Induction of differentiation of HL-60 cells by the anti-fungal antibiotic, radicicol

The anti-fungal antibiotic, radicicol, produced in the culture broth of Neocosmospora tenuicristata, was found to induce differentiation of HL-60 cells into macrophages from the following evidence: (1) it caused morphological changes into macrophage-like cells, (2) induced NBT (Nitrobluetetrazolium) reduction activity, (3) induced phagocytosis, and (4) induced alpha-naphthyl acetate esterase activity. The concentration of radicicol required to differentiate HL-60 cells is 50-100 ng/ml, and the incubation time required for commitment of differentiation is 16 hours. Flow cytometry analysis indicated that radicicol blocks the cell cycle of HL-60 cells at the G1 and G2 sites. In addition, radicicol induced reversal of the transformed phenotype of ras-transformed NIH3T3 cells (DT cells) at 25 ng/ml.

Serum lipid and lipoprotein concentrations in obese dogs

Serum lipid and lipoprotein concentrations in 10 obese and 16 control dogs were examined. The serum triglyceride (TG) concentration in obese dogs was significantly higher than in control dogs. The serum concentrations of TG and phospholipid (PL) in beta lipoprotein and PL in pre-beta lipoprotein were significantly higher in obese dogs, while the serum PL concentration in alpha 1 lipoprotein was significantly lower in obese animals. In the serum total cholesterol concentration in obese dogs, a higher tendency for beta and pre-beta lipoproteins and lower tendency for alpha 1 lipoprotein were observed. These abnormal lipoprotein profiles were similar to those in diabetes mellitus in men and acute pancreatitis in dogs.

Genomic DNA and messenger RNA expression alterations of the CDKN2B and CDKN2 genes in esophageal squamous carcinoma cell lines

The genes CDKN2B (MTS2) and CDKN2 (MTS1) encoding the proteins p15 and p16 are both located on chromosomal band 9p21, a locus at which frequent homozygous and heterozygous deletions occur in many primary human tumors, including esophageal carcinoma. CDKN2 and CDKN2B belong to a family of cyclin-dependent kinase 4 inhibitors (INK41) and control cell proliferation during the G1 phase of the cell cycle. Their inactivation may contribute to uncontrolled growth in human cancers. To investigate whether CDKN2B and CDKN2 are involved in esophageal tumorigenesis, we studied homozygous deletion, intragenic mutation, and messenger RNA (mRNA) expression of CDKN2 and CDKN2B in nine esophageal squamous cancer cell lines. Polymerase chain reaction (PCR) amplification revealed that five of the nine cell lines (55%) manifested homozygous deletions of CDKN2B, CDKN2, and/or flanking loci on chromosomal band 9p21. Reverse transcriptase-PCR (RT-PCR) was used to examine CDKN2 and CDKN2B mRNA in the nine cell lines. Lack of CDKN2 and CDKN2B mRNA correlated perfectly with homozygous deletion involving these genes. No subtle intragenic mutations of CDKN2B or CDKN2 were detected by DNA sequencing of their entire coding sequences in any cell lines lacking homozygous deletion. Two of the cell lines manifested homozygous deletions excluding CDKN2; one of these two deletions also excluded CDKN2B. These results suggest that inactivation of CDKN2B and CDKN2 may contribute to the malignant phenotype in esophageal cells and that homozygous deletion may be the predominant mechanism for inactivation of CDKN2B and CDKN2. Alternatively, a gene or genes adjacent to CDKN2B/CDKN2 may constitute the target(s) of deletion at this locus.

Relationship of the ipsilateral rotation in night period and striatal dopamine content reduction in unilateral nigrostriatal 6-OHDA lesioned rats

In order to discriminate well-lesioned rats after unilateral microinjection of 6-OHDA into the nigrostriatal dopamine system, we measured the spontaneous rotation in the night period and calculated the rate of ipsilateral rotation movement. The rate of ipsilateral rotation movement increased along with the total rotation movement. The rats with over 95% of ipsilateral rotation kept the rate relatively constant for 4 weeks after 6-OHDA lesion and showed a significant increase of contralateral rotation (253.2 +/- 37.9) as compared with the rat that had lower than 95% ipsilateral rotation (3.6 +/- 1.4) after the injection of apomorphine (0.25 mg/kg, s.c.). The reduction percentages of striatal DA contents in animals with unilateral rotation over 95% and under 95% to the lesioned side were 97.8 +/- 0.6% and 59.6 +/- 5.8% (P < 0.001), respectively. The rats with over 90% reduction of striatal DA levels corresponded nicely to rats with 95% ipsilateral rotation among rats injected with apomorphine. These results suggested that the evaluation of ipsilateral rotation, taken the level of 95% rotation to the lesioned side as a standard, was able to discriminate well-lesioned rats without apomorphine treatment after unilateral nigrostriatal 6-OHDA application.

