Rapid progression of a coronary artery aneurysm caused by IgG4-related disease

BACKGROUND

IgG4-related disease (IgG4-RD) is a recently recognized fibro-inflammatory disorder that can affect almost any organ. IgG4-RD has also been reported in coronary arteries as periarteritis. IgG4-related coronary periarteritis may cause coronary artery aneurysms, and IgG4-related coronary artery aneurysms (IGCAs) are life-threatening. We describe a case of a patient with IGCA that highlights the usefulness and limitations of various IGCA evaluation modalities and provides insight into disease pathophysiology.

CASE SUMMARY

A 60-year-old man with IgG4-RD diagnosed 2 years before and with IGCA at the proximal right coronary artery (RCA) on coronary angiography (CAG) 9 months prior to admission to the hospital presented with acute coronary syndrome. Emergent CAG revealed the rapid progression of IGCA at the RCA, an obstruction of the diagonal branch, and stenosis of the left anterior descending artery (LAD) and the high lateral branch (HL). The patient underwent percutaneous coronary intervention for the diagonal branch. The RCA aneurysm was resected and bypassed with a saphenous vein graft (SVG); coronary bypass grafting (left internal mammary artery to LAD and SVG to HL) was performed. Pathological findings showed inflammatory cell infiltration and disruption of the elastic plate.

CONCLUSION

IGCAs require careful follow-up with computed tomography scans for early detection of aneurysmal enlargement.

Comparative physiology of canopy tree leaves in evergreen and deciduous forests in lowland Thailand

The typical seasonally dry forests in Southeast Asia are the mixed deciduous forest (MDF), dry dipterocarp (deciduous) forest (DDF), and dry evergreen forest (DEF). We obtained 21 physiological traits in the top/sunlit leaves of 107, 65 and 51 tree species in MDF, DEF and DDF, respectively. Approximately 70%, 95% and 95% of canopy tree species which consist of MDF, DEF and DDF are sampled, respectively. Light-saturated photosynthetic rates (Asat) exhibit a positive correlation with foliar nitrogen (N) and phosphorus (P) on leaf mass and area bases across tree species. Decreased leaf mass-based P reduces the positive slope of the mass-based N and Asat relationship across species and habitats. The differences in nutrient and water use and leaf habits are well matched to the variation in soil properties among the forest types, highlighting the reliability of this comprehensive database for revealing the mechanism of niche segregation based on edaphic factors.

A new fractal index to classify forest fragmentation and disorder

Context

Forest loss and fragmentation pose extreme threats to biodiversity. Their efficient characterization from remotely sensed data therefore has strong practical implications. Data are often separately analyzed for spatial fragmentation and disorder, but no existing metric simultaneously quantifies both the shape and arrangement of fragments.

Objectives

We present a fractal fragmentation and disorder index (FFDI), which advances a previously developed fractal index by merging it with the Rényi information dimension. The FFDI is designed to work across spatial scales, and to efficiently report both the fragmentation of images and their spatial disorder.

Methods

We validate the FFDI with 12,600 synthetic hierarchically structured random map (HRM) multiscale images, as well as several other categories of fractal and non-fractal test images (4880 images). We then apply the FFDI to satellite imagery of forest cover for 10 distinct regions of the Romanian Carpathian Mountains from 2000–2021.

Results

The FFDI outperformed its two individual components (fractal fragmentation index and Rényi information dimension) in resolving spatial patterns of disorder and fragmentation when tested on HRM classes and other image types. The FFDI thus offers a clear advantage when compared to the individual use of fractal fragmentation index and the Information Dimension, and provided good classification performance in an application to real data.

Conclusions

This work improves on previous characterizations of landscape patterns. With the FFDI, scientists will be able to better monitor and understand forest fragmentation from satellite imagery. The FFDI may also find wider applicability in biology wherever image analysis is used.

Ontogenetic changes in root and shoot respiration, fresh mass and surface area of Fagus crenata

BACKGROUND AND AIMS

To date, studies on terrestrial plant ecology and evolution have focused primarily on the trade-off patterns in the allocation of metabolic production to roots and shoots in individual plants and the scaling of whole-plant respiration. However, few empirical studies have investigated the root : shoot ratio by considering scaling whole-plant respiration at various sizes throughout ontogeny.

METHODS

Here, using a whole-plant chamber system, we measured the respiration rates, fresh mass and surface area of entire roots and shoots from 377 Fagus crenata individuals, from germinating seeds to mature trees, collected from five different Japanese provenances. Non-linear regression analysis was performed for scaling of root and shoot respiration, fresh mass and surface area with body size.

KEY RESULTS

Whole-plant respiration increased rapidly in germinating seeds. In the seedling to mature tree size range, the scaling of whole-plant respiration to whole-plant fresh mass was expressed as a linear trend on the log-log coordinates (exponent slightly greater than 0.75). In the same body size range, root and shoot respiration vs. whole-plant fresh mass were modelled by upward-convex (exponent decreased from 2.35 to 0.638) and downward-convex trends (exponent increased from -0.918 to 0.864), respectively. The root fraction in whole-plant respiration, fresh mass and surface area shifted continuously throughout ontogeny, increasing in smaller seedlings during early growth stages and decreasing in larger trees.

CONCLUSIONS

Our results suggest a gradual shift in allocation priorities of metabolic energy from roots in seedlings to shoots in mature trees, providing insights into how roots contribute to shoot and whole-plant growth during ontogeny. The models of root : shoot ratio in relation to whole-plant physiology could be applied in tree growth modelling, and in linking the different levels of ecological phenomena, from individuals to ecosystems.

