Cocoa and chocolate are the subjects of much research in the fields of food chemistry, food technology, and health science. We now know that cocoa contains a remarkable number of bioactive compounds, and these are being tested in humans to verify their disease prevention characteristics. This state of the art text thoroughly explores the different aspects of the relationship between chocolate and health. After introductory discussion of the historical background, careful attention is devoted to technological developments designed to improve the health-giving qualities of chocolate and biochemical and clinical trials of cocoa and its components. Various health impacts of cocoa and chocolate are thoroughly evaluated, including acute vascular effects and effects on blood pressure, blood lipids, and platelets. Psychological drivers of chocolate consumption and craving are also considered. Readers will find this book to be a rich source of essential information on cocoa and chocolate, their purported health-giving qualities, and the advances that are being made in this area.

List of Contributors xviii An Aging Humankind: New Realities E. Dicgalusy Does Menopause Increase the Risk of Coronary Heart Disease? M.V. Huisrnan Chronic Low-Grade Metabolic Acidosis in Normal Adult Humans: Pathophysiology and Consequences L. Frassetto, R.C. Morris, Jr., K. Todd, and A. Sebastian The Menopause, Sex Hormones, and Rheumatic Disease G. Hall Novel Mechanisms of Estrogen Action J.-A. Gustafsson The Action of Ovarian Steroid Hormones on Tissues and Organs M.J. Legato Nongenomic Mechanisms of Sex Hormones J.H.H. Thijssen Action of Specific Estrogens on Vascular Cells C.S. Wingrove and J.C. Stevenson Direct Actions of Estrogen on Vascular Cells Ameliorates Response to hjury D. W. Losordo ix Newer Progestogens G. Samsioe IV. 11. Cardiovascular Disease: Risk Factors Related to Thrombosis G. de Gaetano, M.B. Donati, and L. Iacoviello Estrogen Effect upon Coronary Vasculature G.M.C. Rosano, F. Leonardo, and G. Panina Estrogen and Endothelial Function A. Virdis, L. Ghiadoni, I. Sudano, S. Pinto, S. Taddei, and A. Salvetti Action of Specific Estrogens on the Coronary Artery: Effects on Lipoproteins, Coagulation, and Fibrinolysis J.M. Sullivan Coronary Heart Disease in Women: Status 1998 N. K. Wenger Introduction to Osteoporosis C. Christiansen Genetics of Osteoporosis L. Masi, L. Gennari, A. Falchetti, and M.L. Brandi The Clinical Management of Osteoporosis S.E. Papapou los VI.

The International Symposium on Prostaglandins and Related Compounds, first held in Vienna 1972, revisited the city after 24 years for the 10TH Symposium. For the many re searchers working in this multi-disciplinary field it was an opportunity to exchange their ex periences and share new data with colleagues from all around the world. This scientific exchange was largely encouraged by the unseasonably cold and rainy weather. For the first time, there was quite a large attendance from the former Communist countries. Eugene Garfield prepared a key note address delivered during the meeting (The Sci entist 1996, 12) reviewing the contribution of the Nobel Laureates U.S. von Euler, l.R. Vane, S.K. Bergstrom, and B.I. Samuelsson, discussing the relevance of the more than 40,000 pa pers in this area published since 1991. Overall, there is still a rapidly growing interest, and in particular a great variety of clinical applications of this family of compounds which were dis cussed in detail during the meeting. Beside the lectures there were 19 workshops covering nearly all the topics of key in terest. All the speakers were invited to prepare a manuscript which has resulted in the volume now in your hands. Special thanks to Dr. Patrick Wong and the new publisher of this series who helped to publish the proceedings in the usual quality and reasonable period of time. Looking forward to seeing all of you again in Florence in 1999, hopefully with much more sun."

