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150 Background: The number of cancer patients has been increasing in Japan. It is estimated that 56,143 parents with 87,017 young children (under 18 years old) are diagnosed with cancer per year in Japan (Inoue, 2015). The aim of this study is to investigate the needs of cancer patients who have young children. Methods: The survey was conducted from February to April 2018 to the cancer patients who have young children treated at the National Cancer Center Hospital with the questionnaires. It was on items about parenting concerns evaluated with the 4-point Likert scale: 1. strongly disagree, 2. slightly disagree, 3. slightly agree, and 4. strongly agree. The items included “cancer notification to their children”, “parental anxieties”, and others. The items were analyzed separately. Results: The respondents were 152 (143 cancer patients (94%) and nine spouses (6%)). Most respondents (92%) agreed the importance of psychosocial support for the children and parents in hospital. The average age of their young children (n = 237) was 9.5 (ages 0 – 17). The result showed that 148 (62%) children were told true parents’ illness. This study also revealed that parents were struggling with the conflict telling their children truth. Most parents wanted to protect children from emotional distresses and were afraid of it or don’t know how to cope with some changes during treatments. Conclusions: The study describes how cancer impacts on parents for child rearing. Almost all of the patients with minor children had been found psychologically distressed. It is necessary to improve an effective psychosocial support system in hospitals for cancer patients with young children based on their needs.

We report a case of severe exertional heat stroke with multiple organ failure successfully treated with continuous plasma diafiltration (CPDF). PDF effectively removed proinflammatory cytokines, and simultaneously, supported liver function. Furthermore, CPDF therapy showed beneficial effects on multiple organ functions. These features suggest that it is a primary treatment option for exertional heat stroke with multiple organ failure. J. Clin. Apheresis 31:490-492, 2016. © 2015 Wiley Periodicals, Inc.

Background Intestinal perforation is known to correlate with neurodevelopmental outcome in very low-birthweight (VLBW) infants, and its two major causes are necrotizing enterocolitis (NEC) and focal intestinal perforation (FIP). Infants with FIP are reported to have better neurodevelopmental outcome than infants with NEC, but outcome has not been compared with that in infants without diseases that require surgery. The aim of this study was to compare neurodevelopmental outcomes between FIP survivors and infants without diseases that require surgery. Methods Records of VLBW infants with FIP and infants without surgical diseases were retrospectively analyzed. Neurodevelopmental outcome was compared between eight infants with FIP and 24 case-matched control infants without surgical diseases using the Kyoto Scale of Psychological Development. Control group members were individually matched with FIP survivors for sex, gestational age, birthweight, and intraventricular hemorrhage (IVH) grade. Those with an episode of sepsis or severe IVH (grade 3–4) that occurred irrespective of FIP were excluded. Results Three FIP survivors and 12 infants without surgical diseases were classified as neurodevelopmentally normal (37.5% vs 50%, P = 0.69) at a corrected age of 18 months–3 years. All neurodevelopmentally normal FIP survivors were born at a gestational age ≥26 weeks. Conclusion Excluding the influence of sepsis or severe IVH, no significant difference was found in neurodevelopmental outcome between FIP survivors and infants without surgical diseases. None of the FIP infants born before 26 weeks of gestation, however, had normal neurodevelopment, suggesting that longer gestation might be needed to overcome the stress associated with FIP.

Although ammonium acid urate (AAU) calculi are extremely rare renal stone components, it was recently found that many urinary tract calculi that cause post-renal renal failure in rotavirus (RV) gastroenteritis are AAU calculi. The mechanism of AAU calculi development in RV gastroenteritis has not been fully elucidated. We analyzed data from eight RV gastroenteritis patients who transiently had AAU crystals in their urinary sediment. In these patients, formation of AAU crystals occurred earlier than the formation of AAU calculi. No difference was observed in serum and urine uric acid levels between RV gastroenteritis patients with or without AAU crystals. Interestingly, fractional excretion of sodium was extremely low among patients with AAU crystals. These results suggest that the formation of AAU crystals might not be due to excretion of uric acid, but excretion of sodium.

The dehydrogenative coupling of maleic acids with alkynes proceeds smoothly accompanied by decarboxylation under rhodium catalysis to produce variously substituted α-pyrone derivatives. The catalyst system is also applicable to the coupling with 1,3-diynes and alkenes.