The morphology and nutrient content drive the leaf carbon capture and economic trait variations in subtropical bamboo forest

Carbon absorption capability and morphological traits are crucial for plant leaf function performance. Here, we investigated the five bamboos at different elevations in Wuyi Mountain to clarify how the leaf trait responds to the elevational gradient and drives the photosynthetic capacity variations. The Standardized Major Axis Regression (SMA) analyses and the Structural Equation Model (SEM) are applied to identify how the bamboo leaf trait, including the ratio of leaf width to length (W/L), leaf mass per area (LMA), photosynthesis rates (Pn), leaf nitrogen, and phosphorus concentration (Leaf N and Leaf P) response to elevation environment, and the driving mechanism of Pn changes. Across the five bamboo species, our results revealed that leaf P scaled isometrically with respect to W/L, leaf N scaled allometrically as the 0.80-power of leaf P, and leaf N and leaf P scaled allometrically to Pn, with the exponents of 0.58 and 0.73, respectively. Besides, the SEM result showed altitude, morphological trait (W/L and LMA), and chemical trait (leaf N and leaf P) could together explain the 44% variations of Pn, with a standard total effect value of 70.0%, 38.5%, 23.6% to leaf P, leaf N, and W/L, respectively. The five bamboo species along the different elevational share an isometric scaling relationship between their leaf P and W/L, providing partial support for the general rule and operating between morphological and chemical traits. More importantly, the leaf W/L and leaf P as the main trait that affects leaf area and P utilization in growth and thus drives bamboo leaf photosynthetic capacity variations in different elevations.

Generating polyketide diversity in Dictyostelium: a Steely hybrid polyketide synthase produces alternate products at different developmental stages

The soil is a rich ecosystem where many ecological interactions are mediated by small molecules, and in which amoebae are low-level predators and also prey. The social amoeba Dictyostelium discoideum has a high genomic potential for producing polyketides to mediate its ecological interactions, including the unique 'Steely' enzymes, consisting of a fusion between a fatty acid synthase and a chalcone synthase. We report here that D. discoideum further increases its polyketide potential by using the StlB Steely enzyme, and a downstream chlorinating enzyme, to make both a chlorinated signal molecule, DIF-1, during its multi-cellular development, and a set of abundant polyketides in terminally differentiated stalk cells. We identify one of these as a chlorinated dibenzofuran with potent anti-bacterial activity. To do this, StlB switches expression from prespore to stalk cells in late development and is cleaved to release the chalcone synthase domain. Expression of this domain alone in StlB null cells allows synthesis of the stalk-associated, chlorinated polyketides. Thus, by altered expression and processing of StlB, cells make first a signal molecule, and then abundant secondary metabolites, which we speculate help to protect the mature spores from bacterial infection.

Scaling the leaf length-times-width equation to predict total leaf area of shoots

BACKGROUND AND AIMS

An individual plant consists of different-sized shoots, each of which consists of different-sized leaves. To predict plant-level physiological responses from the responses of individual leaves, modelling this within-shoot leaf size variation is necessary. Within-plant leaf trait variation has been well investigated in canopy photosynthesis models but less so in plant allometry. Therefore, integration of these two different approaches is needed.

METHODS

We focused on an established leaf-level relationship that the area of an individual leaf lamina is proportional to the product of its length and width. The geometric interpretation of this equation is that different-sized leaf laminas from a single species share the same basic form. Based on this shared basic form, we synthesized a new length-times-width equation predicting total shoot leaf area from the collective dimensions of leaves that comprise a shoot. Furthermore, we showed that several previously established empirical relationships, including the allometric relationships between total shoot leaf area, maximum individual leaf length within the shoot and total leaf number of the shoot, can be unified under the same geometric argument. We tested the model predictions using five species, all of which have simple leaves, selected from diverse taxa (Magnoliids, monocots and eudicots) and from different growth forms (trees, erect herbs and rosette herbs).

KEY RESULTS

For all five species, the length-times-width equation explained within-species variation of total leaf area of a shoot with high accuracy (R2 > 0.994). These strong relationships existed despite leaf dimensions scaling very differently between species. We also found good support for all derived predictions from the model (R2 > 0.85).

CONCLUSIONS

Our model can be incorporated to improve previous models of allometry that do not consider within-shoot size variation of individual leaves, providing a cross-scale linkage between individual leaf-size variation and shoot-size variation.

Acute myocardial infarction with simultaneous total occlusion of the left anterior descending artery and right coronary artery successfully treated with percutaneous coronary intervention

BACKGROUND

Simultaneous thrombosis in more than one coronary artery is an uncommon angiographic finding in patients with acute ST-segment elevation myocardial infarction. It is difficult to identify using 12-lead electrocardiography and usually leads to cardiogenic shock and fatal outcomes, including sudden cardiac death. Therefore, immediate revascularization and adequate mechanical circulatory support are required.

CASE PRESENTATION

We report the case of a 58-year-old man who presented with vomiting and chest pain complicated by cardiogenic shock and complete atrioventricular block. Electrocardiography revealed ST-segment elevation in leads II, III, aVF, and V1-V6. Emergency coronary angiography revealed total occlusion of the proximal left anterior descending artery and right coronary artery. The patient successfully underwent primary percutaneous coronary intervention with ballooning and stenting for both arteries. An Impella CP was inserted during the procedure. Fifty-seven days after admission, he had New York Heart Association class II heart failure and was transferred to a rehabilitation hospital.

