Construction of Tertiary Chiral Centers by Pd-catalyzed Asymmetric Allylic Alkylation of Prochiral Enolate Equivalents

The palladium-catalyzed decarboxylative allylic alkylation of enol carbonates derived from lactams and ketones is described. Employing these substrates with an electronically tuned Pd catalyst system trisubstituted chiral centers are produced. These stereocenters have been previously challenging to achieve using Pd complex/chiral P-N ligand systems.

Pentacoordinated carboxylate π-allyl nickel complexes as key intermediates for the Ni-catalyzed direct amination of allylic alcohols

Direct amination of allylic alcohols with primary and secondary amines catalyzed by a system made of [Ni(1,5-cyclooctadiene)2 ] and 1,1'-bis(diphenylphosphino)ferrocene was effectively enhanced by adding nBu4 NOAc and molecular sieves, affording the corresponding allyl amines in high yield with high monoallylation selectivity for primary amines and high regioselectivity for monosubstituted allylic alcohols. Such remarkable additive effects of nBu4 NOAc were elucidated by isolating and characterizing some nickel complexes, manifesting the key role of a charge neutral pentacoordinated η(3) -allyl acetate complex in the present system, in contrast to usual cationic tetracoordinated complexes earlier reported in allylic substitution reactions.

Impact of phrenic nerve paralysis on the surgical outcome of intercostal nerve transfer

Brachial plexus injuries (BPI) can be complicated by diaphragmatic paralysis (DP). This study determined the influence of DP on biceps brachii (BB) recovery after intercostal nerve transfer (ICNT) for BPI and investigated the respiratory complications of ICNT. The study included 100 patients, 84 showing no DP in preoperative and early postoperative chest radiographic images (non-DP group) and 16 with DP that persisted for over one year after surgery (DP group). The postoperative reinnervation time did not differ between groups. BB strength one year after surgery was lower in the DP group than non-DP group (p = 0.0007). No differences were observed 2-3 years after surgery. In the DP group, four patients had respiratory symptoms that affected daily activities and their outcomes deteriorated (p = 0.04). Phrenic nerve transfer should not be combined with ICNT in patients with poor respiratory function because of the high incidence of respiratory complications.

Asymmetric hydrogenation of quinazolinium salts catalysed by halide-bridged dinuclear iridium complexes bearing chiral diphosphine ligands

Asymmetric hydrogenation of 4-substituted quinazolinium salts catalyzed by dinuclear Ir complexes is described.

[Purtscher's retinopathy following blunt chest compression]

Following chest or abdominal injury, acute blurring of vision occurs without direct eye injury. This disease is known as Purtscher's retinopathy. A 74-year-old man suffered blunt chest injury by air bag inflation at traffic accident. Next morning, he suddenly complained of visual abnormality. An ophthalmoscopy revealed multiple cotton-wool exudation and retinal edema. He was diagnosed as Purtscher's retinopathy. The symptoms of soft exudation and retinal edema gradually resolved. The visual acuity gradually improved, but not reached to the previous level. We must be aware of this retinopathy, since this is rare but sometimes sight-threatening condition.

Hydrogenation of amides catalyzed by a combined catalytic system of a Ru complex with a zinc salt

Hydrogenation of unactivated amides has been achieved by using the combined catalytic system of a ruthenium catalyst with a zinc salt.

Cardiac involvements in myasthenia gravis associated with anti-Kv1.4 antibodies

BACKGROUND AND PURPOSE

There is no general consensus as to whether autoimmune myasthenia gravis (MG) is associated with heart diseases, despite the fact that myocarditis, a serious cardiac involvement treatable by immunotherapy, is a complication of MG. It has been observed previously that MG patients with clinically suspected myocarditis had anti-Kv1.4 antibodies. The purpose of this study was to disclose the association between anti-Kv1.4 antibodies and cardiac involvements in MG patients.

METHODS

Anti-Kv1.4 antibody was detected by an immunoprecipitation assay using (35) S-labeled rhabdomyosarcome cellular extract as the antigen source. Cardiac findings including electrocardiography (ECG) and clinical features of clinically suspected myocarditis in MG patients with anti-Kv1.4 antibodies were investigated. Ultrasound echocardiography (UCG) of ex vivo chick embryos was performed to determine the suppressive effects of sera with or without anti-Kv1.4 antibodies on heart muscle functions.

