Modified technique for reconstruction of large cyclodialysis cleft with capsular tension ring and continuous and cerclage sutures without scleral flaps.

To present a modified technique for the reconstruction of a large cyclodialysis cleft with capsular tension ring (CTR) and continuous and cerclage sutures without scleral flaps in 12 cases. The mean visual acuity was 0.75 ± 0.47 logarithm of the minimal angle of resolution (logMAR), and the average intraocular pressure (IOP) was 3.35 ± 0.41 mmHg before surgery. Ultrasound biomicroscopy (UBM) revealed a ciliary cleft of 4.3 ± 3.5 clock hours. We performed the modified technique for the reconstruction of a large cyclodialysis cleft. Postoperative visual acuity improved to 0.48 ± 0.26 logMAR, and the IOP improved to 15.88 ± 3.81 mmHg. Postoperative UBM showed that cyclodialysis disappeared in the whole circumference of 12 eyes. The postoperative complications included 42% (5 eyes) with a temporary elevation of IOP and 16% (2 eyes) with a posterior shift of the ciliary body. No other complications were detected during the follow-up. Based on the results, our modified technique might be useful for most cyclodialysis clefts.

Cobalt-Catalyzed Enantioconvergent Negishi Cross-Coupling of α-Bromoketones.

Cobalt-catalyzed enantioconvergent cross-coupling of α-bromoketones with aryl zinc reagents is achieved to access chiral ketones bearing α-tertiary stereogenic centers with high enantioselectivities. The more challenging and sterically hindered α-bromoketones bearing a 2-fluorophenyl group or ß-secondary and tertiary alkyl chains could also be well-tolerated. Adjusting the electronic effect of chiral unsymmetric N,N,N-tridentate ligands is critical for improving the reactivity and selectivity of this transformation, which is beneficial for further studies of asymmetric 3d metal catalysis via ligand modification. The control experiments and kinetic studies illustrated that the reaction involved radical intermediates and the reductive elimination was a rate-determining step.

Ligand relay catalysis for cobalt-catalyzed sequential hydrosilylation and hydrohydrazidation of terminal alkynes.

Sequential double hydrofunctionalizationalization of alkynes is a powerful method to construct useful vicinal compounds. Herein, we report a cobalt-catalyzed sequential hydrosilylation/hydrohydrazidation of alkynes to afford 1,2-N,Si compounds via ligand relay catalysis. A phenomenon of ligand relay is found that the tridentate anionic N-ligand (OPAQ) could capture the cobalt ion from bidentate neutral P-ligand (Xantphos) cobalt complex. This protocol uses three abundant chemical feedstocks, alkynes, silanes, and diazo compounds, and also features operationally simple, mild conditions, low catalyst loading (1 mol%), and excellent functional group tolerance. The 1,2-N,Si compounds can be easily further derivatized to afford various substituted silane derivatives via Si-H functionalization, alcohols via Fleming-Tamao oxidation, free amines and amides via N-N bond cleavage and protection. The asymmetric reaction could also be carried out to afford chiral products with up to 86% ee. The ligand relay has been supported by control experiments and absorption spectra.

Cobalt-Catalyzed Markovnikov-Type Selective Hydroboration of Terminal Alkynes.

A cobalt-catalyzed Markovnikov-type hydroboration of terminal alkynes with HBpin to access α-alkenyl boronates with good regioselectivity and atom economy is reported. A new ligand has been developed for the cobalt hydride catalyst that has been used for a unique Markovnikov selective insertion of terminal alkynes into metal hydride bond. This operationally simple protocol exhibits excellent functional group tolerance to deliver valuable alkene derivatives.

Endophthalmitis caused by Mycobacterium houstonense: case report.

BACKGROUND: Mycobacterium houstonense is rapidly growing mycobacteria (RGM) that belongs to M. fortuitum group. So far, there have been few associated reports of human diseases induced by M. houstonense worldwide. CASE PRESENTATION: We present a delayed-onset postoperative endophthalmitis caused by M. houstonense after glaucoma drainage implant (GDI) surgery. The ocular infection lasted for 2 months without appropriate treatment that developed into endophthalmitis and the patient underwent an emergency enucleation. CONCLUSION: Implant erosion and a delay in diagnosis of ocular infection could lead to irreversible damage as observed in our case. Ophthalmologists should be alert for ocular RGM infection, and prompt laboratory diagnosis with initiation of effective multidrug therapy might prevent loss of vision.

Cobalt-Catalyzed Markovnikov Selective Sequential Hydrogenation/Hydrohydrazidation of Aliphatic Terminal Alkynes.

Here, we reported for the first time a mechanistically distinctive cobalt-catalyzed Markovnikov-type sequential semihydrogenation/hydrohydrazidation of aliphatic terminal alkynes in one pot. A cobalt hydride species was employed as two roles for both a unique metal-catalyzed Markovnikov-type insertion of the aliphatic terminal alkynes and then metal-catalyzed hydrogen atom transfer of alkenes. This operationally simple protocol exhibits excellent functional group tolerance and step economy. The hydrazone products could be easily transferred to various valuable amine derivatives.

Combined aspirin and clopidogrel therapy in phacoemulsification cataract surgery: a risk factor for ocular hemorrhage?

