To clarify the incidence of stenotic lesions according to the coronary arterial diameter in the acute phase. we investigated 190 patients with coronary arterial lesions who underwent an initial coronary angiogram (CAG) less than 100 days after the onset of Kawasaki disease. The largest diameters of the major branches were measured in the initial CAGs. The diameter of the large group was > or = 8.0 mm, that of the medium group was > or = 6.0 mm but < 8.0 mm, and that of the small group was > or = 4.0 mm but < 6.0 mm. There were 121 patients in the large group, 85 in the medium group, 77 in the small group. We investigated the stenotic lesions in the follow-up CAGs and evaluated the incidence of stenotic lesions in each group by the Kaplan-Meier method. The mean interval from the initial CAGs to the latest CAG was 97 months. The incidence of stenosis at 5, 10, and 15 years in the large group was 44, 62, and 74%, respectively. In the medium group the corresponding values were 6, 20, 58%, respectively. None of the patients in the small group developed stenotic lesions. Dilatation of more than 6.0 mm produces a high probability of irreversible change in the coronary arterial wall, leading to subsequent stenotic lesions.
These results indicate that in patients with Kawasaki disease the coronary disease accompanying impaired reactivity to nitroglycerin is present at the sites of regressed aneurysms as well as in angiographically normal coronary segments. We suggest that these sites with morphologic and functional abnormalities are related to the development of significant stenosis.
Segmentation of a natural scene into objects and background is a fundamental but challenging task for recognizing objects. Investigating intermediate-level visual cortical areas with a focus on local information is a crucial step towards understanding the formation of the cortical representations of figure and ground. We examined the activity of a population of macaque V4 neurons during the presentation of natural image patches and their respective variations. The natural image patches were optimized to exclude the influence of global context but included various characteristics of local stimulus. Around one fourth of the patchresponsive V4 neurons exhibited significant modulation of firing activity that was dependent on the positional relation between the figural region of the stimulus and the classical receptive field of the neuron. However, the individual neurons showed low consistency in figureground modulation across a variety of image patches (55-62%), indicating that individual neurons were capable of correctly signaling figure and ground only for a limited number of stimuli. We examined whether integration of the activity of multiple neurons enabled higher consistency across a variety of natural patches by training a support vector machine to classify figure and ground of the stimuli from the population firing activity. The integration of the activity of a few tens of neurons yielded discrimination accuracy much greater than that of single neurons (up to 85%), suggesting a crucial role of population coding for figure-ground discrimination in natural images.
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