This microreview describes our contributions to the development of palladium-catalyzed annulations of organodimetallic reagents with organic dihalides, which serve as versatile synthetic methods for functionalized polycyclic aromatic hydrocarbons. Presented first are palladium-catalyzed double cross-coupling reactions of 1,2-diborylalkenes and -arenes with 2,2′-dibromobiaryls and 1-bromo-2-(2-bromoethenyl)arenes, respectively. The next section describes palladium-catalyzed coupling reactions between 9-stannafluorenes and 1,2-dibromoarenes, in which the 9-stannafluorenes act as equivalents of 1,4-dimetal reagents. The last section covers palladium-catalyzed double cross-coupling reactions variously between 1,2-diboryl reagents and 1-bromo-2-(bromomethyl)arenes, between 1,1-diborylalk-1-enes and 2,2′-dibromobiaryls, and between 9-stannafluorenes and 1,1-dibromoalk-1-enes, to form systems containing five-membered rings in one-step fashion.

To assess the serum interleukin (IL)-6 and IL-18 levels in patients with systemic juvenile idiopathic arthritis (s-JIA) and to identify the clinical features of patient subsets with different cytokine profiles, we analyzed the serum levels of IL-6 and IL-18 in patients with s-JIA and compared them with the clinical features of s-JIA. Eighteen patients were analyzed. IL-6 and IL-18 levels were quantified in serum by enzyme-linked immunosorbent assays. Interestingly, two distinct s-JIA patient subsets based on their serum IL-6 and IL-18 levels were identified: an IL-6 dominant and an IL-18 dominant. The serum IL-6 and IL-18 levels were consistent both at relapse and at the onset of s-JIA in each subset. The IL-6-dominant subset had a significantly greater number of joints with active disease and higher serum levels of matrix metalloproteinase-3, whereas the IL-18-dominant subset was more likely to develop macrophage activation syndrome (MAS). These findings indicate that two subsets of patients with s-JIA, one which is prone for arthritis and another with prone for MAS, can be identified on the basis of their serum IL-6 and IL-18 levels. These two subsets appear to be characterized by certain distinct clinical features.

Macrophage activation syndrome (MAS) has been observed in patients with systemic lupus erythematosus (SLE). Recognition of MAS in patients with SLE may be particularly challenging because it may mimic the clinical features of the underlying disease or be confused with an infectious complication. Massive hypercytokinemia is strongly associated with the pathogenesis of systemic lupus erythematosus-associated macrophage activation syndrome (SLE-MAS) but the pathogenesis and kinetics of cytokine release in SLE-MAS patients is not well studied. We present a case of SLE-MAS. The patient showed the distinct cytokine profile of SLE-MAS compared to systemic juvenile idiopathic arthritis associated MAS and Epstein-Barr virus-induced hemophagocytic lymphohistiocytosis. The observed TNF-α dominant increase appears to be characteristic of SLE-MAS. IgM type antilymphocyte antibody (ALAB) was detected on the surface of lymphocytes during the acute phase and disappeared when the patient was in remission. The patient had a heterozygous P369S-R408Q mutation in the MEFV gene. Our results suggest that ALAB and a MEFV mutation might play important roles in the pathogenesis of SLE-MAS. Furthermore, the cytokine profile of SLE-MAS differs from that of S-JIA-MAS: the TNF-α dominant increase appears to be characteristic.

We herein describe a case of systemic juvenile idiopathic arthritis (s-JIA)-associated macrophage activation syndrome (MAS) in which the 18Ffluorodeoxyglucose positron emission tomography (18FFDG-PET) findings were characteristic. The pattern of greater 18FFDG accumulation into the spleen compared with the liver was more remarkable in this patient compared with s-JIA. This pattern, however, was also observed in cases of acute leukemia. In the present patient, serum interleukin (IL)-18 was extremely elevated (255 000 pg/mL), whereas in leukemia patients it is mildly elevated (360–1480 pg/mL). 18FFDG-PET might be a useful indicator of s-JIA and MAS in patients with fever of unknown origin. The pattern of 18FFDG accumulation, however, can also be observed in acute leukemia. The combination of 18FFDG-PET and serum IL-18 might be useful for the diagnosis of s-JIA and MAS.

Herein we describe a case of microangiopathic antiphospholipid syndrome (MAPS) due to anti-phosphatidylserine/prothrombin complex (aPS/PT) IgM antibody successfully treated with rituximab. A significant correlation was observed between the clinical course and the aPS/PT IgM antibody titer, which can rise earlier before the appearance of clinical symptoms. Rituximab can be safely and effectively used for MAPS. Although detection of only aPS/PT IgM antibody is rare, aPS/PT IgM antibody might be associated with the pathogenesis of MAPS and might be a useful marker of disease activity.

