Background-We sought to investigate the mechanism of geometric changes after main branch (MB) stent implantation and to identify the predictors of functionally significant "jailed" side branch (SB) lesions. Methods and Results-Seventy-seven patients with bifurcation lesions were prospectively enrolled from 8 centers. MB intravascular ultrasound was performed before and after MB stent implantation, and fractional flow reserve was measured in the jailed SB. The vessel volume index of both the proximal and distal MB was increased after stent implantation. The plaque volume index decreased in the proximal MB (9.1Ϯ3.0 to 8.4Ϯ2.4 mm

Programmed death 1 (PD-1) signaling through its ligands, PD-L1 and PD-L2, has been known to negatively regulate T-cell responses. In addition, PD-L1 has been shown to interact with B7-1 costimulatory molecule to inhibit T-cell responses. Extensive studies have shown that PD-1/PD-L blockade restores exhausted T cells during chronic viral infections and tumors. In this study, we evaluated the effects of soluble PD-1 (sPD-1) as a blockade of PD-1 and PD-L1 on vaccine-elicited antigen-specific T-cell responses in mice. Coadministration of sPD-1 DNA with human papilloma virus-16 E7 DNA vaccine significantly enhanced E7-specific CD8(+) T-cell responses, resulting in potent antitumor effects against E7-expressing tumors. We also found that sPD-1, codelivered with adenovirus-based vaccine, could increase antigen-specific CD8(+) T-cell responses, indicating vaccine type-independent adjuvant effect of sPD-1. In addition, the frequency and functional activity of adoptively transferred OT-I cells, particularly memory CD8(+) T cells, were augmented by coadministration of sPD-1 DNA, which was closely associated with increased T-cell proliferation and reduced T-cell apoptosis through upregulation of Bcl-xL expression during T-cell activation. Codelivery of sPD-1 DNA also enhanced maturation of dendritic cells (DCs) in vivo which was accompanied by upregulation of DC maturation markers such as major histocompatibility complex class II. Taken together, our findings show that sPD-1 potently enhances codelivered antigen-specific CD8(+) T-cell responses and in vivo maturation of DCs during activation of naive CD8(+) T cells, suggesting that an immunization strategy with sPD-1 as an adjuvant can be used to increase antigen-specific T-cell immunity elicited by vaccination.

Coronary angiography is increasingly performed with multi-detector row computed tomography (CT) in the clinical setting. Successful use of this method, however, depends on the radiologist's knowledge of its potential pitfalls and familiarity with methods for minimizing or avoiding them. To identify artifacts and other pitfalls that commonly degrade image quality and that could result in misinterpretation, contrast-enhanced coronary angiograms acquired with a multi-detector row CT scanner with four detector rows in 110 consecutive patients were analyzed. The problems identified were classified into four broad categories: (a) motion-related artifacts caused by cardiac, pulmonary, or other body motion; (b) beam-hardening effects caused by metallic implants, severe calcifications, or air bubbles in the pulmonary artery that obscured the underlying coronary vessel lumen; (c) structural artifacts produced by adjacent contrast material-filled structures and overlying vessels; and (d) artifacts that resulted from technical errors or limitations. The most frequently observed artifacts were those related to cardiac motion. The most effective methods for minimizing cardiac motion artifacts are (a) premedication with beta-blockers to maintain optimal heart rate during scanning and (b) optimal selection of the reconstruction window.