More than 1500 articles were then screened to derive the relevant

More than 1500 articles were then screened to derive the relevant analysis. As markers of sympathetic nervous system activation, studies of plasma norepinephrine concentrations, power

spectral analysis, muscle sympathetic nerve activity and norepinephrine spillover were reviewed. Overall, each drug lowered blood pressure in hypertensive patients in association with only small changes in heart rate (i.e. < 1 beat/min). Plasma norepinephrine concentrations, as the most widely reported marker of sympathetic nervous system activity, showed greater increases in patients treated with amlodipine than with nifedipine GITS. The evidence indicates that both these once-daily dihydropyridine CCBs lower blood pressure effectively with minimal effects on heart rate. There are small differences between the drugs in Elafibranor Metabolism inhibitor the extent to which each activates the sympathetic nervous system with an overall non-significant trend in favour of nifedipine GITS.”
“Primitive myxoid mesenchymal tumor of infancy is an extremely rare and recently recognized soft tissue tumor entity with a tendency for multiple recurrences. Only ten cases have been described in the literature and most cases are reported in Western countries. This tumor ranges in size from 2

to 15 cm and is characterized microscopically by a diffuse growth of primitive cells in a myxoid background with focal fascicles or a herringbone pattern. In this study, we describe a primitive myxoid mesenchymal tumor of infancy on Rigosertib the scalp of a 3-month-old Taiwanese boy. The histology showed typical morphology and the tumor cells showed vimentin and CD99 immunoreactivities. The translocation t(12,15)(p13;q25)

was not found by fluorescence in situ hybridization. After complete surgical excision, no recurrence was noted during find more an 18-month follow-up.”
“This study aimed to assess the efficacy and tolerability of atorvastatin in Tanner stage (TS) 1 patients ages 6 to 10 years and TS a parts per thousand yen2 patients ages 10 to < 18 years with genetically confirmed heterozygous familial hypercholesterolemia (HeFH) and a low density lipoprotein cholesterol (LDL-C) level of 4 mmol/l (155 mg/dl) or higher. In this open-label, 8-week study, 15 TS 1 children were treated initially with atorvastatin 5 mg/day and 24 TS a parts per thousand yen2 children with 10 mg/day. Doses were doubled at week 4 if the LDL-C target (< 3.35 mmol/l [130 mg/dl]) was not achieved. The efficacy variables were the percentage change from baseline in LDL-C, total cholesterol (TC), triglycerides (TG), high density lipoprotein cholesterol (HDL-C), very low density lipoprotein cholesterol (VLDL-C), and apolipoprotein (Apo) A-I and Apo B. Safety evaluations included clinical monitoring, subject-reported adverse events (AEs), vital signs, and clinical laboratory tests.

We administered verbal, nonverbal, and reading tasks to determine

We administered verbal, nonverbal, and reading tasks to determine factors precipitating seizures. Linguistic characteristics of the words were manipulated. Results indicated that reading-induced seizures were significantly more Selleck BMS-754807 numerous than those observed during verbal and nonverbal tasks. In reading tasks, spike frequency significantly increased with involvement of the phonological reading route. Spikes were recorded predominantly in left parasagittal regions. Future cerebral imaging studies will enable us to visualize the spatial localization and temporal course of reading-induced seizures and brain

activity involved in reading. A better understanding of reading epilepsy is crucial for reading rehabilitation in these patients. (C) 2011 Elsevier Inc. All rights reserved.”
“Extreme heat during certain days of the summer renders pigs susceptible to severe heat stress, which negatively affects their growth Quisinostat performance. We hypothesized that such heat stress impaired the small intestinal mucosa, a site responsible for nutrient absorption. To simulate heat stress, Chinese experimental mini-pigs were treated with 5 h of continual 40 degrees C temperature each day for 10 d in succession. Pigs were killed at 1, 3, 6 and 10 d after treatment, and small intestinal epithelia were sampled for histochemical examination and biochemical

analyses. The duodenum and jejunum were seriously damaged within 3 d of initiation of treatment. Subsequent study of the process of jejunum recovery showed that the initiation of recovery

