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Continued sales growth despite challenging agricultural conditions worldwide Leadership position reinforced through unique range of products and solutions Increasing demands of customers met through greater innovation and services Continued growth with dynamic development in key regions Although the worldwide crop protection industry faced a difficult period in agriculture in 1998 because of unfavorable weather conditions in the US and Western Europe and increased price pressure for herbicides in the US, Novartis Crop Protection recorded growth of 2 per cent in local currencies during the year. We attained notable sales increases in most of Latin America and the Asia-Pacific Region. In Europe, good results were achieved in the Benelux countries and Southern Europe. Total turnover reached CHF 6.0 billion. New herbicides receive registrations and positive safety reviews 1998 saw the registration of S-metolachlor, a herbicide applied mainly to corn, soybeans and sorghum, in a number of key markets worldwide. The conversion of metolachlor to the highly concentrated new active ingredient in the US was completed well ahead of schedule. From 1999 onwards, only products containing S-metolachlor will be formulated. The European Standing Committee accepted the S-metolachlor dossier as complete. This enables EU member States to grant provisional registration. In the US we received approval of Northstar primisulfuron + dicamba ; as a new, broad spectrum, low-rate herbicide for weed control lasting the whole season. The Environmental Protection Agency EPA ; also approved Spirit primisulfuron + prosulfuron ; . These two products successfully complete the strategy to provide effective alternatives to farmers in areas where crop rotation can be critical. Acceptance and first sales proved to be highly successful. Horizon clodinafop ; continues strong growth, particularly in Canada, where it has captured the number one market-share position. Based on a completely updated EU dossier, German authorities agreed to the registration of Brasan dimethachlor + clomazone ; for oilseed rape. The product launch and initial sales were extremely successful. The plant growth regulator Moddus trinexapac ; received further registrations for small grain cereals. As an important label extension, Indonesia granted the use of the product in sugar cane, an interesting opportunity in a supplementary market. Atrazine has been re-evaluated by WHO's International Agency for Research and Cancer IARC ; . Its classification has been changed from 2B possibly carcinogenic to humans ; to 3 not classifiable as to carcinogenicity ; . This is a major success which supports the US atrazine review. In the EU the final European Community Co-Ordination ECCO ; report on atrazine and simazine revealed no major technical problems, another key step towards the EU re-registration.

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Introduction: The deteriorating socio-economic factors have led to a large number of people living on the margins of society who use licit and illicit drugs to cope with their harsh reality. Due to stigmas, limited resources and gaps in information the public and social sector has not been able to address the needs of this growing population. Homeless street children, female sex workers and Afghan refugees now represent a significant portion of street drug users in Quetta Pakistan. Objective: To reduce drug and drug related harm on the streets in particular indictable drug use and related harm ; and prevent the HIV and other blood borne diseases among drug users and related vulnerable population groups. A. J. Frew and M. J. Plummeridge, J. Allergy Clin. Immuno., 2001, 108, 3 M. Navarro, H. Prez and R. A. Snchez-Delgado, J. Med. Chem., 1997, 40, 1937 M. Navarro, E. J. Cisneros-Fajardo, T. Lehmann, R. A. Snchez-Delgado, R. Atenico, P. Silva, R. Lira and J. A. Urbina, Inorg. Chem., 2001, 40, 6879 E. R. T. Tiekink, Crit. Rev. Oncol. Hematol., 2002, 42, 225 D. Crump, G. Siasios and E. R. T. Tiekink, Metal-Based Drugs, 1999, 6, 361 D. de Vos, P. Clements, S. M. Pyke, D. R. Smyth and E. R. T. Tiekink, Metal-Based Drugs, 1999, 6, 31 D. de Vos, D. R. Smyth, E. R. T. Tiekink, Metal-Based Drugs, 2001, 8, 303 e.g. M. J. McKeage, L. Maharaj and S. J. Berners-Price, Coord. Chem. Rev. 2002, 232, 127 e.g. a ; R. V. Parish, Metal-Based Drugs, 1999, 6, 271; b ; M. B. Dinger, W. Henderson, J. Organomet. Chem. 1998, 560, 233 and levaquin. Agent Brand Name Generic Availability Dosage forms Almotriptan Axert No Oral tablet Eletriptan Relpax No Oral tablet Frovatriptan Frova No Oral tablet Naratriptan Amerge No Oral tablet Rizatriptan Maxalt No Oral tablet, Orally disintegrating tablet. Migraine Sumatriptan Omitrex No Oral tablet, Nasal spray, SC injection. Migraine, Cluster headache. Zolmitriptan Zomig No Oral tablet, Oral disintegrateing tablet, Nasal spray. Migraine. 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Edelstein found that relator's psychiatric condition had improved since 1997 and that she was no longer incapable of resuming her duties as a school bus driver. Claire V. Wolfe, M.D., provided a report focusing on the physical findings. Dr. Wolfe diagnosed myofascial pain syndrome but stated that "I do not believe that her fibromyalgia is in any way disabling for doing anything, nor do I believe that she has any significant lumbar disease that would preclude driving a school bus." Dr. Wolfe tended to agree that the psychological condition was causing more disability than the physical problems; however, based on her observations of relator during the examination, she concurred with Dr. Edelstein that relator was not disabled by depression. SERS terminated disability status, agreeing with the recommendation of its medical advisory board and lipitor.