J. Folch-Pi Director of Scientific Research, McLean Hospital, Belmont, Mass., U.S.A. The development of the central nervous system is possibly the most significant aspect of the growth of a mammal from embryo to adulthood. The central nervous system is obviously the main repository not only of the species' inherited functional characteristics but also of the process of individuation. Whatever "engrams" constitute the basis of individual characteristics are laid down mainly in the central nervous system, and especially the brain, during its growth. The chemical aspect of this process IS clearly of great importance and the significance of its study should be self evident. Nevertheless, it is only one aspect of a parel lei series of morphological, physiological, biochemical and psychological events which take place as an integrated process, the final result of which is the transformation of the post-embryonic nervous system into the functioning adult system. It is imperative, therefore, that any study or description of the chemical events during the development of the CNS should be undertaken in ful I awareness of the concomitant morphological, physiological and psychological events. It is only against this multidiscipl inary informational framework that the chemical events during 2 J. FOLCH-PI development can be correctly interpreted and acquire their ful I significance. With this in mind, the introduction to this volume may best serve its purpose by describing briefly the morphological and physiological events that accompany the chemical aspect of development.

Although the importance of calcium (Ca2+) in the maintenance of cardiac contractility was recognized as early as 1880, the critical role of the ion in the contractile process in skeletal, cardiac, and smooth muscle has only been established within the last three decades. As the complexity of the pharmacological actions of the Ca2+ channel inhibitors grows, there is a continued need to further clarify the inhibitors, both chemically and functionally. This volume provides an update of the field based on the work presented at the 5th International Symposium on Calcium Antagonists: Pharmacology and Clinical Research. It reviews the current state of the growing area of molecular biology of Ca2+ channels. In the cardiovascular area, in addition to the well-established clinical uses of Ca2+ channel inhibitors, exciting new work pointing to an application in atherosclerosis is described. The book also includes important uses of Ca2+ antagonists in novel areas of interest such as the gastrointestinal tract, renal protection and multi-drug resistance.

This volume is a collection of the most significant contributions to the 4th International Symposium on MULTIPLE RISK FACTORS IN CARDIOVASCULAR DISEASE: STRATEGIES OF PREVENTION OF CORONARY HEART DISEASE, CARDIAC F AlLURE, AND STROKE held in Washington, D. C. in April 1997. The meeting focused on the risk factors for cardiovascular disease and their interactions. The need for this symposium is based on the epidemiological, clinical, and biological evidence that individuals from industrialized countries often possess two or more risk factors which synergistically increase the global risk profile. This has become more evident in recent years with the increase in life expectancy of populations in the industrialized countries. The evidence that a combination of risk factors confers a very high risk of developing cardiovascular diseases, is of pivotal interest in the process of detection of patients who will benefit the most from pharmacological treatment. Many recent epidemiological data identifying the intrinsic and environmental factors contributing to the development of atherosclerosis are discussed. These results, in parallel with basic and clinical research, underline atherosclerosis as a complex and multifactorial process involving the influences of lipids, including lipoprotein subfractions, blood pressure rheologic forces, carbohydrate tolerance, and thrombogenic factors, including fibrinogen, tissue factor, PAl-I, and homocysteine. Furthennore, the risk associated with anyone of these risk factors varies widely depending on the level of the associated atherogenic risk factors. Hyper cholesterolemia and hypertriglyceridemia, for instance, are more common than would be expected by chance among hypertensive patients.

This volume, based on the International Congress Creatine: From Basic Science to Clinical Application, held in Milan on June 4, 1999, outlines the physiological role of creatine in the human body as well as its possible role in different pathological conditions. Creatine is already used as a dietary supplement to augment muscle performance in healthy individuals and inpatients with immobilizing diseases, such as complex fractures. There is also an increasing interest in its administration in a growing number of clinical conditions. A specific deficit of endogenous synthesis of creatine which responds to high dosage exogenous supplementation has been described. In cardiac failure and in chronic obstructive pulmonary disease, creatine improves the contractility of the muscular system. Promising effects of this substance have also been described in animal models of neurodegenerative disorders, such as amyotrophic lateral sclerosis, and in some mitochondrial cytopathies. This volume is of obvious interest to basic scientists working on the physiology of creatine and to clinicians interested in its medical indications.