started within 6 d following heat stress. Such damage was associated with the downregulation Tipifarnib chemical structure of epithelial growth factor signaling. In conclusion, heat stress induced short-term damage to the epithelium of porcine intestine. Because the intestinal epithelium is crucial for nutrient uptake, such damage should partially account for the impairment of growth performance of pigs under heat stress.”
“The influence of external magnetic fields on the bending vibration of a one-side clamped iron filled carbon nanotube (CNT) has been analyzed theoretically and experimentally, with particular consideration given to the changes in the resonance frequency. The model involves the application of a modified Euler-Bernoulli-beam to analyze the zero field oscillatory behavior, as well as a magnetostatic approach used to determine the influence of any external field distributions. The experiments were conducted in situ in a scanning electron microscope. The measured magnetic moment of the nanowire at room temperature was mu = 2.1 x 10(-14) Am(2). Due to the favorable geometry of the CNT oscillator, the raw signal obtained using this approach is significantly more favorable than that with state of the art cantilever magnetometry.

We determined Pearson correlation coefficients between

th

We determined Pearson correlation coefficients between

the reference standard and the three other methods for lobar volumes and emphysematous lobar volumes. We also compared the relative errors among the three measurement methods.

RESULTS: Both semi-automatic and automatic computer-aided diagnosis results were more strongly correlated with the reference standard than the number of segments method. The correlation coefficients for automatic computer-aided diagnosis were slightly lower than those for semi-automatic computer-aided diagnosis because there was one outlier among 50 cases (2%) in the right upper lobe and two outliers among 50 cases (4%) in the other lobes. The number of segments method relative error was significantly greater than those for semi-automatic and automatic computer-aided diagnosis (P < 0.001). The computational time for automatic computer-aided diagnosis was 1/2 to Torin 2 mouse 2/3 than that of semi-automatic computer-aided diagnosis.

CONCLUSIONS: A novel lobar volumetry computer-aided diagnosis system could more precisely measure lobar volumes than the conventional number of segments method. Because semi-automatic computer-aided

diagnosis and automatic computer-aided diagnosis were complementary, in clinical use, it would be more practical to first measure volumes by automatic computer-aided diagnosis, and then use semi-automatic measurements if automatic computer-aided diagnosis failed.”
“Cytotoxicity and antioxidant properties of the methanol Mdm2 inhibitor extracts of leaves and flowers of Cornus mas and Cotinus coggygria were studied, together with their chemical composition. Extracts of C. coggygria flowers and leaves showed better antioxidant activity in reaction with 1,1-diphenyl-2-picrylhydrazyl (DPPH) radical as well as in inhibition selleck chemical of lipid peroxidation (LP) than C. mas extracts. Preliminary

results showed that all extracts possessed potential cytotoxic activity towards HeLa and LS174 human cancer cell lines in vitro, with stronger inhibition against growth of HeLa cell growth than against LS174 cell growth. Cytotoxic activity of C. coggygria extracts showed good correlation with their antioxidative activity in vitro. In the brine shrimp lethality test, there were no significant changes in toxicity.”
“Objective To determine the clinical and histologic effects of diode endoscopic cyclophotocoagulation (ECP) in the phakic equine eye. Animals studied Phase I: 10 equine cadaver eyes. Phase II: four normal adult horses. Procedures Phase I: ECP probe angle of reach (AR) was determined. Multiple ECP energy levels: 0.75, 0.90, 1.05, 1.20, 1.35, 1.50J, and the resulting visible and histologic ciliary process changes were evaluated. Phase II: Ocular quadrants were treated with ECP at 0.90, 1.14, 1.

Titanium mesh was placed between the periosteum and the cortical

Titanium mesh was placed between the periosteum and the cortical bone, with or without holes. A distraction screw was placed

Compound C rigidly under the center of the mesh. After a 7-day latency period, the periosteum was distracted 0.5 mm per day for 8 consecutive days. Rabbits were sacrificed after consolidation periods of 4 and 8 weeks. Cross-sectional radiographs were evaluated with densitometry. Specimens were fixed, decalcified, and stained with hematoxylin and eosin.

Results: At 8 weeks after periosteal distraction, the area of new bone formation averaged 25.7 +/- 5.1 mm(2) and 12.9 +/- 3.2 mm(2) (mean +/- SD) with and without decortication, respectively. In this study, periosteal distraction showed better bone regeneration on the lateral aspect of mandibles with rather than without decorticating holes.