Purification and characterization of thrombopoietin

A thrombopoietic factor, termed thrombopoietin (TPO), was highly purified directly from the plasma of sublethally irradiated 1,100 rats by measuring the production of megakaryocytes from a highly enriched population of rat megakaryocyte progenitor cells (CFU-MK). The rat plasma TPO is a glycoprotein and strongly hydrophobic. The total activity and purification yields obtained were about 29% and 1.49 x 10(8), respectively. The amino acid sequences of the two peptide fragments prepared from the purified 19 kDa TPO were analyzed, and used for the cloning of rat and human TPO cDNAs. It was found that the 19 kDa TPO was truncated but comprised at least 163 amino acids. The sequence of human TPO cDNA revealed that the TPO was identical to the c-Mpl ligand. Both rat and human TPOs expressed in COS-1 cells exhibited significant activity toward the CFU-MK in vitro, and were active in stimulating platelet production in mice. These results indicate that a thrombopoietic factor originally found in the irradiated rat plasma is a ligand for the rat c-Mpl.

p53 mutation, murine double minute 2 amplification, and human papillomavirus infection are frequently involved but not associated with each other in esophageal squamous cell carcinoma

We examined the relationship between p53 mutation, murine double minute 2 (MDM2) gene amplification, and human papillomavirus (HPV) infection in 72 esophageal squamous cell carcinomas. We identified p53 mutations in 29 tumors (40.3%) by PCR-single-strand conformation polymorphism analysis and direct sequencing. Amplification of the MDM2 gene was detected by Southern blot hybridization in 13 (18.1%) of 72 tumor tissues and in 4 (33.3%) of 12 cultured esophageal squamous cell lines. All four cell lines with MDM2 amplifications showed overexpression of the MDM2 mRNA in Northern blotting. We observed HPV infection in 15 (20.8%) of 72 tumor tissues by specific PCR amplification and Southern blot hybridization. In most tumors, amplification of the MDM2 gene or infection of HPV was not associated with p53 mutations, except in four cases with p53 mutation and MDM2 amplification, and three cases with p53 mutation and HPV infection. Since p53 mutations, MDM2 overexpression, and HPV infection are all considered to abrogate the normal function of p53 protein, each of these genetic changes may be equally important in tumorigenesis. In addition, we found that patients with MDM2 amplification exhibited a significantly shorter survival period (P = 0.0053).

[The effects of glucose and insulin upon functional recovery in the rat heart preserved by continuous perfusion with St. Thomas' Hospital cardioplegic solution]

The aim of this study was to determine the effect of the continuous perfusion with Krebs-Henseleit bicarbonate buffer (KHBB) solution or St. Thomas' Hospital cardioplegic solution (ST solution) containing glucose and insulin upon the post-preservation recovery in the isolated rat heart.

METHODS

Hearts from male Wistar rats (n = 6/group) were subjected to working perfusion with KHBB solution for measurement of cardiac function. They were continuously perfused (1) with KHBB solution or ST solution for 12 hours at 20 degrees C, (2) with ST solution for 12 hours at 37 degrees C, 20 degrees C or 4 degrees C, (3) with ST solution or ST solution containing glucose (9 mmol/L) for 12 hours at 20 degrees C or 4 degrees C, and (4) with ST solution containing glucose (9 mmol/L) or ST solution containing glucose (9 mmol/L) and insulin (10 U/L solution) for 20 hours at 20 degrees C. This was followed by 15 min of Langendorff perfusion and 20 min of working perfusion with KHBB solution. During the second working perfusion after preservation, cardiac function was measured again.