RESULTS

Seventy (10.8%) of 650 MG patients had anti-Kv1.4 antibodies and 60% of them had abnormal ECG findings with high frequencies of T-wave abnormality and QT prolongation. Clinically suspected myocarditis was found in eight MG patients with anti-Kv1.4 antibodies but in none of the MG patients without anti-Kv1.4 antibodies. Most patients showed rapid deterioration with lethal arrhythmias such as ventricular tachycardia, sick sinus syndrome, or complete atrial ventricular block and severe heart failure. It was concluded using UCG of ex vivo chick embryos that MG serum with anti-Kv1.4 antibodies suppressed heart muscle functions.

CONCLUSION

It has been demonstrated that anti-Kv1.4 antibodies are possible markers for cardiac involvements in MG patients.

Advances in characterization of neuroprotective peptide, humanin

Humanin (HN), a short amino acid peptide, protects neurons as well as other cells from amyloid β-induced toxicities and other stresses. A number of HN binding proteins have been identified and their involvements in HN-mediated neuroprotection have been suggested in some cases. However, the way HN binds to the target molecules has never been clarified. Here we will review the structures of HN and HN analogs in solution as a function of solvent conditions and attempt to relate their structural characteristics to the functional properties.

[Pleural solitary fibrous tumor from diaphragm, being suspected of liver invasion; report of a case]

We report a case of solitary fibrous tumor (SFT) from diaphragmatic pleura. A 71-year-old female was admitted to our hospital because of an abnormal shadow on chest X-ray. A preoperative imaging study revealed a mass on her right diaphragm. At thoracoscopic exploration, the tumor was found to originate from diaphragm and was suspected of liver invasion. The conversion to open thoracotomy was introduced to perform appropriate surgical procedure. Pathological examination revealed proliferation of spindle cells and collagen fibers. Immuno-histochemical findings showed positive immunostaining for cell differentiation (CD) 34 and vimentin. The tumor was diagnosed as SFT with malignant potential.

Is there any circadian variation consequence on acute case fatality of stroke? Takashima Stroke Registry, Japan (1990-2003)

BACKGROUND

Circadian periodicity in the onset of stroke has been reported. However, it is unclear whether this variation affects the acute stroke case fatality. Time of the day variation in stroke case fatality was examined using population-based stroke registration data.

METHODS

Stroke event data were acquired from the Takashima Stroke Registry, which covers a stable population of approximately 55,000 in Takashima County in central Japan. During the period of 1990-2003, there were 1080 (549 men and 531 women) cases with classifiable stroke onset time. Stroke incidence was categorized as occurring at night (midnight-6 a.m.), morning (6 a.m.-noon), afternoon (noon-6 p.m.), and evening (6 p.m.-midnight). The 28-day case fatality rates and 95% confidence intervals (95% CI) were calculated by gender, age, and stroke subtype across the time blocks. After adjusting for gender, age at onset, and stroke severity at onset, the hazard ratios for fatal strokes in evening, night, and morning were calculated, with afternoon serving as the reference.

RESULTS

For all strokes, the 28-day case fatality rate was 23.3% (95% CI:19.4-27.6) for morning onset, 16.9% (95% CI:13.1-21.6) for afternoon onset, 18.3% (95% CI:13.6-24.1) for evening onset, and 21.0% (95% CI:15.0-28.5) for the night onset stroke. The case fatality for strokes during the morning was higher than the case fatality for strokes during afternoon. This fatality risk excess for morning strokes persisted even after adjusting for age, gender, and stroke severity on onset in multivariate analysis.

CONCLUSION

In the examination of circadian variation of stroke case fatality, 28-day case fatality rate tended to be higher for the morning strokes.

Relation of dietary and lifestyle traits to difference in serum leptin of Japanese in Japan and Hawaii: the INTERLIPID study

BACKGROUND AND AIMS

Previously, we found significantly higher serum leptin in Japanese-Americans in Hawaii than Japanese in Japan. We investigated whether differences in dietary and other lifestyle factors explain higher serum leptin concentrations in Japanese living a Western lifestyle in Hawaii compared with Japanese in Japan.

METHODS AND RESULTS

Serum leptin and nutrient intakes were examined by standardized methods in men and women ages 40-59 years from two population samples, one Japanese-American in Hawaii (88 men, 94 women), the other Japanese in central Japan (123 men, 111 women). Multiple linear regression models were used to assess role of dietary and other lifestyle traits in accounting for serum leptin difference between Hawaii and Japan. Mean leptin was significantly higher in Hawaii than Japan (7.2 ± 6.8 vs 3.7 ± 2.3 ng/ml in men, P < 0.0001; 12.8 ± 6.6 vs 8.5 ± 5.0 in women <0.0001). In men, higher BMI in Hawaii explained over 90% of the difference in serum leptin; in women, only 47%. In multiple linear regression analyses in women, further adjustment for physical activity and dietary factors--alcohol, dietary fiber, iron--produced a further reduction in the coefficient for the difference, total reduction 70.7%; P-value for the Hawaii-Japan difference became 0.126.

