; , depends upon the cause of the condition. A shortened form of the classification table that we use to describe the causes of PAH is shown in table 1. Since most of the research has been conducted on patients with Idiopathic Pulmonary Arterial Hypertension IPAH ; , we will concentrate on that group of patients and will discuss the other categories as they relate to the IPAH group of patients. I. Treatment of IPAH Prognosis: The treatment of IPAH depends upon an understanding of the factors which affect the prognosis or expected outcome of the condition. We know that untreated, patients with PAH have a poor prognosis, and that treatment with both intravenous and oral medication has improved that survival significantly. The classification of shortness of breath performing different kinds of activity is a key determinant of prognosis. At the most severe end of the spectrum, patients who can't perform any physical activity, e.g. dressing, showering etc. ; would be classified as NYHA class IV. At the other end of the spectrum, people who have heart disease in this case PAH ; but are able to carry on with normal activity including carrying groceries up stairs, garden work or jogging would be classified as NYHA class I. A patient with NYHA class II would have a slight limitation of physical activity. Walking more than 2 blocks on the level or more than 1 flight of stairs at an ordinary pace would cause symptoms in such a patient. We would not likely treat a person who is NYHA class I or class II as this does not follow recommendations of the American Colleges of Cardiology and Chest Physicians and the European College of Cardiology. There are other factors which we use to assess prognosis including some found on a detailed assessment of the cardiac ultrasound; fluid around the heart pericardial effusion ; and an enlarged right atrium to name just a few. Drug Treatments: 1. Calcium Channel Blockers These agents, which are primarily used for systemic hypertension, are useful for treating a small percentage of patients with IPAH. We determine which patients will respond by performing a vaso-reactivity challenge during a Right Heart Catheterization. If they are to be prescribed , the specific drugs are usually nifedipine, diltiazam or amlodipine. 2. Prostacyclin and Prostacyclin Analogues Epoprostenol Flolan ; was the first drug that was used specifically for IPAH in BC. It was demonstrated to improve.
FIG 5. Same ECG lead II and atrial electrograms from the same episode as illustrated in Fig 4, showing the spontaneous termination of the previously stable atrial flutter. As seen in the atrial electrograms recorded.
Pneumonia due to Chlamydia pneumoniae. International Journal of Antimicrobial Agents 15, 14952. 10. Hammerschlag, M. R., Reznik, T. & Roblin, P. 2001 ; . Microbiologic efficacy of levofloxacin for the treatment of serious communityacquired pneumonia due to Chlamydia pneumoniae. Journal of Antimicrobial Chemotherapy 47, Suppl. S1, Abstract P112, p. 45. 11. Barry, A. L., Fuchs, P. C. & Brown, S. D. 2001 ; . In vitro activity of the ketolide ABT-773. Antimicrobial Agents and Chemotherapy 45, 29224. 12. Jung, R., Danziger, L. H. & Pendland, S. L. 2002 ; . Intracellular activity of ABT-773 and other antimicrobial agents against Legionella pneumophila. Journal of Antimicrobial Chemotherapy 49, 85761.
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When I told others that my doctor was Vic Tapson, most would say, `That hunk!!'" Thirty-two health-care professionals, in addition to handsome Dr. Tapson, attended. Some came from England and Canada. Judy Simpson met ahead of time with hotel staff supervisors to explain about PH and the special concerns of PH patients. She told them, for example, that many attendees would be in wheelchairs and or using oxygen, and that many used an unusual medication called Flolan that had to be kept cold and that discontinuation of this medicine could result in a user's quick demise. Such pre-conference briefing has proved to be important, and has been done as well at all of the following conferences. Some medical problems cannot be planned away; two patients using Flolan were hospitalized with central line infections. A small number of medical emergencies have occurred with regularity at PHA conferences. ; These were UPAPH's goals at that first conference: For patients to gain first-hand information from experts For patients to interact with physicians and health care professionals to help them understand problems that PH patients encounter To assist researchers who are gathering data To network--to connect doctors and patients with others in similar circumstances or with similar interests Research Done at the Conference Two weeks prior to the conference, Ed Simpson received a call from Dr. Greg Elliott University of Utah ; asking permission to draw blood and obtain family histories from patients at the conference. Ed contacted the Scientific Advisory Board and checked out Dr. Elliott's credentials he passed with flying colors ; and permission was granted--with the stipulation that the blood samples and information gathered be shared with other physicians 44 and flu!
