 HHHHHH   HHHHHH   HHHHHH          H    H   HHHHHH   H     H   HHHHHH
 H        H        H               HH   H   H        H     H   H
 H        HHHHH    HHHHHH   HHHH   H H  H   HHHH     H  H  H   HHHHHH
 H        H             H          H  HHH   H        H  H  H        H
 HHHHHH   H        HHHHHH          H   HH   HHHHHH    HHHHH    HHHHHH


            Chronic Fatigue Syndrome Electronic Newsletter

 --------------------------------------------------------------------
 No. 35                      May 4, 1994                Washington DC
 --------------------------------------------------------------------

                    LLOYD REVIEWS CFS RESEARCH /
                            MAY 12 UPDATE

        CONTENTS

 >>>1.  Dr. Andrew Lloyd reviews CFS research
 >>>2.  May 12 update

 -------------------------------------------------------------------

 >>>1.  Dr. Andrew Lloyd reviews research

[The following report appeared in the March 1994 edition of EmeRGE,
the newsletter of the ME/CFS Society of Victoria, Australia.  Dr.
Andrew Lloyd is a member of a world-renowned medical team studying
CFS at Prince Henry Hospital in Sydney.]

            CHRONIC  FATIGUE  SYNDROME  -- THE  CHALLENGE

This is a summary of the talk given to our Society at the Annual
General Meeting on 13th  November, 1993.  The speaker was Dr Andrew
Lloyd, MD, FRACP, staff specialist in infectious diseases at The
Prince Henry Hospital, and Senior Lecturer in Medicine at the
University of NSW, Sydney.

   *INTRODUCTION*

Fundamental to all the  Chronic Fatigue Syndrome (CFS) research that
has taken place over the last few  years are the diagnostic criteria
used to define CFS.  While fatigue is incredibly common -- up to 30%
of the general community complain of fatigue at any one time -- CFS
patients represent only a small fraction of this population.  The
development of diagnostic criteria by Dr Lloyd and his colleagues
early in their research was an attempt  to unify the patient group
for research studies, to ensure (as far as possible) that all
patients were suffering from the same disorder. Indeed, very few of
the patients identified as having CFS have turned out to have another
known medical or psychiatric disorder.

However, after more than six years of research, the team in Sydney
has come to the recognition that people who meet the existing
diagnostic criteria for CFS do not all have the same illness.  This
conclusion  will have a major impact on the direction of future CFS
research.  Dr Lloyd  put this into perspective with an overview of
past, current and future CFS  research at The Prince Henry Hospital
and the University of NSW.

   *THE PAST*

PATHOGENESIS OF CFS

The working hypothesis of the Sydney researchers has been that CFS
results from a disordered immune response, leading to the production
of excessive amounts of cytokines by the immune system, which in turn
affect the brain and muscles of CFS patients. The disordered immune
response may result when a number of factors are present at the same
time: an antigenic challenge (eg. an infection or a vaccination);
genetic risk factors (which are  present in  many immunological
diseases); and any of a number of other factors (eg. stress, physical
exercise, etc.). This sequence is illustrated below:


 Antigenic
 Challenge    \                                       Brain
                \   Disordered        Excessive     /
 Genetic Risk --- > Immune    ------> Production of         Symptoms
 Factors         /  Response          Cytokines     \
               /                                      Muscles
 Other Factors


In testing this hypothesis, Dr Lloyd and  the other researchers who
have worked with him have conducted studies into the following
aspects of CFS:

      --  Epidemiology
      --  Psychiatry
      --  Neurophysiology
      --  Immunology
      --  Genetics
      --  Therapy

EPIDEMIOLOGY

Prevalence Study

The principal findings of this study were that:

 --  CFS was precipitated by an acute 'viral' illness in 75% of
     patients.  In one-third of these, the virus was identified at
     onset.  The remaining 25% of patients had no apparent
     precipitant for their illness.