CONCLUSION

The significantly higher mean leptin concentration in Hawaii than Japan may be attributable largely to differences in BMI. Differences in nutrient intake in the two samples were associated with only modest relationship to the leptin difference.

A Novel Therapeutic and Prophylactic Vaccine against Tuberculosis Using the Cynomolgus Monkey Model and Mouse Model

We have developed a novel tuberculosis (TB) vaccine; a combination of the DNA vaccines expressing mycobacterial heat shock protein 65 (HSP65) and interleukin 12 (IL-12) delivered by the hemagglutinating virus of Japan (HVJ)-envelope and -liposome (HSP65 + IL-12/HVJ). This vaccine provided remarkable protective efficacy in mouse model compared to the BCG. This vaccine also provided therapeutic efficacy against multi-drug resistant TB (MDR-TB) and extremely drug resistant TB (XDR-TB) in murine models. Furthermore, we extended our studies to a cynomolgus monkey model, which is currently the best animal model of human tuberculosis. This novel vaccine provided a higher level of the protective efficacy than BCG based upon the assessment of mortality. The BCG prime and HSP65 + IL-12/HVJ vaccine (boost) by the prime-boost method showed a synergistic prophylactic effect in the monkey. Furthermore, this vaccine exerted therapeutic efficacy (100% survival) and augmentation of immune responses in the TB-infected monkeys.HVJ-Envelope/HSP65 DNA + IL-12 DNA vaccine increased the body weight of TB-infected monkeys, improved the ESR, and augmented the immuneresponses (proliferation of PBL and IL-2 production). The enhancement of IL-2 production from monkeys treated with this vaccine was correlated with the therapeutic efficacy of the vaccine. These data indicate that our novel DNA vaccine might be useful against Mycobacterium tuberculosis including XDR-TB and MDR-TB for human therapeutic clinical trials.

[Clinical study of forty-two patients who underwent resection for pulmonary adenosquamous carcinoma]

Pulmonary adenosquamous carcinoma is a rare malignant tumor as defined by the Japan Lung Cancer Society Classification. At our institution, of the 1,023 patients who underwent resection for primary lung cancer, 42 (4.0%) had adenosquamous carcinoma. Here, we present the clinical features of this malignant tumor. The male : female ratio was low. Many tumors were located peripherally, and the positive rate for carcinoembryonic antigen (CEA) was 54.8%; these clinical findings were similar to those of adenocarcinoma. On the other hand, many tumors had relatively large diameter, and most of the patients were heavy smokers; these findings were consistent with those of squamous cell carcinoma. Hence, the cases of adenosquamous carcinoma had the characteristics of both adenocarcinoma and squamous cell carcinoma. The prognosis of patients with adenosquamous carcinoma was poorer than those of patients with adenocarcinoma and those with squamous cell carcinoma, irrespective of whether it was stages I or II. Adenosquamous carcinoma is characterized by a highly aggressive biological behavior and a high rate of early metastasis. Therefore, even if the diagnosis is made at an early phase, an aggressive approach, including adjuvant chemotherapy, might be necessary for adenosquamous carcinoma.

Living-donor liver transplantation in 126 patients with biliary atresia: single-center experience

OBJECTIVES

To describe our experience with 126 consecutive living-donor liver transplantation (LDLT) procedures performed because of biliary atresia and to evaluate the optimal timing of the operation.

PATIENTS AND METHODS

Between May 2001 and January 2010,126 patients with biliary atresia underwent 130 LDLT procedures. Mean (SD) patient age was 3.3 (4.2) years, and body weight was 13.8 (10.7) kg. Donors included 64 fathers, 63 mothers, and 3 other individuals. The left lateral segment was the most commonly used graft (75%). Patients were divided into 3 groups according to body weight: group 1, less than 8 kg (n = 40); group 2,8 to 20 kg (n = 63); and group 3, more than 20 kg (n = 23). Medical records were reviewed retrospectively. Follow up was 4.5 (2.7) years.