In Drugs and the Liver: High Risk patients and Transplantation, leading physicians, hepatologists, pharmacologists, pathologists and transplant surgeons discuss the most recent advances in the field of liver disease and their treatment. Attention is focused on epidemiology, the diagnosis of disease (clinical chemistry, histopathology, medical imaging analysis), prognosis, prediction, and clinical management. Pathogenesis of diseases such as liver cirrhosis following viral disease or alcohol abuse are discussed at length, and special attention is dedicated to high risk patients (children, fulminant hepatitis). The other major topics include terminal liver failure, for which transplantation is now routine. The latter is discussed in depth, starting from the organ donor management, organ evaluation and preservation, new surgical techniques, post-transplant patient follow-up including side effects of immunosuppression, and reports of the latest drugs used to prevent rejection.

Despite its universality in human female aging, the menopause and its biology are not completely understood. New biologic mechanisms by which sex hormones may be detrimental or confer protection are continually being discovered. We are now starting to understand that the role of the estrogen receptor is not identical in all tissues. Important nongenomic effects for sex hormones have also been described. Hormone replacement therapy (HRT) has produced effects on health risks: some are reduced, some are increased, and the rest remain uncertain. HRT is being used by an increasing number of women to alleviate climacteric symptoms in the perimenopausal period and to prevent osteoporosis and cardiovascular disease later. Positive effects on Alzheimer's disease and dementia on the one hand, and an increase in venous thrombosis on the other, are currently being reported by several groups. Both the preventive benefits and the risk of breast cancer seem to be linked to long-term and current use. HRT requires further testing through specific clinical trials, currently underway in the United States, before confident recommendations may be made about the full range of benefits and risks.

Few topics in women's medicine today are as fraught with confusion and controversy as the question of appropriate treatment for menopausal symptoms and the prevention of negative long term health outcomes common to post-menopausal women. Cardiovascular disease (CVD), osteoporosis, and cancer -- the most common causes of death, disability and impaired quality of life for women -- can potentially be prevented or forestalled by dietary, behavioral, and drug interventions. A better understanding of the natural history of the menopause is critical to providing better care. If women and their physicians have a better understanding of predictors of risk, they could make more informed decisions about interventions related to menopausal symptoms, CVD, osteoporosis and gynecologic and breast cancer. Few other recently introduced medical interventions have as great a potential of affecting morbidity and mortality as does hormone replacement therapy (HRT). HRT has produced effect on health risk: some are reduced, some are raised, and some uncertain, and these data are interpreted differently by various scientific, medical and consumer groups.

A great deal of experimental, clinical and epidemiological data have been gathered to confirm the strict and causal correlation between plasma lipoproteins and coronary heart disease. However, as usually happens in research, many more interesting issues are being studied, opening new fields of research for the future. These new advances, together with the combined efforts of cell biologists and lipoprotein chemists, have set the pace for an exciting period of research and clinical applications of diets and drugs affecting plasma and cell lipids. This volume, which includes the work of many of the leading world labortories, represents an authoritative and up-to-date appraisal of the status of the art and a stimulus to future research at the laboratory and clinical level in a fascinating area of clinical and preventive medicine.

This book includes the most significant contributions of the 3rd International Symposium on MULTIPLE RISK FACTORS IN CARDIOVASCULAR DISEASE held in Florence, Italy, July 6-9, 1994. The meeting focused on the risk factors for cardiovascular disease and their interactions. The need for this symposium is based on the epidemiological evidence that individuals from industrialized countries often possess two or more risk factors which synergistically increase the global risk profile. This has become more evident in recent years with the increase in life expectancy of the general population. The evidence that in high risk patients, a combination of risk factors often is detected, is highlighted in these Proceedings. Many recent epidemiological data identifYing the intrinsic and environmental factors contributing to the development of atherosclerosis are discussed. These results, in parallel with basic and clinical research, underline how atherosclerosis is a complex and multifactorial process involving the influences of lipids, including lipoprotein subfractions, blood pressure, rheologic forces, carbohydrate tolerance, and thrombogenic factors. Furthermore, the risk associated with anyone of these risk factors varies widely depending on level of the associated atherogenic risk factors.