CONCLUSIONS

Acute double-vessel coronary thrombosis, a serious event with a high mortality rate, requires prompt diagnosis and management to prevent complications such as cardiogenic shock and ventricular arrhythmias. A combination of judicious medical treatment, efficient primary percutaneous coronary intervention, and early mechanical support device insertion is crucial to improve the survival rate of patients with this disease.

An investigation into the measurement properties of the King-Devick Eye Tracking system

Objectives

Eye tracking has been gaining increasing attention as a possible assessment and monitoring tool for concussion. The King-Devick test (K-DT) was expanded to include an infrared video-oculography-based eye tracker (K-D ET). Therefore, the aim was to provide evidence on the reliability of the K-D ET system under an exercise condition.

Methods

Participants (N = 61; 26 male, 35 female; age range 19-25) were allocated to an exercise or sedentary group. Both groups completed a baseline K-D ET measurement and then either two 10-min exercise or sedentary interventions with repeated K-D ET measurements between interventions.

Results

The test-retest reliability of the K-D ET ranged from good to excellent for the different variables measured. The mean ± SD of the differences for the total number of saccades was 1.04 ± 4.01 and there was an observable difference (p = 0.005) in the trial number. There were no observable differences for the intervention (p = 0.768), gender (p = 0.121) and trial (p = 0.777) for average saccade’s velocity. The mean ± SD of the difference of the total fixations before and after intervention across both trials was 1.04 ± 3.63 and there was an observable difference in the trial number (p = 0.025). The mean ± SD of the differences for the Inter-Saccadic Interval and the fixation polyarea before and after intervention across both trials were 1.86 ± 22.99 msec and 0.51 ± 59.11 mm2 and no observable differences for the intervention, gender and trial.

Conclusion

The results provide evidence on the reliability of the K-D ET, and the eye-tracking components and demonstrate the relationship between completion time and other variables of the K-D ET system. This is vital as the use of the K-DT may be increasing and the combination of the K-DT and eye tracking as one single package highlights the need to specifically measure the reliability of this combined unit.

Diurnal Change of the Photosynthetic Light-Response Curve of Buckbean (Menyanthes trifoliata), an Emergent Aquatic Plant

Understanding plant physiological responses to high temperature is an important concern pertaining to climate change. However, compared with terrestrial plants, information about aquatic plants remains limited. Since the degree of midday depression of photosynthesis under high temperature depends on soil water conditions, it is expected that emergent aquatic plants, for which soil water conditions are always saturated, will show different patterns compared with terrestrial plants. We investigated the diurnal course of the photosynthetic light-response curve and incident light intensity for a freshwater emergent plant, buckbean (Menyanthes trifoliata L.; Menyanthaceae) in a cool temperate region. The effect of midday depression was observed only on a very hot day, but not on a moderately hot day, in summer. The diurnal course of photosynthetic light-response curves on this hot day showed that latent morning reduction of photosynthetic capacity started at dawn, preceding the apparent depression around the midday, in agreement with results reported in terrestrial plants. We concluded that (1) midday depression of emergent plants occurs when the stress intensity exceeds the species' tolerance, and (2) measurements of not only photosynthetic rate under field conditions but also diurnal course of photosynthetic light-response curve are necessary to quantify the effect of midday depression.

Fenestration using a novel cutting balloon for acute vessel occlusion secondary to intramural hematoma following stent implantation

Intramural hematoma after percutaneous coronary angioplasty is associated with adverse events and requires immediate bail out; however, the optimal treatment approach has not yet been established. Herein, we describe a case of coronary occlusion due to an intramural hematoma following stent implantation in the mid left anterior descending (LAD) coronary artery. Intravascular ultrasound revealed a massive intramural hematoma from the distal edge of the stent to the distal segment of the LAD, and the true lumen was completely compressed. By performing fenestration with a Wolverine™ Cutting Balloon™ (Boston Scientific, Massachusetts, United States), we were able to bail out without additional stenting. In conclusion, a cutting balloon with improved crossability can be an effective management strategy for intramural hematoma.

Consistent scaling of whole-shoot respiration between Moso bamboo (Phyllostachys pubescens) and trees

Both Moso bamboo (Phyllostachys pubescens) and tree forests have a large biomass; they are considered to play an important role in ecosystem carbon budgets. The scaling relationship between individual whole-shoot (i.e., aboveground parts) respiration and whole-shoot mass provides a clue for comparing the carbon budgets of Moso bamboo and tree forests. However, nobody has empirically demonstrated whether there is a difference between these forest types in the whole-shoot scaling relationship. We developed whole-shoot chambers and measured the shoot respiration of 58 individual mature bamboo shoots from the smallest to the largest in a Moso bamboo forest, and then compared them with that of 254 tree shoots previously measured. For 30 bamboo shoots, we measured the respiration rate of leaves, branches, and culms. We found that the scaling exponent of whole-shoot respiration of bamboo fitted by a simple power function on a log-log scale was 0.843 (95 % CI 0.797-0.885), which was consistent with that of trees, 0.826 (95 % CI 0.799-0.851), but higher than 3/4, the value typifying the Kleiber's rule. The respiration rates of leaves, branches, and culms at the whole-shoot level were proportional to their mass, revealing a constant mean mass-specific respiration of 1.19, 0.224, and 0.0978 µmol CO₂ kg^- 1 s^- 1, respectively. These constant values suggest common traits of organs among physiologically integrated ramets within a genet. Additionally, the larger the shoots, the smaller the allocation of organ mass to the metabolically active leaves, and the larger the allocation to the metabolically inactive culms. Therefore, these shifts in shoot-mass partitioning to leaves and culms caused a negative metabolic scaling of Moso bamboo shoots. The observed convergent metabolic scaling of Moso bamboo and trees may facilitate comparisons of the ecosystem carbon budgets of Moso bamboo and tree forests.

