A one-pot approach to 3,3′-bisindolylmethane derivatives from nitrobenzene derivatives through the Bartoli indole synthesis was developed, in which the acid used to quench the reaction markedly ...affected its outcome. Quenching the reaction with concd HCl produced 3,3′-bisindolylmethane in contrast to the formation of 7-substituted indole by quenching with NH4Cl.
A one-pot approach to indolo2,1-bquinazolines from indole-3-carbaldehydes through the Dakin oxidation was developed. It was shown that the reaction proceeded through the condensation of ...indole-3-carbaldehydes with isatoic anhydrides, derived in situ from indole-3-carbaldehydes by the Dakin oxidation, and further oxidation/cyclization steps.
Mutations in the TTC21B gene have been identified in patients with nephronophthisis and were recently found in some patients with focal segmental glomerulosclerosis. We herein report a Japanese boy ...with end-stage renal disease due to medullary polycystic kidney disease and primary focal segmental glomerulosclerosis. Next-generation sequencing detected a new compound heterozygous missense mutation in the TTC21B gene. His renal pathological findings and gene mutations have not been previously reported in patients with ciliopathy. For children with severe renal dysfunction, mutations in the TTC21B gene cause both ciliopathy characterized by bilateral polycystic kidney disease and primary focal segmental glomerulosclerosis.
Background
Some pediatric patients on maintenance dialysis may need end-of-life care in the future because of being excluded from the indication of kidney transplantation and experiencing difficulty ...in continuation of their dialysis. This study aimed to thoroughly elucidate mortality outcomes of children on maintenance dialysis including the cause of death and clinical background of exclusion from indication of transplantation.
Patients and methods
This single-center retrospective study enrolled 53 children who received kidney transplantation (5) or maintenance peritoneal dialysis (PD, 48) as initial renal replacement therapy (RRT). We examined the selected RRT modalities, mortality outcomes, clinical backgrounds of cause of death, and risk factors of excluding from future the indication of transplantation.
Results
Nine (17%) of all 53 patients, all receiving PD (9/48, 19%), were finally excluded from next RRT indication—7 were excluded due to severe extrarenal complications that indicated high risk for transplantation and 2 were excluded due to severe psychomotor retardation and at the guardians’ discretion. Patients who were excluded from the indication had a younger age at PD induction and higher proportion of cerebral and cardiac complications or psychomotor retardation than patients who were included in the indication. Of the nine patients, seven died; of which, one patient died due to fatal progression of extrarenal complications and six died due to infectious or noninfectious dialysis-related complications.
Conclusion
Patients with severe extrarenal complications or psychomotor retardation tend to be excluded from the indication of transplantation. Their condition becomes fatal because of the complications of long-term dialysis and progression in extrarenal complications.
Many studies have demonstrated that oxidative stress plays an important role in several ailments including neurodegenerative diseases and cerebral ischemic injury. Previously we synthesized some ...carbazole compounds that have anti-oxidant ability in vitro. In this present study, we found that one of these 22 carbazole compounds, compound
(3-ethoxy-1-hydroxy-8- methoxy-2-methylcarbazole-5-carbaldehyde), had the ability to protect neuro2a cells from hydrogen peroxide-induced cell death. It is well known that neurite loss is one of the cardinal features of neuronal injury. Our present study revealed that compound
had the ability to induce neurite outgrowth through the PI3K/Akt signaling pathway in neuro2a cells. These findings suggest that compound
might exert a neurotrophic effect and thus be a useful therapy for the treatment of brain injury.
The total syntheses of the neuronal cell‐protecting carbazole alkaloids carbazomadurin A and (S)‐(+)‐carbazomadurin B were achieved. The key step of the synthesis of the polysubstituted carbazole ...rings included an allene‐mediated electrocyclic reaction of the 6π‐electron system that involved the indole 2,3‐bond. The cleavage of the alkoxy groups of the resulting 3‐ethoxy‐8‐isopropoxycarbazole successfully gave the 3,8‐dihydroxycarbazole, which was converted into the 3,8‐bis(OSEM)‐carbazole (SEM = 2‐trimethylsilylethoxymethyl). A Suzuki–Miyaura cross‐coupling reaction of the 3,8‐bis(OSEM)‐carbazole with the corresponding alkenyl pinacol borates afforded the 1‐alkenylcarbazoles, which were treated with tetra‐n‐butylammonium fluoride (TBAF) followed by reduction with NaBH4 to provide carbazomadurin A and (S)‐(+)‐carbazomadurin B, respectively.