RESULTS

(1) Percent recoveries of cardiac output (%CO) preserved with KHBB and ST solution were 44.9 +/- 4.0 and 57.7 +/- 3.8%, respectively (p < 0.05). (2) %CO after preservation with ST solution at 37, 20, 4 degrees C were 0*, 57.7 +/- 3.8 and 74.4 +/- 2.2*%, respectively (*p < 0.05 vs the 20 degrees C group). (3) At 20 degrees C, glucose addition to ST solution increased %CO to 76.5 +/- 2.4% from 57.7 +/- 3.8% in glucose-free ST solution group (p < 0.05). However, at 4 degrees C, glucose addition to ST solution was rather harmful and decreased %CO to 61.4 +/- 2.8% from 74.4 +/- 2.2 in glucose-free ST solution group (p < 0.05). (4) The addition of insulin to the glucose-containing ST solution resulted in a significant increase in %CO from 24.6 +/- 4.0% in the insulin-free solution to 69.2 +/- 2.0%.

CONCLUSIONS

Our results indicate that 1) ST solution might be better than KHBB solution for a continuous perfusion medium of myocardial preservation, and 2) at 20 degrees C, the addition of glucose and insulin to the ST solution could be beneficial for the continuous infusion as a method of preservation, however, at 4 degrees C, these addition might be harmful, suggesting the temperature dependence in the utility of energy substrate.

Cloning, sequencing and expression of a novel cDNA encoding human vacuolar ATPase (14-kDa subunit)

A cDNA encoding the 14-kDa subunit of vacuolar ATPase was cloned from human fetal brain. The sequence was composed of 680 nucleotides containing an open reading frame of 357 nucleotides. The deduced peptide sequence consisted of 119 amino acid residues with a calculated molecular weight of 13,369 Da and a pI of 5.19. Overall, this amino-acid sequence was respectively 69% and 70% identical to those of Manduca sexta and Drosophila melanogaster 14-kDa subunits, although the two representatives of Class Insecta were remarkably similar to one another (91% identity). Three regions in particular (the N-terminal, amino acids 5-36; the middle, residues 58-68; and the C-terminal, residues 88-118) were highly conserved. Hence, we think that the 14-kDa subunits have evolved from the same ancestral gene, and that the three conserved regions are important for the structure and function of vacuolar ATPase. A single 0.8-kb band was detected in various human tissues by Northern blot analysis. Since the human 14-kDa subunit is expressed ubiquitously, it might be a housekeeping protein. A separate transcript found in the cDNA library lacked a 6-bp segment in the 5' non-coding region (nucleotides -40 to -35) and also carried a 23C to T (8Thr to Ile) point mutation in the coding region; these minor differences likely reflected normal polymorphism.

The sequence of a rat cDNA encoding thrombopoietin

Overlapping cDNA clones encoding rat thrombopoietin (TPO) were isolated from liver-derived cell line cDNA libraries and the nucleotide sequences were determined. The deduced 326-amino-acid rat TPO showed significant homology to the known TPO of other species, especially in the N-terminal sequence.

Congenital dumbbell neuroblastoma

STUDY DESIGN

New babies with neurologic deficits resulting from intraspinal extension of congenital neuroblastoma is very unusual. Two patients with congenital dumbbell neuroblastoma with paraplegia are described, and 16 other cases are reviewed.

OBJECTIVE

To study the clinical features and prognosis of congenital dumbbell neuroblastoma.

SUMMARY OF BACKGROUND DATA

Only 16 cases were found in the literature.

METHODS

Two girls were diagnosed and underwent surgery.

RESULTS

Although no recurrence occurred in both patients, incomplete paresis remained. Corrective surgery was needed because of the post-laminectomy spinal deformity in patient 2.

CONCLUSIONS

Although a high survival rate in patients with congenital dumbbell neuroblastoma is encouraging, the poor neurologic recovery is of great concern. The authors recommend an early diagnosis by magnetic resonance imaging and early spinal cord decompression followed by chemotherapy for congenital dumbbell neuroblastoma.

Twenty-four hour monitoring of pH in the gastric tube replacing the resected esophagus

BACKGROUND

Peptic ulcers in the gastric tube replacing the resected esophagus develop silently and cause serious problems. In this study, the acidity of the gastric tube was examined by 24-hour pH monitoring to determine if the acidity of the gastric tube was sufficient to cause peptic ulcers.

STUDY DESIGN

The acidity of a gastric tube was evaluated by 24-hour pH monitoring of both the fundus and the antrum in 55 patients treated for carcinoma of the esophagus. The correlation between the fasting serum gastrin concentration and the intraluminal acidity of the completely vagotomized gastric tube was examined.