To investigate clinical usefulness of serum interleukin (IL)-33 levels as an indicator of disease activity in juvenile idiopathic arthritis (JIA).We measured serum levels of IL-33 in 39 patients with JIA, including 7 patients with rheumatoid factor positive poly-JIA (RF + poly-JIA), 8 patients with RF negative poly-JIA (RF-poly-JIA), 20 patients with oligoarticular JIA (Oligo-JIA), 4 patients with enthesitis-related arthritis (ERA) and 30 age-matched healthy controls. Furthermore, we determined their correlation with measures of disease activity.Serum IL-33 levels in patients with RF + poly-JIA were significantly elevated compared to those in patients with RF-poly-JIA, oligo-JIA and HC. Serum IL-33 levels in patients with RF-poly-JIA, oligo-JIA and ERA were not elevated compared to those in HC. Serum IL-33 levels in RF + poly-JIA patients normalized in remission phase. Serum IL-33 levels correlated positively with RF in patients with RF + poly-JIA.These results indicate that serum IL-33 levels in RF + poly-JIA patients correlated with disease activity, suggesting a potential role of IL-33 as a promising indicator of disease activity.

Much interest has been paid to cyclic diaryliodonium salts as bis(electrophile)s in transition-metal-catalyzed annulation reactions to produce polycyclic (hetero)aromatic hydrocarbons. Herein, we report that dibenziodolium triflates smoothly react with potassium thioacetate in the presence of CuCl2 in THF or DMSO at 100–110 °C to afford the corresponding dibenzothiophenes in good-to-high yields. The coupling reaction tolerates reactive functional groups such as chloro and cyano and serves as a facile and reliable method for the synthesis of unsymmetrical dibenzothiophenes.

The clinical features and laboratory parameters of patients with Kawasaki disease (KD) and systemic juvenile idiopathic arthritis (s-JIA) tend to overlap. Furthermore, there have been no definitive biomarkers for these diseases, making clinical diagnosis difficult. The purpose of this study was to investigate the diagnostic value of serum ferritin levels for differentiating KD from s-JIA and predicting the disease severity of KD.We analyzed 228 patients with KD and 81 patients with s-JIA. Serum ferritin levels were compared between patients with s-JIA and KD. Furthermore, serum ferritin levels in patients with KD were compared with respect to clinical features such as responsiveness to intravenous immunoglobulin (IVIG) therapy.Serum ferritin levels in KD patients with no response to IVIG therapy were significantly higher than those in KD patients with a good response to IVIG therapy. Serum ferritin levels in patients with KD needing plasma exchange (PE) were significantly higher than those in patients not needing PE. However, serum ferritin levels overlapped between severe KD patients with nonresponsiveness to IVIG therapy or needing PE and other patients with mild KD. Furthermore, patients with s-JIA showed a distinct elevation of serum ferritin levels compared with KD patients. The cutoff value of serum ferritin levels for differentiating KD from s-JIA was 369.6 ng/ml.Serum ferritin levels were significantly elevated in s-JIA patients compared with KD patients. Measurement of serum ferritin levels can be useful for differentiating s-JIA from KD.

The considerably conjugated π systems of the group 14 dithienometallole-linked ethynylene-conjugated porphyrin dimers (1Ms) were described based on comprehensive experimental and theoretical studies. The electronic absorption spectra of 1M displayed a large splitting in the Soret band and a red-shifted Q-band, indicating that the dithienometallole spacer was effective in facilitating the porphyrin–porphyrin electronic coupling. Torsional planarization behaviors of 1M were observed in the time-resolved fluorescence spectra. Density functional theory (DFT) calculations revealed that the dithienometallole spacer is an ideal partner for the ethynylene-conjugated porphyrin to produce fully delocalized highest occupied molecular orbital (HOMO) and lowest unoccupied molecular orbital (LUMO) levels due to their similar HOMO and LUMO levels. Finally, 1M exhibited a strong propensity for the quinoidal–cummulenic conjugation in the dithienometallole spacer when in a photoexcited state.