Simple and Fast One-Pot Cellulose Gel Preparation in Aqueous Pyrrolidinium Hydroxide Solution-Cellulose Solvent and Antibacterial Agent

Cellulose is the main component of biomass and is the most abundant biopolymer on earth; it is a non-toxic, low-cost material that is biocompatible and biodegradable. Cellulose gels are receiving increasing attention as medical products, e.g., as wound dressings. However, the preparation of cellulose hydrogels employing unmodified cellulose is scarcely reported because of the cumbersome dissolution of cellulose. In previous studies, we developed the new promising cellulose solvent N-butyl-N-methylpyrrolidinium hydroxide in an aqueous solution, which can dissolve up to 20 wt% cellulose within a short time at room temperature. In this study, we employed this solvent system and investigated the gelation behavior of cellulose after crosslinker addition. The swelling behavior in water (swelling ratio, water uptake), the mechanical properties under compression, and the antibacterial activity against Escherichia coli and Bacillus subtilis were investigated. We have developed a simple and fast one-pot method for the preparation of cellulose gels, in which aqueous pyrrolidinium hydroxide solution was acting as the solvent and as an antibacterial reagent. The pyrrolidinium hydroxide content of the gels was controlled by adjustment of the water volume employed for swelling. Simple recovery of the solvent system was also possible, which makes this preparation method environmentally benign.

Shade Avoidance and Light Foraging of a Clonal Woody Species, Pachysandra terminalis

(1) Background: A central subject in clonal plant ecology is to elucidate the mechanism by which clones forage resources in heterogeneous environments. Compared with studies conducted in laboratories or experimental gardens, studies on light foraging of forest woody clonal plants in their natural habitats are limited. (2) Methods: We investigated wild populations of an evergreen clonal understory shrub, Japanese pachysandra (Pachysandra terminalis Siebold & Zucc.), in two cool-temperate forests in Japan. (3) Results: Similar to the results of herbaceous clonal species, this species formed a dense stand in a relatively well-lit place, and a sparse stand in a shaded place. Higher specific rhizome length (i.e., length per unit mass) in shade resulted in lower ramet population density in shade. The individual leaf area, whole-ramet leaf area, or ramet height did not increase with increased light availability. The number of flower buds per flowering ramet increased as the canopy openness or population density increased. (4) Conclusions: Our results provide the first empirical evidence of shade avoidance and light foraging with morphological plasticity for a clonal woody species.

Visceral fat accumulation and left atrial phasic function in the general population

Background

Obesity carries independent risk for incident atrial fibrillation (AF), although the impact of abdominal fat distribution on LA morphological and functional remodeling is not fully elucidated. Speckle-tracking echocardiography is a novel and sensitive tool that allows quantification and detection of subtle alterations in left atrial (LA) phasic function.

Purpose

This study aimed to investigate whether increased visceral adiposity is independently associated with impaired LA phasic function in a community-based cohort.

Methods

We included 527 participants without overt cardiac disease who underwent laboratory testing, abdominal computed tomographic examination and speckle-tracking echocardiography. Abdominal adiposity was quantitatively assessed as visceral fat area (VFA) and subcutaneous fat area (SFA) at the level of the umbilicus. Speckle-tracking echocardiography was performed to assess LA phasic function including reservoir, conduit and pump strain as well as left ventricular global longitudinal strain (LVGLS).

Results

Mean age was 57±10 years and 362 of the participants (69%) were men. LA reservoir and conduit strain were decreased according to the VFA quartiles (both p<0.05), whereas there was no significant difference in LA volume index and LA pump strain. When stratified by SFA, there was no significant differences in LA volume index and all LA phasic strain across the quartiles. In multivariable analysis, VFA as continuous variable was significantly associated with LA conduit strain, independent of traditional cardiovascular risk factors, pertinent laboratory parameters and LV morphology and function including LVGLS (standardized b=−0.146, p=0.011). Representative cases are shown in the Figure.

Conclusion

In a sample of the general population, VFA accumulation was independently associated with worse LA conduit strain, which may be involved in the pathophysiological mechanism of obesity-related AF.

Funding Acknowledgement

Type of funding source: Foundation. Main funding source(s): Yamauchi Susumu Scholarship for Cardiovascular Research

Association between insulin resistance and left ventricular diastolic dysfunction in non-diabetic general population

Background

Insulin resistance due to visceral fat accumulation plays a central role in the development of diabetic mellitus and subsequent cardiovascular disease. Abdominal obesity and diabetic mellitus are associated with the progression of left ventricular diastolic dysfunction which is the major structural abnormality in patients with heart failure. However, whether insulin resistance influences left ventricular diastolic dysfunction in non-diabetic subjects is unclear.

Purpose

In this study, we aimed to clarify the association between insulin resistance and left ventricular diastolic dysfunction in non-diabetic general population.

