Biology of GDNF in Diabetic Neuropathy

formapproval tehdrou0g5h /2004卫生与公众服务部公共卫生服务拨款申请不超过56个字符长度限制，包括空格。1. GDNF在糖尿病神经病变中的生物学研究0925-0001留白仅供小灵通使用，J类活动编号审核小组原理事会/理事会（月，年）收到日期2。对特定申请请求或项目公告或征集的回应[]否[]是（如果“是”，说明编号和标题）编号：PA-99-159标题：生长因子的作用3。首席研究员/项目主管。名字（最后，第一，中间）Stucky, Cheryl L.职位名称助理教授3e细胞生物学、神经生物学和解剖学专业分科医学院电话和传真（区号、号码和分机）电话：414-456-8373传真：414-456-6517否[]是4c。美国国立卫生研究院定义的III期临床试验[]否[]是预算期7a.要求的费用。直接成本（$）人类受试者4a。研究豁免[]研究如果“是”，豁免否。[][参考译文]人类受试者保证编号[]是。建议的支持期日期（月、日、年——月/日/年）：2002年12月1日至2007年11月30日申请人机构名称威斯康星医学院地址8701 Watertown Plank Road邮政信箱26509密尔沃基，53226-0509机构简介文件编号（如果已知）和6001 12。如果获得奖励，将通知行政官员姓名罗德尼·w·基森头衔主任，资助与合同地址威斯康星医学院邮编26509密尔沃基，WI 53226-0509电话414-456-8507传真414-456-6555电子邮件grants@rncw.edu糖尿病并发症的发展新研究者[]否[]是3b。DEGREE(S) PhD 3d邮寄地址（街道，城市，州，邮政编码）威斯康星医学院细胞生物学，神经生物学和解剖学系8701 Watertown Plank Road邮政信箱26509密尔沃基，WI 53226-0509电子邮件地址：cstucky@mcw.edu脊椎动物[]不[]是5。如果“是”，IACUC 11/15/00批准日期5b。动物福利保证no A-3102-01 FORINITIAL 8。拟议支助期间所需费用7b。总成本（$）直接成本（$ 80亿）。总成本（美元）75000,250000,375000组织类型公营：- b>[]联邦[]州[]地方私营：- >[]私营非营利性：- >[]一般[]小型企业[]妇女所有[]社会和经济上处于不利地位。实体识别号1390806261a3。（如果有的话）93-763-9060国会第五区申请机构正式签名姓名威廉·亨迪博士头衔高级助理研究主任地址威斯康星医学院水城Plank路8701号邮编：26509密尔沃基，电话：53226-0509电话：414)456-4402传真：414)456-6554电子邮件：grants@mcw， edu 14。首席研究员/项目主管保证：我保证在我所知的范围内，这里的陈述是真实、完整和准确的。我知道任何虚假、虚构或欺诈性的陈述或索赔可能使我受到刑事、民事或行政处罚。本人同意承担该项目的科学实施责任，并提供所需的进度报告，如本申请获得拨款。申请机构的证明和接受：我保证在此陈述的内容是真实、完整和准确的，并接受如果申请获得资助，我有义务遵守公共卫生服务的条款和条件。我知道任何虚假、虚构或欺诈性的陈述或索赔可能使我受到刑事、民事或行政处罚。pphs398（05/01修订版）3a中PI/PD的面部签名。(在墨水。_;_/_" _i_nature not aocep.t_e。_。官方姓名签名（以墨水书写）。不接受“Per”签名。),。我页面表单页面 ¿ ======================================== 节结束 ===========================================

¿ FormApprovTehdrou0g5h/2004 Department of Health and Human Services Public Health Services Grant Application Do not exceed 56-character length restrictions, including spaces. 1. TITLE OF PROJECT Biology of GDNF in Diabetic Neuropathy OMBNo. 0925-0001 LEAVE BLANKmFOR PHS USE ONLY, Type J Activity Number Review Group Formerly Council/Board (Month, Year) Date Received 2. RESPONSE TO SPECIFIC REQUEST FOR APPLICATIONS OR PROGRAM ANNOUNCEMENT OR SOLICITATION [] NO [] YES (If "Yes," state number and title) Number: PA-99-159 Title:The Role of Growth Factors 3. PRINCIPAL INVESTIGATOR/PROGRAM DIRECTOR 3a. NAME (Last, first, middle) Stucky, Cheryl L. 3c. POSITION TITLE Assistant Professor 3e. DEPARTMENT, SERVICE, LABORATORY, OR EQUIVALENT Cell Biology, Neurobiology & Anatomy 3¿ MAJOR SUBDIVISION School of Medicine 3g. TELEPHONE AND FAX (Area code, number and extension) TEL: 414-456-8373 FAX: 414-456-6517 No [] Yes 4c. NIH-defined Phase III Clinical Trial [] No [] Yes 7. COSTS REQUESTED BUDGETPERIOD 7a. Direct Costs ($) 50,000 4. HUMAN SUBJECTS 4a. Research Exempt [] RESEARCH If"Yes," Exemption No. __ [] No 4b. Human Subjects Assurance No. [] Yes 6. DATES OF PROPOSED PERIOD OF SUPPORT (month, day, year--MM/DD/YY) From 12/01/02 J Through11/30/07 9. APPLICANT ORGANIZATION Name Medical College of Wisconsin Address 8701 Watertown Plank Road PO Box 26509 Milwaukee, WI 53226-0509 Institutional Profile File Number (if known) & 6001 12. ADMINISTRATIVE OFFICIAL TO BE NOTIFIED IF AWARD IS MADE Name Rodney W. Kison Title Director, Grants & Contracts Address Medical College of Wisconsin PO Box 26509 Milwaukee, WI 53226-0509 Tel 414-456-8507 FAX 414-456-6555 E-Mail grants@rncw.edu in the Development of Diabetes Complications Newlnvestigator [] No [] Yes 3b. DEGREE(S) PhD 3d. MAILING ADDRESS (Street, city, state, zip code) Medical College of Wisconsin Dept of Cell Biology, Neurobiology & Anatomy 8701 Watertown Plank Road PO Box 26509 Milwaukee, WI 53226-0509 E-MAIL ADDRESS: cstucky@mcw.edu 5. VERTEBRATE ANIMALS [] No [] Yes 5a. If"Yes," IACUC 11/15/00 approval Date 5b. Animal welfare assurance no A-3102-01 FORINITIAL 8. COSTS REQUESTED FOR PROPOSED PERIOD OF SUPPORT 7b. Total Costs ($) 8a. Direct Costs ($) 8b. Total Costs ($) 75,000 250,000 375,000 10. TYPE OF ORGANIZATION Public: --> [] Federal [] State [] Local Private: --> [] Private Nonprofit For-profit:--> [] General [] Small Business [] Woman-owned [] Socially and Economically Disadvantaged 11. ENTITY IDENTIFICATION NUMBER 1390806261A3 DUNS NO. (if available) 93-763-9060 Congressional District 5 13. OFFICIAL SIGNING FOR APPLICANT ORGANIZATION Name William Hendee, Ph. D. Title Sr. Assoc. Dean for Research Address Medical College of Wisconsin 8701 Watertown Plank Road PO Box 26509 Milwaukee, Wl 53226-0509 Tel (414) 456-4402 FAX (414) 456-6554 E-Mail grants@mcw, edu 14. PRINCIPAL INVESTIGATOR/PROGRAM DIRECTOR ASSURANCE: I certify that the statements herein are true, complete and accurate to the best of my knowledge. I am aware that any false, fictitious, or fraudulent statements or claims may subject me to criminal, civil, or administrative penalties. I agree to accept responsibility for the scientific conduct of the project and to provide the required progress reports if a grant is awarded as a result of this application. 15 APPLICANT ORGANIZATION CERTIFICATION AND ACCEPTANCE: I certify that the statements herein are true, complete and accurate to the best of my knowledge, and accept the obligation to comply with Public Health Services terms and conditions if a grant is awarded as a result of this application. I am aware that any false, fictitious, or fraudulent statements or claims may subject me to criminal, civil, or administrative penalties. ¿ PHS 398 (Rev. 05/01) Face SIGNATURE OF PI/PD NAMED IN 3a. (In ink. _;_/_" _i_Inature not aocep.t_e._ .,_ , SIGNATURE OF'_FFICIAL NA_ (In ink. "Per" signature not acceptable.) ,.i Page Form Page I ¿ ========================================Section End===========================================