Treatment Effect of Niaspan, a Controlled-release Niacin, in Patients With Hypercholesterolemia: A Placebo-controlled Trial.

BACKGROUND: The present study was designed to determine the efficacy and safety of Niaspan (Kos Pharmaceuticals, Inc, Hollywood, FL), a new controlled-release formulation of niacin, in the treatment of primary hyperlipidemia, the occurrence and severity of flushing events, and potential adverse effects, particularly hepatotoxicity. METHODS AND RESULTS: The study was conducted as a multicenter, randomized, double-blind, placebo-controlled, parallel comparison of Niaspan in doses of 1000 mg/day and 2000 mg/day, administered once a day at bedtime. One hundred twenty-two patients with low-density lipoprotein cholesterol levels >4.

Expression of thrombospondin-1 in cancer: a role in tumor progression.

Thrombospondin-1 (TSP-1), a trimeric high molecular weight glycoprotein, is one of the major secreted proteins of human platelets and an extracellular matrix component of a variety of cells including vascular endothelial cells and tumor cells. TSP-1 has been shown to be highly expressed in human malignant tissues and present in higher than normal levels in the plasma of cancer patients. TSP-1 has also been shown to promote hematogenous tumor spread, tumor cell adhesion and invasion, and angiogenesis.

Synthesis of alpha-galactosyl epitopes by recombinant alpha1,3galactosyl transferase for opsonization of human tumor cell vaccines by anti-galactose.

The immunogenicity of tumor-associated antigens in autologous tumor vaccines is limited because of insufficient uptake by antigen-presenting cells (APC). Anti-Galactose (Gal) IgG, abundantly produced in humans, can serve as a natural adjuvant increasing the uptake of vaccinating autologous tumor cell membranes by APC. Anti-Gal interacts with the alpha-galactosyl epitope (Ga1alpha1-3Galbeta1-4GlcNAc-R), which is normally absent in humans.

Late induction of CREB/ATF binding and a concomitant increase in cAMP levels in T and B lymphocytes stimulated via the antigen receptor.

Transcription factors of the cAMP-responsive element (CRE) binding protein/activating transcription factor (CREB/ATF) family were implicated in the expression of T cell-specific genes and in the expression of oncogenic retroviruses associated with leukemia in T and B lymphocytes. To study the regulation of CREB/ATF transcription factors during lymphocyte activation, studies were pursued in primary cultures of resting murine splenic T and B lymphocytes stimulated via the Ag receptor. Using consensus/CRE and proliferating cell nuclear Ag (PCNA)/CRE as probes in the DNA binding assay, we showed that a marked induction of CRE binding is associated with activation of splenic T lymphocytes with anti-CD3 Ab.

Application of Motor Learning Principles to the Stroke Population.

The physical rehabilitation of patients with stroke is shifting from a medical model of treating neurophysiological impairment to an educational model that emphasizes the reeducation of patients in motor tasks. This greater focus on patient learning requires knowledge not only in how to assist patients in the restoration of efficient movement patterns, but also in how to help patients learn to create and modify movement strategies to solve the functional problems they encounter in daily tasks. This article provides an overview of principles to be considered when attempting to optimize the motor learning of stroke patients.

Percutaneous technique for management of persistent airspace with prolonged air leak using fibrin glue.

A 68-year-old white man with lung carcinoma underwent removal of the lower lobe of the left lung. Four months later, the patient developed a hemothorax requiring exploratory thoracotomy, evacuation of hemothorax, and decortication. Postoperatively a persistent airspace with prolonged air leak developed.

Apical and basolateral Ca(2) channels modulate cytosolic Ca(2)+ in gallbladder epithelia.

Gallstone formation is associated with altered gallbladder (GB) ion transport and increased concentration of GB bile Ca2+. Recent studies show that increased cytosolic Ca2+ ([Ca2+]i) stimulates GB Cl- secretion. However, the mechanism by which extracellular Ca2+ ([Ca2+]e) enters the cytosol remains unclear.

Isolation and sequencing of the 5' end of the rat microtubule-associated protein (MAP1B)-encoding cDNA.

We have isolated and sequenced the 5' end of the cDNA encoding the rat microtubule-associated protein 1B (MAP1B). We found that this region is highly homologous to the corresponding regions of the human [Lien et al., 22 (1994) 273-280] and mouse [Noble et al.

Tolerance to cardiac allografts requires a time lag between intrathymic treatment and transplantation.

Permanent tolerance to an experimental heterotopic cardiac allograft can be achieved by pretreatment with antilymphocyte serum (ALS) and intrathymic inoculation of donor cells. Most successful experimental protocols have employed a time lag of 2 to 3 weeks between intrathymic pretreatment and transplantation, which makes this treatment strategy impractical for clinical heart transplantation. In these experiments we modified the standard protocol by giving ALS 24 hr prior to both intrathymic injection of donor cells and heterotopic transplantation.

Thrombospondin-1 (TSP-1) promotes the invasive properties of human breast cancer.

TSP-1 is a matrix-bound adhesive glycoprotein, which plays a role in tumor cell proliferation and tumor angiogenesis. The purpose of this study was to investigate the effect of TSP-1 on breast tumor cell invasion. Tumor cell invasion assays were performed using a modified Boyden chamber apparatus with collagen-coated membranes.

Impulsive aggression in personality disorder correlates with tritiated paroxetine binding in the platelet.

Background: To examine the relationship between binding parameters of the platelet central serotonergic (5-HT) transporter and measures of aggression and impulsivity in adult human subjects.