Conclusion: Periosteal distraction with decorticating holes can be effective in augmenting atrophic bone. (C) 2009 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac

Surg 67:1478-1485, 2009″
“Background: AZD5363 manufacturer Cognitive impairment reflecting CNS disruption in chronic solvent abusers can resolve within two years of abstinence. However, the specific time course for recovery has yet to be determined empirically. This study monitored cognition among solvent (i.e., gasoline) abusers throughout 8 weeks of residential treatment. It also investigated the extent to which solvent-related cognitive impairments persisted following discharge.

Methods: Non-drug using healthy controls (n = 33) and solvent abusers (n = 29) who had inhaled gasoline, regularly or episodically, for an average of 4.3 years (SD = 2.7) were assessed. Using linear mixed model analyses, solvent abusers

were compared to healthy controls throughout treatment at baseline, two weeks, four weeks and six weeks, selleck chemical on visual motor, attention, learning, memory, and executive function tasks. Ten users who maintained abstinence were reassessed an average of 12 months later (SD = 2.8) and were compared to healthy controls (n = 12) retested at the same time interval using ANCOVA while controlling for age and baseline performance.

Results: At baseline, solvent abusers showed cognitive deficits on visual motor, learning and memory, paired associate learning, and executive functions. Paired associate learning performance improved within 6 weeks of abstinence, however, impairments in visual motor speed, learning and memory, and executive function persisted throughout and in some cases beyond treatment.

Conclusions: Cognitive deficits exist for solvent abusers upon treatment entry. Some impairments resolve within weeks of abstinence, while memory and executive function improves gradually over months to years of abstinence, and might never fully recover. (C) 2011 Elsevier Ireland Ltd. All rights reserved.

Published by Elsevier B V All rights reserved “
“Purpose of

Published by Elsevier B.V. All rights reserved.”
“Purpose of review

Controversy remains regarding the best methodology of

handling exocrine pancreatic fluid and pancreatic venous effluent. Bladder drainage has given way to enteric drainage. However, is there an instance in which bladder drainage is preferable? Also, hyperinsulinemia, as a result of systemic venous drainage (SVD), is claimed to be proatherosclerotic, whereas portal venous drainage (PVD) is 5-Fluoracil cost more physiologic and less atherosclerotic.

Recent findings

Bladder drainage remains a viable method of exocrine pancreas drainage, but evidence is sparse that measuring urinary amylase has a substantial benefit in the early detection of acute rejection in all types of pancreas transplants. Currently, there is no incontrovertible evidence that systemic hyperinsulinemia is proatherosclerotic, whereas recent metabolic studies on SVD and PVD showed that there was no benefit to PVD.

Summary

Given the advent of newer immunosuppressive Nirogacestat concentration agents and overall lower acute rejection rates, the perceived benefit of bladder drainage as a means to measure urinary amylase as an early marker of rejection has not been substantiated. However, there may be a selective role for bladder drainage in ‘high risk’ pancreases. Also, without a clear-cut metabolic benefit to PVD over SVD, it remains the surgeon’s choice as to which

method to use.”
“Purpose of reviewAn off-clamp, or zero-ischemia, approach to laparoscopic partial nephrectomy has been a proposed means of preserving global renal function by preventing ischemia to normal renal parenchyma. However, for clinical stage T1b tumors this provides a unique challenge as the large size of these tumors further complicates an already difficult

procedure. This review provides an overview of outcomes for laparoscopic partial nephrectomies performed with or without hilar clamping for clinical stage T1b tumors.Recent findingsThere is a paucity of data for laparoscopic Dihydrotestosterone datasheet partial nephrectomies for this larger tumor size. The feasibility of performing laparoscopic partial nephrectomy for renal tumors 4-7cm in size has clearly been demonstrated. Not unexpectedly, using an off-clamp technique during laparoscopic partial nephrectomy has variably shown increased intraoperative blood loss when compared to hilar controlled procedures. This does not, however, seem to translate into increased risk of transfusion or loss of visualization leading to compromise in oncologic outcomes. Lastly, some data suggest improved short-term and long-term preservation of renal function as estimated by estimated glomerular filtration rate.SummaryWith accumulating data pointing to the long-term health benefits of nephron sparing surgery over radical nephrectomy and its oncologic equivalency confirmed, there is an increased push to perform partial nephrectomy for larger tumors.