PURPOSE: To evaluate the safety of phacoemulsification cataract surgery in the patients undergoing dual antiplatelet therapy with aspirin and clopidogrel. METHODS: Consecutive patients undergoing phacoemulsification cataract surgery with a clear corneal incision under topical anesthesia were eligible for inclusion in the study. Thirty-eight eyes from 38 patients on combined aspirin and clopidogrel therapy who continued the treatment were classified into the maintenance group, a matched group of 38 eyes from 38 patients on no antiplatelet/anticoagulant therapy as the control group. The best-corrected visual acuity (BCVA) and incidences of complications were compared between the two groups. RESULTS: There was no significant difference in final BCVA between the maintenance group and the control group (p = 0.178). No significant difference existed in the incidences of hemorrhagic or non-hemorrhagic complications between the two groups (p = 0.529 and p = 0.589, respectively). Moreover, no surgery was postponed or cancelled due to hemorrhagic complications in either group, and no cardiovascular events occurred during the follow-up. There was no case of anterior chamber hemorrhage, vitreous hemorrhage, or suprachoroidal hemorrhage. CONCLUSIONS: Our outcomes indicated that phacoemulsification cataract surgery using a clear corneal incision with topical anesthesia could be safely done without stopping dual antiplatelet therapy with aspirin and clopidogrel.

Ligand-promoted cobalt-catalyzed radical hydroamination of alkenes.

Highly regio- and enantioselective intermolecular hydroamination of alkenes is a challenging process potentially leading to valuable chiral amines. Hydroamination of alkenes via metal-catalyzed hydrogen atom transfer (HAT) with good regioselectivity and functional group tolerance has been reported, however, high enantioselectivity has not been achieved due to the lack of suitable ligands. Here we report a ligand-promoted cobalt-catalyzed Markovnikov-type selective radical hydroamination of alkenes with diazo compounds. This operationally simple protocol uses unsymmetric NNN-tridentate (UNT) ligand, readily available alkenes and hydrosilanes to construct hydrazones with good functional group tolerance. The hydrazones can undergo nitrogen-nitrogen bond cleavage smoothly to deliver valuable amine derivatives. Additionally, asymmetric intermolecular hydroamination of unactivated aliphatic terminal alkenes using chiral N-imidazolinylphenyl 8-aminoquinoline (IPAQ) ligands has also been achieved to afford chiral amine derivatives with good enantioselectivities.

Cobalt-Catalyzed Asymmetric Sequential Hydroboration/Hydrogenation of Internal Alkynes.

A highly regio- and enantioselective cobalt-catalyzed hydroboration/hydrogenation of internal alkynes with HBpin and a hydrogen balloon in one pot was developed. A new type of chiral imidazoline iminopyridine (IIP) ligand was introduced for the first time in this novel and efficient strategy. This protocol used relatively simple and available starting materials with good functional group tolerance to construct more valuable chiral secondary organoboronates. The primary mechanistic studies illustrated that the cobalt-catalyzed regioselective hydroboration of alkynes did initially occur followed by HBpin-promoted and cobalt-catalyzed enantioselective hydrogenation of alkenylboronates.

Iron-Catalyzed Hydroboration of Vinylcyclopropanes.

An iron-catalyzed hydroboration of vinylcyclopropane with HBpin is first reported for the preparation of valuable homoallylic organoboronic esters. The iron catalysts enable efficient and regioselective C-C cleavage of vinylcyclopropanes, stereoselectively delivering E-alkenes with good stereospecific selectivity at an allylic position. This protocol exhibits mild conditions with good functional group tolerability. The chiral homoallylic organoboronic esters could be further converted into chiral polysubstituted tetrahydrofuran and tetrahydropyran.

Regio- and Enantioselective Cobalt-Catalyzed Sequential Hydrosilylation/Hydrogenation of Terminal Alkynes.

A highly regio- and enantioselective cobalt-catalyzed sequential hydrosilylation/hydrogenation of alkynes was developed to afford chiral silanes. This one-pot method is operationally simple and atom economic. It makes use of relatively simple and readily available starting materials, namely alkynes, silanes, and hydrogen gas, to construct more valuable chiral silanes. Primary mechanistic studies demonstrated that highly regioselective hydrosilylation of alkynes with silanes occurred as a first step, and the subsequent cobalt-catalyzed asymmetric hydrogenation of the resulting vinylsilanes showed good enantioselectivity.

Clinical and pathological features of acute optic neuritis in Chinese patients.

BACKGROUND: The incentives and the factors that affect the onset and outcome of optic neuritis (ON) are not very clear. The aim of this study is to define and get a comprehensive understanding of the clinical profile of ON, and to identify the factors that were related to the prognosis of the patients. METHODS: Medical records of patients with diagnosis of ON at Huashan Hospital, Fudan University between March 2008 and June 2011 were reviewed. Clinical features, ophthalmologic and neurologic assessments, neuroimaging studies, laboratory examinations, visual recovery, and final outcome of the patients were evaluated by the authors. RESULTS: Records of 50 patients (32 females and 18 males), aged 15 - 56 years, were reviewed, in which 22% patients had a previous onset of ON. Maximal visual deficit was severe in 72.5% (< 20/200). Abnormal rates of hormone levels and rheumatoid indicators were found in 54.2% and 25.0%. ANA test returned positive in 40%, oligoclonal banding (OCB) was identified in 31.3%, and Serum neuromyelitis optica (NMO)-IgG studies were abnormal in 25% of the patients. Neuroimaging abnormalities associated with ON were documented in six patients. Three of the 50 patients have been diagnosed with multiple sclerosis, and two with NMO. Visual acuity was 20/20 or better in 26.1% and 20/100 or worse in 39.1% affected eyes at the last visit. Poor visual acuity at onset is the main factor that would affect the final outcome of vision (P < 0.05). CONCLUSIONS: Vision defects of this group of patients were severe. Females had a higher incidence of ON than males. Hormone levels, rheumatoid indicators and immune parameters may be related to the onset of ON. The severe reduction of visual acuity at onset may be related to the poor outcome of vision in ON patients.