RESUMO
Tumor lysis syndrome (TLS) is an oncologic emergency that usually occurs after initial treatment of a malignant tumor. It manifests as hyperuricaemia, hyperkalaemia, hyperphosphataemia and hypocalcaemia, ultimately resulting in acute kidney failure, seizures, cardiac arrhythmias, and even death. Here, we report a very rare case of spontaneous TLS in a patient with advanced gastric adenocarcinoma who eventually succumbed to renal failure. Extra vigilance towards electrolyte imbalances should be given during initiation of therapy in cases of large gastric cancer with severe distant metastasis. Risk assessment prior to surgery, early diagnosis and comprehensive treatment strategies are vital in improving the prognosis of gastric cancer patients with TLS. Urgent hemodialysis should be implemented as soon as possible in order to prevent further renal deterioration.
RESUMO
AIM: In a search for new cardiovascular drug candidates, a series of novel oxime ethers derived from a natural isochroman-4-one were synthesized. METHOD: Compounds 3 and 6, derived from the natural antihypertensive compound 7, 8-dihydroxy-3-methyl-isochroman-4-one (XJP), were designed and synthesized. Subsequently, a series of novel isochroman-4-one oxime ether hybrids were prepared by hybridizing various N-substituted isopropanolamine functionalities to isochroman-4-one oxime. Furthermore, ß1-adrenergic blocking activities of the synthesized compounds were assayed using the isolated rat left atria. RESULTS: Twenty target compounds were obtained, and the preliminary structure-activity relationships were deduced. The most promising compound Ic exhibited ß1-adrenoceptor blocking activity (inhibition: 52.2%) at 10(-7) mol·L(-1), which was superior to that of propranolol (inhibition: 49.7%). CONCLUSION: The results suggested that natural product XJP/isopropanolamine moiety hybrids may provide a promising approach for the discovery of novel cardiovascular drug candidates.