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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

No Effect of Selective Maturation on Fruit Traits for a Bird-Dispersed Species, Sambucus racemosa.

Selective abortion, also called selective maturation, is a phenomenon wherein maternal plants selectively mature ovules that have the potential to grow into higher-quality fruits, such as those that contain more seeds. We hypothesized that the effects of selective maturation on fruit traits could be influenced by the dispersal mechanism. However, to date, limited studies have been conducted on selective maturation in bird-dispersed fruits. Unlike self- or wind-dispersed species, bird-dispersed species would not selectively mature fruits that contain more seeds because they are not preferred by birds. Here, we investigated the effect of selective abortion on the fruit traits of a bird-dispersed species, elderberry (Sambucus racemosa L. subsp. kamtschatica). We performed a flower-removal experiment. Half of the inflorescences on each individual tree were removed for the treatment group, whereas the control group was not manipulated. We found that the flower-removed trees showed higher fruit sets, suggesting the existence of resource limitation. The number of seeds per fruit did not increase by the experimental treatment. Additionally, the control individuals did not produce larger fruits. The lack of effects on fruit traits supported our hypothesis that the effect of selective maturation on fruit traits may differ among species with different dispersal mechanisms.

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.

Effect of orbital atherectomy in calcified coronary artery lesions as assessed by optical coherence tomography.

OBJECTIVES: We sought to assess plaque modification and stent expansion following orbital atherectomy (OA) for calcified lesions using optical coherence tomography (OCT). BACKGROUND: The efficacy of OA for treating calcified lesions is not well studied, especially using intravascular imaging in vivo. METHODS: OCT was performed preprocedure, post-OA, and post-stent (n = 58). Calcium modification after OA was defined as a round, concave, polished calcium surface. Calcium fracture was complete discontinuity of calcium. RESULTS: Comparing pre- vs post-OA OCT (n = 29), calcium area was significantly decreased post-OA (from 3.4 mm2 [2.4-4.7] to 2.9 mm2 [1.9-3.9], P < 0.001). Poststent percent calcium fracture (calcium fracture length/calcium length) correlated with post-OA percent calcium modification (calcium modification length/calcium length) (r = 0.31, P = 0.01). Among 75 calcium fractures in 35 lesions, maximum calcium thickness at the fracture site was greater with vs without calcium modification (0.58 mm [0.50-0.66] vs 0.45 mm [0.38-0.52], P = 0.003). Final optimal stent expansion, defined as minimum stent area ≥6.1 mm2 or stent expansion ≥90% (medians of this cohort) at the maximum calcium angle site, was observed in 41 lesions. Larger post-OA lumen area (odds ratio 2.64; 95% CI 1.21-5.76; P = 0.02) and the presence of calcium fracture (odds ratio 6.77; 95% CI 1.25-36.6; P = 0.03) were independent predictors for optimal stent expansion. CONCLUSIONS: Calcium modification by OA facilitates poststent calcium fracture even in thick calcium. Greater calcium modification correlated with greater calcium fracture, in turn resulting in better stent expansion.

A prospective, single-center, randomized study to assess whether automated coregistration of optical coherence tomography with angiography can reduce geographic miss.

OBJECTIVE: We sought to evaluate whether automated coregistration of optical coherence tomography (OCT) with angiography reduces geographic miss (GM) during coronary stenting. BACKGROUND: Previous intravascular ultrasound or OCT studies have showed that residual disease at the stent edge or stent edge dissection was associated with stent thrombosis or edge restenosis. This has been termed GM. METHODS: Two hundred de novo coronary lesions were randomized in a 1:1 ratio to OCT-guided percutaneous coronary intervention (PCI) with versus without automated coregistration of OCT with angiography. GM, the primary endpoint, was defined as angiographic ≥type B dissection or diameter stenosis >50% or OCT minimum lumen area <4.0 mm2 with significant residual disease or dissection (dissection flap >60°) within 5 mm from the stent edge. RESULTS: The prevalence of GM was not different comparing OCT-guided PCI with versus without automated coregistration (27.6% vs 34.0%, P = 0.33). However, there was a trend toward a reduced prevalence of significant distal stent edge dissection in lesions with automated coregistration (11.1% vs 20.8%, P = 0.07). The discrepancy in the distance between planned versus actual implanted stent location with automated coregistration was significantly shorter than without coregistration (1.9 ± 1.6 mm vs 2.6 ± 2.7 mm, P = 0.03), especially the prevalence of ≥5 mm discrepancy that was less frequent with automated coregistration. CONCLUSIONS: Automated coregistration of OCT with angiography did not reduce the primary endpoint of GM after stent implantation.

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.