The acidosis improved significantly when the patient was treated

The acidosis improved significantly when the patient was treated with thiamin. Although selleck chemicals llc TPN is life saving in the NICU, meticulous attention must be paid while treating a patient with TPN, and all possible nutrients should be provided. In this report, a case of a preterm newborn requiring a prolonged period of TPN and complicated

by serious lactic acidosis is presented and discussed.”
“The use of the cytochrome oxidase test reagent, as a differential agent to study the pathogenic and saprophytic leptospires was studied. Growth of the leptospiral strains of the saprophytic group was almost involved in the conversion of colorless tetramethyl p-phenelene diamine dihydrochloride solution to dark brown color whereas pathogenic leptospirae strains showed reddish brown color. Saprophytic strains required 20-35 min for oxidation of cytochrome, however, pathogenic strains required more

time, about 45 min for cytocrome oxidation. By this preliminary investigation, it is now possible to differentiate and report the saprophytic and Nirogacestat concentration parasitic strains based on the differential observation of the cytochrome oxidase test.”
“In this case report we describe a short circuit in the Riata 1570 defibrillator lead (Riata 1570, St. Jude Medical, St. Paul, MN, USA) that was unsuspected owing to normal lead parameters until defibrillator threshold testing at the time of elective generator change. On this occasion, the short circuit manifested as unsuccessful defibrillation of ventricular fibrillation with immediate battery depletion. This report adds weight to existing concerns over narrow caliber leads, it draws attention to the possibility of lead malfunction despite unremarkable interrogation, and lastly it highlights the potential role of routine defibrillator threshold testing, particularly at elective generator change (an issue that remains sparingly buy SB203580 addressed in the existing literature). (PACE 2012; 35:e154e155)”
“Purpose: To measure reader agreement

in determining whether lung nodules detected at baseline screening computed tomography (CT) had changed at subsequent screening examinations and to evaluate the variability in recommendations for further follow-up.

Materials and Methods: All subjects were enrolled in the National Lung Screening Trial (NLST), and each participant consented to the use of their de-identified images for research purposes. The authors randomly selected 100 cases of nodules measuring at least 4.0 mm at 1-year screening CT that were considered by the original screening CT reader to be present on baseline CT scans; nodules considered by the original reader to have changed were oversampled. Selected images from each case showing the entire nodule at both examinations were preloaded on a picture archiving and communication system workstation.

In this review, we discuss recent approaches on experimental bact

In this review, we discuss recent approaches on experimental bacteriolytic therapy, emphasizing the specific interplay between bacteria, AG-881 manufacturer immune cells and tumor cells to break

the tumor-induced tolerance.

Experimental research during the last decades demonstrated beneficial but also adverse influence of bacteria on tumor growth. There is a strong correlation between chronic infections and tumor incidence. However, acute bacterial infections have favourable effects on tumor growth often contributing to complete remission. Tumor regression is usually attributable to both direct tumor cell killing (via apoptosis and/or necrosis, depending on the applied bacteria) and indirect immune stimulation. This includes (I) elimination of immunosuppressive immune cells (i.e. tumor-associated macrophages, myeloid-derived suppressor, and regulatory T cells), (II) suppression of Th2-directed cytokine secretion (TGF alpha, IL10), (III) providing a pro-inflammatory micro-milieu (tumor infiltrating neutrophils) and (IV) supporting the influx of cytotoxic T cells into tumors. selleck products This finally forces the development of an immunological memory and may provide long-term protection against cancer.

Immunotherapy using bacteria is still a double-edged sword. Experiences from the last years have substantially contributed to when bacteria and defined components thereof might be integrated into immunotherapeutic

concepts. Attempts in transferring this approach

into the clinics are on their selleck chemical way.”
“The objective of this study was to compare the efficacy of gabapentin with placebo for neuropathic pain at the individual and population levels.

This study used an n-of-1 trial methodology with three double-blind, randomized, crossover comparisons of gabapentin with placebo.

This study was carried out at specialist outpatient clinics at two Australian hospitals.

The patients are adults with chronic neuropathic pain.

Following a dose-finding period, participants underwent three comparisons of 2-week periods on gabapentin (600-1,800 mg per day) and placebo. The dose-finding period was commenced by 112 patients, of whom 39 had no response so they did not enroll, leaving 73 trial participants. Of these, 48 completed and 7 partially completed their trials, and 18 withdrew.

