Seven strains of marine aerobic anoxygenic phototrophs belonging to the genus Erythrobacter were isolated. The strains were characterized regarding their physiological and biochemical properties, 16S rDNA and pufM gene sequences, morphological features, substrate preference, as well as pigment and lipid composition. All strains had functional type-2 reaction centers containing bacteriochlorophyll, served by small, light-harvesting complex 1, and were photosynthetically competent. In addition, large pools of carotenoids were found, but only some of the accessory pigments transfer energy to the reaction centers. All of the isolates were facultative photoheterotrophs. They required an organic carbon substrate for growth; however, they are able to supplement a significant fraction of their metabolic requirements with photosynthetically derived energy.
Nutcracker syndrome (NCS) is an extrinsic compression of the left renal vein (LRV) by the superior mesenteric artery (SMA) anteriorly and aorta posteriorly resulting in renal vascular congestion manifesting as hematuria, proteinuria, orthostatic hypotension, pain, or even renal dysfunction. Longstanding venous compression can encourage collateral drainage pathways through gonadal and pelvic veins, which may explain reported symptom and syndrome overlap with pelvic congestion syndrome. Diagnosis can be challenging and variable, frequently involving a combination of ultrasound Doppler, cross-sectional, and invasive imaging. Often, intravascular pressure measurements are required to prove a renocaval pressure gradient to aid in a definitive diagnosis. Conservative management is appropriate, especially in children, who tend to outgrow the disorder. In the interim, medical management with angiotensin converting enzyme inhibitors (ACEIs) is a useful therapy to manage orthostatic hypotension in the pediatric population.In adults, invasive therapies are more frequently pursued. These are aimed at relieving the extrinsic compression on the LRV. The standard of care is renal vein transposition, with renal autotransplantation reserved for recalcitrant cases. Endovascular stenting is a less invasive option. Laparoscopic placement of an exovascular stent is a newer therapy intended to minimize trauma to the LRV. In this review, we will discuss the clinical manifestations, diagnostic criterion, imaging features, and conservative and surgical therapies for this condition.
Popliteal artery entrapment syndrome (PAES) is a rare vascular disorder defined as compression of the popliteal artery by aberrant myotendinous structures in the popliteal fossa. PAES was first identified by Stuart, a medical student in 1879, who noted an anomalous course of the popliteal artery medial to the medial gastrocnemius muscle in an amputated leg (1). PAES often presents as exertional claudication in a young, otherwise healthy individual. These atypical symptoms should raise suspicion and prompt diagnostic workup. While uncommon, early diagnosis of PAES is crucial to prevent chronic vascular injury resulting in arterial stenosis, thrombosis, and possible amputation (2).
Anatomy and pathophysiologySymptoms of PAES arise from the compression of the neurovascular bundle within the popliteal fossa by the surrounding musculotendinous structures. Popliteal vein and/or tibial nerve compression may exist alone or in combination with arterial pathology (3). The syndrome exists in six forms, divided into two categories: anatomic/ congenital and functional. Anatomic PAES results from abnormal embryological development of the popliteal artery, gastrocnemius muscle, or other myofascial structures
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