First observation of 28O

Subjecting a physical system to extreme conditions is one of the means often used to obtain a better understanding and deeper insight into its organization and structure. In the case of the atomic nucleus, one such approach is to investigate isotopes that have very different neutron-to-proton (N/Z) ratios than in stable nuclei. Light, neutron-rich isotopes exhibit the most asymmetric N/Z ratios and those lying beyond the limits of binding, which undergo spontaneous neutron emission and exist only as very short-lived resonances (about 10-21 s), provide the most stringent tests of modern nuclear-structure theories. Here we report on the first observation of 28O and 27O through their decay into 24O and four and three neutrons, respectively. The 28O nucleus is of particular interest as, with the Z = 8 and N = 20 magic numbers1,2, it is expected in the standard shell-model picture of nuclear structure to be one of a relatively small number of so-called 'doubly magic' nuclei. Both 27O and 28O were found to exist as narrow, low-lying resonances and their decay energies are compared here to the results of sophisticated theoretical modelling, including a large-scale shell-model calculation and a newly developed statistical approach. In both cases, the underlying nuclear interactions were derived from effective field theories of quantum chromodynamics. Finally, it is shown that the cross-section for the production of 28O from a 29F beam is consistent with it not exhibiting a closed N = 20 shell structure.

Alpelisib and fulvestrant in PIK3CA-mutated hormone receptor-positive HER2-negative advanced breast cancer included in the French early access program

SOLAR-1 and BYLieve trials documented the efficacy of the PI3K-inhibitor alpelisib in pre-treated PIK3CA-mutant, hormone receptor-positive, HER2-negative (HR+/HER2-) advanced breast cancer (ABC) patients. We report here real-life data of patients prospectively registered in the French alpelisib early access program (EAP) opened to PIK3CA-mutant HR+/HER2- ABC patients treated with alpelisib and fulvestrant. Primary endpoint was PFS by local investigators using RECIST1.1. Eleven centers provided individual data on 233 consecutive patients. Patients had received a median number of 4 (range: 1-16) prior systemic treatments for ABC, including CDK4/6 inhibitor, chemotherapy, fulvestrant and everolimus in 227 (97.4%), 180 (77.3%), 175 (75.1%) and 131 (56.2%) patients, respectively. After a median follow-up of 7.1 months and 168 events, median PFS was 5.3 months (95% CI: 4.7-6.0). Among 186 evaluable patients, CBR at 6 months was 45.3% (95% CI: 37.8-52.8). In multivariable analysis, characteristics significantly associated with a shorter PFS were age < 60 years (HR = 1.5, 95% CI = 1.1-2.1), >5 lines of prior treatments (HR = 1.4, 95% CI = 1.0-2.0) and the C420R PI3KCA mutation (HR = 4.1, 95% CI = 1.3-13.6). N = 91 (39.1%) patients discontinued alpelisib due to adverse events. To our knowledge, this is the largest real-life assessment of alpelisib efficacy. Despite heavy pre-treatments, patients derived a clinically relevant benefit from alpelisib and fulvestrant.

Screw versus staple fixation for Akin osteotomy

INTRODUCTION

Akin osteotomies are commonly fixed with a screw or staple. Hardware-related symptoms are not uncommon. We compared the outcomes and costs of the two implants.

METHODS

We evaluated 74 Akin osteotomies performed in conjunction with first metatarsal osteotomy for hallux valgus. The osteotomy was fixed with a headless compression screw in 39 cases and a staple in 35 cases. We looked at the implant-related complications, removal of metalwork, revision, non-union and cost. Pre- and postoperative hallux valgus interphalangeal (HI) angles and length of the proximal phalanx were measured.

RESULTS

There was 100% union, no failure of fixation, no revision surgery and no delayed union in either group. The radiological prominence of screws was significant (p=0.02), but there was no significant difference in soft-tissue irritation (p=0.36) or removal of implants (p=0.49). Two cortical breaches (5.8%) occurred in staple fixation and 4 (10.2%) in screw fixation (not statistically significant (NS), p=0.50). The mean improvement in HI angle was 4.3° with screw fixation and 4.1° with staple fixation (NS, p=0.69). The mean shortening of the proximal phalanx was 2.5mm with screw fixation and 2.3mm with staple fixation (NS, p=0.64). The total cost was £1,925 for staple fixation and £4,290 for screw fixation.