HA to its quaternary ammonium salt allows it to be dissolved in dimethyl sulfoxide. The advantage of using this solvent is that it allows all structural hydrogen atoms to be observed in NMR spectra Scott and Heatley, 1982 ; . Initial studies of the HA disaccharides assigned one resonance to the amide proton Heatley et al., 1982 ; . However, comparison with the NMR spectra from HA tetra-, hexa-, and octasaccharides revealed a new resonance for the amide proton, downfield from that observed in the disaccharide. This new resonance increases in magnitude as the oligomeric series is ascended Scott et al., 1984 ; . The two resonances were found to correspond to the external and internal linkages of the polymer, respectively. Thus, we expect the internal linkages of tetrasaccharides to resemble to polymeric linkages, and the external linkages to be similar to disaccharides. Circular dichroism CD ; data for a series of HA oligosaccharides produced by testicular hyaluronidase digestion allowed the conformation to be assessed as a function of length Cowman et al., 1981 ; . It was concluded that the structural features of high molecular weight HA, which resulted in enhancement of the 209 nm CD band, were present in the interior residues of tetrasaccharides and larger oligosaccharides. Thus, analysis of the tetrasaccharides is important for understanding the role of hydrogenbonding in the HA polymer, as they are the smallest oligomers in which characteristics of the constituent monosaccharides and the polymer are simultaneously exhibited. Our approach involves performing MD simulations of solvated molecules, and comparing the results with x-ray scattering and hydrodynamic experiments. Here we extend our solvated MD studies of the HA disaccharides Almond et al., 1997 ; to the more polymer-like HA tetrasaccharides. New hydrogen-bonding analysis tools, which we have developed, has allowed the dynamic 974.
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Management's Discussion and Analysis continued ; RESULTS OF OPERATIONS Year Ended December 31, 2002 Compared to Year Ended December 31, 2001 Revenues Total net revenue increased 6.1 million, or 29.4%, to , 128.3 million in 2002 from 2.3 million in 2001, due primarily to the growth and acquisition of branded pharmaceutical products. Net sales from branded pharmaceutical products increased 9.3 million, or 30.1%, to , 032.8 million in 2002 from 3.5 million in 2001. This increase was due primarily to growth in net sales of Altace, Levoxyl and Thrombin-JMI, the acquisition of Corzide, Delestrogen and Florinef and a license to Corgard in August 2001, and the acquisition of Prefest on May 29, 2002. This increase was partially offset by a .1 million charge for corrections of immaterial errors related to underpayments of amounts due under Medicaid and other governmental pricing programs for the years 1998 to 2001; a .4 million charge for corrections of immaterial errors related to underpayments of amounts due under Medicaid and other governmental pricing programs related to 2002 and recorded in the fourth quarter of 2002; a .0 million charge arising from changes made in 2002 in accounting estimates for the years 1998 to 2002 related to Medicaid and other governmental pricing programs; and decreases in net sales of Lorabid, Tapazole and several women's health products. Net sales from branded pharmaceutical products for 2001 have not been reduced by estimated underpayments of amounts due under Medicaid and other governmental pricing programs for that year. We expect continued growth in net sales of our branded pharmaceuticals, due primarily to the anticipated increase in net sales of Altace, the Intal, Tilade and Synercid product acquisition on December 30, 2002 and the acquisition of Sonata and Skelaxin on June 12, 2003. Although we expect overall net sales of our branded pharmaceuticals to grow, we expect sales of Lorabid, Florinef, Cortisporin ophthalmic suspension and women's health products to decrease due to the developments explained above. We refer you to the "Risk Factors" section in this annual report where we describe events that could cause results to materially differ. Revenue from royalties is derived from payments we receive based on sales of Adenoscan and Adenocard. Revenues from royalties increased .6 million, or 24.8%, to .4 million in 2002 from .8 million in 2001 primarily due to an increase in unit sales of Adenoscan. While we anticipate continued growth from royalty revenues, we are not responsible for the marketing of these products and, thus, are not able to predict whether growth in 2003 will continue at the rate experienced in 2002. Revenues from contract manufacturing increased .3 million, or 21.1%, to .9 million