This volume contains the Proceedings of the invited lectures of the Second International Sym posium on SEROTONIN from Cell Biology to Pharmacology and Therapeutics held in Houston, Texas September 15-18, 1992. The meeting was held under the co-sponsorship of the Serotonin Club, the Giovanni Lorenzini Medical Foundation, and the Fondazione Giovanni Lorenzini. This volume discusses the major exploration in knowledge that has occurred recently of the complex role that 5- hydroxytryptamine (serotonin) plays in health and disease. In par ticular, these Proceedings highlight major breakthroughs in molecular biology and classification of receptor subtypes that are responsible for the many actions of the monoamine. The ever increasing importance of serotonin in central regulation, whether autonomic or behavioral is represented by a large number of chapters prepared by world experts. Additionally, the role of serotonin in peripheral organs is also discussed. Hence, this volume provides the reader with a unique, up-to-date review of this exciting and novel area of science. These Proceedings obviously are of great interest, not only to the researchers directly engaged in the quest for the understanding and unraveling of the actions of the interactions with serotonin as a major neurohumoral mediator, but also to all scholars and clinicians who wish to acquire a better understanding of the functioning of the brain and of peripheral organs. Since this volume was constructed as a compilation of invited lectures, the scientific content and the opinions expressed in the chapters are the sole responsibility of the authors.

The effects of alcohol consumption on human health have fuelled a vigorous scientific debate in recent years. This volume, based on the scientific sessions of the International Meeting on MODERATE ALCOHOL CONSUMPTION AND CARDIOVASCULAR DISEASE, held in Venice October 30-31, 1999, is intended to offer an up-to-date view of the most recent information on this complex topic. While comprehension ofthe damages associated with alcohol abuse has improved, an increasing number of epidemiological studies performed in different countries of the world, have shown that individuals consuming moderate amounts of alcohol (l 0-30 g/day, approximately equivalent to not more than two drinks per day in men and one drink per day in women) are less affected by acute coronary events than total abstainers. The apparent protection is evident (the rate of coronary events in most studies is reduced by about 30%) and has been observed and documented among various population groups (men, women, several racial groups, middle-aged and older individuals). Protection is seen in patients with no known history of coronary heart disease, as well as in those with coronary heart disease, diabetes, etc. Recent data suggest that the protection induced by a moderate alcohol use extends to the risk of ischemic strokes and of ischemic damage to the lower limbs. Since adverse alcohol effects are less frequent at these low daily intakes, total mortality is also favourably affected in moderate alcohol consumers as compared to abstainers.

The circulatory system is usually considered to be composed of tubes of various diameters, characterized by collateral and terminal branches. There is also a tendency to treat blood vessels merely as conducting tubes in which the various structures of the wall act as mechanical pumps wlrich modify their diameter. This is, of course, not so. In fact, we know that blood vessels, and in particular arteries, are organs with personalities of their own and a particular susceptibility to several diseases. In addition, blood vessels differ in structure, according to their localization, and age at differing rates. The experimental work car ried out so far clearly confirms the data that have come from spontaneous human pathology; experimentally induced arterial lesions have a definite tendency to appear in certain arteries and not in others, depending on the experimental procedures used, and in each specific artery the lesions appear to have a specific location. We now know that the arterial wall is a metabo licallyactive structure, in which a number of enzyme activities have been clearly demonstrated. It possesses a sensitive vasa vasorum apparatus and a specific reactivity to various lesion-inducing stimuli. We must also remember that the arterial wall is in continuous contact with the blood circulating through the endothelial cells lining the vascular bed. It is obvious, therefore, that any variation in the circulating blood mass can modify the morphology as well as the function of the vessel wall.