CONCLUSIONS

Staple and screw fixation are reproducible modalities with satisfactory outcomes, but screw fixation is expensive. We conclude staple fixation is a cost-effective alternative.

Pairing Forces Govern Population of Doubly Magic ^{54}Ca from Direct Reactions

Direct proton-knockout reactions of ^{55}Sc at ∼220  MeV/nucleon were studied at the RIKEN Radioactive Isotope Beam Factory. Populated states of ^{54}Ca were investigated through γ-ray and invariant-mass spectroscopy. Level energies were calculated from the nuclear shell model employing a phenomenological internucleon interaction. Theoretical cross sections to states were calculated from distorted-wave impulse approximation estimates multiplied by the shell model spectroscopic factors, which describe the wave function overlap of the ^{55}Sc ground state with states in ^{54}Ca. Despite the calculations showing a significant amplitude of excited neutron configurations in the ground-state of ^{55}Sc, valence proton removals populated predominantly the ground state of ^{54}Ca. This counterintuitive result is attributed to pairing effects leading to a dominance of the ground-state spectroscopic factor. Owing to the ubiquity of the pairing interaction, this argument should be generally applicable to direct knockout reactions from odd-even to even-even nuclei.

Probing the Symmetry Energy with the Spectral Pion Ratio

Many neutron star properties, such as the proton fraction, reflect the symmetry energy contributions to the equation of state that dominate when neutron and proton densities differ strongly. To constrain these contributions at suprasaturation densities, we measure the spectra of charged pions produced by colliding rare isotope tin (Sn) beams with isotopically enriched Sn targets. Using ratios of the charged pion spectra measured at high transverse momenta, we deduce the slope of the symmetry energy to be 42<L<117  MeV. This value is slightly lower but consistent with the L values deduced from a recent measurement of the neutron skin thickness of ^{208}Pb.

Evidence for a New Compact Symmetric Fission Mode in Light Thorium Isotopes

Taking benefit of the R3B/SOFIA setup to measure the mass and the nuclear charge of both fission fragments in coincidence with the total prompt-neutron multiplicity, the scission configurations are inferred along the thorium chain, from the asymmetric fission in the heavier isotopes to the symmetric fission in the neutron-deficient thorium. Against all expectations, the symmetric scission in the light thorium isotopes shows a compact configuration, which is in total contrast to what is known in the fission of the heavier thorium isotopes and heavier actinides. This new main symmetric scission mode is characterized by a significant drop in deformation energy of the fission fragments of about 19 MeV, compared to the well-known symmetric scission in the uranium-plutonium region.

Extending the Southern Shore of the Island of Inversion to ^{28}F

Detailed spectroscopy of the neutron-unbound nucleus ^{28}F has been performed for the first time following proton/neutron removal from ^{29}Ne/^{29}F beams at energies around 230  MeV/nucleon. The invariant-mass spectra were reconstructed for both the ^{27}F^{(*)}+n and ^{26}F^{(*)}+2n coincidences and revealed a series of well-defined resonances. A near-threshold state was observed in both reactions and is identified as the ^{28}F ground state, with S_{n}(^{28}F)=-199(6)  keV, while analysis of the 2n decay channel allowed a considerably improved S_{n}(^{27}F)=1620(60)  keV to be deduced. Comparison with shell-model predictions and eikonal-model reaction calculations have allowed spin-parity assignments to be proposed for some of the lower-lying levels of ^{28}F. Importantly, in the case of the ground state, the reconstructed ^{27}F+n momentum distribution following neutron removal from ^{29}F indicates that it arises mainly from the 1p_{3/2} neutron intruder configuration. This demonstrates that the island of inversion around N=20 includes ^{28}F, and most probably ^{29}F, and suggests that ^{28}O is not doubly magic.

Analysis of the impact of EEA stapler size on risk of anastomotic complications in colorectal anastomosis: does size matter?

BACKGROUND

Colorectal anastomotic complications are dreaded and dramatically affect outcomes. Causes are multifactorial, with the size of the end-to-end anastomosis (EEA) stapler a modifiable factor and potential target for risk reduction. Our goal was to examine the impact of the EEA stapler size on the risk of anastomotic complications in left-sided colorectal resections.