 --  The peak age of onset was between 20 and 40 years.

 --  A minimum prevalence of approximately 40 cases of CFS per
     100,000 of population was identified.  The female to male ratio
     was 1.3 : 1.0.

 --  Cases precipitated by Ross River virus, or Epstein-Barr virus,
     could not be distinguished clinically, indicating that the
     individual's immune response to the virus -- rather than the
     virus itself -- may be important in developing the illness.

 --  The socio-economic profile of CFS patients was similar to that
     for the population as a whole.  This demonstrated that 'Yuppie
     Flu' was a nonsensical concept.

Cost of Illness

Few medical disorders have been subjected to cost analysis anywhere
in the world.  Based on the above prevalence study, Dr Lloyd
estimated that the minimum cost of CFS to the Australian community
was approximately $60 million per annum (1988/89 dollars). This type
of information is a good basis on which to put a case for research
funding, and on which to demonstrate the need for support for the
disability which CFS causes.

PSYCHIATRY

Depression

When Dr Lloyd commenced his studies into CFS in 1987, the general
medical view was that CFS was a psychiatric illness (such as
depression), or that patients were malingerers.  Research has now
shown that CFS is not simply depression, even though depression can
be one of the symptoms of the illness.  There are perhaps a dozen
studies  now saying  that CFS  is not  simply a  form of  depression.
The researchers in Sydney have demonstrated that  the immunological
changes seen in 37 researchers in Sydney have demonstrated that  the
immunological changes seen in CFS are not able to be explained on the
basis of depression, although similar but minor changes are found in
those with severe depression.

Somatisation Disorder

Some people diagnosed with  CFS actually have a psychological illness
known as somatisation disorder, according to Dr Lloyd.  The
psychological illness produces physical symptoms in sufferers of this
condition.  Diagnosis of somatisation disorder is a 'thorny issue' in
CFS, especially since people with somatisation disorder "have
multiple unexplained physical symptoms and present frequently to
medical attention over a long period of time."

NEUROPHYSIOLOGY

Muscle studies conducted at The Prince Henry Hospital have indicated
that the muscles, the nerves  joining the  muscles to the  spinal
cord,  the spinal cord itself, and the motor cortex in the  brain,
are all essentially normal in CFS patients. Dr Lloyd's conclusion is
that the  fatigue in CFS arises in the brain and not the muscles.
Other research groups have confirmed this. Dr Lloyd believes that a
region of the brain which controls the perception of fatigue is
affected in CFS.

IMMUNOLOGY

Immunological studies have been a  major focus of the research team
in Sydney.  They have found that in CFS, the immune  system is
abnormal in a subtle way.  An association between altered T-cell
immunity and CFS has been demonstrated.  More recently, studies of
cytokines have been undertaken in an attempt to determine if abnormal
production of these chemicals occurs in CFS.

Cytokines are chemical messengers produced by cells  of the immune
system.  They have a variety of functions, and are important in
mobilising different parts of the immune system when something
foreign (eg. a virus) enters the body.  It is now known that the
symptoms of a viral infection, such as fever, muscle and joint pain,
and headache, are due not to the virus itself, but to the body's
response to the virus.  The immune system releases cytokines such as
interferon which cause the symptoms.

In one study looking at several cytokines, Dr Lloyd and colleagues
found that the level of alpha-interferon was elevated in the spinal
fluid of some CFS patients when compared with the level in healthy
controls. Another study sought to determine if exercise was a
co-factor for increasing the levels of cytokines in CFS patients, but
no difference was found between the patients and healthy controls.

Although the cytokine hypothesis is appealing, it is clear that
results will not come easily, and the task of identifying which
immune product (if any) is involved in CFS is almost overwhelming.
There are about 100 different immunological proteins such as
cytokines which could be of relevance to CFS, and these are being
discovered at a rate of three to four per year.  Only half-a-dozen
have been investigated by the Sydney team, and even this has
involved a significant  amount of work.  Furthermore, cytokine
action  may be very site-specific, eg. in a lymph node or in a
particular area of the brain, and elevated levels may not show up in
blood or spinal fluid.