Methods

We examined 2,572 non-diabetic subjects with preserved left ventricular systolic function (ejection fraction ≥50%) and without a past history of diabetic mellitus, heart failure, coronary artery disease, atrial fibrillation, stroke, moderate to severe valvular disease, who underwent medical check-ups at the University of Tokyo Hospital from January 2009 to December 2018. Diabetes mellitus was defined as fasting glucose level ≥126 mg/dL or a subject's use of oral antidiabetic medications or insulin. We calculated the Homeostasis Model Assessment-Insulin Resistance (HOMA-IR) score [HOMA-IR = fasting glucose (mg/dL) × insulin (μU/mL) / 405], and defined insulin resistance as HOMA-IR ≥2.5. Left ventricular diastolic function was assessed by echocardiography, using tissue doppler analysis (E/E' ratio in septal and lateral). Visceral adiposity was assessed as visceral fat volume measured by computed tomography scanner.

Results

Mean age was 53.3±9.8 years, and 1,746 subjects (67.9%) were male. Overall, HOMA-IR was 1.1 on average, and HOMA-IR ≥2.5 was observed in 5.0% of study population. BMI and the prevalence of obesity were higher in subjects with HOMA-IR ≥2.5 than in those without. There was no significant difference in left ventricular ejection fraction between HOMA-IR ≥2.5 and ≤2.5. E/E' ratio in septal and lateral were higher in subjects with HOMA-IR ≥2.5 than in those without. Multivariable logistic regression analysis demonstrated that obesity and waist circumference, visceral fat volume were independently associated with HOMA-IR ≥2.5, however, age, hypertension, hypercholesterolemia were not. Further, multiple regression analysis including insulin resistance, age, male gender, obesity, hypertension, hypercholesterolemia, cigarette smoking and visceral fat volume, showed that insulin resistance was an independent determinant of increasing E/E' in both septal and lateral, whereas visceral fat volume was not (Figure 1).

Conclusion

The results of the present study suggest that insulin resistance due to visceral fat accumulation might be associated with the development of left ventricular diastolic dysfunction in non-diabetic general population without overt cardiovascular disease.

Figure 1

Funding Acknowledgement

Type of funding source: None

Relationship between Histological Grade and Histopathological Appearance in Canine Mammary Carcinomas

Canine mammary carcinomas are common tumours in female dogs and histopathological examination has an important role in identifying whether they are benign or malignant. The latest and most commonly used histological grading system was established by Peña et al. (2013) and is based on the extent of tubule formation, nuclear pleomorphism and number of mitoses. Before the establishment of this grading system, tumour size and classical histological indicators of malignancy such as lymphovascular invasion, infiltration into surrounding tissue, necrosis and presence of a micropapillary pattern were important predictors of biological behaviour. However, the system of Peña et al. does not consider tumour size or these histological features. Clarifying the association of these features and histological grade, especially in grade II and III carcinomas, is important. In this study, we confirmed that the system of Peña et al. is effective for predicting biological behaviour and that evaluation of histological features of malignancy reinforced histological grade, as determined by the system of Peña et al., especially in grade II carcinomas.

Oxophilicity as a Descriptor for NO Cleavage Efficiency over Group IX Metal Clusters

Iridium and rhodium are group IX elements that can both catalytically reduce NO. To understand the difference in their reactivity toward NO, the adsorption forms of NO onto clusters of Ir and Rh are compared using vibrational spectra, recorded via infrared multiple-photon dissociation spectroscopy. The spectra give evidence for the existence of at least two specific adsorption forms. The main Ir₆⁺NO isomer is one in which NO is dissociated, whereas one other is a local minimum structure in the reaction pathway leading to dissociative adsorption. In contrast to adsorption onto Rh₆⁺, where less than 10% of the isomeric population was found in the global minimum associated with dissociative adsorption, a substantial fraction (about 50%) of NO dissociates on Ir₆⁺. This higher efficiency is attributed to a considerably reduced activation barrier for dissociation on Ir₆⁺. The key chemical property identified for dissociation efficiency is the cluster's affinity to atomic oxygen.

Characterization of very long chain fatty acid synthesis inhibition by ipfencarbazone

Ipfencarbazone exhibits excellent herbicidal activity against Echinochloa spp. and is safe for rice. The effects of ipfencarbazone on very long chain fatty acid (VLCFA) elongation in rice and late watergrass and its inhibitory mechanism were investigated in this study. Although ipfencarbazone inhibited VLCFA elongation in the microsomes prepared from late watergrass and rice at low concentrations, the inhibitory effect was higher in late watergrass than in rice. These results suggested that the primary site of action of ipfencarbazone is VLCFA elongase (VLCFAE) and ipfencarbazone has a differential affinity between the VLCFAEs of the plants. The inhibitory activity of ipfencarbazone became higher in proportion to pre-incubation period with the VLCFAE. The degree of inhibition did not decrease by dilution of the VLCFAE-ipfencarbazone complex. These results suggested that ipfencarbazone binds to the VLCFAE irreversibly.

Successful contemporary reverse controlled antegrade and retrograde subintimal tracking without contrast medium: a case report

Background

Contrast-induced acute kidney injury is one of the common adverse events related to percutaneous coronary intervention and a predictor for worse outcome. In the setting of percutaneous coronary intervention for chronic total occlusion, large amounts of contrast medium, more than 200–400 mL, are generally injected. A higher dose of contrast medium causes contrast-induced acute kidney injury more frequently. Therefore, patients who undergo chronic total occlusion-percutaneous coronary intervention are at risk for contrast-induced acute kidney injury.

Case presentation

We present the case of a 77-year-old Japanese man with post-acute myocardial infarction angina pectoris, heart failure, and chronic kidney disease who underwent percutaneous coronary intervention for chronic total occlusion in his right coronary artery. In the procedure, the retrograde wire was a visible penetration mark that made contrast medium unnecessary. Contemporary reverse controlled antegrade and retrograde subintimal tracking was successfully achieved and stents were implanted without contrast medium. Contrast medium was injected two times after stent implantation to confirm coronary flow and no perforation. The total amount of contrast medium was only 8 mL for chronic total occlusion-percutaneous coronary intervention.

