Bundle Branch Reentrant Ventricular Tachycardia

Bundle branch reentrant (BBR) tachycardia is an uncommon form of ventricular tachycardia (VT) incorporating both bundle branches into the reentry circuit. The arrhythmia is usually seen in patients with an acquired heart disease and significant conduction system impairment, although patients with structurally normal heart have been described. Surface ECG in sinus rhythm (SR) characteristically shows intraventricular conduction defects. Patients typically present with presyncope, syncope or sudden death because of VT with fast rates frequently above 200 beats per minute. The QRS morphology during VT is a typical bundle branch block pattern, usually left bundle branch block, and may be identical to that in SR. Prolonged His-ventricular (H-V) interval in SR is found in the majority of patients with BBR VT, although some patients may have the H-V interval within normal limits. The diagnosis of BBR VT is based on electrophysiological findings and pacing maneuvers that prove participation of the His- Purkinje system in the tachycardia mechanism. Radiofrequency catheter ablation of a bundle branch can cure BBR VT and is currently regarded as the first line therapy. The technique of choice is ablation of the right bundle. The reported incidence of clinically significant conduction system impairment requiring implantation of a permanent pacemaker varies from 0% to 30%. Long-term outcome depends on the underlying cardiac disease. Patients with poor systolic left ventricular function are at risk of sudden death or death from progressive heart failure despite successful BBR VT ablation and should be considered for an implantable cardiovertor-defibrillator

Correlates of testosterone change as men age

Objective: The literature on testosterone (T) in men reports diverse correlates of T, some with minimal empirical support and most with little indication of how they change with advancing age. We test eight putative correlations across age.Method: Correlations were tested on a large sample of British men.Results: Seven of eight correlations replicated. Most change across men's life courses. The diurnal cycle of T is considerably weaker among older than younger men. Single men have higher T than married men of the same age; however, this difference lessens as men get older. Elevated T among smokers is less pronounced as men age. The inverse relationship between obesity and T is sustained across the adult age range. The lessening of T with age is well established, however there is disagreement about the course of decline. We find T having a steep decline around age 30, with possibly a rebound around age 50, after which levels remain roughly constant. Correlations involving health become stronger among older men. After age 30 or 40, the inverse relationships between T and HbA1c, diabetes, and metabolic syndrome all become increasingly significant, though not necessarily strong in magnitude.Conclusion: Most putative correlates of T are replicated. There is a basis here for the generalization that among older men, those healthy have higher T than those who are not, but not a lot higher

Intrinsic regulation of FIC-domain AMP-transferases by oligomerization and automodification

Filamentation induced by cyclic AMP (FIC)-domain enzymes catalyze adenylylation or other posttranslational modifications of target proteins to control their function. Recently, we have shown that Fic enzymes are autoinhibited by an α-helix (αinh) that partly obstructs the active site. For the single-domain class III Fic proteins, the αinh is located at the C terminus and its deletion relieves autoinhibition. However, it has remained unclear how activation occurs naturally. Here, we show by structural, biophysical, and enzymatic analyses combined with in vivo data that the class III Fic protein NmFic from Neisseria meningitidis gets autoadenylylated in cis, thereby autonomously relieving autoinhibition and thus allowing subsequent adenylylation of its target, the DNA gyrase subunit GyrB. Furthermore, we show that NmFic activation is antagonized by tetramerization. The combination of autoadenylylation and tetramerization results in nonmonotonic concentration dependence of NmFic activity and a pronounced lag phase in the progress of target adenylylation. Bioinformatic analyses indicate that this elaborate dual-control mechanism is conserved throughout class III Fic proteins

Timing of life-threatening arrhythmias detected by implantable cardioverter-defibrillators in relation to changes in cosmophysical factors