GENETICS

In a study of approximately 20 families with multiple members
affected by CFS, a preliminary association between a particular
genetic marker and CFS has been found.  Dr Lloyd stressed that this
work needs to continue and be strengthened.

THERAPY

Four potential treatments for CFS have been rigorously tested  in
Sydney: high-dose intravenous gammaglobulin; transfer factor;
cognitive-behavioural therapy; and Moclobemide.  The Moclobemide
results are not yet available, but of the other three, only high-dose
gammaglobulin has proved to be of any benefit.  A second, larger
study examining the effect of different doses of intravenous
gammaglobulin has been  completed, and is  currently being analysed.
Again, it appears that high-dose gammaglobulin is of benefit to some
people with CFS, while lower doses produce no benefit.
Unfortunately, gammaglobulin is not available for treating CFS in
Australia.  The limited supplies are reserved for people with life-
threatening diseases.

*It has become clear that there is a definite need to understand the
processes that cause CFS before adequate treatments can be designed.*

   *THE PRESENT*

INTELLECTUAL / COGNITIVE PERFORMANCE

As part of her PhD research, psychologist Ute Vollmer-Conna undertook
a study designed to characterise the nature of any differences in
intellectual and cognitive processes in four different groups of
people: those with CFS; those with an acute viral illness; those with
depression; and those with no health problems (healthy controls).
The carefully matched participants  underwent a battery of written,
spoken and computer-based tasks.  It was found that there are
recognisable and measurable difficulties in certain tasks in CFS.  In
particular, CFS patients performed extremely poorly on tasks in which
they were deliberately distracted.  People with depression as their
chief complaint performed well, although slowly, on all tasks.

This study effectively represents the end of an 'era' in the
research of the Sydney team.  It is 'descriptive' research which
doesn't address the cause of the illness.  However, finding the
cause(s) of CFS has been complicated by the results of the
international collaborative  study, which looked at symptom profiles
in CFS.

SYMPTOM PROFILES

Dr Andrew Wilson at The Prince Henry Hospital has statistically
analysed the results of the international collaborative study  on
CFS, which included approximately 1,000 patients from eight centres
around the world.  He has found that there are perhaps three
sub-groups within the apparently uniform groups of CFS patients. All
patients in this study satisfied diagnostic criteria for CFS.
Analysis of data from the patient group from Sydney revealed that
one of the sub-groups, representing one-half to two-thirds of all
patients, has the following characteristics:

   --    more likely to have less severe illness
   --    more likely to have a smaller cluster of symptoms
   --    more likely to have an infectious onset
   --    more likely to have involvement in school or work
   --    more likely to have abnormal immunological findings
   --    more likely to be helped by immunological therapy

In contrast, another sub-group is characterised by:

   --    more severe illness
   --    more likely to be bed-bound
   --    non-acute onset
   --    less likely to have immunological abnormalities
   --    less likely to respond to immunological therapies, eg.
               gammaglobulin
   --    more severe current psychiatric symptoms

The data from the patients in Sydney is almost identical to that from
other centres around the world.

The previously published diagnostic criteria have not taken into
account these apparent sub-groups, and it is possible that the
results of published research studies would have been different if
sub-groups were accounted for.  Thus, there is a problem with the
definition of CFS.  All future research will have to recognise that,
using current diagnostic criteria, the CFS patient group is
heterogeneous, not uniform.  A  more sophisticated approach to
diagnosis is required, and the international collaborative study will
assist with this.

IMMUNOLOGY

The immunological research into CFS also needs to become more
sophisticated.  This is one reason why Dr Lloyd spent three years in
the USA working in a specialised immunology laboratory. Recent work
by the team in Sydney investigated whether CFS patients make more or
less alpha-interferon in response to an immunological challenge
than healthy controls.