METHODS

A prospective divisional database was reviewed for consecutive elective left-sided resections with a colorectal anastomosis using an EEA stapler from January 2013 May 2018 inclusive. Patients were stratified into 25-29 mm or 30-33 mm cohorts. Patient and disease demographics, operative variables, and postoperative outcomes were evaluated. The main outcome measures were the rate and factors associated with anastomotic complications.

RESULTS

Four hundred seventy-three cases were evaluated, 185 ( 39.1%) were in the 25-29 mm group and 288 (60.9%) in the 30-33 mm group. Patients were comparable in demographics and operative variables. More males were anastomosed with the 30-33 mm than with the 25-29 mm stapler (57.6% vs 28.6%, p < 0.01). Significantly more patients developed an anastomotic stricture with the 25-29 mm than with the 30-33 mm staplers (7.1% vs. 2.1%; p = 0.007). There was no significant difference in leak rates or reoperation/interventions between groups. On logistic regression, neither gender, operative indication nor approach were associated with anastomotic leak, readmission, or reoperation/intervention. Stapler size remained significantly associated with stricture (p = 0.032).

CONCLUSIONS

The 25-29 mm EEA staplers were associated with an increased rate of anastomotic stricture compared to 30-33 mm staplers in left-sided colorectal anastomoses. As stapler size is a simple process measure that is easily modifyable, this is a potential target for improving anastomotic complication rates. Further controlled trials may help assess the impact of stapler size on improving patient and quality outcomes.

Fragmentation of Single-Particle Strength around the Doubly Magic Nucleus ^{132}Sn and the Position of the 0f_{5/2} Proton-Hole State in ^{131}In

Spectroscopic factors of neutron-hole and proton-hole states in ^{131}Sn and ^{131}In, respectively, were measured using one-nucleon removal reactions from doubly magic ^{132}Sn at relativistic energies. For ^{131}In, a 2910(50)-keV γ ray was observed for the first time and tentatively assigned to a decay from a 5/2^{-} state at 3275(50) keV to the known 1/2^{-} level at 365 keV. The spectroscopic factors determined for this new excited state and three other single-hole states provide first evidence for a strong fragmentation of single-hole strength in ^{131}Sn and ^{131}In. The experimental results are compared to theoretical calculations based on the relativistic particle-vibration coupling model and to experimental information for single-hole states in the stable doubly magic nucleus ^{208}Pb.

Towards the Limits of Existence of Nuclear Structure: Observation and First Spectroscopy of the Isotope ^{31}K by Measuring Its Three-Proton Decay

The most remote isotope from the proton dripline (by 4 atomic mass units) has been observed: ^{31}K. It is unbound with respect to three-proton (3p) emission, and its decays have been detected in flight by measuring the trajectories of all decay products using microstrip detectors. The 3p emission processes have been studied by the means of angular correlations of ^{28}S+3p and the respective decay vertices. The energies of the previously unknown ground and excited states of ^{31}K have been determined. This provides its 3p separation energy value S_{3p} of -4.6(2)  MeV. Upper half-life limits of 10 ps of the observed ^{31}K states have been derived from distributions of the measured decay vertices.

Approaching the Gamow Window with Stored Ions: Direct Measurement of ^{124}Xe(p,γ) in the ESR Storage Ring

We report the first measurement of low-energy proton-capture cross sections of ^{124}Xe in a heavy-ion storage ring. ^{124}Xe^{54+} ions of five different beam energies between 5.5 and 8 AMeV were stored to collide with a windowless hydrogen target. The ^{125}Cs reaction products were directly detected. The interaction energies are located on the high energy tail of the Gamow window for hot, explosive scenarios such as supernovae and x-ray binaries. The results serve as an important test of predicted astrophysical reaction rates in this mass range. Good agreement in the prediction of the astrophysically important proton width at low energy is found, with only a 30% difference between measurement and theory. Larger deviations are found above the neutron emission threshold, where also neutron and γ widths significantly impact the cross sections. The newly established experimental method is a very powerful tool to investigate nuclear reactions on rare ion beams at low center-of-mass energies.

Abstract P1-11-23: Patient care in breast cancer: Unmet and fulfilled needs

Background Comprehensive cancer care uses complementary approaches alongside specific anticancer therapy. Using a dedicated questionnaire, the Calista 2 national survey sought to assess the importance of supportive care and activities among breast cancer (BC) patients, how often these services are made available, the uptake rate, and the proportion of unmet needs.