RESULTS

In the patients with high postoperative acidity in the fundus or the antrum (46 percent of the 41 patients examined), the intraluminal pH remained consistently low, even long after operative treatment. Significant correlations existed between the percentage of time that the pH remained below 3 preoperatively and postoperatively in both the fundus and the antrum (r = 0.4777, p = 0.0386, and r = 0.7597, p = 0.0002, respectively). The percentage did not decrease significantly postoperatively. A significantly negative correlation (r = -0.783401, p < 0.0001) was found between the fasting serum gastrin level and the proportion of time that the nocturnal pH in the antrum remained below 3.

CONCLUSIONS

Even long after esophagectomy, the pH of the gastric tube is low enough to cause peptic ulcers, especially in patients with high preoperative acidity. In these patients, the intraluminal pH in the antrum of the gastric tube correlates inversely with the fasting serum gastrin level.

[Fibronectin and macrophage]

Monocyte-macrophages play a great part in atherogenesis. Interaction between macrophages and subendothelial-tissue including basement membrane and intima may play a critical role in atherogenesis. Therefore we examined the ability of macrophages to attach to various types of extracellular matrix proteins, which are the main components of these tissues. Adhesion of macrophages to fibronectin was remarkable compared to collagen. In addition we examined the effect of age on adhesion to fibronectin. Age-related increase in macrophage adhesion to fibronectin was found in vitro. It was also related to the concentration of surface receptors of macrophages which recognize the RGDS sequence within fibronectin (i.e. VLA5) during aging. Age-related increases in macrophage ability to attach to fibronectin may be related to atherogenesis during aging.

Monkey pulpal response to adhesively luted indirect resin composite inlays

Monkey pulpal responses to resin-bonded indirect resin composite inlays were histopathologically evaluated by placing them in either etched-enamel, total-etched, or adhesive-resin-lined cavities. Initial pulpal responses caused by re-exposure of the cut dentin surfaces and luting procedure subsided if a tight marginal seal was secured by final cementation of the inlay. The adhesive resin coating of freshly cut dentinal walls/floors seems to provide a new technique to protect the dentin and pulp in indirect restorations requiring temporary sealing.

Reaction mechanism of T4 endonuclease V determined by analysis using modified oligonucleotide duplexes

The reaction mechanism of bacteriophage T4 endonuclease V was investigated using modified oligodeoxyribonucleotide duplexes containing a cis-syn thymine dimer. For the pyrimidine dimer glycosylase step, the formation of a covalent intermediate has been proposed. A fluorine atom was attached to the 2'-position of the 5'-component of the thymine dimer site, which could stabilize the covalent complex and prevent the ring opening of the sugar moiety. The strand cleavage of the 12 base pair substrate analog did not occur, although the glycosyl bond was cleaved by this enzyme. A covalent enzyme--substrate complex was separated by gel electrophoresis under denaturing conditions. It was shown that the enzyme molecules were completely converted to a stable complex in the reaction mixture. Two mechanisms have been proposed for the beta-elimination step. A 12-mer containing a phosphorothioate linkage between adjacent thymidines was prepared. The diastereomers were separated, and the absolute configurations were determined. After formation of the thymine dimer and 32P-labeling of the 5'-terminus, these oligonucleotides were annealed to the complementary 12-mer, and the reaction rates of the pyrimidine dimer glycosylase step and the overall reaction for each duplex were measured under the substrate-saturation conditions. The rate constants indicated that the chemical reaction at the beta-elimination step was rate-limiting. Since no difference was observed in the rate constants for the Rp- and Sp-phosphorothioate substrates, it is concluded that the beta-elimination reaction is catalyzed, not by the internucleotide phosphate, but by an amino acid residue of the enzyme.

[The effects of Ebselen upon post-ischemic functional recovery in rat heart]