Peripheral blood mononuclear cells (PBMCs)  were separated from blood
samples taken from three groups of people: those with CFS; those with
an acute viral illness; and healthy  controls.  The cells were
exposed to various amounts of Sendai virus, and the resulting
production of alpha-interferon was monitored.  The cells from the
healthy controls produced the  most alpha-interferon, and those from
people with an acute viral infection, the least.  CFS patients' cells
produced an intermediate amount.  It is possible that another
cytokine suppresses alpha-interferon production in CFS and acute
viral illness. An overseas group headed by Dr Phillip Peterson in
Minnesota has found excessive production of a cytokine called TGF-b
from PBMCs of CFS patients, and in mice inoculated with infectious
organisms.  This cytokine is known to switch off the immune system
(and thus production of other cytokines) when released.

   *THE FUTURE*

Dr Lloyd emphasised that it is now time to leave descriptive research
behind, and to concentrate on the 'core' of the problem of CFS --
what is causing it.  There are three areas that Dr Lloyd and his
colleagues will focus on in the future:

   --    A prospective cohort
   --    An animal model
   --    Sleep disorder

PROSPECTIVE COHORT

To try and identify what the disease process is and how it is
generated, all people who report to University Student Health
Services in Sydney with glandular fever (caused by Epstein-Barr
virus) will be followed frequently and repetitively from the onset of
their ill-health until they recover, or until they develop CFS.
Immunological and other tests will be done during this time.  While
it is expected that only a minority of people with glandular fever
will remain unwell (and thus get a diagnosis  of CFS), this project
will provide the researchers with an opportunity to study a
homogeneous group of patients who are definitely suffering
from the same illness.  Hopefully, it will be possible to identify
factors which determine why some people recover, and why some do not.
After a pilot study of six months, the major study will continue for
three years, if funding is available.  The findings will then be
tested in a broader range of CFS patients.

ANIMAL MODEL

Dr Phillip Peterson (from Minnesota) has developed an animal 'model'
of immunologically-mediated fatigue, using mice which have been
inoculated with infectious organisms.  He has shown that when the
mice generate an immune response, they stop physical activity, and
exhibit severe fatigue after exercise, as happens in people with CFS.
Mice are much easier to study than humans, and this applies
particularly to brain function and biochemistry, so it is useful
to study animal models to generate basic information about disease
processes.  The researchers in Sydney will generate animal models of
CFS as part of their future work.

SLEEP DISORDER

Sleep disorders are common in CFS, but it is unclear what role they
play.  Dr Harvey Moldofsky of the Toronto Hospital in Canada believes
sleep disorder may be central to the CFS disease process, and the
research team in Sydney will investigate this prospect, working with
healthy people first.

*CONCLUSION*

'Persistence pays out' was Dr  Lloyd's final message.  Progress is
very slow in medical research, and CFS research is no exception.  The
only way to speed up progress is to commit more resources to finding
answers to the basic questions about the illness.  This will require
fundraising and political lobbying by those with the most to gain
from research -- people with CFS.

Jim Oakley

Ed: Thanks to Dr Lloyd for reviewing this summary before publication.

[Thanks to EmeRGE editor Jim Oakley for providing this article in
electronic form. -- CFS-NEWS]


 -=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-

 >>>2.  May 12 Update

[The following text is excerpted from the May '94 update on May 12
International CFIDS/ME Awareness Day as provided by the RESCIND
organization.  Thanks to Matt Straznitskas for assistance and hard
work.]

            MAY 12: International CFIDS/ME Awareness Day
                        May 1994 Update

This is it!  MAY 12: International CFIDS/ME Awareness Day is now only
days away.  All of the months of planning by groups around the world
will pay off shortly.  If you are a CFIDS/ME patient or care about
someone who is, make certain that your voice heard on May 12, 1994 by
calling your government officials (see section two, "MAY 12 ACTION").
Whatever other projects you also may be working on, please support
our international effort by promoting May 12 as an awareness day
for CFIDS/ME.  Together, we will turn the spotlight on CFIDS/ME!