Background: Studies have linked the natural history of many pathologies with environmental physical activity. This study investigated the relationship between the occurrence of ventricular tachycardia/fibrillation (VT/VF) recorded by implantable cardioverter defibrillators (ICD) and geomagnetic and cosmic ray (neutron) activity. Methods: The study group included 85 patients (73 men) with cardiomyopathy (80% ischemic) who underwent ICD placement in the years 1995&#8211;2006; 74% had a left ventricular ejection fraction of < 30%. Data on the days on which VT/VF occurred (total number of days: 284) and the days on which the patients were treated (total number of treatments: 580) were collected from the ICD records. The findings were analyzed against levels of geomagnetic activity (GMA) (Io&#8211;IVo) and cosmic ray activity (CRA), derived from international observatories, on the same days and throughout the study period. Results: On days of VT/VF, daily values of GMA level averaged 1.5 &#177; 0.7, consistent with level Io (quiet). The ratios of daily VT/VF episodes and treatment to GMA level for the whole study period were as follows: 1.2 level I; 0.9 level II; 0.69 level III; 0.78 level IV (r = &#8211;0.974; p = 0.02). Mean CRA on days of VT/VF was 9246.8 &#177; 299.0 imp/min, and for all 4383 days studied, 8805.33 &#177; 411.4 imp/min (p < 0.0001). Conclusions: In patients with predominantly ischemic cardiomyopathy and severe left ventricular dysfunction, VT/VF occurs more often on days of low GMA and high CRA. Further studies are needed to determine the underlying mechanism of the effect of neutron activity on cardiac electrical instability

Langevin Equation for the Rayleigh model with finite-ranged interactions

Both linear and nonlinear Langevin equations are derived directly from the Liouville equation for an exactly solvable model consisting of a Brownian particle of mass $M$ interacting with ideal gas molecules of mass $m$ via a quadratic repulsive potential. Explicit microscopic expressions for all kinetic coefficients appearing in these equations are presented. It is shown that the range of applicability of the Langevin equation, as well as statistical properties of random force, may depend not only on the mass ratio $m/M$ but also by the parameter $Nm/M$, involving the average number $N$ of molecules in the interaction zone around the particle. For the case of a short-ranged potential, when $N\ll 1$, analysis of the Langevin equations yields previously obtained results for a hard-wall potential in which only binary collisions are considered. For the finite-ranged potential, when multiple collisions are important ($N\gg 1$), the model describes nontrivial dynamics on time scales that are on the order of the collision time, a regime that is usually beyond the scope of more phenomenological models.Comment: 21 pages, 1 figure. To appear in Phys. Rev.

Swimmer-tracer scattering at low Reynolds number

Understanding the stochastic dynamics of tracer particles in active fluids is important for identifying the physical properties of flow generating objects such as colloids, bacteria or algae. Here, we study both analytically and numerically the scattering of a tracer particle in different types of time-dependent, hydrodynamic flow fields. Specifically, we compare the tracer motion induced by an externally driven colloid with the one generated by various self-motile, multi-sphere swimmers. Our results suggest that force-free swimmers generically induce loop-shaped tracer trajectories. The specific topological structure of these loops is determined by the hydrodynamic properties of the microswimmer. Quantitative estimates for typical experimental conditions imply that the loops survive on average even if Brownian motion effects are taken into account.Comment: 14 pages, to appear in Soft Matte

Anionic fluorophore-assisted fabrication of gold microstructures inside a hydrogel by multi-photon photoreduction

The fabrication of accentuated gold microstructures is demonstrated by multi-photon photoreduction inside an anionic fluorophore-containing hydrogel. We attempted to facilitate gold-ion photoreduction near the focal point of laser pulses, expecting the donation of electrons by the oxidation of fluorophores in the vicinity of gold ions. The presence of anionic FITCdextran also inhibited the spontaneous reduction in untargeted zones, which is attributed to the coordination of gold ions and the anionic FITC-dextran. Simultaneous facilitation and inhibition are promising for the fabrication of dense metal microstructures in the targeted zone while maintaining the hydrogel's light permeability. © 2020 Optical Society of America. All Rights Reserved