in 2002 from .7 million in 2001. The majority of the increase was due to increased unit volume of products manufactured for third parties in 2002 compared to 2001. We anticipate a significant increase in contract manufacturing revenue in 2003 due to the acquisition of Meridian on January 8, 2003. Revenue from all other sources, which primarily includes the sale of generic pharmaceuticals, decreased .1 million, or 47.3%, to .2 million in 2002 from .3 million in 2001 primarily due to decreased sales of a private-label generic product line to another pharmaceutical company. Operating Costs and Expenses Total operating costs and expenses increased 8.1 million, or 64.8%, to 4.1 million in 2002 from 6.0 million in 2001. The increase was primarily due to special items during 2002 resulting in a net charge of 2.8 million, cost of revenues associated with increased unit sales of our branded pharmaceutical products, and increased fees associated with the promotion of Altace under our Co-Promotion Agreement with Wyeth, offset by special items during 2001 resulting in a net charge of .1 million. Special items are those particular income or expense items that our management believes are not related to our ongoing, underlying business, are non-recurring, or are not generally predictable. These items include, but are not limited to, merger and restructuring expenses; non-capitalized expenses associated with acquisitions, such as in-process research and development charges and one-time inventory valuation adjustment charges; charges resulting from the early extinguishment of debt; asset impairment charges; expenses of drug recalls; and gains and losses resulting from the divestiture of assets. We believe the identification of special items enhances an investor's analysis of our ongoing, underlying business and of our financial results when comparing those results to that of a previous or subsequent like period. However, it should be noted that the determination of whether to classify an item as a special item involves judgments by our management. Cost of revenues increased 8.4 million, or 58.1%, to 5.0 million in 2002 from 6.6 million in 2001. The increase was primarily due to costs associated with increased unit sales of our branded pharmaceutical products, including Altace, Levoxyl and Thrombin-JMI, and an increase in special items related to inventory totaling .1 million during 2002, as compared to a net charge totaling .0 million during 2001. Special items were as follows: As a result of a continuing decline of Lorabid prescriptions and our inability, to date, to divest our rights to Lorabid, we have determined that we will be unable to sell all of the Lorabid inventory that we are required to purchase under our supply agreement with Eli Lilly. Accordingly, we have recorded in the fourth quarter of 2002 a .9 million charge related to the liability associated with the amount of the purchase commitments in excess of expected demand. We incurred a charge of .2 million relating to inventory donations during the fourth quarter of 2002, attributable to our decision to divest our rights to Lorabid. We incurred a charge in the amount of .9 million during the fourth quarter of 2001 and .2 million in 2002 related to our voluntary recall of products manufactured for us by DSM Pharmaceuticals as a result of regulatory issues related to DSM's manufacturing facility in Greenville, North Carolina. Distribution of the affected products was resumed during 2002. We incurred a charge in the amount of .8 million during the second quarter of 2002, due primarily to the voluntary recalls of Liqui-Char and Theravac, two of our smaller products. We incurred a charge in the amount of .1 million during the third quarter of 2001, relating to the write off of obsolete Levoxyl inventory. The FDA approved the NDA for our new formulation of Levoxyl on May 25, 2001. Pursuant to FDA guidance, we have distributed only the FDA approved new formulation of Levoxyl since August 14, 2001 and flucytosine.
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Figure 3. Correlations between brain volume and neurobehavioral change. Frontal and temporal lobe brain tissue volumes are presented for first-episode and previously treated patients. The neurobehavioral domains include abstraction and flexibility ABF ; , attention ATT ; , verbal memory VME ; , spatial memory SME ; , verbal abilities VER ; , spatial abilities SPA ; , sensory SEN ; , and motor MOT ; . Positive correlations indicate less tissue loss associated with less neurobehavioral deterioration and negative correlations indicate less tissue loss associated with more deterioration or, conversely, more tissue loss associated with less neurobehavioral deterioration.
