Carotid Plaque Composition Assessed by CT Predicts Subsequent Cardiovascular Events among Subjects with Carotid Stenosis.

BACKGROUND AND PURPOSE: Currently, the characteristics of carotid plaques are considered important factors for identifying subjects at high risk of stroke. This study aimed to test the hypothesis that carotid plaque composition assessed by CTA is associated with an increased risk of future major adverse cardiovascular events among asymptomatic subjects with moderate-to-severe carotid artery stenosis. MATERIALS AND METHODS: This single-center, retrospective cohort study included 194 carotid plaques from 176 asymptomatic subjects with moderate-to-severe carotid artery stenosis. The association of CTA-determined plaque composition with the risk of subsequent adverse cardiovascular events was analyzed. RESULTS: During a median follow-up of 41 months, the adverse cardiovascular event incidence among 194 carotid plaques was 19.6%. There were significant differences in plaque Hounsfield units (P < .001) and spotty calcium presence (P < .001) between carotid plaques from subjects with and without subsequent adverse cardiovascular events. Multivariable analysis revealed carotid plaque Hounsfield unit density (P < .001) and spotty calcium (P < .001) as independent predictors of subsequent adverse cardiovascular events. In association with moderate carotid artery stenosis, the plaque Hounsfield unit values were significantly lower among carotid plaques from subjects who experienced subsequent adverse cardiovascular events (P = .002), strokes (P = .01), and cardiovascular deaths (P = .04); the presence of spotty calcium was significantly associated with the occurrence of adverse cardiovascular events (P = .001), acute coronary syndrome (P = .01), and cardiovascular death (P = .04). CONCLUSIONS: Carotid plaque Hounsfield unit density and spotty calcium were independent predictors of a greater risk of adverse cardiovascular event occurrence.

Reliability and validity of the Korean version of the manual ability classification system for children with cerebral palsy.

BACKGROUND: To investigate the inter- and intra-rater reliability of the Korean version of the Manual Ability Classification System (MACS) for children with cerebral palsy. METHODS: After a two-step forward and one-step backward translation, the inter-rater reliability of the Korean version of the MACS was assessed separately by parents, occupational therapists and physicians. A second assessment for intra-rater reliability was performed 4 weeks later. RESULTS: Sixty-nine children were enrolled. The intra-class correlation coefficients were 0.956 between occupational therapists and physicians, 0.927 between parents and physicians, and 0.960 between parents and occupational therapists. Intra-rater reliability ranged from 0.965 to 0.987. CONCLUSIONS: The Korean version of the MACS is reliable and valid and is suitable for assessing manual ability in Korean children with cerebral palsy.

Anti-apoptotic role of Bfl-1 in staurosporine-treated B-lymphoblastic cells.

To examine the relationship between the expression level of Bfl-1 and the susceptibility to staurosporine-induced apoptosis in B-lymphoblastic cells, we tested cell survival in 4 cell lines: 2 that are Bfl-1-nonexpressing (Reh and JM-1) and 2 that are Bfl-1-expressing (IM-9 and Wil2-NS). Reh and JM-1 showed apoptosis levels of 62% (Reh) and 30% (JM-1) as early as 3 hours after treatment with staurosporine, whereas IM-9 and Wil2-NS showed apoptosis levels of only 40% and 26%, respectively, even after 1 day of treatment with staurosporine. Either induced expression of Bfl-1 with 12-o-tetradecanoyl phorbol-13-acetate or exogenous expression of Bfl-1 by transfection in Reh cells promoted cell survival. These results suggest that expression of Bfl-1 contributes to regulating apoptosis in the B-cell lines we examined.

Alteration of signal-transducing molecules and phenotypical characteristics in peripheral blood lymphocytes from gastric carcinoma patients.

The mechanisms underlying the impaired immune response frequently observed in cancer patients are not fully understood. Alteration of T-cell-associated signal transduction molecules has recently been implicated in immune suppression in tumor-bearing hosts. Furthermore, T cells from tumor-bearing host, irrespective of the presence of the zeta-chain, showed a lack of proliferative activity and cytotoxic function. In the present study, we investigated the expression of the zeta-chain molecule and the p56(lck) and p59(fyn) protein tyrosine kinase (PTK) levels in peripheral blood T lymphocytes (T-PBL) from patients with advanced gastric carcinomas; for this, flow cytometric analysis and immunoblotting, respectively, were used. We also compared the results of flow cytometric analysis of PBL between stomach cancer patients and normal healthy volunteers. In T-PBL from 22 tumor-bearing hosts, significantly reduced zeta-chain expression (16/22, 73%) was observed. Moreover, the expression level of p56(lck) in T-PBL from patients was significantly lower than that of p59(fyn). Flow cytometric analysis of T-PBL indicated a markedly increased CD8+28- cell population in T-PBL from 19 tumor-bearing hosts.

The abstraction of intervening concepts from experience with multiple input-multiple output causal environments.

The purpose of this article is threefold: (a) introduce a new paradigm for investigating how intervening concepts are learned, (b) report four new experiments that provide converging evidence for the acquisition of intervening concepts, and (c) propose a simple associative learning mechanism to account for the results. The new paradigm utilizes a stimulus-response-feedback task in which subjects learn trial by trial how a multivariate set of inputs maps into a multivariate set of outputs. The first two experiments use evidence based on a principal component analysis to replicate the finding that intervening-concept learning occurs spontaneously, but only in environments that contain an intervening factor. The next experiment provides a second converging line of evidence for this conclusion by showing that subjects can use an intervening concept to make accurate inferences to a new fourth output during a transfer test. The last experiment provides a third line of evidence by showing that subjects can use an intervening concept to make accurate inferences from a new fourth input. The results are explained by a hidden-unit connectionist learning mechanism that includes both accuracy and parsimony as learning objectives.

Sulfhydryl groups are essential for organic cation exchange in rabbit renal basolateral membrane vesicles.

The effect of N-ethylmaleimide (NEM), an irreversible sulfhydryl modifying reagent, on the transport of organic cations in the renal basolateral membrane was examined. The studies were conducted examining the exchange of [3H]tetraethylammonium (TEA) for unlabeled TEA in basolateral membrane vesicles isolated from the outer cortex of rabbit kidneys. NEM inactivated TEA transport in a dose-dependent fashion with an IC50 value of 260 microM. The rate of TEA transport inactivation followed apparent pseudo-first-order reaction kinetics. A replot of the data gave a linear relationship between the apparent rate constants and the NEM concentration with a slope of 4.0. The data imply that inactivation involves the binding of at least four molecules of NEM per active transport unit. This is most consistent with the presence of four sulfhydryl groups at this site. The substrate TEA displayed a dose-dependent enhancement of NEM inactivation, with 50% enhancement occurring at 365 microM TEA. Another organic cation, N1-methylnicotinamide, known to share a common transport mechanism with the TEA/TEA exchanger is also capable of increasing the reactivity of sulfhydryl groups to NEM. These results demonstrate that there are essential sulfhydryl groups for organic cation transport in the basolateral membrane. In addition, the capability of organic cations to alter the susceptibility to sulfhydryl modification suggests that these groups may have a dynamic role in the transport process.