Time frame: throughout study ] [ designated as safety issue: no ] clinical response in pnd patients who are treated with tacrolimus and prednisone [ time frame: throughout study ] [ designated as safety issue: no ] secondary outcome measures: collection and archiving of serum and lymphocytes for future studies on the mechanism of neuronal autoimmunity. buy cheap viagra [ time frame: end of study ] [ designated as safety issue: no ] estimated enrollment: century study start date: april 2006 estimated study completion date: may 2015 estimated primary completion date: may 2015 (final data collection date for primary outcome measure) arms assigned interventions experimental: tacrolimus tacrolimus at doses of 0. 15- 0. 3mg/kg/day in two divided oral doses, in conjunction with, initially, up to 60mg/day of oral prednisone drug: tacrolimus (fk506) tacrolimus at doses of 0. 15- 0. cheap viagra 3mg/kg/day in two divided oral doses, in conjunction with, initially, up to 60mg/day of oral prednisone detailed description: patients may stay either in-hospital while being treated with tacrolimus, receive treatment as an outpatient, or a combination of the two. Additionally, patients who are too sick to be treated at rockefeller university (eg. Patients actively seizing), but are in need of urgent treatment, may be treated at either memorial sloan-kettering cancer center or new york-presbyterian hospital in conjunction with mds there. viagra 20mg vs viagra 50mg Dr. Robert darnell, being credentialed at both institutions, will be the primary person responsible for monitoring all portions of the study performed at mskcc and new york-presbyterian hospital. During treatment, patients will undergo blood draws, at set intervals (see section g below), clinical evaluation, possibly repeat leukapheresis or large volume blood draw, and lumbar puncture (see below). viagra side effects blood pressure Since many patients live far away from ny, some of these procedures may be performed by ru staff or in conjunction with their local mds. where can i buy viagra locally without a prescription Patients who are terminated from tacrolimus treatment after 7-21 days will be followed up as outpatients for evaluation of their neurologic and medical status. Wherever possible, these patients will be seen on days 3 and 10 post treatment termination, and then on a biweekly basis for two months. Since many patients live far away from ny, they may instead be monitored in conjunction with their local mds. viagra generic Patients who show a definite clinical response to tacrolimus may be maintained on a therapeutic dose for up to one year, and will be followed as outpatients. For patients receiving retreatment, they may be treated as inpatients or on an outpatient basis, at the discretion of the pi, on the same schedule as patients being treated initially (see 10. G. ). buy viagra cheap Long term improvement or decline in neurologic function will be objectively assessed by neurologic exam, which will be quantified by use of the karnofsky scale (a measure of functional neurologic status). viagra online Since the vast majority of hu pat. viagra or viagra price

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