The term "autoimmunity" has been used to categorize a number of different diseases of unknown etiology. The term as applied to many of these diseases would probably be interpreted best as "autoreactivity," as the clinical phenotypes are often characterized by an inflammatory-like accumulation of activated cells of the immune system at sites of obvious damage of normal cells and/or tissue. The reasons as to why an immune system should attack itself are far from clear, although the association with specific infectious diseases in genetically susceptible people remains perhaps our best lead. The input of the biotechnological revolution has enabled us to attempt to readdress many of the fundamental questions raised by clinical and serological associations with autoimmune disease. The ability to dissect the immune response to these infectious agents which are associated with autoimmune features (as well as the facility to identify new agents, e. g. HIV), in addition to the ability to clone and sequence immune response genes, has enabled a much better understanding, at least of the complexity of "autoimmunity" to be gleaned. This volume contains the chapters that summarize the plenary presentations given at The Impact of Biotechnology on AUTOIMMUNI1Y meeting in Florence, Italy in June 1993. They cover all aspects from pathogenesis to treatment. The association with infectious diseases and autoimmunity is comprehensively covered by David Isenberg who reviews major issues, such as the association of autoantibodies appearing after infectious disease and antibacterial antibodies associated with autoimmune disease.

This book includes the most significant contributions of the First International Symposium on "Multiple risk factors in cardiovascular disease", chaired by Professors A. V. Chobanian (Boston), A. M. Gotto Jr. (Houston), c. Lenfant (Bethesda), R. Paoletti and A. Zanchetti (Milan), held in Washington DC, 10-12 December 1990, which focused on the risk factors for cardiovascular disease and their interactions. The need for this symposium is based on the epidemiological evidence that individuals from industrialized countries often possess two or more risk factors which synergically increase the global risk profile. The evidence that isolated vascular risk factors are not commonly found in high risk patients but more often a combination of risk factors are detected, is highlighted. Many recent epidemiological data identifying the intrinsic and environ mental factors contributing to the development of atherosclerosis are discussed. These results, in parallel to basic and clinical research, underline how atherosclerosis is a complex and multifac torial process involving the influences of lipid deposition, blood pressure, rheologic forces, carbohydrate tolerance, and thrombogenic factors (fibrinogen and platelets). Atherosclerosis is markedly accelerated by other risk factors, more so in the presence of concomitant hypercholes terolemia, hypertension, diabetes, upper body obesity. Furthermore, the risk associated with anyone of these risk factors varies widely depending on level of the associated atherogenic risk factors.

This book contains the proceedings of the ARW NATO Conference on "Action of Free Radicals and Active Forms of Oxygen on Lipoproteins and Membrane Lipids: Cellular Interactions and Atherogenesis", held in Bendor, France, October 5-8,1988. Since the pioneer work of Mc Cord and Fridovitch, growing interest has been focused on the study of the role of oxyradicals role in pathology. This interest is reflected in the exponential increase in the number of papers on free radicals, the success of specialized journals and books on this theme, and the organization of national and international meetings. These meetings have discussed, from.a broad point of view, the problems concerning the mechanisms of production of free radicals, their effects on cell CO!1$tituants (lipids, proteins, nucleic acids) and cell function, the methods of analysis of these phenomena, the pathological states in which free radicals may be involved, natural biological defense systems, and the design of "antiradical" therapies. But it is now well established that the most common target of oxy free radicals are membrane lipids because of their chemical nature (cholesterol in saturation, malonic linkage of polyunsaturated fatty acids (PUFA" and of their regular structural arrangement (monolayers in lipoproteins, bilayers in cell membranes). Thus the analysis of the products resulting from the action of oxy free radicals on PUFA is considered the best tool to indirectly evaluate the effects of tissue peroxidations, although the analytical basis for doing so is very questionable.