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Abstract of ARO Meeting Denver, Colorado ; Gentiana I Wenzel1, Hubert H Lim1, Timo Stver1, Thomas Lobl2, John Schloss2, Burkard Schwab1, Thomas Lenarz1 1 Medizinische Hochschule Hannover, 2NeuroSystec Gacyclidine is a highly specific NMDA receptor antagonist with neuroprotective properties. In guinea pigs, administration of gacyclidine adsorbed to Gelfoam ; into the round window niche or as a bolus injection into the cochlea suppressed salicylate-induced tinnitus. Thus, we investigated in humans and animals if gacyclidine could provide a safe and effective treatment for tinnitus. We administered gacyclidine as a compassionate treatment in unilateral deaf patients with tinnitus. These patients experienced temporary relief from tinnitus after constant perfusion of gacyclidine into the round window niche for 40-60 hours. This demonstrated that gacyclidine has the potential to suppress tinnitus. However, controlled and long-term delivery of the drug will be necessary for effective treatment. Since the main candidates for this therapy will be hearing patients, we needed to assess whether chronic administration of this drug would compromise hearing performance. Thus, we measured the effects of chronic intracochlear gacyclidine perfusion on frequency-specific ABR thresholds in guinea pigs. Guinea pigs were implanted with osmotic pumps that delivered 0.5 L h of 0.3 mM gacyclidine for 9 days via a catheter inserted through the round window membrane. The concentration and rate of drug delivery were selected to provide a dose that was substantially higher than is expected for tinnitus control in humans. Frequency-specific ABRs 1- 40 kHz, 10-80 dB SPL in 10dB steps ; were recorded before implantation and compared with those obtained after drug administration. No significant changes in ABR thresholds were observed suggesting that prolonged administration of gacyclidine for tinnitus treatment should be safe in terms of hearing preservation. Further studies investigating the toxicological effects of different dosages and durations are under way to ensure the safety of the drug for long-term human use and to warrant clinical trials.
Honor that the IMF recognizes others who, like her, reach out and make a difference. Over the years we've recognized patients and family members. It was our honor and privilege for the first time to recognize a doctor for his outstanding work in helping myeloma patients. We were thrilled to present Dr. Bart Barlogie with the Francesca Thompson Award. On hand for the presentation was I. Dodd Wilson, Chancellor, University of Arkansas for Medical Sciences. The Patient & Family Seminar was a huge success and I would like to extend a very heartfelt thank you to Bonnie Jenkins Director of Program Coordination ; and Janet Aronson Administrator ; for all their hard work in making the meeting a success and our trip to Little Rock a truly memorable experience. Dr. Guido Tricot.

