Adjunctive everolimus treatment improved seizure frequency with a tolerable safety relative to placebo among 35 Japanese patients with TSC-associated refractory seizures, consistent with the results of overall EXIST-3 study involving 366 patients. A favorable trend towards the improvement of ASD symptoms was observed.

No abstract

Nelfinavir, one of human immunodeficiency virus (HIV) specific protease inhibitors(PIs), is widely used for the treatment of HIVinfection. Nelfinavir, which is metabolized with the cytochrome p450 isoforms, elevate the phenytoin level theoretically because nelfinavir acts as an inhibitor of phenytoin metabolism through the enzyme. However, we encountered a case of seizure recurrence caused by a lowered phenytoin level after initiation of nelfinavir. Weshould be aware of the change in the phenytoin level in concomitant use of nelfinavir. (Internal Medicine 38: 302-303, 1999)

One‐way delay variation (OWDV) has become increasingly of interest to researchers as a way to evaluate network state and service quality, especially for real‐time and streaming services such as voice‐over‐Internet‐protocol (VoIP) and video. Many schemes for OWDV measurement require clock synchronization through the global‐positioning system (GPS) or network time protocol. In clock‐synchronized approaches, the accuracy of OWDV measurement depends on the accuracy of the clock synchronization. GPS provides highly accurate clock synchronization. However, the deployment of GPS on legacy network equipment might be slow and costly. This paper proposes a method for measuring OWDV that dispenses with clock synchronization. The clock synchronization problem is mainly caused by clock skew. The proposed approach is based on the measurement of inter‐packet delay and accumulated OWDV. This paper shows the performance of the proposed scheme via simulations and through experiments in a VoIP network. The presented simulation and measurement results indicate that clock skew can be efficiently measured and removed and that OWDV can be measured without requiring clock synchronization.

In the ongoing, international, phase 3 study Evaluating Nilotinib Efficacy and Safety in Clinical Trials-Newly Diagnosed Patients (ENESTnd), nilotinib 300 and nilotinib 400 mg, both twice daily, are compared with imatinib 400 mg once daily for the treatment of newly diagnosed chronic myeloid leukemia in the chronic phase (CML-CP). Results for the overall population in ENESTnd (n = 846) showed that nilotinib resulted in higher response rates vs. imatinib and was well tolerated. Outcomes among Japanese patients in ENESTnd were specifically analyzed after 1 year of follow-up, and showed similar trends to the overall population; we present updated analysis of the Japanese subgroup based on 5 years of follow-up. Among Japanese patients in the nilotinib 300-mg (n = 29), nilotinib 400-mg (n = 23), and imatinib (n = 25) arms, 86.2, 78.3, and 60.0%, respectively, achieved major molecular response [BCR-ABL1 ≤ 0.1% on the International Scale (BCR-ABL1 )] by 5 years, and 65.5, 69.6, and 40.0%, respectively, achieved MR (BCR-ABL1 ≤ 0.0032%). Safety results were consistent with prior reports. In this subgroup, one death occurred during treatment in the nilotinib 400-mg twice-daily arm (unknown cause), and one patient in each arm progressed to accelerated phase/blast crisis by the data cutoff.