Enthesitis-related arthritis (ERA) diagnosis is sometimes challenging because the frequency of back pain is lesser and that of peripheral symptoms is higher compared with adult spondyloarthritis1. Distinguishing ERA from other subtypes of juvenile idiopathic arthritis is also sometimes difficult when inappropriate imaging techniques are selected. A 13-year-old boy with fever and arthralgia, and an unremarkable family history, was referred to …

A shape-programmed linearity through supramolecular polymerization is demonstrated by a step-growth double-strand formation of a telechelic oligomeric porphyrin array in which two alternating pyridyl-porphyrin sequenced units are held together by self-complementary ligand-to-metal coordination. The stiff rod-like structure and sufficiently large binding constant of the double-strand unit considerably extended a supramolecular array in the one dimension, which produced a tightly stretched string with a length that exceeded several micrometers.

Angiopoietin (Ang)-1 and -2 play important roles in maintaining vascular homeostasis. This study aimed to assess the roles of angiopoietin (Ang)-1 and -2 and to investigate the clinical significance of their serum levels in patients with hemolytic uremic syndrome (HUS) induced by enterohemorrhagic Escherichia coli (EHEC).Twenty patients with HUS and 15 healthy controls were studied. Serum Ang-1 and Ang-2 levels were quantified using enzyme-linked immunosorbent assay. The results were compared with the clinical features of HUS.During the HUS phase, serum Ang-1 levels were significantly decreased, whereas serum Ang-2 levels and the Ang-2/Ang-1 ratio were significantly elevated. Compared with patients without encephalopathy, serum Ang-2 levels and Ang-2/Ang-1 ratio were significantly elevated in patients with encephalopathy. Patients with HUS and serum Ang-2 levels of 7061 pg/mL or Ang2/Ang1 ratios of 2.29 were at high risk of encephalopathy. Serum Ang-1 levels were significantly decreased in patients in the pre-HUS phase compared with those in healthy controls.Disruption of homeostasis of vascular endothelial function by Ang-1 and -2 may be closely associated with the development of HUS. Serum Ang-1 and -2 levels and the Ang-2/Ang-1 ratio may be promising indicators of disease activity in HUS and the development of encephalopathy.

The chirality found in living organisms is one of unsolved mysteries on Earth. It is crucial to understand the manner in which small achiral molecules evolve into helical superstructures in the absence of chiral components because this process can provide important insights regarding the origin of chirality in nature. 1) the uncommon helical assembly of an achiral trigonal chromophore into helical nanostructures with aggregation-induced emission enhancement (AIEE) characteristics and 2) the tunability of the helical pitch and fluorescence intensity in response to light is reported. The Rietveld refinement of X-ray diffraction (XRD) patterns and the growth process suggest that a striking transformation from an achiral to an asymmetric molecule can occur as a result of specific interactions with certain solvents, presumably leading to the unique helical assembly. More importantly, exposure to UV or visible light promoted not only the formation of irregular helical structures with a wide range of pitch lengths but also an increase in fluorescence intensity.

To compare pro-inflammatory cytokine profiles and kinetics in patients with adult-onset Still's disease (AOSD) to those in patients with systemic juvenile idiopathic arthritis (s-JIA), we analyzed serum cytokine concentrations in 33 patients with AOSD and 77 patients with s-JIA and compared them with clinical features. Patients with AOSD and s-JIA shared a common cytokine profile pattern of a significant increase in IL-18. Patients with AOSD were classified into two subgroups based on serum IL-6 and IL-18 levels. The number of patients with arthritis was significantly higher in the IL-6-dominant subgroup. The cytokine patterns associated with s-JIA and AOSD share common features, such as a significant and predominant increase in IL-18. Distinct IL-6- and IL-18-based cytokine profiles might be responsible for distinct clinical manifestations. The presence of two distinct subgroups in patients with both diseases further supports the view that s-JIA and AOSD share a disease category.

Infection with Streptococcus pyogenes, a Group A beta-hemolytic streptococcus (GAS), is a rare cause of hemolyticuremic syndrome (HUS). Invasive infections with Streptococcus pneumoniae that produce neuraminidase are a well-recognized cause of HUS without diarrhea. The Thomsen- Friedenreich antigen (T antigen) plays a role in the pathophysiology of pneumococcal HUS. We describe the case of a 3-year-old boy with GAS-associated HUS and show how T-antigen exposure was implicated in this case. He had no diarrhea and cultures for blood, urine, and stool were negative. The urinary pneumococcal antigen was negative; his direct Coombs test was positive. Glomerular capillary loops, tubular epithelium on his renal biopsy specimen, and red blood cells in his blood smear showed positive fluorescence with anti-T lectin. Although the pathogenesis of GAS-associated HUS is not well understood, T-antigen exposure may be implicated in some cases with GAS-associated HUS.

