Alternating wide complex tachycardia after surgical aortic valve replacement

A 51-year-old male developed recurrent episodes of palpitations and pre-syncope after surgical aortic valve replacement. Electrocardiograms after surgery revealed a wide complex tachycardia with alternating left bundle branch and right bundle branch block morphologies. An electrophysiology study (EPS) demonstrated typical bundle branch reentry ventricular tachycardia (BBRVT) treated successfully with right bundle ablation. We demonstrate the key diagnostic features of BBRVT on EPS, describe the circuit of BBRVT with explanation of the HV pseudointerval, and highlight the association of BBRVT and valve replacement.     

Refractory heart failure with LBBB - Pause before CRT

In this report, we describe complete disappearance of LBBB with normalization of LV function in two patients with cardiac sarcoidosis (CS) after immunosuppressive therapy. Both of these patients were ideal Class IA candidates for CRT (Complete LBBB, QRS ≥ 150 ms, EF < 30%). If CS is identified early, immunosuppressive treatment can lead to not only improvement of left ventricular function but also disappearance of the left bundle branch block. Timely diagnosis and management of CS obviated the need of CRT in these patients. It may be reasonable to evaluate all non-ischemic cardiomyopathies for underlying reversible causes prior to CRT implantation.     

Still entangled: Assembly of the central spindle by multiple microtubule modulators

The central spindle is a microtubule-based structure that assembles during anaphase of mitosis in animal cells and is essential for multiple steps of cytokinesis. Central spindle assembly occurs by the cooperative action of multiple microtubule motors and modulators. Here, we review the mechanism by which the central spindle is formed, the role of several key proteins in this process and how central spindle assembly is temporally and spatially coordinated with mitosis.     

The efficiency of C4 photosynthesis under low light conditions in Zea mays,Miscanthus x giganteus and Flaveria bidentis

The efficiency of C₄ photosynthesis in Zea mays, Miscanthus x giganteus and Flaveria bidentis in response to light was determined using measurements of gas exchange, ¹³CO₂ photosynthetic discrimination, metabolite pools and spectroscopic assays, with models of C₄ photosynthesis and leaf ¹³CO₂ discrimination. Spectroscopic and metabolite assays suggested constant energy partitioning between the C₄ and C₃ cycles across photosynthetically active radiation (PAR). Leakiness (φ), modelled using C₄ light‐limited photosynthesis equations (φ_mod), matched values from the isotope method without simplifications (φ_is) and increased slightly from high to low PAR in all species. However, simplifications of bundle‐sheath [CO₂] and respiratory fractionation lead to large overestimations of φ at low PAR with the isotope method. These species used different strategies to maintain similar φ. For example, Z. mays had large rates of the C₄ cycle and low bundle‐sheath cells CO₂ conductance (g_bs). While F. bidentis had larger g_bs but lower respiration rates and M. giganteus had less C₄ cycle capacity but low g_bs, which resulted in similar φ. This demonstrates that low g_bs is important for efficient C₄ photosynthesis but it is not the only factor determining φ. Additionally, these C₄ species are able to optimize photosynthesis and minimize φ over a range of PARs, including low light.     

Updated Review of Nuclear Molecular Imaging of Thyroid Cancers

ObjectivesWe initiate this comprehensive review to update the advances in this field by objectively elucidating the efficacies of promising radiopharmaceuticals.MethodsWe performed a comprehensive PUBMED search using the combined terms of “thyroid cancer” and “radiopharmaceuticals” or “nuclear medicine”, yielding 3273 and 11026 articles prior to December 31, 2020, respectively.ResultsBased on the mechanism of molecular metabolism, the evaluation of differentiated thyroid cancer and dedifferentiated thyroid cancer is largely centered around radioiodine and fluorine 18 (¹⁸F)-fludeoxyglucose, respectively. Further, ¹⁸F-L-dihydroxyphenylalanine and gallium 68 DOTATATE are the preferred tracers for medullary thyroid cancer. In dedifferentiated medullary thyroid cancer and anaplastic thyroid cancer, ¹⁸F-fludeoxyglucose is superior.ConclusionsThe future lies in advances in molecular biology, novel radiopharmaceuticals and imaging devices, paving ways to the development of personalized medication for thyroid cancer patients.     

Variation in urine concentrating ability and water balance of the Black-tailed Tree Rat Thallomys nigricauda, along an aridity gradient

Mechanisms behind variation in physiological traits may assist in explaining how certain traits have evolved. The ability of mammals to concentrate urine has been seen as an adaptation to xeric environments. Urine osmolality and relative medullary thickness (RMT) are two indices which indicate urine concentrating powers. In addition, mammals living in xeric regions have lower water turnover rates (WTR) than their mesic counterparts. The RMT, urine concentrating ability (UCA) and WTR of the Black-tailed Tree Rat, Thallomys nigricauda, were investigated at three study sites along an aridity gradient. We investigated the extent to which these traits are influenced by evolutionary adaptation and/or phenotypic flexibility. There was no significant difference in RMT between sites and no difference in osmolalities when site and season were taken into account. In addition, there was no significant effect of site and season on WTR. This suggests that these traits might have a genetic basis, and reflect an evolutionary adaptation. Lack of differences in the renal traits in T. nigricauda across their range may be interpreted as lack of phenotypic flexibility. However, as a consequence of the degree of individual variation in the parameters measured there appears to be phenotypic flexibility with individuals responding to their specific conditions. This has positive implications for the survival of the species in the light of climate change.     