Methods Of the 82 physicians who accepted to take part in the survey, 29 recruited 257 patients with BC of whom 210 answered the patient-reported questionnaire. Patients meeting the inclusion criteria were adult females already on specific therapy for early or advanced BC. The patient-reported questionnaires covered drug management of pain, fatigue, adverse events (AE), sleep disorders, social and psychological support, physical activities, and complementary and alternative medicines. Items were rated on a scale of 0 – 10. Questionnaires were collected between September 2016 and October 2017.

Results After exclusion of non-valid patient questionnaires, 197 were analyzed. The mean age of these patients was 56.8 years (SD 12.6); 53% had early stage disease and 41% advanced stage disease. Patients perceived the management of AE and pain, and self-image improvement techniques as the three most important items (8.0, 7.5, 6.7, respectively), followed by physical activity (6.3) and the management of fatigue (6.0), while preservation of fertility (2.3), spiritual support (2.5), counselling with regards to employment (3.2), and art therapy (3.3) were the least important. Most facilities were available at the point of care. Physicians frequently suggested management AE and pain (83% and 73%, respectively), self-image improvement techniques (73%) and psychological support for the patient (70%). Management of fatigue was however far less frequently proposed (30%). Management of AE (75%) and pain (60%), and self-image improvement (50%) were the most widely used support techniques. Only 19% of patients who were offered support in the management of fatigue declared actually using it. The management of fatigue nevertheless represented one of the three main unmet needs (for 27% of patients), together with complementary medicines (37%) and relaxation (29%).

Conclusion These key findings highlight the fact that support for the management of AE and pain, together with self-image improvement techniques, are important for patients, are available, suggested and used. Although management of fatigue is available, it is rarely suggested by physicians and is therefore seen by patients as an unmet need. Patients also expressed the need for complementary medicines and relaxation techniques; these are however less frequently available at the point of care and seldom proposed.

Citation Format: Simon H, Viguier J, Naman H, Touboul C, Lhomel C, Ganem G, Eisinger F, Morère J-F. Patient care in breast cancer: Unmet and fulfilled needs [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-11-23.

Investigation of sedimentation rates and sediment dynamics in Danube Delta lake system (Romania) by 210Pb dating method

Being a dynamic environment associated with complex costal, fluvial and marine processes, only a few studies regarding the evolution of the Danube Delta and the human impacts on its ecosystem have been carried out. Being a sensible to all processes occurring in its catchment area, information is stored in the deposited sediments, which can be used as tracers for natural and anthropogenic processes. The aim of this study is to determine a detailed reconstruction of the sedimentation rates in the last century by applying the ²¹⁰Pb dating method validated by ¹³⁷Cs profiles. Additionally, the impacts of the construction of river-regulating structures (mainly the Iron Gates Hydro-Energetic Power Plants) are investigated, along with the assessment of natural phenomena (floods, storms etc.). To achieve this, 26 sediment cores from seven lakes were collected. ²¹⁰Pb_sup and ¹³⁷Cs were determined using gamma spectrometry, while ²¹⁰Pb_tot was measured via alpha spectrometry (²¹⁰Po), using the CRS model for age determination. From the assessed lakes, the most affected was the Matița Lake with a maximum sedimentation rate of 10.93 g cm^-2 yr^-1 and the least affected was the Isac Lake. Average sedimentation rates are: 0.95 g cm^-2 yr^-1 for Cruhlig Lake, 0.70 g cm^-2 yr^-1 for Uzlina Lake, 0.44 g cm^-2 yr^-1 for Isac Lake, 0.47 g cm^-2 yr^-1 for Cuibida Lake, 0.51 g cm^-2 yr^-1 for Iacob Lake, 1.00 g cm^-2 yr^-1 for Matița Lake and 0.76 g cm^-2 yr^-1 for Merhei Lake. Physical parameters (water content, porosity and bulk density) and LOI (organic matter and inorganic carbon content) were determined for each core to differentiate organic and non-organic sedimentation. Beside the natural influences, it is difficult to track the effects of the Iron Gates and not all analysed lakes were suitable for this task. The 1940-1970 period and the following ten years were compared in means of sedimentation: a decrease in sedimentation can be observed in four of the lakes: 59% in Cruhlig Lake, 16% in Uzlina Lake, 10% in Iacob Lake and 42% in Isac Lake, leading to an average 32% for the four lakes. The other three lakes show increasing tendencies of 39% in this period: 87% in Matița Lake, 6% in Merhei Lake and 24% in Cuibida Lake. Sedimentation rates show growths of 3 times after 1989, the most affected being the two northern lakes (3 times increase in both Matița Lake and Merhei Lake) and the four central lakes (2 times in case of Cuibida Lake, 3 times in Iacob Lake, 3 times in Isac Lake and 4 times in Uzlina Lake) with an average increase of 3 times, while the southern one (Cruhlig Lake) 2 times.