To investigate the role of alternative activation of macrophages, in particular, the role of the CD163/HO-1 axis in systemic juvenile idiopathic arthritis (s-JIA), we serially examined the concentrations of HO-1, sCD163 and pro-inflammatory cytokines (IL-10, IL-18, IL-6, neopterin, soluble TNF-α receptor types I and II) in patients with s-JIA complicated by macrophage activation syndrome (MAS/s-JIA). Serum concentrations of HO-1, sCD163 and IL-10 in s-JIA patients were markedly elevated in the active phase including MAS and correlated positively with indicators for s-JIA disease activity. Serum concentrations of HO-1, sCD163 and IL-10, as well as IL-18, remained elevated in s-JIA patients even in the inactive phase of disease, whereas clinical parameters and other pro-inflammatory cytokines normalized. These findings indicate that alternative macrophage activation plays an important role not only in the active phase but also in the inactive phase of s-JIA. These findings suggest that the inactive phase of s-JIA represents a state of compensated inflammation rather than absence of immune activity.

Rituximab (RTX) is a new steroid-sparing therapy for childhood steroid-dependent nephrotic syndrome (NS). However, relapses frequently occur immediately after CD19 recovery. We report the cases of two steroid-dependent NS patients treated with RTX followed by mizoribine (MZB). One patient relapsed, and the other developed proteinuria after CD19 recovery until the MZB was replaced by mycophenolate mofetil. These patients exhibited different lymphocyte phenotypes, with the CD4+/CD8+ profile favoring CD8+ T lymphocytes, while CD3+ HLA-DR-expressing activated T lymphocyte expansion occurred in the relapsed patient. Based on these findings, we suggest that T cell activation may influence outcome and that phenotypic analysis in addition to B cell monitoring may facilitate the detection of NS relapse.

Primary sclerosing cholangitis (PSC) is a serious disease that not only affects quality of life but can also have a significant effect on patient survival. The treatment for PSC is primarily supportive with the aim of controlling cholestatic symptoms and preventing complications. Ursodeoxycholic acid may induce biochemical improvements in affected patients; however, long-term pediatric studies to determine its possible benefits in young patients are lacking. Thus, the treatment of pediatric PSC remains a significant clinical challenge. We describe a patient with PSC and undetermined colitis who was treated with a combination of a steroid, salazosulfapyridine, and a probiotic. This treatment provided benefits both for PSC and the undetermined colitis. These findings suggest that bacterial flora and gut inflammation are closely associated with the pathogenesis of inflammatory bowel disease-related PSC. Suppression of bowel inflammation and maintenance of bacterial homeostasis may be important for treating PSC.

(Z)-1,2-Diaryl-1,2-bis(pinacolatoboryl)ethenes underwent double-cross-coupling reactions with 1-bromo-2-[(Z)-2-bromoethenyl]arenes in the presence of [Pd(PPh(3))(4)] as a catalyst and 3 M aqueous Cs(2)CO(3) as a base in THF at 80 °C. The double-coupling reaction gave multisubstituted naphthalenes in good to high yields. Annulation of 1,2-bis(pinacolatoboryl)arenes with bromo(bromoethenyl)arenes in the presence of a catalyst system that consisted of [Pd(2)(dba)(3)] (dba=dibenzylideneacetone) and 2-dicyclohexylphosphino-2',6'-dimethoxybiphenyl (SPhos) under the same conditions produced fused phenanthrenes in good to high yields. The first annulation coupling occurred regiospecifically at the bromoethenyl moiety. This procedure is applicable to the facile synthesis of polysubstituted anthracenes, benzothiophenes, and dibenzoanthracenes through a double annulation pathway by using the corresponding dibromobis[(Z)-2-bromoethenyl]benzenes as diboryl coupling partners.