Conclusion

Chronic total occlusion-percutaneous coronary intervention with contemporary reverse controlled antegrade and retrograde subintimal tracking without contrast medium may be safe and feasible in selected patients.

Electronic supplementary material

The online version of this article (10.1186/s13256-018-1918-2) contains supplementary material, which is available to authorized users.

Effects of environmental factors on the herbicidal activity and phytotoxicity of ipfencarbazone

Ipfencarbazone exhibits excellent herbicidal activity against Echinochloa spp. and is safe for transplanted rice at a dose of 250 g a.i./ha. However, the effect of various environmental factors on its activity has not been verified. The present study evaluated the factors affecting the herbicidal activity of ipfencarbazone against Echinochloa spp. and its phytotoxicity to transplanted rice. The herbicidal activity and phytotoxicity of ipfencarbazone were barely affected by temperature, soil texture, water leakage, or flooding water depth. When an overflow was conducted artificially 6 hr after application, the herbicidal activity was stable. Furthermore, ipfencarbazone completely inhibited the emergence of Echinochloa spp. for 56 days regardless of the soil texture, water leakage and overflow conditions. When the period between application and reflooding was within 24 hr of herbicide application, the phytotoxicity of ipfencarbazone on transplanted rice was slight. These results suggest that ipfencarbazone shows stable efficacy in practical use.

Intravascular ultrasound assessment of the effects of rotational atherectomy in calcified coronary artery lesions

We sought to clarify intravascular ultrasound (IVUS) features of rotational atherectomy (RA) of calcified lesions. IVUS was performed post-RA and post-stent in 38 lesions and analyzed every 1 mm. Pre-intervention IVUS was performed when the IVUS catheter crossed the lesion (n = 11). Calcium Index was average calcium angle multiplied by calcium length. We compared lowest (n = 13), middle (n = 13), and highest (n = 12) Calcium Index tertiles. Reverberations (multiple reflections from calcium) with a concave-shaped lumen in the post-RA IVUS were considered to represent RA-related calcium modification. Newly visible perivascular tissue through a previously solid arc of calcium in the post-stent IVUS was also evaluated. Comparing the pre and post-RA IVUS, maximum reverberation angle, and length increased significantly after RA (angle, from 45° [31, 67] to 96° [50, 148], p = 0.003; length, from 4.0 mm [2.0, 6.0] to 8.0 mm [4.0, 14.0], p = 0.005). In the post-RA IVUS, reverberations had a larger angle in the middle and highest Calcium Index tertiles (lowest, 91° [64, 133]; middle, 135° [107, 201]; highest, 150° [93, 208], p = 0.03). Post-stent newly visible perivascular tissue was more frequent in the middle and highest Calcium Index tertiles (lowest, 30.8%; middle, 69.2%; highest, 75.0%, p = 0.049). Minimum stent area was similar after calcium modification by RA irrespective of the severity of the Calcium Index (lowest, 6.7 mm² [5.7, 8.9]; middle, 5.6 mm² [4.9, 6.8]; highest, 6.7 mm² [5.9, 8.2], p = 0.2). Greater calcium modification by RA occurs in severely calcified lesions with smaller lumen diameters to mitigate against stent underexpansion.

Rheology and Foaming of Long-Chain Branched Ethylene-Tetrafluoroethylene Copolymer and Its Blends

The long-chain branched ethylene-tetrafluoroethylene copolymer (B-ETFE) was synthesized by radical polymerization using ethylene, tetrafluoroethylene, termonomer, and a very small amount of divinyl monomer. We studied melt rheology under shear and elongational flow, and foamability for B-ETFE, comparing with conventional linear ETFE. Addition of a small amount of the divinyl monomer had a considerable impact on the melt rheology of ETFE and its blends. The observed non-linear elongational behavior and emergence of long relaxation time components can be explained by long-chain branching in the modified ETFE. B-ETFE and its blends showed excellent foaming processability: uniform and smaller cell sizes and much higher cell number densities than those of linear ETFE. To the best of our knowledge, this is the first report of the enhancement of the melt rheology of ETFE from the viewpoint of modification of its molecular architecture.

Minimally invasive percutaneous transluminal renal artery stenting

BACKGROUND

Minimally invasive percutaneous transluminal renal artery stenting (MIPTRS) is a method that prevents complications to the greatest extent possible. The present study aimed to investigate the safety and efficacy of MIPTRS performed in cases of renal artery stenosis with an estimated glomerular filtration rate (eGFR)≤45mL/min.

METHODS

Cases of patients who underwent MIPTRS at our hospital between December 2010 and June 2015 in whom eGFR was ≤45mL/min were retrospectively analysed. MIPTRS was performed as follows: 1) using a 4Fr sheathless guiding catheter in a trans-radial approach and 2) using a guiding catheter non-touch technique. The amount of contrast agent used was maintained at ≤10mL with 3) carbon dioxide enhancement and 4) intravascular ultrasound guide stenting, and 5) a distal protection device was used.

RESULTS

MIPTRS was performed in 22 patients (32 lesions). The pre-MIPTRS creatinine level and eGFR were 2.01±0.88mg/dL and 29.2±9.0mL/min/1.73m², respectively. On postoperative day 2, they were 1.78±0.73mg/dL and 35.1±12.3mL/min/1.73m²; at 1month after the procedure, they were 1.80±0.74mg/dL and 33.3±12.3mL/min/1.73m². Creatinine level did not change significantly, but eGFR was significantly elevated after versus before the procedure, both 2days later (p<0.01) and 1month later (p<0.05).