About GLYCART: GLYCART is a privately held Swiss biotechnology company focussed on the development and commercialization of a new generation of antibody products based on its proprietary GlycoMAbTM technology. GLYCART is developing its own GlycoMAbTM-based antibody portfolio by in-licensing and acquiring antibodies at early stage of development and applying its proprietary GlycoMAbTM technology to them. The first products are next-generation antibody therapeutics against well-characterized and clinically validated targets. GLYCART is conducting preclinical and early clinical development studies, while actively seeking pharmaceutical and biotech partners to complete clinical development and commercialization. Taking advantage of its broad technology platform, GLYCART is also establishing collaborations and partnerships with biotech and pharmaceutical companies to enhance the efficacy and utility of their antibody drug candidates. GLYCART was founded in 2000 as a spin-off from the Swiss Federal Institute of Technology ETH ; at Zrich, and is located in Zrich-Schlieren. About GlycoMAbTM: GlycoMAb is a fully developed, broad technology platform that efficiently increases the specific biological activity of therapeutic monoclonal antibodies for target cell ablation. It is based on an active modulation of antibody glycosylation during production leading to antibody products with increased ADCC antibody-dependent cellular cytotoxicity ; . A high relevance for therapeutic efficacy, industrial scale applicability, broad patent protection and an extensive body of proof including external validation ; are the distinct hallmarks of this technology. For further information please contact.
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Clinical care manifested the problems suggested by key informants, focus-group participants, and surveyed clinicians. Population Studied: Key informants consisted of administrators and clinicians at the four hospitals, Harlem, New York City. Nine focus groups in English and Spanish included African-American and Latino hypertensive patients from hospital clinics managing hypertension. We surveyed the 469 clinicians in those clinics. We reviewed charts of 99 consecutive uncontrolled hypertensives with scheduled appointments who had been treated at least six months and whose blood pressures exceeded guidelines by 10mmHg systolic or 5mmHg diastolic. Principal Findings: Key informants noted access problems; patients' profound life problems; and patient mistrust of the health system. Focus-group patients were well aware of the importance of medications and lifestyle, but sometimes skeptical about their medication regimens. Some reported lack of respect at certain medical centers, access problems, and interest in home blood-pressure monitors. From the 79% of surveys completed, clinicians were knowledgeable about evidence-based blood-pressure targets 86% or more ; , except for renal disease 9% ; . Clinicians' blood-pressure targets were not significantly associated with patient demographic characteristics in the hypothetical vignettes. But clinicians' expectations about achieving control had significant negative associations with patients' being unemployed, employed as cashiers, African-American, or Hispanic. According to chart review, in the year before the scheduled appointment, patients averaged 5.1 clinic visits after the first uncontrolled blood pressure. For visits with uncontrolled pressures, physicians incorrectly noted control for 11%, entered no comments for 28%, noted patients' non-adherence for 24%, and recorded no action for 51%. Conclusions: Problems underlying uncontrolled hypertension among treated Harlem patients relate to patient selfmanagement, lack of clinical adjustments despite frequent contacts, and system and cultural barriers. Implications for Policy, Delivery or Practice: Based on these exploratory studies, we designed and implemented a nursemanagement intervention to target the problems underlying hypertension control in this community, and are evaluating its effectiveness and cost-effectiveness in a randomized controlled trial. Bilingual nurses counsel patients; train them to use home blood-pressure monitors; follow-up regularly by telephone and provide social support; interact with clinicians to adjust medications until control is attained; and facilitate access to social work and insurance coverage. The program has strong clinical and administrative support. Primary Funding Source: AHRQ Call for Papers.