Wiskott-Aldrich syndrome (WAS) is a rare X-linked disorder caused by mutations in the WAS gene. Glomerulonephritis is a frequent complication, however, histopathological data from affected patients is scarce because the thrombocytopenia that affects most patients is a contraindication to renal biopsies. We found that WASp-deficient mice develop proliferative glomerulonephritis reminiscent of human IgA nephropathy (IgAN). We examined whether increased aberrant IgA production is associated with the development of glomerulonephritis in WASp-deficient mice. Serum IgA and IgA production by splenic B cells was increased in WASp-deficient mice compared to wild-type (WT) mice. A lectin-binding study revealed a reduced ratio of sialylated and galactosylated IgA in the sera from old WASp-deficient mice. Circulating IgA-containing immune complexes showed significantly higher titers in WASp-deficient mice compared to WT mice. These results indicate that the increased IgA production and aberrant glycosylation of IgA may be critically involved in the pathogenesis of glomerulonephritis in WAS.

We synthesised 12,12-diisopropyl-7-methyl-12H-indololo[3,2-d]-naphtho[1,2-b][1]silole from 1-bromo-2-naphtholvia four steps. The silylene-bridged 2-(2-naphthyl)indole exhibited intense blue photoluminescence in solution and in the solid state. For example, the fluorescence maximum of the powder appeared at 476 nm with a high quantum yield (Φ = 0.70). The organic light-emitting device using the silylene-bridged indole as a light-emitting layer demonstrated a high current efficiency of 3.80 cd A−1 and a power efficiency of 3.64 lm W−1 at 10 mA cm−2 with excellent colour coordinates (0.152, 0.094), while the device fabricated with the blue-emissive indole as a dopant achieved even higher current and power efficiencies of 6.68 cd A−1 and 5.58 lm W−1, respectively, at 10 mA cm−2.

Benzosiloles fused to heterocycles such as thiophene, benzothiophene, and benzofuran, and indole- and benzosilole-fused dibenzosiloles were prepared by palladium-catalyzed intramolecular coupling of the corresponding 2-(arylsilyl)aryl triflates in good to high yields. Molecular and crystal structures of 5,7-dihydro-5,5,7,7-tetrakis(1-methylethyl)bis[1]benzosilolo-[2,3-b:3′, 2′-d]thiophene, 6-methyl-12,12-diisopropyl-12H-indololo[3,2-b][1]silafluorene, and 5,5,11,11-tetraisopropyl-5,11H-benzosilolo[3,2-c]silafluorene were determined by X-ray diffraction analysis. The UV absorption spectra of the (di)benzosilole derivatives in cyclohexane red-shifted when compared to 1,1-diisopropyldibenzosilole, indicating that replacing a benzene ring of dibenzosilole by the heterocycles as well as fusion of indole and benzosilole moieties onto dibenzosilole narrowed the HOMO-LUMO gaps of the π-conjugation system. The thiophene-fused benzosiloles were faintly fluorescent in solution and in the solid state, whereas the dibenzosiloles exhibited luminescence with moderate and high quantum yields in cyclohexane and in microcrystals, respectively. In other words, aggregation-induced emission was observed for the dibenzosiloles. Notably, 5,5,11,11-tetraisopropyl-5,11H-benzosilolo[3,2-c]silafluorene in microcrystals exhibited violet fluorescence (λmax = 396 nm) with a quantum yield of 0.70. Density functional theory (DFT) calculations of the prepared (di)benzosiloles were also performed.

This study demonstrates that the double cross-coupling reaction of 1,2-bis(pinacolatoboryl)alkenes and -arenes with 2,2′-dibromobiaryls proceeds smoothly with the aid of a catalytic amount of Pd(PPh3)4 in the presence of excess base to give a variety of polycyclic aromatic hydrocarbons, such as phenanthrenes, [5]helicene, dithienobenzenes, triphenylenes, dibenzo[g,p]chrysenes, and triphenyleno[1,2-b:4,3-b′]dithiophenes in good to high yields. It is noteworthy that the annulations using 2,2′-dibromooctafluorobiphenyl as an electrophile furnish the otherwise difficult to synthesize octafluorophenanthrenes and semi-fluorinated dibenzo[g,p]chrysenes in high yields.

A new molecular design of organic emitters exhibiting efficient solid-state fluorescence, which involves planarity breaking of N , N -diorganoquinacridones, is presented. The new design principle led to the development of dimethyl 2,5-diaminoterephthalates and 2,5-diamino-1,4-diaroylbenzenes, which emitted green to yellow and yellow to red light with high-to-excellent quantum yields, respectively. In addition, the photoluminescence properties of the diaroylbenzenes were dependent on the morphology and reversibly variable by thermal and solvent vapor stimuli.