CONCLUSION

The results of this study demonstrated the usefulness of MIPTRS for protecting renal function. This method can be safely used in patients with decreased renal function.

Morphological assessment of chronic total occlusions by combined coronary computed tomographic angiography and intravascular ultrasound imaging

Aims

The relationship between CTO morphology and vessel remodelling is unclear. We described chronic total occlusion (CTO) morphology using coronary computed tomographic angiography (CCTA) combined with intravascular ultrasound (IVUS).

Methods and results

Pre-intervention CCTA and IVUS of 130 CTO lesions (128 patients) were evaluated. Based on CCTA, positive CTO lesion remodelling [PR, maximum CTO segment vessel diameter > proximal reference vessel diameter (RVD)] was seen in 44 (33.8%) lesions. In the other 86 lesions without PR, 74 (56.9%) had a minimum CTO segment vessel diameter >50% of the proximal RVD and were classified as non-PR; 12 (9.2%) lesions had a minimum CTO segment vessel diameter ≤50% of the proximal RVD and were classified as collapse. Comparing the three groups, CTO with PR had the greatest maximum atheroma cross-sectional area (CSA) while the collapse group had the least atheroma CSA (16.0 mm2 [12.0, 19.4] vs. 9.1 mm2 [6.0, 15.9], P < 0.001). The maximum arc of attenuated plaque was greatest in the PR group (51° [0, 167]); and the maximum arc of calcium was greatest in the non-PR group (91° [51, 174]). In the collapse group distal to the occluded segment, there was a normal-appearing vessel by IVUS that corresponded to the collapsed segment by CCTA; its minimum plaque burden was 33.2% [19.9, 38.1] with a smooth concave-shaped lumen surface, implying that the CCTA collapse segment was not occluded.

Conclusion

Not all CTOs are the same with regard to lesion remodelling and underlying morphology. The combination of IVUS and CCTA can help to categorize CTO morphology.

Cytomegalic Inclusion Disease caused by Cytomegalovirus Infection in the Salivary Glands of an African Hedgehog (Atelerix arbiventris)

Cytomegalic inclusion disease (CID) in the salivary gland of African hedgehogs (Atelerix arbiventris) has been reported before, and is suspected to reflect a cytomegalovirus infection. However, a recent ultrastructural study reported that African hedgehog CID reflected oncocytic metaplasia, mimicking a cytomegalovirus infection. We examined the submandibular and sublingual salivary glands of a 1-year-old male African hedgehog. Histologically, there were multiple foci composed of cytomegalic cells with intranuclear inclusion bodies. Ultrastructurally, viral particles (109-118 nm in diameter) were observed in the nuclei of the cytomegalic cells. There were numerous vesicles containing various numbers of enveloped viruses in the cytoplasm. We also attempted to detect viral DNA fragments by degenerate polymerase chain reaction and obtained amplicons of a predicted size. Phylogenetic analysis indicated that the virus is a betaherpesvirus, comparatively related to human and rodent cytomegaloviruses. The present study suggested that African hedgehog CIDs also include those caused by the cytomegalovirus.

Olympic torch flap: one-stop option for simultaneous brow, upper and lower lid reconstruction in post burn patients

Facial units reconstruction in a post burn patient poses tough challenges. Simultaneous brow and lid reconstruction is one of them. This article presents a 45-year-old epileptic male with burn of complete face. The task of reconstructing the brow, upper and lower lids was successfully accomplished using a modification of the Guyuron postauricular fasciocutaneous flap, after initial grafting and radial forearm flap reconstruction of forehead and other parts of the face. The article gives a single-stop solution for simultaneous reconstruction of brow and lids using a random pattern extension of the traditional postauricular flap, thus proving the excellent vascularity and hence durability of the flap in spite of a 180 degrees change in the orientation of the flap with respect to the axis.

Angioscopic and optical coherence tomographic evaluation of neointimal coverage: 9 months after expandable polyterafluoroethylene covered stent implantation

An expandable polytetrafluoroethylene (ePTFE) covered stent is generally employed to seal coronary artery perforation. The frequency of ePTFE covered stent use is relatively low; thus, only a handful of studies have reported neointimal coverage and endothelialization inside the deployed ePTFE and clinical time course after ePTFE implantation. This case report presents a 78-year-old man treated with an ePTFE covered stent when he suffered from coronary artery perforation after the implantation of two everolimus eluting stents in the left anterior descending artery. Follow-up coronary angiography 9 months after ePTFE covered stent implantation depicted favorable stent patency. Optical coherence tomography showed thin and uneven stent strut coverage at the culprit. Angioscopy also depicted partial white-coated coverage and stent strut exposure. The outcome of this case suggested that long-term dual antiplatelet therapy should be prescribed for preventing thrombosis after ePTFE covered stent implantation.

A lognormal distribution of the lengths of terminal twigs on self-similar branches of elm trees

Lognormal distributions and self-similarity are characteristics associated with a wide range of biological systems. The sequential breakage model has established a link between lognormal distributions and self-similarity and has been used to explain species abundance distributions. To date, however, there has been no similar evidence in studies of multicellular organismal forms. We tested the hypotheses that the distribution of the lengths of terminal stems of Japanese elm trees (Ulmus davidiana), the end products of a self-similar branching process, approaches a lognormal distribution. We measured the length of the stem segments of three elm branches and obtained the following results: (i) each occurrence of branching caused variations or errors in the lengths of the child stems relative to their parent stems; (ii) the branches showed statistical self-similarity; the observed error distributions were similar at all scales within each branch and (iii) the multiplicative effect of these errors generated variations of the lengths of terminal twigs that were well approximated by a lognormal distribution, although some statistically significant deviations from strict lognormality were observed for one branch. Our results provide the first empirical evidence that statistical self-similarity of an organismal form generates a lognormal distribution of organ sizes.