Strong Neutron Pairing in core+4n Nuclei

The emission of neutron pairs from the neutron-rich N=12 isotones ^{18}C and ^{20}O has been studied by high-energy nucleon knockout from ^{19}N and ^{21}O secondary beams, populating unbound states of the two isotones up to 15 MeV above their two-neutron emission thresholds. The analysis of triple fragment-n-n correlations shows that the decay ^{19}N(-1p)^{18}C^{*}→^{16}C+n+n is clearly dominated by direct pair emission. The two-neutron correlation strength, the largest ever observed, suggests the predominance of a ^{14}C core surrounded by four valence neutrons arranged in strongly correlated pairs. On the other hand, a significant competition of a sequential branch is found in the decay ^{21}O(-1n)^{20}O^{*}→^{18}O+n+n, attributed to its formation through the knockout of a deeply bound neutron that breaks the ^{16}O core and reduces the number of pairs.

Quasifree (p, 2p) Reactions on Oxygen Isotopes: Observation of Isospin Independence of the Reduced Single-Particle Strength

Quasifree one-proton knockout reactions have been employed in inverse kinematics for a systematic study of the structure of stable and exotic oxygen isotopes at the R^{3}B/LAND setup with incident beam energies in the range of 300-450  MeV/u. The oxygen isotopic chain offers a large variation of separation energies that allows for a quantitative understanding of single-particle strength with changing isospin asymmetry. Quasifree knockout reactions provide a complementary approach to intermediate-energy one-nucleon removal reactions. Inclusive cross sections for quasifree knockout reactions of the type ^{A}O(p,2p)^{A-1}N have been determined and compared to calculations based on the eikonal reaction theory. The reduction factors for the single-particle strength with respect to the independent-particle model were obtained and compared to state-of-the-art ab initio predictions. The results do not show any significant dependence on proton-neutron asymmetry.

High-precision measurement of isotopic fission yields of 236U*

We report on the second SOFIA experiment, dedicated to the fission yields of 236U*, analog to 235U(n,f). The measurement is based on the inverse kinematics method, using a relativistic, secondary beam of 236U. Both fission fragments are identified in mass and charge in the SOFIA recoil spectrometer. The obtained isotopic yields are compared with existing spectroscopy measurements and the elemental yields are used to discuss the treatment of the even-odd effect with energy in nuclear data libraries.

137Cs contamination over Transylvania region (Romania) after Chernobyl Nuclear Power Plant Accident

Following the radionuclide releases due to Chernobyl Nuclear Power Plant accident, various studies were completed by researchers all over the world in order to measure the surface contaminations by artificial radionuclides. The aim of this study was to evaluate ¹³⁷Cs surface contamination and to create an inventory distribution for Transylvania region (Romania) after the Chernobyl event using γ spectrometric measurements on soil samples collected from 153 locations. The results were compared to measured data from the Danube Delta and Moldova Republic, as well as to ¹³⁷Cs concentrations from the rest of Europe reported by literature. The ¹³⁷Cs surface concentrations in soil samples ranged between 0.4±0.1kBqm^-2 and 301.1±3.0kBqm^-2, having an average of 8.3±0.2kBqm^-2, with more elevated values in the mountain areas (18.3±0.6kBqm^-2) compared to the hills and plains (2.6±0.1kBqm^-2). Taking into consideration the cardinal regions, the northern and western regions received the least amount of ¹³⁷Cs (2.9±0.1kBqm^-2), while the southern part received 16.3±0.6kBqm^-2. Sampling points with eastern slope exposure received the highest average (27.8±0.5kBqm^-2), while southern, north-western and north-eastern ones received less than 8kBqm^-2. Two hotspots are reported at Iezer-Ighiel (72.7±5.9kBqm^-2) and Tulgheș areas (51.5±0.6kBqm^-2).