The total syntheses of the neuronal cell‐protecting carbazole alkaloids carbazomadurin A and (S)‐(+)‐carbazomadurin B were achieved. The key step of the synthesis of the polysubstituted carbazole rings included an allene‐mediated electrocyclic reaction that involved the indole 2,3‐bond.
A tandem ring-closing metathesis and dehydrogenation reaction under oxygen atmosphere was newly developed to the synthesis of carbazole-1,4-quinones. This new tandem reaction was applied to the ...synthesis of murrayaquinone A in four steps.
Renal tubular dysgenesis (RTD) is the absence or poor development of the renal proximal tubules caused by gene mutations in the renin-angiotensin system. Although RTD has been considered fatal, ...improving neonatal intensive care management has enhanced survival outcomes. However, little has been reported on the survival of extremely preterm infants. This study reports the survival of an extremely preterm infant with RTD and discusses the appropriate management of RTD by reviewing the literature. A female infant weighing 953 g was delivered at 27 weeks’ gestation by Cesarean section because of oligohydramnios. She exhibited severe persistent pulmonary hypertension, severe systemic hypotension, and renal dysfunction shortly after birth. Respiratory management was successfully undertaken using nitric oxide inhalation and high-frequency oscillatory ventilation. Desmopressin was effective in maintaining her blood pressure and urinary output. She was diagnosed with RTD based on genetic testing, which revealed a compound heterozygous mutation in the angiotensin-converting enzyme gene in exon 18 (c.2689delC; p.Pro897fs) and exon 20 (c.3095dupT; p.Leu1032fs). At 2 years, she started receiving oral fludrocortisone for treating persistently high serum creatinine levels, which was attributed to nephrogenic diabetes insipidus caused by RTD. Subsequently, her urine output decreased, and renal function was successfully maintained. Currently, there is no established treatment for RTD. Considering cases reported to date, treatment with vasopressin and fludrocortisone appears to be most effective for survival and maintenance of renal function in patients with RTD. This study presents the successful management of RTD using this strategy in an extremely preterm infant.
A new entry to the total synthesis of isocryptolepine (cryptosanguinolentine), isolated from Cryptolepis sanguinolenta, was achieved by constructing a tetracyclic ring system through a ...microwave-assisted tandem Curtius rearrangement and electrocyclic reaction of an aza 6π-electron system. The tetracyclic lactam was converted to isocryptolepine in a four-step sequence.
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Large‐dose cyclic tidal peritoneal dialysis (TPD) is an original prescription of TPD involving frequent infusion and drainage of the dialysate to increase weekly urea clearance normalized to total ...body water (Kt/Vurea) and fluid removal. This study aimed to evaluate the efficiency of solute clearance and fluid removal achieved with large‐dose cyclic TPD compared to that achieved with nightly peritoneal dialysis (NPD). Seventeen patients with end‐stage renal disease, for whom maintenance PD was changed from NPD to large‐dose cyclic TPD, were enrolled. Their median age at administration of PD was 4.9 years. Kt/Vurea and fluid removal were compared between large‐dose cyclic TPD and NPD. The median peritoneal Kt/Vurea achieved with NPD and large‐dose cyclic TPD was 1.5 and 2.7, respectively. The median peritoneal Kt/Vurea per hour with large‐dose cyclic TPD was significantly higher than that with NPD (P = 0.0003). Among nine patients who used dialysates with the same glucose concentration for both NPD and large‐dose cyclic TPD, nightly fluid removal amount per hour with large‐dose cyclic TPD was significantly higher than that with NPD (P = 0.0039). Large‐dose cyclic TPD is a useful prescription of PD for increasing Kt/Vurea and fluid removal.
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