3,2′-Silylene-bridged 2-phenylindoles were prepared in high yields by palladium-catalyzed silicon-migrative intramolecular coupling of 2-(2-indolylsilyl)aryl triflates. The high thermal stability of the benzosilole-fused indoles was indicated by thermogravimetric analysis (TGA). The absorption spectra revealed that the absorption edges, namely, the HOMO–LUMO energy gaps, could be effectively tuned by substitution with functional groups such as chloro, cyano, methoxy, and phenyl at the meta-positions with respect to nitrogen and silicon, whereas there was no effective conjugation between the core and an aryl group on nitrogen. The changes in the HOMO–LUMO gaps, which were induced by variation of the functional groups, were well reproduced by density functional theory calculation. The indoles exhibited blue fluorescence with high-to-excellent quantum yields both in cyclohexane and in powder as well as in doped poly(methyl methacrylate) (PMMA) films. The emission maxima of each indole exhibited a red-shift, ...

全身型若年性特発性関節炎（systemic-onset juvenile idiopathic arthritis : s-JIA）の治療中に，突然の高熱を来たし，急速に白血球数や血小板数の減少が進行し凝固異常などを呈する場合，マクロファージ活性化症候群（macrophage activation syndrome : MAS）への移行を考慮する必要がある．一方，敗血症においても同様の臨床像を呈することがあり，治療方針を決定する上で両者の鑑別は非常に重要となる．今回我々はs-JIAの治療中に敗血症を合併しMASとの鑑別を要した1歳5ヶ月女児例を経験した．本症例では，全経過を通してInterleukin (IL)-18が著明な高値を呈し，敗血症合併時にはプロカルシトニンが強陽性となり，IL-6が他のMAS合併症例と比較し著明な高値を呈していた．本症例の経験からサイトカインプロファイルによるモニタリングは，s-JIA症例の病態や経過の把握やMASと敗血症の鑑別に非常に有用であると思われた． The differential diagnosis of macrophage activation syndrome (MAS) and sepsis must be considered in the clinical course of systemic-onset juvenile idiopathic arthritis (s-JIA) with sudden onset of high-grade fever and abnormal laboratory findings, including leukocytopenia, thrombocytopenia, and coagulopathy. In this report, we describe the case of a 17-month-old girl diagnosed with s-JIA complicated with sepsis. Her serum interleukin (IL)-18 level was significantly elevated throughout the clinical course. Furthermore, compared to other MAS patients, she showed a significantly elevated serum IL-6 level and procalcitonin in sepsis. Therefore, our results suggest that a patient's cytokine profile may be a useful indicator of disease activity and may thus help in the differential diagnosis of sepsis and MAS in s-JIA.

The aim of this study was to evaluate limited sampling designs to estimate the maximal concentration (C(max)) and area under the curve (AUC) of mizoribine in pediatric patients with renal disease. We utilized 48 serum mizoribine concentration profiles obtained from the full (6-point) sampling pharmacokinetic test, and estimated 48 individual C(max) and AUC values accurately with Bayesian analysis using the full sampling data. We then developed limited sampling models (LSM) for C(max) and AUC using 1-4 serum mizoribine concentration data points. The C(max) and AUC estimation performance of the Bayesian and LSM analysis was fairly good in the 3-point (2, 3, and 6 hr after the dose) sampling design. In addition, the C(max) estimation performance of the Bayesian and LSM analysis deteriorated only marginally even in the 1-point (3 hr) sampling design. On the other hand, the AUC estimation performance seemed to be inadequate in the 1-point (3 hr) sampling design; however, it improved markedly in the 2-point (3 and 6 hr) sampling design. These findings suggested that the 1-point (3 hr) sampling design is promising for approximate C(max) estimation, but that the 2-point (3 and 6 hr) sampling design is preferable to estimate the AUC of mizoribine.

