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Mobilization of Philadelphia chromosome (Ph) negative blood progenitors was attempted in 23 newly diagnosed chronic myeloid leukaemia (CML) patients using a regimen of cyclophosphamide (CY) 5 g/m 2 and rHUG-CSF 1150 μg/m 2 daily. This regimen was well tolerated with no major adverse events reported. More than 2 x 10 6 /kg CD34 + cells were collected in 21 patients (91%). Predominantly Ph-negative mobilization (0-25% Ph-positive) was seen in 30% of cases overall and was confined to patients with a Sokal prognostic score < 1 (7/11 with Sokal score

Factor EF-P is a nonribosomal (soluble) protein of Escherichia coli that stimulates peptide bond synthesis when certain aminoacyl-tRNA analogues are used. The purification of this protein to apparent homogeneity is described here. EF-P has a molecular weight of about 21 000, a Stokes radius of 27 Å (1 Å = 0.1 nm), and a frictional coefficient of 1.48, suggesting an asymmetric structure. By this and a number of other criteria, EF-P is a new factor that controls peptide bond formation during protein biosynthesis.

Over the past two decades, biomedical science has developed an impressive array of new technologies that have heightened human control over the reproductive process. At the same time, these technologies have created difficult new moral questions for individuals and families. Genetic screening, techniques of fetal diagnosis and life-extending neonatal technologies have presented parents or prospective parents with painful new choices throughout the whole course of the reproductive process. In what follows, I propose to explore the implications of traditional Jewish thinking for some of the new choices made possible by genetic and neonatal medicine. Jewish thinking in this area has importance for several reasons. First, because many Jews find themselves instructed and informed by the values embodied in their tradition. Those who would treat or counsel Jewish patients, therefore, must have some understanding of the inherited beliefs and values that may shape these individuals' thinking. Second, there are a number of genetic diseases which disproportionately afflict persons of Jewish background. This results from the unique social history of the Jews, their emphasis on marriage within the Jewish community and their frequent isolation in small, separated communities. One example of such a 'Jewish' genetic affliction is the carrier state for Tay-Sachs disease whose incidence is ten times higher among Jews of Ashkenazic or East-European background than among other major European or Mediterranean populations."^ This higher rate of incidence for certain genetic diseases means that one is very likely to encounter individuals of Jewish ethnic background in the counseling or health care setting when genetic disease is involved. It also means that the Jewish community has a special interest in programs of screening for genetic disease. This interest, I might add, is greatly magnified by the fact that the Jewish community in our time has almost been

The renal clearance of melphalan and the fraction unbound in plasma were determined after intravenous infusion of 5 mg/m2 over 5 min in nine patients with cancer to obtain information regarding the mechanism of renal handling of melphalan. Four of the patients underwent bone marrow transplantation and also received an IV dose of 220 mg/m2. Total melphalan clearance after the 5 mg/m2 dose ranged from 66.0 to 272 ml/min per m2; the percentage of the dose excreted unchanged in urine, from 2.5% to 92.8%; renal clearance, from 4.1 to 188 ml/min per m2; the fraction unbound in plasma, from 0.0598 to 0.460; and t1/2 beta, from 39.4 to 84.3 min. Unbound melphalan clearance and renal clearance calculated from the unbound fraction in plasma for each patient ranged from 441 to 3356 ml/min per m2 and 15 to 961 ml/min per m2 respectively and were not related to serum albumin, serum creatinine or creatinine clearance. The percentage of the dose excreted and melphalan renal clearance were not related to urine flow. There was evidence of active secretion of melphalan in the kidney an possible reabsorption. There were no significant paired differences in melphalan disposition between the high- and low-dose studies. Highly variable renal clearance involving active secretion may contribute in part to large interpatient differences in the total plasma clearance of melphalan in patients with cancer.

The incidence of foodborne disease in England and Wales shows a continuous rise\ud throughout the latter part of the twentieth and early twenty first centuries despite regular\ud inspections by Environmental Health Officers (EHOs). In order to ameliorate this, the\ud concept of a risk based system of food safety management, HACCP, was introduced.\ud This thesis describes the research to determine the effectiveness of EHOs in identifying\ud and controlling the significant risks of foodborne disease in micro owner/managed\ud catering businesses (MO/MCBs) over a 14 year period which marked the transition from\ud prescriptive to risk based legislation. By deconstructing and itemising inspection reports\ud on 80 premises the EHOs' findings are collated and any trends revealed, thereby\ud quantitatively demonstrating the propensity of EHOs to identify these risks.\ud The MO/MCB perception of authority, in particular EHOs, is explored by a series of indepth\ud discussions with a focus group of 12 participants, taken from the original 80\ud businesses, thus exposing any cultural issues which relate to the effectiveness of\ud identifying and controlling risk.\ud The results show that significant risks are rarely identified by EHOs in food safety reports\ud prior to the introduction of the risk based legislation and that there is little change\ud afterwards, it further shows that a major factor is the unwillingness of the MO/MCBs to\ud confide in EHOs regarding food safety problems.\ud The findings of this research highlight a weakness in the concept of HACCP in this sector\ud in that MO/MCBs do not have the scientific expertise, and EHOs do not have sufficient\ud knowledge of the systems within the business, to comprehensively identify the significant\ud risks in the businesses.\ud This demonstrates the need for a cooperative rather than a confrontational approach to\ud enforcement in order to effectively identify and control the significant risks of foodborne\ud illness within the MO/MCB sector.\ud xvii

PURPOSE To describe a newly established international registry recruiting diverse patients with advanced prostate cancer across academic and community practices to address unmet needs in this population. PATIENTS AND METHODS Initiated in 2017, IRONMAN (International Registry for Men with Advanced Prostate Cancer) is a prospective cohort of patients with advanced prostate cancer. The study will enroll 5,000 patients with metastatic hormone-sensitive prostate cancer (mHSPC) or castration-resistant prostate cancer (CRPC), recruited from Australia, the Bahamas, Barbados, Brazil, Canada, Ireland, Jamaica, Kenya, Nigeria, Norway, South Africa, Spain, Sweden, Switzerland, the United Kingdom, and the United States. The study is collecting datatypes to study variation in care and treatment of advanced prostate cancer across countries and across academic, community-based, and government practices with a focus on clinical outcomes, patient-reported outcomes, epidemiologic data, biologic subtypes, and clinician questionnaires. RESULTS Through July 2022, 2,682 eligible patients were enrolled in 11 of 12 active countries. Sixty-six percent of patients have mHSPC, and 34% have CRPC. On the basis of self-report, 11% of patients are Black and 9% are Hispanic. Five Veterans Affairs Medical Centers are enrolling patients. Globally, 23% of patients report being veterans of military service. CONCLUSION To our knowledge, this is the first international cohort of people newly diagnosed with advanced prostate cancer designed to describe variations in patient management, experiences, and outcomes. IRONMAN aims to identify optimal treatment sequences to improve survival, understand patient-reported outcomes, and explore novel biomarkers to understand treatment resistance mechanisms. Insights from IRONMAN will inform and guide future clinical management of people with mHSPC and CRPC. This cohort study will provide real-world evidence to facilitate a better understanding of the survivorship of people with advanced prostate cancer.