The treatment of menopausal and postmenopausal symptoms is a focus of considerable debate, on account of both the medical and social factors involved. And perhaps the cause of the greatest current interest and concern is not so much the effectiveness of present-day treatment but its safety. Opinions on the subject vary; and to resolve the arguments we must turn to the results of scientific experiment, both the clinical and biological. It is only by comparing experimental results that it is possible to move forward, albeit slowly, towards a generally agreed consensus based upon objective scientific data. It is for this reason that we are particularly grateful to Ayerst Laboratories whose support and help have enabled us to turn our original proposal for an International Symposium into a reality. We are also grateful to the publishers for the efficiency with which they have organized the publication of the Proceedings. It is our hope and that of all the distinguished participants that all readers of this volume will be able to find something in it which will stimulate further thought and discussion - even though they may not necessarily agree with all the conclusions expressed - for the success of a Symposium turns not only on the subject under examination but also on the quality of debate and discussion it encourages.

Interest in the field of atherosclerosis research has broadened in recent years. However the main focus remains on the physiopathology of the arterial wall and on its interaction with blood constituents. The purpose of this NATO Advanced Study Institute on "Factors in Formation and Regression of the Atherosclerotic Plaque" was to discuss the following points: a) The physiopathology of the arterial wall; b) Animal models; c) Methods of studying the progression and regression of atherosclerotic lesions quantitatively; d) The role of lipoproteins, platelets, smoke, alcohol, etc. in the formation of atherosclerotic lesions; e) The pharmacological and dietary control of "risk factors." This volume is a collection of the most relevant presentations on these topics. We hope it will provide a background for young scientists as well as a stimulus for further research to biologists and clinicians. We wish to acknowledge the support of NATO and the Nutrition Foundation of Italy in organizing this Advanced Study Institute.

Arachidonic acid metabolites are known to playa regulatory role in a number of biological systems, in which they function as microenviron mental hormones and intracellular signal mediators. One of the most exciting areas of research of these compounds is the one that studies the relationship between prostaglandins and tumor cell growth and function. In the last few years there has been an extraordinary evolution of data on prostaglandins (and related compounds) and cancer. This vol ume is based on papers presented at the 1986 International Confer ence on Prostaglandins and Cancer organized by the Italian National Research Council and the II University of Rome, and held in Rome, Italy, in June, 1986. This Conference brought together oncologists and specialists in the areas of prostaglandin chemistry, biochemistry, pharmacology, physiology, cellular and molecular biology to overview the actual state of knowledge on the role of eicosanoids in cancer and to focus on the key questions that need to be answered. The picture that comes out of this book describes a very complicated network of interactions between arachidonic acid metabolites and different as pects of the complex phenomenon "cancer." Eicosanoids participate in carcinogenesis initiation and promotion, and their relationship with tumor promoters and growth factors is well established. During cancer growth, different prostaglandins can have different roles in the regulation of cell proliferation and differentiation and in metastasis formation; meanwhile evidence is accumulating for a pos sible use of some of these compounds as antineoplastic agents."

This volume represents the proceedings ofthe invited lectures ofthe first International Symposium on "Serotonin from Cell Biology to Pharmacology and Therapeutics" which was held in Florence on March 29 -Aprill, 1989. This meeting, held under the co-sponsorship of the Serotonin Club and the Fondazione Giovanni Lorenzini, represents the first attempt to bring together scientists fascinated by the complexity of the action of 5-hydroxytryptamine throughout the body and in various species. Hence this volume provides the reader with the unique overview of the sources, effects, receptors, physiological actions and pathological role of Serotonin. As such it will be of interest not only to the person devoting herorhis research efforts to the study of 5-hydroxytryptamine but also to all scholars and even clinicians wanting to know how the powerful monoamine can modulate cellular functions. To accelerate the publication of these proceedings the Editors and the publishers have selected the camera ready format and have avoided a lengthy refereeing process. Hence the scientific content of, and the opinions expressed in the chapters are the sole responsibility of the authors. The Editors Milan and Houston The Editors want to thank Mrs. H. Liepman and her staff at Kluwer for the prompt and efficient handling of the manuscripts.