RESULTS

All group 3 donors underwent left lobectomy, and all group 1 donors underwent left lateral segmentectomy. No donors required a second operation or died. Comparison of the 3 groups demonstrated that recipient Pediatric End-Stage Liver Disease score in group 1 was highest, operative blood loss in group 2 was lowest (78 mL/kg), and operative time in group 3 was longest (1201 minutes). Hepatic artery complications occurred more frequently in group 1 (17.9%), and biliary stenosis (43.5%) and gastrointestinal perforation (8.7%) occurred more frequently in group 3. The overall patient survival rates at 1, 5, and 9 years was 98%, 97%, and 97%, respectively. Five-year patient survival rate in groups 1,2, and 3 were 92.5%, 100%, and 95.7%, respectively. Gastrointestinal perforation (n = 2) was the primary cause of death.

CONCLUSIONS

Living-donor liver transplantation is an effective treatment of biliary atresia, with good long-term outcome. It seems that the most suitable time to perform LDLT to treat biliary atresia is when the patient weighs 8 to 20 kg.

Potential application of arginine in interaction analysis

Aqueous solution of 0.1-2 M arginine at mildly acidic to neutral pH is widely used in biotechnology and protein research, including protein refolding, purification, and formulation. This is largely because of its ability to suppress non-specific protein-protein and protein-surface interactions. Here we propose potential applications of arginine in interaction analysis for proteins. One of the important goals of such analysis is discovery of small molecule antagonistic or agonistic ligands that bind to target proteins and thereby modulate their function. Such research is often hampered by the low solubility of the small molecules, the instability of target proteins and the non-specific protein-ligand interactions. Aqueous arginine solution increases the solubility of small molecules, which should give an alternative to conventional dissolution method of small molecules by organic solvents. Arginine may also directly impact on the analysis of protein-protein or protein-ligand interactions by suppressing weak non-specific interactions.

Rhodium-catalyzed alkenylation of nitriles via silicon-assisted C-CN bond cleavage

Rhodium-catalyzed Mizoroki-Heck type reaction of nitriles via the cleavage of C-C bonds is described. Orthogonal and iterative functionalizations of arenes were also demonstrated by combining the present and conventional halide-based cross-coupling reactions.

[Post-operative acute exacerbation of interstitial pneumonea associated with amyopathic dermatomyositis]

Amyopathic dermatomyositis (ADM) is a variant of dermatomyositis that is characterized by the typical skin rash but without the muscle abnormalities. We report a case of ADM complicated with interstitial pneumonitis (IP) and lung cancer. A 73-year-old female was hospitalized for skin rash and dry cough. Skin biopsy findings were compatible with dermatomyositis though no subjective and objective findings suggestive of skeletal muscle involvement were noted. Chest computed tomography (CT) revealed a consolidation of her right upper lung and irregular opacity of bilateral lower lobe. By histopathological evaluation, she was diagnosed as lung cancer with ADM. Therapy consisting of prednisone was begun. Two weeks after the surgery, dry cough progressed. Her acute exacerbation of IP did not respond to the therapy and passed away by disseminated intravascular coagulation and respiratory failure.

Critical role of cytosolic phospholipase A2{alpha} in bronchial mucus hypersecretion in CFTR-deficient mice

Cystic fibrosis (CF) is due to mutations in the CF transmembrane conductance regulator gene CFTR. CF is characterised by mucus dehydration, chronic bacterial infection and inflammation, and increased levels of cytosolic phospholipase A2α (cPLA2α) products in airways. We aimed to examine the role of cPLA2α in the modulation of mucus production and inflammation in CFTR-deficient mice and epithelial cells. Mucus production was assessed using histological analyses, immuno-histochemistry and MUC5AC ELISA. cPLA2α activation was measured using an enzymatic assay and lung inflammation determined by histological analyses and polymorphonuclear neutrophil counts in bronchoalveolar lavages. In lungs from Cftr(-/-) mice, lipopolysaccharide induced mucus overproduction and MUC5AC expression associated with an increased cPLA2α activity. Mucus overproduction was mimicked by instillation of the cPLA2α product arachidonic acid, and abolished by either a cPLA2α null mutation or pharmacological inhibition. An increased cPLA2α activity was observed in bronchial explants from CF patients. CFTR silencing induced cPLA2α activation and MUC5AC expression in bronchial human epithelial cells. This expression was enhanced by arachidonic acid and reduced by cPLA2α inhibition. However, inhibition of CFTR chloride transport function had no effect on MUC5AC expression. Reduction of CFTR expression increased cPLA2α activity. This led to an enhanced mucus production in airway epithelia independent of CFTR chloride transport function. cPLA2α represents a suitable new target for therapeutic intervention in CF.