The effects of Ebselen (DR-3305) upon cardiac function and CK leakage with or without ischemia reperfusion insults were investigated in this isolated working rat heart study. In order to evaluate the effects of Ebselen upon cardiac function, it was administrated to the isolated rat heart with Langendorff perfusion for 15 min at 100 cmH2O. Cardiac functions such as aortic and coronary flow, heart rate and aortic pressure, before and after Ebselen treatment, were measured and expressed as percent of the control value. The coronary resistance was significantly reduced in 100 nM, 500 nM and 1000 nM of Ebselen pretreatment with dose dependent manner. However pretreatment with 1000 nM of Ebselen significantly decreased cardiac output with significant increase of CK leakage. The myocardial protective effects of Ebselen in the cardioplegia or reperfusate were investigated under conditions of normothermic ischemia. After measuring preischemic cardiac functions, the St. Thomas' Hospital cardioplegic solution was infused for 3 min followed by 35 min of global ischemia at 37 degrees C. Hearts were then aerobically reperfused for 15 min in the Langendorff mode. Subsequently, cardiac function was measured and expressed as percent of the preischemic control value. Ebselen addition to the St. Thomas' cardioplegic solution did not possess any myocardial protective effects, although addition to reperfusate possess the protective abilities at a concentration of 10 nM. From these data, Ebselen, which was one of the free radical scavenger, had the myocardial protective effects if it was added to reperfusate at a concentration of 10 nM.

Clinical trial of continuous infusion of 5-fluorouracil using an ambulatory pump for metastatic colorectal cancer

A clinical trial was conducted in order to evaluate the anti-tumor effect and toxicity of a continuous infusion of 5-fluorouracil (5-FU) for metastatic colorectal cancer. Two-hundred and fifty mg/m2/day 5-FU was administered as a continuous infusion through an indwelling central venous catheter with ambulatory pump. Twenty patients with metastatic colorectal cancer which could be measured or evaluated were enrolled in the trial. The objective response rate was 35% (95% confidence interval, 14-56%). The response rates by site were 33% in liver, 17% in lung, 60% in lymph nodes, 50% in adrenal gland and 50% in primary lesion. The major toxicity was stomatitis (50%; grades 2 and 3 on Eastern Cooperative Oncology Group (ECOG) criteria) and hand-foot syndrome (40%; grades 2 and 3 on ECOG criteria). The sequence of toxicity was stomatitis first, followed by hand-foot syndrome. The median cumulative dose of 5-FU from the initiation of therapy to the onset of toxicity was 7125 mg in stomatitis and 17,875 mg in hand-foot syndrome. These toxicities were mild and reversible after a short interruption to the 5-FU infusion. Neither hematological toxicity nor serious catheter-related complications were observed. We concluded that continuous infusion of 5-FU was a feasible treatment for the patient with metastatic colorectal cancer, and manageable on an out-patient basis.

[Anatomical analysis of small bronchial arteries in front of the trachea by 3D-CT and digital subtraction angiography: implications for esophageal cancer surgery]

To preserve blood supply to the trachea and bronchus in the surgical procedure for esophageal cancer, anatomical characteristics of small bronchial arteries which course in front of the trachea were analysed by three-dimensional computed tomography (3D-CT) and digital subtraction angiography (DSA). In the 3D-CT study using five mediastina, three dimensional images of the bronchial arteries were reconstructed after the injection of contrast medium into the intercostobronchial arteries. Thus the detailed vascular network of the course of the small bronchial arteries in front of the trachea could be delineated. In the DSA study using seven mediastina, through this network of bronchial arteries, the branches originating from the aorta and the arteries supplying the cranial portion of the trachea could be viewed. These results indicate that the bronchial arteries are connected by a vascular network in front of the trachea. Based on these detailed findings, it is considered critical to avoid damage to the intercostobronchial artery and also the network of bronchial arteries in order to preserve blood supply to the trachea and bronchus.

Structure of a conformationally constrained Arg-Gly-Asp sequence inserted into human lysozyme

To examine the effect of a conformational constraint introduced into the Arg-Gly-Asp (RGD) sequence on cell adhesion activity, we constructed a mutant protein by inserting an RGD-containing sequence flanked by two Cys residues between Val74 and Asn75 of human lysozyme. The CRGDSC-inserted lysozyme was expressed in yeast, purified, and designated as Cys-RGD4. Using baby hamster kidney cells, Cys-RGD4 was shown to possess even higher cell adhesion activity than that of the RGDS-inserted lysozyme, RGD4. The Cys-RGD4 protein was co-crystallized with a lysozyme inhibitor, tri-N-acetylchitotriose, and the three-dimensional structure was determined at 1.6-A resolution by x-ray crystallography. In contrast to RGD4, the inserted RGD-containing region of Cys-RGD4 was well defined. The structural analysis revealed that the two inserted Cys residues form a new disulfide bond in Cys-RGD4, as expected, and that the RGD region assumes a type II' beta-turn conformation of Gly-Asp with a hydrogen bond between the C = O of Arg and the H-N of Ser. In addition, it was confirmed that two more hydrogen bonds are present in the RGD region of the Cys-RGD4 lysozyme. These results suggest that the conformation of the RGD-containing region is rigid and stable in the Cys-RGD4 molecule and that the type II' beta-turn structure of RGD is essential for binding to integrins with high affinity.