The recent symposium and the appearance of this new book on Drugs Affecting Lipid Metabolism take place at a very unusual time for the development of this area. After the publication and wide acceptance of the results of the cholestyramine study by the Lipid Clinics in the USA, showing for the first time a direct association between drug induced reduction of plasma levels of total and LDL cholesterol and coronary heart disease in a high risk population, an unparalleled interest in drugs and other procedures able to control plasma cholesterol levels has been activated. Two other significant events occurred during 1986 and 1987: the availability of compact instruments for the immediate determination of total cholesterol in plasma or total blood and the developments of new agents such as the inhibitors of HMG-CoA (hydroxymethyl glutaryl CoA) reductase and ACAT inhibitors, with potentially great effect on plasma lipid levels after oral administration. These new advances, together with the combined efforts of cell biologists and lipoprotein chemists, have set the pace for an exciting period of research and clinical applications of diets and drugs af fecting lipids. This volume, which includes the work of many of the leading world laboratories, represents an authoritative and up-to-date ap praisal of the status of the art and a stimulus to future research at laboratory and clinical level in an area of opportunity for clinical and preventive medicine."

Even a brief scan of the table of contents of the present volume is enough to disclose the diversity of research interests and opinions in the field of lipidology. It is precisely this diversity that is the strength of our field and that was showcased by the XII International Symposium of DRUGS AFFECTING LIPID METABOLISM (DALM). The papers published here from these proceedings may be divided into three categories: those that define-and refine---our understanding ofthe clinical benefit of aggressive lipid management, those that develop our knowledge of ris!. assessment, and those that discuss the genetic, bio~hemical, and biophysical mechanisms underlying the pathology of coronary heart disease. On the clinical front, further analysis of the results of the Scandinavian Simvastatin Survival Study (4S) has indicated the cost-effectiveness of therapy in patients with established coronary heart disease. The West of Scotland Coronary Prevention Study (WOSCOPS), whose methodology was described at the DALM XII symposium, has demonstrated in a mostly primary-prevention population what 4S demonstrated for secondary prevention the year before: aggressive lipid-regulating therapy reduces coronary heart disease morbidity and mortality rates without concurrently increasing mortality from noncardiovascular causes. In the future, important considerations will be to develop protocols that maximize benefit in groups underrepresented in traditional clinical research for example, women and the elderly-and to improve compliance to existing treatment regimens. Furthermore, antioxidant, omega-3 fatty acid, and gene therapies warrant further investigation.

The 11th international Conference on ADVANCES IN PROSTAGLANDIN AND LEUKOTRIENE RESEARCH: BASICSCIENCEANDNEWCLlNICALApPLlCA TIONS was held, as in the past, in Florence, Italy, on June 4-8, 2000. A selection of lectures presented at the meeting is included in this volume, which continues the tradition of covering both basic and clinical aspects of prostaglandin and leukotriene research. At this meeting particular emphasis was given to the lipid mediator circuits of lipoxin and leukotrienes and to the expression ofthe COX2 gene. The plenary lectures by C.N. Serhan (Boston, Massachusetts, U.S.A.) and H.R. Herschman (Los Angeles, California, U.S.A.) were devoted to these areas, while S. Narumiya (Kyoto, Japan) and J.M. Drazen (Boston, Massachusetts, U.S.A.) presented the latest advances in the fields ofprostanoid receptors and the genetics of asthma. Specific sessions focused on vascular physiopathology, cell differentiation and cancer, and the cardiovascular system. Lipoxygenases were discussed in detail at the molecular and cellular levels and attention was given to signal transduction pathways for leukotrienes and prostanoids. K.F. Austen (Boston, Massachusetts, U.S.A.) and T. Izumi (Tokyo, Japan) clarified the role and regulation ofLTC synthase ofleukotriene biosynthesis. Other important sessions 4 described regulation and control of nitric oxide, cannabimimetic eicosanoids, and the roles of eicosanoids in neuroscience. Applied clinical sessions devoted to the respiratory system and inflammation, including cyclooxygenase pathways, concluded the meeting.