Measurement of Excitation Spectra in the ^{12}C(p,d) Reaction near the η^{'} Emission Threshold

Excitation spectra of ^{11}C are measured in the ^{12}C(p,d) reaction near the η^{'} emission threshold. A proton beam extracted from the synchrotron SIS-18 at GSI with an incident energy of 2.5 GeV impinges on a carbon target. The momenta of deuterons emitted at 0° are precisely measured with the fragment separator (FRS) operated as a spectrometer. In contrast to theoretical predictions on the possible existence of deeply bound η^{'}-mesic states in carbon nuclei, no distinct structures are observed associated with the formation of bound states. The spectra are analyzed to set stringent constraints on the formation cross section and on the hitherto barely known η^{'}-nucleus interaction.

Atmospheric flux, transport and mass balance of (210)Pb and (137)Cs radiotracers in different regions of Romania

This study focuses on the determination of (210)Pb and (137)Cs fluxes from different areas in Transylvania, Romania and on the determination of transport and mass balance within the lacustrine system of Red Lake. In order to achieve this, samples were taken from six different locations (Bihor County area, Ighiel area, Red Lake area, Mluha Peatbog, Mohos Peatbog and Zanoaga Rosie Peat bog in the Semenic Mountains) throughout Romania, these being compared to the values of the Danube Delta area. The activity concentrations of the soil samples were measured by gamma spectrometry (HPGe detector) for both (210)Pbtotal, (210)Pbsup ((226)Ra) and (137)Cs, while peat samples were measured by both alpha ((210)Po) spectrometry (PIPS detectors) as well. The mean value for the (210)Pb flux was measured in the Danube Delta region (42±8Bqm(-2) yr(-1)), while the highest was measured in the Semenic Peatbog (227±54Bqm(-2) yr(-1)); the average being 132±8Bqm(-2) yr(-1). In case of (137)Cs the mean was 298±3Bqm(-2) yr(-1), maximum being 1683±15Bqm(-2) yr(-1) in case of Ighiel area and minimum being 32±1Bqm(-2) yr(-1) in the Danube Delta region. In case of the Red Lake, from the total inventory of 410±23Bqm(-2) yr(-1) in the sediments, the loss by outflows is 100±12Bqm(-2) yr(-1), the catchment to lake transfer factor being 0.84%.

Observation and Spectroscopy of New Proton-Unbound Isotopes ³⁰Ar and ²⁹Cl: An Interplay of Prompt Two-Proton and Sequential Decay

Previously unknown isotopes (30)Ar and (29)Cl have been identified by measurement of the trajectories of their in-flight decay products (28)S+p+p and (28)S+p, respectively. The analysis of angular correlations of the fragments provided information on decay energies and the structure of the parent states. The ground states of (30)Ar and (29)Cl were found at 2.25(-0.10)(+0.15) and 1.8±0.1  MeV above the two- and one-proton thresholds, respectively. The lowest states in (30)Ar and (29)Cl point to a violation of isobaric symmetry in the structure of these unbound nuclei. The two-proton decay has been identified in a transition region between simultaneous two-proton and sequential proton emissions from the (30)Ar ground state, which is characterized by an interplay of three-body and two-body decay mechanisms. The first hint of a fine structure of the two-proton decay of (30)Ar*(2(+)) has been obtained by detecting two decay branches into the ground and first-excited states of the (28)S fragment.

Über den Tryptophan-Stoffwechsel des Mutterkornpilzes

Zwei verschiedenen Clavicepsstämmen, von denen der eine in saprophytischer Kultur kein Mutterkornalkaloid bildet, wurde tritiummarkiertes Indol angeboten. Von dem einen wurde Indol in Clavinalkaloide eingebaut, während bei dem anderen Stamm aus der Verwertung des Indols-T und von Anthranilsäure auf die Reaktionsfolge Anthranilsäure → (Indol?) → Tryptophan → Kynurenin → Anthranilsäure geschlossen wird.

ᴅ-Tryptophan-T wird bei der Biogenese von Elymoclavin gut verwertet.