[Recent advances in chemotherapy for advanced gastric cancer: from the standpoint of survival advantages]

Recently, there have been many reports indicating higher response rates in combination chemotherapies for advanced gastric cancer. Since 1990, several randomized controlled trials (RCT) have been reported, which showed evidences of survival impacts in such cases. Patients treated with chemotherapy obtained significant survival advantages over those with best supportive care in three RCTs. The RCT from EORTC also resulted in more significant survival prolongation in FAMTX than in FAM, and FAMTX should be a reference arm for new regimens. Some RCTs are now under way to establish a standard therapy for advanced gastric cancer. From the analysis of long-term results of Japanese studies, 3% of entry cases survived longer than 5 years with no evidence of disease by chemotherapy. Chemotherapy for gastric cancer should be evaluated with survival advantages or rate of long-term survivors in future studies.

Purification and some properties of a protease from Streptomyces limosus

Streptomyces limosus was selected because it secreted a novel protease that catalyzed the synthetic reaction forming Pro-Pro-Pro from Pro-Pro. The protease was purified to an electrophoretically homogeneous state and an activity of more than about 20,000-fold that of the culture broth. The molecular mass of the enzyme was estimated to be 50 kDa by SDS-polyacrylamide gel electrophoresis. The enzyme was most active in alkaline pH for the synthetic reaction producing Pro-Pro-Pro from Pro-Pro, although for the hydrolytic reaction forming proline it was most active in neutral pH. The enzyme was inhibited by 1,2-epoxy-3-(p-nitrophenoxy)propane (EPNP) and diazoacetyl-DL-norleucine methyl ester (DAN). It can be considered that this enzyme belongs to the class of aspartic proteases. The substrate specificity indicates that this enzyme has a strong affinity for proline as a N-terminal amino acid of peptides.

Decreased interleukin-6 level in the cerebrospinal fluid of patients with Alzheimer-type dementia

We examined IL-6 levels in the cerebrospinal fluid (CSF) of patients clinically diagnosed with Alzheimer-type dementia (ATD) and with vascular dementia (VD) and of age-matched normal subjects. The IL-6 levels in the CSF of ATD, but not VD patients, were significantly decreased. In the early onset ATD patients (disease onset < 65 years), IL-6 levels were reduced to 21% of the control level. The IL-6 levels in the CSF were not associated with the severity of the dementia or the duration of the disease since the identification of the first symptoms.

Relation of angiographically defined coronary artery disease and plasma concentrations of insulin, lipid, and apolipoprotein in normolipidemic subjects with varying degrees of glucose tolerance

We investigated the association between hyperinsulinemia and changes in lipid, lipoprotein, and apolipoprotein that would increase the risk of coronary artery disease (CAD) independent of glucose tolerance. A coronary angiogram was recorded in 127 male subjects, including 41 with normal glucose tolerance, 41 with impaired glucose tolerance, and 45 with non-insulin-dependent diabetes mellitus (NIDDM). Subjects were divided into 2 groups according to results: the group with CAD (n = 94) and the group with normal coronary arteries (n = 33). All subjects were normolipidemic (total cholesterol < 230 mg/dl and triglycerides < 150 mg/dl). The CAD group had a significantly lower plasma level of high-density lipoprotein (HDL) cholesterol and apolipoprotein A-I (apo A-I) and a higher level of apolipoprotein B (apo B) than the normal group with normal glucose tolerance. In considering subjects with impaired glucose tolerance or NIDDM, the CAD group had a significantly lower plasma level of HDL cholesterol and apo A-I and a significantly higher plasma level of total cholesterol, triglycerides, and apo B than the normal group. In each of the subjects with normal and impaired glucose tolerance, and NIDDM, the elevation of plasma insulin concentration during both the complete test period and the early phase of an oral glucose challenge was significantly higher in the CAD than in the normal group. In all subjects, graded reductions in HDL cholesterol and apo A-I and graded increases in plasma total cholesterol, triglycerides, and apo B were observed with increasing tertiles of the postglucose challenge measurements of insulinemia.(ABSTRACT TRUNCATED AT 250 WORDS)