The Relation between Hamstring Strain Injury and Physical Characteristics of Japanese Collegiate Sepak Takraw Players

The aim of this study was to investigate the injuries in Japanese collegiate sepak takraw players. We primarily focused on hamstring strain injury (HSI), and investigated the associated physical characteristics. The study included 77 Japanese collegiate sepak takraw players who were interviewed; data were collected regarding injuries sustained by them during the game within the past year. The hip range of motion (ROM) was measured. The total number of injuries was 48 in a year. The rate of HSI was the highest (31.3%) among all the injuries. All HSIs occurred in the dominant leg because of the sunback spike. Using the Mann-Whitney U test, significant differences in age and sport-related experience were observed between the injured group and uninjured group. Upon using logistic regression analysis, the presence of a HSI was found to be associated with the sport-related experience (adjusted odds ratio [OR], 0.30; 95% confidence interval [CI], 0.12-0.77) and the hip extension ROM (adjusted OR, 0.81; 95% CI, 0.66-0.99) after adjusting for sex, sport-related experience, and the hip ROM. HSI is the most common injury in Japanese collegiate sepak takraw players. Short sport-related experience and small hip extension ROM are related with the occurrence of HSI.

Atomic step-and-terrace surface of polyimide sheet for advanced polymer substrate engineering

Typical thermostable and flexible polyimide polymers exhibit many excellent properties such as strong mechanical and chemical resistance. However, in contrast to single-crystal substrates like silicon or sapphire, polymers mostly display disordered and rough surfaces, which may result in instability and degradation of the interfaces between thin films and polymer substrates. As a step toward the development of next-generation polymer substrates, we here report single-atom-layer imprinting onto the polyimide sheets, resulting in an ultrasmooth 0.3 nm high atomic step-and-terrace surface on the polyimides. The ultrasmooth polymer substrates are expected to be applied to the fabrication of nanostructures such as superlattices, nanowires, or quantum dots in nanoscale-controlled electronic devices. We fabricate smooth and atomically stepped indium tin oxide transparent conducting oxide thin films on the imprinted polyimide sheets for future use in organic-based optoelectronic devices processed with nanoscale precision. Furthermore, toward 2D polymer substrate nanoengineering, we demonstrate nanoscale letter writing on the atomic step-and-terrace polyimide surface via atomic force microscopy probe scratching.

'Transfer out' tuberculosis patients: treatment outcomes after cross-checking registers, 2012-2013, Lusaka, Zambia

SETTING

Lusaka, Zambia.

OBJECTIVE

To assess the actual treatment outcomes of 'transfer out' (TO) cases at a diagnostic centre in Lusaka, in the third and fourth quarters of 2012, and to see the impact of this cross-check in treatment success rates (TSR) in 2013 and early 2014.

DESIGN AND METHOD

In this retrospective cohort study, treatment outcomes for new bacteriologically positive tuberculosis (TB) cases referred from the diagnostic centre were reviewed and compared with those at the receiving treatment units.

RESULTS

Of 49 (58%) cases referred to three treatment units, the treatment outcomes of nine had to be updated at the diagnostic centre, which reduced the proportion of TO cases from 17.6% to 11.8% and increased the TSR to 70.6% from 64.7%.

CONCLUSION

The review and cross-checking of the TB registers at the diagnostic and treatment units led to a significant reduction in non-assessed cases, suggesting that the TB registers in the diagnostic and treatment units should be cross-checked regularly. There is also need for a complementary intervention to reduce the proportion of TOs associated with high loss to follow-up and non-evaluated TO rates.

Aortic annulus displacement assessed by contrast left ventriculography during invasive coronary angiography as a predictor of adverse events

BACKGROUND

We propose the use of aortic annulus displacement (AAD) detected on contrast left ventriculography (LVG) during invasive coronary angiography as a marker of left ventricular (LV) long-axis shortening. In the present study, we aimed to investigate whether AAD is associated with adverse events in patients who underwent coronary angiography because of suspected coronary artery disease.

METHODS

In this retrospective study, we evaluated the medical records of 998 consecutive patients who underwent invasive coronary angiography and LVG. LV lengths were measured from the apex to the aortic valve insertion by using LVG images. AAD (%) was calculated as [(LV end-diastolic length-LV end-systolic length)/LV end-diastolic length]×100.

RESULTS

The participants' median age was 67 years. Ninety-six adverse events (composite events; all-cause death, 39; congestive heart failure, 21; late revascularization, 34; and myocardial infarction, 2) were observed during a median follow-up period of 3.1 years. In multivariate Cox regression analysis, adverse events were associated with lower AAD (hazard ratio, 0.703; p=0.002), after adjusting for traditional risk factors and coronary artery stenosis. The area under the curve of AAD for predicting adverse events was greater than that of LV ejection fraction (0.656 vs. 0.541, p<0.05).

CONCLUSIONS

AAD was superior to LV ejection fraction as a predictor of adverse events in patients with and without coronary arterial stenosis. AAD may be the optimal method for assessing longitudinal LV systolic function in the catheter laboratory.