The core 15-kDa ; , singly glycosylated 20-kDa ; , and doubly glycosylated 25-kDa ; forms. Indeed, treatment with N-glycosidase F collapsed the 25- and 20-kDa bands into the 15-kDa band Figure 1B; similar observations in another experiment ; . Ab1 also detected a 20-kDa band in the cRNA lane Figure 1A, top ; . This is probably dog KCNE2 protein from the canine pancreatic microsomes present in the translation reaction, because 1 ; KCNE2 transcript has been detected in pancreas, 18 2 ; a 20-kDa band was consistently detected by both KCNE2 Abs Ab1 and Ab2 ; in membrane proteins from dog hearts Figures 1D and 2A; see also Figures 4A and 5 ; , and 3 ; after N-glycosidase F treatment, this band was not detectable, consistent with the notion that it too was collapsed by the enzyme into a smaller band Figure 1B and fludarabine.
This publication is intended for plastic surgeons, dermatologists, and other allied health professionals.
5: 00 p.m. S17 Measles, Mumps, Rubella and Varicella-zoster Virus Vaccine Immunogenicity Evaluation by Fluorescent-bead Array Multiplex Test K. S. Venkateswaran1, M. Pitesky1, C. Priess2, C. Cossen2, F. Milanovich3, B. Colston1, B. Forghani2 1Medical Physics & Biophysics Division and Biodefense Division, Lawrence Livermore National Laboratory, Livermore, CA; 2Viral and Rickettsial Disease Laboratory, California State Department of Health Services, Richmond, CA; 3Chemical Biological National Security Program, Lawrence Livermore National Laboratory, Livermore, CA S18 Effective Induction of Cell Mediated Immunity by Non-Covalent Complex of Heat Shock Protein 70 and Herpes Simplex virus HSV ; Antigenic Peptide: Implication for HSV-2 Peptide Vaccine Development A. Varnavski1, D. Mielcarz1, H. Scaltreto1, H. Chen1, S. Monks1, A. Truneh1, P. Srivastava2, A. Mo1 1Host Defense, Antigenics, Inc., Lexington, MA; 2University of Connecticut School of Medicine, Center for Immunotherapy of Cancer and Infectious Diseases, Farmington, CT Adjournment and flumist.
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Figure 14: the epiture easytouchtm, a laser assisted drug delivery device and fluoride.
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At the end of the treatment period, 8 of 40 20% ; patients receiving conventional therapy alone died, whereas none of the 41 patients receiving flolan died p 003 and fluphenazine.
SURGERY Not applicable to this study. OTHER THERAPY Not applicable to this study. PATHOLOGY Not applicable to this study. PATIENT ASSESSMENTS 11.1 Study Parameters Procedure History & Physical Neurological Assessment Height, Weight & KPS Tumor Measurement Chest x-ray, PA & LAT, EKG Chest CT scan liver & adrenals ; CBC, diff, platelets SMA-12d, electrolytes, Mg + FVC, FEV1, DLCO Pregnancy Test as applicable ; Metastatic Evaluation bone, brain ; Toxicity Evaluation Pretreatment see Section 4.0 for timing ; X X X Weekly During Chemo RT X X After RXa X X X and flolan.
Johnson, a physician and chief medical correspondent for ABC News. "I personally believe there must be a strong firewall between any money from industry and the research being supported by such money, " Johnson said. When he took the job of editor of the New England Journal of Medicine last month, Drazen was immediately criticised for his close ties with several pharmaceutical companies that have funded his pulmonary research and hired him as a consultant. Under the journal's rules on conflict of interest, he is barred from writing editorials or review articles relating to his research or related work within two years and flurazepam.
Tu-POS67 Na Ca EXCHANGE MEDIATED CONTRACTIONS IN FELINE VENTRICULOCYTES. H. Bradley Nuss and Steven R. Houser. Temple University School of Medicine, Department of Physiology, Philadelphia, PA.
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