Methods: Maximal number of platelet tritiated paroxetine binding sites (Bmax) and dissociation constant (Kd) values were measured in patients with personality disorder (n = 24) and healthy volunteers (n = 12). Measures of aggression and impulsivity included the total score and aggression subscale of the Life History of Aggression, the Motor Aggression factor and the assault subscale of the Buss-Durkee Hostility Inventory, and the total score and motor impulsivity subscale of the Barratt Impulsiveness Scale.

Tri-state region pulmonary rehabilitation survey. Delivery of exercise conditioning services. The Pulmonary Rehabilitation Committee, Tri-State Society for Cardiovascular and Pulmonary Rehabilitation.

Purpose: This report analyzes the delivery of exercise conditioning services in the 1991 Pennsylvania, New Jersey, and Delaware regional survey of pulmonary rehabilitation programs.

Methods: Data from a questionnaire was analyzed with special consideration given to whether the program provided services for patients with only pulmonary diseases (n = 41) or with cardiac and pulmonary diseases (n = 18).

Results: All 59 programs included exercise conditioning.

Site-directed mutagenesis of Saccharomyces cerevisiae beta-tubulin: interaction between residue 167 and benzimidazole compounds.

Benzimidazoles are widely used as anthelmintic agents and systemic fungicides. In susceptible organisms, benzimidazoles bind to beta-tubulin and block microtubule polymerization. To further characterize this interaction, site-directed mutagenesis followed by gene replacement was used to change Saccharomyces cerevisiae beta-tubulin residue Phe-167 to Tyr.

Arrest of afferent axon extension by target neurons in vitro is regulated by the NMDA receptor.

Cerebellar granule neurons in vitro specifically arrest the extension of their appropriate presynaptic axons, mossy fibers. This "stop-growing signal" may be an essential step in the formation and specificity of synapses. Here, we have tested whether ionotropic glutamate receptors are involved in the stop-growing signal.

Myenteric ganglionic 5-hydroxytryptamine(1P) signal transmission is mediated via Go protein.

The role of G proteins in mediating the signal transduction of the guinea pig myenteric ganglionic 5-hydroxytryptamine (5-HT)1P receptors was examined. Stimulation of ganglionic membranes with 5-HT in the presence of [35S]GTPgammaS or [alpha 32P]GTP increased guanine nucleotide binding to G(alpha)o but not to G(alpha)s, G(alpha)i or G(alpha)q in a concentration-dependent fashion. Pertussis toxin pretreatment markedly reduce this 5-HT induced response.

Pancreatic carboxyl ester lipase: a circulating enzyme that modifies normal and oxidized lipoproteins in vitro.

Pancreatic carboxyl ester lipase (CEL) hydrolyzes cholesteryl esters (CE), triglycerides (TG), and lysophospholipids, with CE and TG hydrolysis stimulated by cholate. Originally thought to be confined to the gastrointestinal system, CEL has been reported in the plasma of humans and other mammals, implying its potential in vivo to modify lipids associated with LDL, HDL (CE, TG), and oxidized LDL (lysophosphatidylcholine, lysoPC). We measured the concentration of CEL in human plasma as 1.

Refractive surgery.

In recent years, there has been increasing interest in refractive surgery among patients and physicians. Refractive surgery lessens or eliminates the need for contact lenses or glasses. The goal of refractive surgery is to allow an individual more independence from optical devices.

Failure of systemic empirical treatment with amphotericin B to prevent candidemia in neutropenic patients with cancer.

We undertook a retrospective review of all patients with hematologic malignancies in whom candidemia developed during chemotherapy-induced neutropenia in 1989 and 1990. Candidemia developed in 11 patients; five were receiving therapeutic doses of amphotericin B at the time of infection. Disseminated infection occurred in 2 of 5 patients with breakthrough infection and 3 of 6 patients with candidemia before receipt of amphotericin B.

Uniform standards for substance user treatment research: an example from Germany for the United States and other countries.

It is only through reasoned, accurate treatment evaluation research that its effectiveness can be assessed. The value of these data can be limited, however, by variability of methods and noncomparability of data. This is not the case, however, in other western countries.

Compartmental isolation of cholesterol participating in the cytoplasmic cholesteryl ester cycle in Chinese hamster ovary 25-RA cells.

Using the Chinese hamster ovary cell line, 25-RA, we have demonstrated that lipoprotein-derived cholesterol and endogenously synthesized cholesterol are selectively differentiated with respect to their cellular locations. These cells lack sterol-mediated regulation, spontaneously storing large amounts of esterified cholesterol, which turns over with a half-time of 7.5 h.

Hypertension in pediatric patients.

The importance of hypertension in the pediatric population has not been as well-appreciated as in adults. This may be due in part to the much lower prevalence of hypertension in children. Nevertheless, hypertension is an important clinical problem in pediatrics, and the approach to its management differs from that in adults in several major respects.

Cerebral extraction of oxygen, lactate production, and perfusion pressure in gunshot wound to the head: case report.

A case of gunshot wound to the head is presented, in which the patient made a satisfactory recovery after a prolonged period of elevated intracranial pressure and increased cerebral extraction of oxygen. Even though cerebral extraction of oxygen was increased in the most acute phase, the arteriojugular lactate difference was never abnormally decreased (ischemic). This finding indicated that, in this patient, increased cerebral extraction of oxygen was not sufficient to result in global cerebral ischemia (increased cerebral lactate production).