The five outcome measures were the visual analog scale (0-10) of pain, sleep interference and functional limitation; frequency of adverse events and medication preference. The aggregate response was determined by weighting the response to each measure equally.

Of the 55 participants who completed at least one cycle, the aggregate response to gabapentin was better than placebo in 16 (29%), of whom 15 continued gabapentin posttrial. No difference was shown in 38 (69%), and 1 (2%) showed a better response to placebo. Fifteen of these 39 continued gabapentin posttrial.

At the 44-week follow-up visits, both groups showed improvement i

At the 44-week follow-up visits, both groups showed improvement in all parameters, but improvement

was more significant in the 5-FU group (p <.05). No side effect was detected in either of the groups. CONCLUSION 5-FU tattooing was more effective than intralesional TAC for the treatment of keloids.”
“Cochlear lateral wall damage is a side effect of cisplatin chemotherapy. Recent studies have shown that cisplatin treatment precipitates platinated DNA adducts in the cochlear lateral wall which suggest that DNA damage may contribute to ototoxicity. Platinated Napabucasin supplier adducts are high-affinity substrates for the global genomic nucleotide excision repair (GG-NER) pathway which is facilitated by xeroderma pigmentosum (XP) complementing proteins, such as XPC, XPD and XPA. Tumor biology has shown that in addition to stimulating GG-NER, cisplatin may deplete telomerase reverse transcriptase

(TERT). In the current study Fischer344 rats were treated with cisplatin (2 mg/kg/4 days, i.p.) and their cochleae harvested for immunohistochemistry. XPC, XPD and XPA expression increased while TERT expression decreased among cisplatin treated animals compared to vehicle control. These findings suggest that in addition to forming platinated adducts, cisplatin chemotherapy may up-regulate DNA repair proteins and modify TERT expression in Mizoribine DNA Damage inhibitor the cochlear lateral wall.”
“The TbCo4-xFexB compounds with x=0, 1, and 2 have been investigated by x-ray and neutron diffraction, magnetic measurements, and iron-57 Mossbauer spectroscopy.

The substitution of cobalt by iron induces both an anisotropic increase in the unit-cell CX-6258 volume and a large increase of approximately 250 K in the Curie temperature; the 4.2 K magnetization decreases continuously with increasing iron content. The powder neutron diffraction patterns and the Mossbauer spectra of the TbCo4-xFexB compounds reveal a strong preferential substitution of iron for cobalt on the 2c site, small transition metal magnetic moments of approximately 1.7 mu(B), and small iron hyperfine fields of approximately 16 T. The compensation temperature of the TbCo4-xFexB compounds decreases continuously from 400 to 350 K between x=0 and 2 as the result of an iron induced increase in the transition metal magnetization. The magnetic moment and hyperfine field are found to be larger on the 2c site than on the 6i site, a difference that reflects the strong hybridization of the 3d orbitals of the 6i site transition metal with the boron 2p orbitals. (C) 2009 American Institute of Physics. [DOI: 10.1063/1.3138808]“
“BACKGROUND Severe anogenital acne inversa (AI) is a debilitating chronic inflammatory disease with a major negative effect on quality of life. OBJECTIVES To evaluate the role of surgery in the treatment of severe anogenital AI. METHODS We analyzed the records of patients with anogenital AI from 2000 to 2010.

Results Complete nutrient removal was achieved in the A2N-SBR in

Results Complete nutrient removal was achieved in the A2N-SBR in Run 3 where the COD/P and COD/N were 20.6 and 6.9, respectively. This coincides well with the highest P release/HAc uptake ratio occurring in Run 3, confirming high abundance of denitrifying phosphorus accumulating organisms (DPAOs) in the biomass. Under the stress of N or P limitation, more poly–hydroxyalkanoates (PHA) was synthesized, with the increasing proportion of poly-hydroxyvalerate (PHV) in PHA. The population biodiversity decreased with increasing carbon loading when P loads were maintained at constant levels, and recovered to the initial level after P loading decreased.

