ormed to better define the role of this apoprotein. We view adrenal accumlation of HDL cholesterol as the result of three sequential events: i) lipoprotein binding, ii) transmembrane movement of cholesterol, iii) intracellular cholesterol movement to sites of storage or utilization. Properites of each of these events will be further examined. The effects of pH, ionic strength, lipoprotein charge and ACTH stimulation on binding will be characterized. The effects of energy inhibition on cholesterol uptake will be determined. We will determine if both esterified and free cholesterol as well as phospholipids may enter the cell. Finally, further studies to better define control of the uptake process will be performed. these studies will provide important information in two areas: (1) HDL structure, function and metabolism and (2) cholesterol metabolism in steroidogenic tissues. Better understanding of HDL metabolism may aid our understanding of the atherosclerotic process and how to prevent or reverse it.

To assess the effects of intrathecal baclofen on persons with generalized dystonia secondary to cerebral palsy or traumatic brain injury. The research design has two phases. First an open label trial of intrathecal baclofen is infused by an external pump. If the patient responds to the trial, they may continue to a second phase: a randomized, double-blind trial of baclofen versus placebo after programmable pump implant. Outcome measures for this study are based on our dystonia scale and functional assessments.

Regionally-advanced and metastatic carcinoma (Ca) of the breast is amenable to a variety of therapeutic modalities. Combination chemotherapy can produce response with improvement in survival. Radiotherapy can provide local control but patients (pts) still die of metastasis. This approach utilizes combination chemotherapy to shrink primary masses and treat overt or micrometastases. Seventeen pts (8 stage III, 9 stage IV) were treated with combination chemotherapy including 5 with inflammatory Ca. After tumor r