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Electrolyte leakage, measured as an increase in conductivity of the solution bathing treated leaf discs, is often used to assay the time course of membrane damage during HR Goodman and Novacky, 1994 ; . We measured the conductivity of leaf discs from RPS2 or rps2 plants with or without SA pretreatment and after addition of 1 mM dex or ethanol. No differences in conductivity were measured during the first 2 h of incubation with ethanol or dex Fig. 3 ; , although by then RPS2 segments treated for only 15 min with dex had depolarized 40 mV on average Table I ; . There was little difference in electrolyte loss for discs from dextreated rps2 leaves and ethanol-treated RPS2 or rps2 leaves throughout the experiment Fig. 3 ; . At the conductivity of these treatments in three experiments ranged from 2.4 6 0.2 to 4.0 6 0.2 mS cm22. Differences between treatments appeared 4 to 6 after dex addition Fig. 3 ; , about the time that the first wilting was observed in RPS2 plant leaves infiltrated with dex but after depolarization was complete. From 6 to 12 after dex addition, the electrolyte leakage of dex-treated RPS2 discs was much greater than that of all other plants and treatments Fig. 3 ; . By conductivity for dex-treated RPS2 samples in the three experiments ranged from 15.8 6 0.4 to 22.4 6 2.5 mS cm22. SA pretreatment substantially blocked dex-induced electrolyte leakage from RPS2 discs Fig. 3 ; . In the three experiments, the conductivity at 12 h after dex averaged 4.9 6 0.4 to 6.6 6 1.6 mS cm22. SA pretreatment of RPS2 leaves without dex did not increase the electrolyte leakage above background data not shown ; . Similarly, SA pretreatment did not increase leakage from dex-treated rps2 discs above background Fig. 3 ; . In summary, depolarization, macroscopic HR, and electrolyte leakage were highly correlated.

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Non-Pharmacological Therapy Surgery For historical purposes, two surgical techniques were used to attempt to maintain sinus rhythm. The corridor operation was designed to maintain sinus rhythm by isolating the sinus node, a corridor of atrial tissue and the AV node from the rest of the atrium. This would potentially maintain the normal chronotropic function of the sinus node with a normal ventricular response. However, the remainder of the atrial tissue remains in AF; therefore atrial mechanical function is not restored. The goal of the Maze operation was not only to maintain sinus rhythm, but also to restore atrial mechanical function and eventually to eliminate the need for anticoagulation. This operation involves multiple incisions and cryosurgery to create a "maze" dividing the left and right atria into a continuous strip of atrial tissue. Sinus depolarization spreads throughout the atria through this maze. Both surgical approaches involve major surgery, carry significant risk and are not widely used at the current time. Approaches have instead turned toward the potential role for catheter ablation techniques. AV Junction Ablation As noted in a previous section, AV junction ablation is a very effective means of controlling the ventricular response in AF. It is used in patients with refractory atrial arrhythmias whose sinus rhythm cannot be maintained and whose ventricular response cannot be adequately controlled in AF, despite AV nodal blocking agents. Some patients may be intolerant to AV nodal blocking drugs due to asthma, COPD or congestive heart failure. Control of the ventricular response is essential and may prevent development of a tachycardia-induced cardiomyopathy. The procedure aims to create complete heart block. Figure 6. Implantation of a permanent pacemaker is required, and patients are usually pacemaker dependent. Catheter Maze Long linear lesions can be created in the right and left atria using an endocardial catheter. Limited data is available regarding efficacy. Due to technical limitations and the high risk of complications, this procedure has been aborted at most centers. Flutter Isthmus Ablation Some patients who receive class I or III antiarrhythmic agents for the treatment of AF may subsequently develop atrial flutter. Ablation of the flutter circuit with a linear lesion placed from the tricuspid valve annulus to the inferior vena cava, results in termination of atrial flutter. Creation of "bi-directional block" interrupts the flutter circuit and prevents recurrence of atrial flutter. Flutter isthmus ablation is associated with a very high success rate and is often utilized as "hybrid"" therapy in conjunction with antiarrhythmic agents utilized to treat AF. Nabar Circ 1999 ; Focal Atrial Fibrillation Ablation Pulmonary Veins ; Some patients have initiation of AF with APDs that arise within the pulmonary veins. Ablation of these foci may eliminate AF in some patients. Haissaguerre NEJM 1998 ; Dual Chamber vs. Single Chamber Pacing Patients with dual chamber pacemakers utilized for the treatment of SSS brady-tachy syndrome ; appear to have a lower risk of recurrent atrial arrhythmias than patients with single chamber VVI pacemakers. It is thought that VVI pacing may be proarrhythmic. Many nonrandomized trials comparing VVI pacing to DDD pacing suggest a higher risk of AF in the VVI pacing groups. A recent randomized trial, the Canadian Trial of Physiological Pacing CTOPP ; , confirmed that patients with dual chamber pacing had a lower risk of AF than those with single chamber pacers. Connolly NEJM 2000 ; However, there was no difference in mortality or stroke risk between the two groups.

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