This is the last MAY 12 update for this year, but RESCIND,
Inc. would like to put together an article which will recap
what groups did for MAY 12.  Please send written accounts and
photographs to: Lori Clovis, 3680 Main Street, P.O. Box 144,
Hinsdale, NY 14743 USA.


I. MAY 12 NEWS

In Australia, the ME/CFS Society of Victoria is undertaking several
projects to promote May 12.  Television and radio programs, and
newspapers and magazines are being contacted to raise awareness.
Persons with CFIDS/ME (PWCs) who are willing to talk to the media
about their personal stories are being asked to register with Society
president Yvette Creighton by leaving a message at tel. 888 8991.
All PWCs are asked to participate in talkback radio shows, and to
participate in the Fax-In/Phone-In campaign to inform Federal
Minister for Health, Senator Graham Richardson, that we need his
assistance in the struggle against this illness.  Senator Richardson
can be contacted at tel. (06) 277 7220 or at fax (06) 273 4146 and he
should be told (1) that May 12 is International ME/CFS Awareness Day,
(2) that you suffer form CFS, (3) the effect it has had on your life,
(4) the need for better information about the illness to be
distributed to doctors, and (5) the need for more medical research
into the causes and treatment of the illness.

In the USA, The CFIDS Buyers Club have enclosed a special two page
MAY 12 bulletin in their Spring 1994 Health Watch publication.  The
special bulletin will be received by more than 60,000 people at a
crucial time -- just days before May 12, 1994. RESCIND, Inc. would
like to extend its deepest thanks to the Buyers Club for undertaking
this very important and timely mailing.

The CFIDS Association of America recently completed a mailing to its
more than 1000 C-ACT members that contained information about MAY 12.
The mailing included an advocacy alert from Tom Sheridan of The
Sheridan Group (a CFIDS lobbyist group in Washington, D.C.) which
urged members to contact government officials for MAY 12.  The
mailing also included a MAY 12 poster for members to copy and hang in
their community.

On May 9th at 10 A.M. in Albany, New York, a delegation of CFIDS
support group leaders from New York will be meeting with Lieutenant
Governor Stan Lundine to mark the MAY 12 event.  For more
information, contact Lori Clovis at (716) 557-2260.

In Florida, The Manasota CFIDS Support Group will be conducting a
letter writing campaign for MAY 12 and a computer savvy member will
be on hand at the May 1 meeting to help those who have trouble
writing letters.  For more information, contact Marion Nelson at
(813) 371-6944.

Aidan Walsh, a CFIDS/ME activist from Quebec, Canada, has completed a
2000 piece mailing to promote a May 12th mass demonstration to take
place on Capitol Hill in Ottawa, Canada from 10 A.M. to dusk. For
more information, contact Aidan at (514) 487-6620.

Note: The Youth Campaign for CFIDS Awareness has announced that the
deadline for letters for its letter writing campaign to President and
Mrs. Clinton has been extended to August 1, 1994.  The deadline was
originally May 12th but it was deemed necessary to extend the time
frame to allow more time for youth to write.  For more information
contact Rebecca Moore at P.O. Box 247, Warwick, NY 10990 tel. (914)
986-1023.


II. MAY 12 ACTION

The most important thing you can do on May 12th as an individual is
to contact your local and national government officials.  Below is a
sample letter you may want to use in writing the officials.
Following that is a resource list of national officials (local
officials can be found in your telephone book):

     Sample Letter:

Dear <name>:

Since you are an influential official who can demand a great deal of
attention to specific issues, I am writing to inform you that May
12th of this year has been designated as the International Chronic
Fatigue and Immune Dysfunction Syndrome (CFIDS)/Myalgic
Encephalomyelitis (ME) Awareness Day.  As you may be aware, CFIDS
(the term used in the United States)/ME (the term used in most of the
rest of the world) is a devastating illness that is striking a
growing number of people around the world -- a fact to which I can
sadly personally attest.