Background/Aims: In oxidative stress, heme oxygenase-1 (HO-1) plays a pivotal role in maintaining renal function and protecting renal structure, especially in renal tubular epithelial cells. We examined urinary HO-1 (uHO-1) levels to assess whether uHO-1 acts as a sensitive biomarker for detecting tubulointerstitial inflammatory damage in renal diseases. Methods: Immunohistochemical analyses and enzyme-linked immunosorbent assays for uHO-1 were performed using 61 urine samples (supernatants and sediment lysates) from healthy children and renal disease patients. Results: Proximal and distal epithelial cells showed higher uHO-1 levels than squamous and urothelial cells. Inflammatory renal disease patients had higher uHO-1 levels than noninflammatory renal disease patients and controls. In IgA nephropathy, patients with interstitial cellular infiltration showed higher uHO-1 levels than those without it. Among patients with increased urinary β2-microglobulin or N-acetyl-β-D-glucosaminidase levels, uHO-1 levels increased only in those with renal disease and tubulointerstitial inflammatory damage. uHO-1 levels positively correlated with urinary interleukin-6 in inflammatory renal disease patients. Conclusions: These results indicate that uHO-1 is a potentially useful, novel, and noninvasive biomarker for evaluating the degree of tubulointerstitial inflammatory damage in renal disease.

Autoimmunity is a surprisingly common complication of primary immunodeficiencies, yet the molecular mechanisms underlying this clinical observation are not well understood. One widely known example is provided by Wiskott-Aldrich syndrome (WAS), an X-linked primary immunodeficiency disorder caused by mutations in the gene encoding the WAS protein (WASp) with a high incidence of autoimmunity in affected patients. WASp deficiency affects T-cell antigen receptor (TCR) signaling and T-cell cytokine production, but its role in TCR-induced apoptosis, one of the mechanisms of peripheral immunologic tolerance, has not been investigated. We find that WASp-deficient mice produce autoantibodies and develop proliferative glomerulonephritis with immune complex deposition as they age. We also find that CD4+ T lymphocytes from WASp-deficient mice undergo reduced apoptosis after restimulation through the TCR. While Fas-induced cell death is normal, WASp deficiency affects TCR-induced secretion of Fas ligand (FasL) and other components of secretory granules by CD4+ T cells. These results describe a novel role of WASp in regulating TCR-induced apoptosis and FasL secretion and suggest that WASp-deficient mice provide a good model for the study of autoimmune manifestations of WAS and the development of more specific therapies for these complications.

There has been extensive research on the development of organic optoelectronic devices, such as organic light-emitting diodes, organic field-effect transistors, and organic solid-state lasers from various viewpoints, ranging from basic studies to practical applications. As organic materials are used as solids in these devices, the importance of organic chromophores that exhibit intense emissions of visible light in the solid state is greatly increasing in the field of organic electronics. However, highly efficient emission from organic solids is very difficult to attain because most organic emitting materials strongly tend to cause concentration quenching of the luminescence in the condensed phase. Therefore, in order to generate and improve organic optoelectronic devices, it is necessary to design novel chromophores that exhibit superior solid-state emission performance. This Focus Review covers the recent development of highly emissive organic small molecules whose photoluminescence quantum yields in the solid state have been reported. Following the introduction, the photophysical processes of excited molecules are briefly reviewed. Subsequently, organic solid fluorophores are described with an emphasis on the characteristics of their molecular structures.

Objectives: To compare the pro-inflammatory cytokine profiles and the cytokine kinetics in patients with secondary macrophage activation syndrome (MAS) due to systemic-onset juvenile idiopathic arthritis (s-JIA) and in both active and inactive disease states of s-JIA (but no MAS), with those demonstrated in EBV-induced haemophagocytic lymphohistiocytosis (HLH) and Kawasaki disease (KD), and to investigate the significance of IL-18 in the pathogenesis of s-JIA. Methods: Five patients with MAS complicating s-JIA (MAS/s-JIA), 10 with HLH due to EBV infection (EBV-HLH), 22 with KD and 28 healthy controls were analysed. Cytokine concentrations (IL-18, IL-6, neopterin and TNF-α receptor Types I and II) were quantified in serum by ELISA. Results: were compared with clinical features of MAS/s-JIA, including ferritin concentrations. Results. Serum IL-18 concentrations in MAS/s-JIA patients were significantly higher than those in EBV-HLH or KD patients (P

Rotavirus (RV) is a common pathogen that causes acute gastroenteritis in childhood. Some cases with RV infection also have prerenal renal failure induced by dehydration associated with vomiting and diarrhea. Here, we report 4 patients with RV infection who developed postrenal renal failure induced by urinary tract obstruction with uroammoniac calculi or crystals. The patients did not have metabolic disorders or abnormalities of the urinary tract, and increased urinary excretion of uric acid was not recognized at discharge. In addition, no abnormalities in the uric acid transporter (URAT1) were found in any of the patients. Uric acid stone formation was considered to have originated from the low pH caused by dehydration and the increase of urinary uric acid excretion from damaged cells.