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Soon, an Ointment That Works Like Viagra?


Viagra is about to get some serious rivals. This summer, Eli Lilly & Co. (LLY) and Bayer (BAY) are both planning to introduce new--and potentially better--remedies for erectile dysfunction (ED). But perhaps more important, NexMed Inc. (NEXM), a pharmaceutical house in Robbinsville, N.J., is developing a topical cream, Alprox-TD, that represents a new approach to treatment.

Because it is applied locally, Alprox-TD avoids the side effects that trouble some Viagra users, including blue-tinted vision and headaches. And it gets around drug-to-drug interactions of the sort that have harmed some Viagra users who take nitroglycerin for heart conditions. One other advantage: NexMed's cream appears to act in minutes, not hours.

The main ingredient in NexMed's cream isn't new. It is alprostadil, an off-patent drug that has been used in the past as an injectable treatment for ED. NexMed has reformulated the medicine so that it can be absorbed through the skin. Earlier this month, the company started a pivotal clinical trial with Alprox-TD among 2,500 men at 80 medical centers in the U.S. NexMed's vice-president for R&D, Dr. James L. Yeager, says the company plans to wrap up the trial later this year and submit its results to the Food & Drug Administration by 2003. The source of the intense pain of migraines has eluded scientists for years. Now, researchers at Boston's Massachusetts General Hospital have evidence that the pain may be caused by the brain itself, even though brain tissue is believed to be unable to feel sensations. Their results are published in the February issue of Nature Medicine.

The researchers, led by neurologist Dr. Michael A. Moskowitz, looked at the 15% to 20% of migraine sufferers who have "auras"--visual disturbances such as flashing lights before an attack. Using PET scans to make highly detailed pictures of the brain during such events, the team discovered that auras were linked to a disturbance deep in the brain called cortical spreading depression, which triggers a massive release of neurochemicals.

These chemicals cause inflammation and increased blood flow on one side of the brain's outside membrane. Then, blood vessels feeding the membrane dilate, irritating the nerves. "We now know that after intense metabolic and neurophysiological activity, the brain not only processes the information but also, in this instance, generates the pain," says Moskowitz. Environmental cleanup is becoming a sweet proposition. This coming May, a national team of researchers will use a type of sugar called cyclodextrin to clean up a contaminated military installation near Norfolk, Va. Unlike other decontaminants, which are often as noxious as the chemicals they seek to remove, cyclodextrin is safe enough to eat.

Found in cornstarch, cyclodextrin is chemically different from the white stuff people put in their coffee. It is composed of seven glucose molecules that can instantly latch on to trichloroethylene (TCE) and other organic contaminants in the soil. So cleaning up a site is simply a matter of injecting the sugar into the ground, letting it bind with pollutants, and pumping it back out.

Thomas Boving, the University of Rhode Island researcher in charge of the cleanup, estimates that it will take nearly 13 tons of cyclodextrin to remediate the military site. That might have meant a hefty price tag, since cyclodextrin costs $3.50 a kilogram. Fortunately, Boving has figured out a way to strip the sugar of its contaminants and reuse it. Shattered by dynamite-hurling fishermen, poisoned by agricultural runoff, or simply warmed to death by rising ocean temperatures, coral reefs around the world are losing their color and their fish. Yet some marine biologists continue to argue that the species living in and around coral reefs are in no danger of extinction. The sheer scale of the earth's oceans ensure that most species will survive somewhere, they say.

Maybe not. According to a survey of reef systems around the world, the slow death of geographically isolated coral reefs could destroy major concentrations of species, threatening the ocean's biodiversity. These "hot spots" are home to 34% of the world's restricted-range marine species--those seen nowhere else. The findings from the Center for Applied Biodiversity Sciences, an arm of Washington-based Conservation International, appear in the Feb. 15 issue of Science.

Still, the CABS report sees reason for hope. In the Philippines, for example, environmentalists have been pushing local fishermen to replace dynamite and cyanide with less destructive fishing methods. Reefs and fish stocks are already rebounding, says Callum Roberts of the University of York in Britain. The greater challenge, he says, will be stemming the devastation caused by coastal development and global warming.


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