The illness, characterized by extreme fatigue, cognitive problems,
and numerous flu-like symptoms like fever and sore throat, leaves
many sufferers ill and bedridden for years at a time.  The toll that
this sudden disability takes on families, not to mention the national
economy, is enormous.

It is important to note that the May 12th date was chosen to
memorialize the birthdate of Florence Nightingale, the English army
nurse who inspired the founding of the International Red Cross.
Nightingale contracted a paralyzing, CFIDS/ME-like illness in her mid
thirties and spent the last 50 years of her life virtually bedridden.

If a cause and cure are to be found for CFIDS/ME in the near future,
government and medicine must respond MUCH more vigorously.  I implore
you to use your substantial power as a public servant to see that
this happens. May 12th of this year should mark the beginning of a
new era of thorough medical investigation into Chronic Fatigue and
Immune Dysfunction Syndrome/Myalgic Encephalomyelitis.

Sincerely yours,

<name>

NOTE: if you write to a President or a Prime Minister, you should
address the letter to "Dear Mr. President:" or "Dear Mr. Prime
Minister:" and then end it with "Yours faithfully,". All the other
persons can be addressed as "Dear Mr. ..." or "Dear Mrs. ...".

   Resource List:

   USA

 President William J. Clinton
 1600 Pennsylvania Avenue NW
 Washington, DC 20500
 public comment telephone line: (202) 456-1111 (9 AM to 5 PM
   Eastern time; bypass the survey and wait for an operator
   to take your comment)
 fax: (202) 456-2461

 Members of Congress -- Identify your local representatives by
referring to your local telephone book, or by calling your county
Board of Elections or your public library.  Please telephone or fax
your local Congressperson at his/her local office.  Contact your
member in the House of Representatives and both of your state's two
Senators. Or send them mail as follows:

  Hon. <name of Senator>
  United States Senate
  Washington, DC 20510

        or

  Hon. <name of Congressperson>
  United States House of Representatives
  Washington, DC 20515


  Donna Shalala
  Secretary of Health and Human Services
  200 Independence Ave. SW   Room 719H
  Washington, DC 20201
  Telephone: (202) 690-6867
  Fax: (202) 690-6608

  Dr. Harold Varmus
  Director of the National Institutes of Health
  Bldg. 31   Room 2B25
  9000 Rockville Pike
  Bethesda, MD 20892
  Telephone: (301) 496-2535
  Fax: (301) 496-0017

  Dr. Anthony Fauci,
  Director of the National Institute of Allergy
  and Infectious Diseases
  Bldg. 31   Room 7803
  9000 Rockville Pike
  Bethesda, MD 20892
  Telephone: (301) 496-5717
  Fax: (301) 496-0017

  Dr. David Satcher
  Director of the Centers for Disease Control and Prevention
  MS-A23
  1600 Clifton Road NE
  Atlanta, GA 30333
  Telephone: (404) 639-3534

   CANADA

Please write to you Member of Parliament.  Also to:

  The Right Honourable Jean Chretien
  Prime Minister's Office
  Langevin Block
  Ottawa, Ontario  K1A 0A2
  Telephone: (613) 992-4211
  Fax: (613) 941-6900

  Honourable Diane Marleau
  Minister of Health
  House of Commons
  Parliament Buildings
  Ottawa, Ontario  K1A 0A6
  Telephone: (613) 957-0200
  Fax: (613) 952-1154
  [Please thank Minister Marleau for recently endorsing
  May 12 as ME Awareness Day]

We are told that the public health officials at the provincial level
are particularly important in Canada.  Please write to them as well
as to your members of your provincial parliament.

