Synthesis of L-2-amino-4-hexynoic acid and derivatives

A synthesis is described of optically pure L-2-amino-4-hexynoic acid and its derivatives, which can serve as potentially useful precursors for the preparation of highly tritium labeled norleucine-containing peptides, as well as other side-chain modified peptides. Catalytic tritiation of one derivative of this acetylenic amino acid afforded the (³H)-L-norleucine derivative with a specific activity of 115 ± 5 Ci/mmol.     

SIPPLE''S SYNDROME ASSOCIATED WITH A LARGE PROLACTINOMA

A 26-year-old male presented with the symptoms and signs of acute congestive heart failure and hypertension. The left ventricle was shown to be thickened and displayed reversible hypokinesia. Further investigations revealed the underlying pathology of a phaeochromocytoma, bilateral medullary thyroid carcinoma (MTC), parathyroid adenoma and macro-prolactinoma. There was a family history of MTC. The echocardiographic features of catecholamine-induced cardiomyopathy were important in this diagnosis. Our research revealed no previous report of Sipple's syndrome associated with a macroprolactinoma. This case, along with the other 13 reports of mixed (type I and II) multiple endocrine neoplasia (MEN), are not within the classical subsets of MEN.     

Synthesis of tritium labeled Boc-[Nle11] -substance P5-11

An optically active, alkynyl analogue of norleucine (Nle), L-2-amino-4-hexynoic acid (Aha), was substituted for Met in the solution synthesis of the Boc-protected C-terminal heptapeptide analogue of substance P. Treatment of the resulting alkynyl peptide with tritium gas in the presence of 10% Pd/C afforded a Boc-(Nle¹¹)-substance P₅-11 with a specific radioactivity of 96 Ci/mmol.     

Kappa 700系列双腔起搏器的应用体会

目的 :观察双腔起搏器自动模式转换功能在房性心律失常治疗中的应用效果。方法 :2 1例患者分别植入MedtronicInc .KappaKDR73 1或 73 3型双腔起搏器 ,分别于术后第 4d、1个月及每隔 3个月一次跟踪随访 ,观察房性心律失常的发生情况和起搏器自动模式转换情况及临床症状。结果 :全部病例随访 1～ 18个月 ,共出现阵发性房颤、房扑及房性心动过速 62阵次 ,起搏后由DDD(R)自动转换成DDI(R)模式 5 8阵次 ,患者自觉心悸 9阵次。结论 :①MedtronicInc .Kap paKDR70 0系列具有良好的房性心动过速诊断和自动模式转换功能。②自动模式转换功能可使起搏器在患者发作房性心动过速时发挥对心室的保护作用 ,有效避免由于起搏器跟踪快速心房率而造成心室率过快 ,引起的血流动力学改变 ,并能明显减轻心悸等临床症状 ,提高病人的舒适性和安全性     

Synthesis of (pGlu-5, MePhe-8, Sar-9) Substance P (5–11) (DiMe-C7) using a polyacrylamide resin and biological activity on guinea pig ileum and tracheal smooth muscle

DiMe-C7 (pGlu-Gln-Phe-MePhe-MeGly-Leu-MetNH₂), a metabolically stable analogue of Substance P, was prepared by solid-phase peptide synthesis using a polyacrylamide resin and a labile anchorage derived from glycolic acid. Myotropic activities in guinea pig ileum (ED₅₀ = 4.0 ± 1.5 10^-8 M) and guinea pig trachea (ED₅₀ = 8.6 ± 3.5 10^-8 M) are discussed in comparison with the corresponding activities of Substance P.     

Anterograde percutaneous transseptal valvuloplasty in a case of severe calcific aortic stenosis

The retrograde catheterization and percutaneous dilatation ofcalcific stenotic aortic valves is not always possible in elderlypatients. We report the case of a 76-year old woman admittedwith severe aortic stenosis in whom it was impossible to reachthe left ventricle retrogradely. This led us to attempt percutaneousaortic valvuloplasty using a transseptal anterograde approach.The Mullins transseptal sheath catheter was advanced into theleft ventricle and a 7 F catheter containing a long guide wire(400 cm) passed through the sheath. The flexible end of theguide wire was advanced through the aortic valve anterogradelyand an angled wireloop retriever used to catch the flexibleend of the guide wire and to draw it out of the body throughthe left femoral artery. A 7 F balloon catheter was introducedpercutaneously over the long guide wire and allowed dilatationof the interatrial septum and femoral vein. A 8 F Schneider-Grüntzigcatheter (80 mm) length, 19mm diameter when inflated) was insertedanterogradely through the aortic valve over the guide wire withoutdifficulty and the balloon catheter was inflated to a pressureof 6 atmospheres with a 30 seconds inflationdeflation cycle.Before the procedure the mean aortic valvular gradient was 114mmHg and the aortic valve area was 0.30 cm². After the procedurethe mean aortic gradient had fallen to 60 mmHg and the valvearea had risen to 0.90 cm². These results are comparable tothose expected using the more usual retrograde balloon dilatationof the aortic valve.     

Congenital lung malformation: Evaluation of prenatal and postnatal radiological findings

Background and objective:   This study evaluated the accuracy of prenatal MRI and postnatal CT imaging in the identification of congenital cystic adenomatoid malformation and bronchopulmonary sequestration by comparison with histological analysis.
Methods:   Over a 3-year period, 15 patients with lung malformations diagnosed prenatally by ultrasound were referred for prenatal MRI, and all were investigated postnatally by chest CT. All asymptomatic newborns with unresolved lesions underwent elective surgery by thoracoscopy. All surgical specimens were analysed histologically.
Results:   Among the 15 patients with an abnormality diagnosed by ultrasound, prenatal MRI findings differed from the final histological diagnosis with respect to extent ( n  = 3), type of lesion ( n  = 1) and aberrant vessel identification ( n  = 4). Postnatal chest CT failed to visualize the aberrant vessel in one patient. Complete regression of the lesion was noted in two patients with bronchopulmonary sequestration, and in one patient with congenital cystic adenomatoid malformation and was confirmed by CT. Elective thoracoscopic lobectomy of the affected lobe was performed for 12 patients. Two conversions to thoracotomy were required. All operated patients had an uneventful hospital course.
Conclusions:   Prenatal MRI is less accurate than postnatal CT scan, which remains the most reliable diagnostic modality to specify the location and extent and kind of lesions.