Lipid biosynthesis by intact mesophyll and bundle sheath chloroplasts from maize

The two dimorphic forms of chloroplast isolated from maize leaves utilized acetate for fatty acid biosynthesis and had similar requirements for cofactors. The oleate:palmitate ratio of the fatty acid products was lower for bundle sheath chloroplasts as was acetate incorporation into total fatty acids. Galactose from UDP-galactose was incorporated into galactolipids by both morphological forms to give monogalactosyl diacylglycerol and digalactosyl diacylglycerol in the ratio of 4:1.     

Leaf structure in relation to solute transport and phloem loading in Zea mays L.

Small and intermediate (longitudinal) vascular bundles of the Zea mays leaf are surrounded by chlorenchymatous bundle sheaths and consist of one or two vessels, variable numbers of vascular parenchyma cells, and two or more sieve tubes some of which are associated with companion cells. Sieve tubes not associated with companion cells have relatively thick walls and commonly are in direct contact with the vessels. The thick-walled sieve tubes have abundant cytoplasmic connections with contiguous vascular parenchyma cells; in contrast, connections between vascular parenchyma cells and thin-walled sieve tubes are rare. Connections are abundant, however, between the thin-walled sieve tubes and their companion cells; the latter have few connections with the vascular parenchyma cells. Plasmolytic studies on leaves of plants taken directly from lighted growth chambers gave osmotic potential values of about-18 bars for the companion cells and thin-walled sieve tubes (the companion cell-sieve tube complexes) and about-11 bars for the vascular parenchyma cells. Judging from the distribution of connections between various cell types of the vascular bundles and from the osmotic potential values of those cell types, it appears that sugar is actively accumulated from the apoplast by the companion cell-sieve tube complex, probably across the plasmalemma of the companion cell. The thick-walled sieve tubes, with their close spatial association with the vessels and possession of plasmalemma tubules, may play a role in retrieval of solutes entering the leaf apoplast in the transpiration stream. The transverse veins have chlorenchymatous bundle sheaths and commonly contain a single vessel and sieve tube. Parenchymatic elements may or may not be present. Like the thick-walled sieve tubes of the longitudinal bundles, the sieve tubes of the transverse veins have plasmalemma tubules, indicating that they too may play a role in retrieval of solutes entering the leaf apoplast in the transpiration stream.     

Macroscopic and microscopic analyses in flexor tendons of the tarsometatarso‐phalangeal joint of ostrich (Struthio camelus) foot with energy storage and shock absorption

Flexor tendons function as energy storage and shock absorption structures in the tarsometatarso‐phalangeal joint (TMTPJ) of ostrich feet during high‐speed and heavy‐load locomotion. In this study, mechanisms underlying the energy storage and shock absorption of three flexor tendons of the third toe were studied using histology and scanning electron microscopy (SEM). Macroscopic and microscopic structures of the flexor tendons in different positions of TMTPJ were analyzed. Histological slices showed collagen fiber bundles of all flexor tendons in the middle TMTPJ were arranged in a linear‐type, but in the proximal and distal TMTPJ, a wavy‐type arrangement was found in the tendon of the M. flexor digitorum longus and tendon of the M. flexor perforans et perforatus digiti III, while no regular‐type was found in the tendon of the M. flexor perforatus digiti III. SEM showed that the collagen fiber bundles of flexor tendons were arranged in a hierarchically staggered way (horizontally linear‐type and vertically linear‐type). Linear‐type and wavy‐type both existed in the proximal TMTPJ for the collagen fiber bundles of the tendon of the M. flexor perforatus digiti III, but only the linear‐type was found in the distal TMTPJ. A number of fibrils were distributed among the collagen fiber bundles, which were likely effective in connection, force transmission and other functions. The morphology and arrangement of collagen fiber bundles were closely related to the tendon functions. We present interpretations of the biological functions in different positions and types of the tendons in the TMTPJ of the ostrich feet.     

Disruption of the autism-related gene Pak1 causes stereocilia disorganization,hair cell loss,and deafness in mice

Several clinical studies have reported that hearing loss is correlated with autism in children. However, little is known about the underlying mechanism between hearing loss and autism. p21-activated kinases(PAKs)are a family of serine/threonine kinases that can be activated by multiple signaling molecules, particularly the Rho family of small GTPases. Previous studies have shown that Pak1 mutations are associated with autism. In the present study, we take advantage of Pak1 knockout(Pak1à/à) mice to investigate the role of PAK1 in hearing function. We find that PAK1 is highly expressed in the postnatal mouse cochlea and that PAK1 deficiency leads to hair cell(HC) apoptosis and severe hearing loss. Further investigation indicates that PAK1 deficiency downregulates the phosphorylation of cofilin and ezrin-radixin-moesin and the expression of b II-spectrin, which further decreases the HC synapse density in the basal turn of cochlea and disorganized the HC stereocilia in all three turns of cochlea in Pak1à/àmice. Overall, our work demonstrates that the autism-related gene Pak1 plays a crucial role in hearing function. As the first candidate gene linking autism and hearing loss, Pak1 may serve as a potential target for the clinical diagnosis of autism-related hearing loss.