  BRITAIN

Please write to your Member of Parliament.  Also to:

 The Right Honourable John Major, MP, Prime Minister
 First Lord of the Treasury
 House of Commons, Westminster
 London   SW1A 0AA

 The Honourable Virginia Bottomley, GP, MP
 Department of Health, Richmond House
 79 Whitehall
 London   SW1A 2NS


  AUSTRALIA

Please write to your Member of Parliament.  Also to:

 The Honourable Paul Keating, Prime Minister
 Parliament House
 Canberra, ACT   26000

 Senator Graham Richardson, Minister of Health
 Parliament House
 Canberra, ACT   26000

  NEW ZEALAND

Please write to your Member of Parliament.  Also to:

 The Right Honourable Jim Bolger, Prime Minister
 Parliament Buildings, Executive Wings
 Wellington

 The Honourable Jenny Shipley, Minister of Health
 Parliament Buildings, Executive Wings
 Wellington


III. CONTACTING RESCIND, INC.

RESCIND, Inc. can be contacted at: 1521 Alton Road, Suite
210, Miami Beach, FL 33139 Fax: (305) 535-0065.

 ------------------------------------

Thanks to our Communications Director Matt Straznitskas for
compiling this update and for designing the MAY 12 and
RESCIND logos.  And special thanks to Roger Burns, Lori
Clovis, Jim Oakley, Kim Shroeder, and others who submitted
ideas and information for this monthly MAY 12 update.


 ===================================================================
 CFS-NEWS (ISSN 1066-8152) is an international newsletter published
 and edited by Roger Burns in Washington D.C.  It is distributed:
 through the "CFS echo" (discussion group) on the Fidonet volunteer
 network of BBSs; via the NIHLIST Listserv on Internet; and as USENET
 Newsgroup bit.listserv.cfs.newsletter.  Back issues are on file on
 the Project ENABLE BBS in West Virginia USA at telephone 1-304-759-
 0727 in file area 22, and the valuable patient resource file named
 CFS-RES.TXT is available there too.  Suggestions and contributions
 of news may be sent to Roger Burns at Internet CFS-NEWS@LIST.NIH.GOV
 or by Fido NetMail to 1:109/432, or at telephone 1-202-966-8738, or
 postal address 2800 Quebec St NW, no. 1242, Washington DC 20008 USA,
 or post a message to the CFS echo or to the Internet CFS-L group or
 to newsgroup alt.med.cfs.  Copyright (c) 1994 by Roger Burns. Per-
 mission is granted to excerpt this document if the source (CFS-NEWS
 Electronic Newsletter) is cited.  Permission is also granted to
 reproduce the entirety of this document unaltered.  This notice does
 not diminish the rights of others whose copyrighted material as so
 noted may be quoted herein.  Note that Fido and Fidonet are
 registered marks of Tom Jennings and Fido Software.
 ===================================================================

INTERNET users are encouraged to obtain the CFS-RES TXT resource file
and other CFS files at the NYSDH file server.  Send the command GET
CFS-RES TXT (or for a full list of files, send GET CFS-D FILELIST) by
Internet e-mail to the address LISTSERV%ALBNYDH2.BITNET@ALBANY.EDU .
Distribution of CFS-NEWS on the Internet is sponsored by the NIH
Computing Utility.  However, the content of this independent
newsletter and the accuracy of the sources which it cites are solely
the responsibility of Roger Burns.  To subscribe, send the command
SUB CFS-NEWS <your> <name> to the address LISTSERV@NIHLIST.BITNET or
LISTSERV@LIST.NIH.GOV .   To get back issues, send GET CFS-NEWS INDEX
to either the Listserv at list.nih.gov or at the Albany address cited
above, and follow the instructions in the file.  Anonymous ftp
available from list.nih.gov (128.231.64.10), directory cfs-news.
=====================================================================


-------------------------------------------------------------------------------