Conclusions Increasing COD/P promoted anaerobically synthesized PHA amount and favored https://www.selleckchem.com/products/ON-01910.html P check details removal. Also, PHB seems to be the crucial internal carbon source relating to P release and uptake, whereas high nitrogen and P removal efficiencies always relate to a high proportion of PHV in PHA. Increasing

carbon loading led to a decreased biodiversity of the community structure but favored higher PAO enrichments, if only P loading is not limited.(c) 2012 Society of Chemical Industry”
“Objective: Drawing on her substantial research experience in oncology and nursing, the 2009 Fox Award winner, Dr McCorkle, describes ways to advance the science of psychosocial oncology through collaboration.

Methods: Critical literature illustrating barriers to collaboration and successful

collaborative process are reviewed and compared to the author’s personal experiences.

Results: Currently, many researchers are beginning to see the need for collaboration, and yet many infrastructures, universities, and centers continue to create isolated researchers and research environments. Rigosertib order Despite the need, there is a dearth of practical and tangible guidelines as well as theoretical defenses for performing collaborative research. This article addresses these gaps with such insights as the need for a team of experts built on humility and trust, pre- and post-study networks across disciplines and settings, consistent meetings of staff as well as resources to support them, intervention monitoring techniques, and the crucial necessity for a stable institutionalized infrastructure that fosters collaboration, research and mentoring despite inevitable personnel turnover.

Conclusions: These insights that stem from the distinctive nursing lens provide crucial methods for advancing the science and addressing the uniquely interdisciplinary nature of oncology. Copyright (C) 2010 John Wiley & Sons, Ltd.”
“Study Design. Case report.

Objective. To describe a technique of thoracic fixation in pediatric cases with anatomy not amenable to hooks and pedicle screws.

Summary of Background Data. Intralaminar screws have been described in cervical and lumbar spines.

Disclosures of relationships with industry or other potential con

Disclosures of relationships with industry or other potential conflicts of interest were reported at the outset and annually. Each recommendation was approved by at least a two-thirds majority of the voting panel (those with a significant conflict recusing themselves from voting on those specific recommendations).”
“This study investigated the possible involvement of matrix metalloproteinase 9 (MMP-9) in early

brain injury (EBI) of subarachnoid hemorrhage (SAH) in rats. MMP-9 activities in hippocampus were examined at 6, 12, 24, 48 and 72 h after SAH. Laminin was detected by immunohistochemistry. Apoptosis of neurons Selleck Cilengitide in hippocampus was observed by TUNEL. Brain water content was also examined. MMP-9 activity and the number of apoptotic neurons increased from 12 to 72 h with a peak at 24 h. Laminin was found to decrease at 12 h, reached minimum at 24 h and began to increase from 48 h, which had a negative correlation with apoptotic neurons. The changes

of brain Salubrinal cost water content were found to be coincidence with that of neuronal apoptosis. Our findings suggest that MMP-9 is probably involved in the pathophysiological events of EBI after SAH, through degrading laminin which leads to neuronal anoikis of hippocampus.”
“Elevated serum total cholesterol (TC) has been considered a risk factor for Alzheimer’s disease (AD), but conflicting results have confused understanding of the relationships of serum lipids to the presence of AD in the elderly. Methods: To clarify these

issues, we evaluated correlations of admission TC, low-density (LDL) and high-density (HDL) cholesterol directly with the densities of Alzheimer Ruboxistaurin cell line hallmarks–neuritic plaques (NP) and neurofibrillary tangles (NFT)–in nursing home residents (n=281). Results: Significant positive associations of TC and LDL with NP densities were found in both the neocortex (TC: r=0.151, p=0.013 and LDL: r=0.190, p=0.005) and the hippocampal/entorhinal (allocortical) region (TC: r=0.182, p=0.002 and LDL: r=0.203, p=0.003). Associations of HDL with NP were less strong but also significant. In contrast, after adjustment for confounders, no correlations of NFT with any lipid were significant. When subjects with any non-AD neuropathology (largely vascular) were excluded, the TC-plaque and LDL-plaque associations for the remaining “”Pure AD”" subgroup were consistently stronger than for the full sample. The TC- and LDL-plaque correlations were also stronger for the subgroup of 87 subjects with an APOE 4 allele. Conclusions: The findings indicate that serum TC and LDL levels clearly relate to densities of NP, but not to densities of NFT. The stronger associations found in the subgroup that excluded all subjects with non-AD neuropathology suggest that cerebrovascular involvement does not explain these lipid-plaque relationships.