Characterization of the one-electron oxidized Cu(II)-salen complexes with a side chain aromatic ring: the effect of the indole ring on the Cu(II)-phenoxyl radical species.

To gain insights into the role of the proximal indole ring in the redox-active metal center as seen in galactose oxidase, we prepared the Cu(II)-salen-type complexes having a pendent indol-3-ylmethyl (1), methyl (2) or benzyl (3) group substituted on the ethylenediamine moiety and investigated the structures and redox properties by various physicochemical methods and theoretical calculations. Neutral complexes 1, 2, and 3 showed no significant difference in the UV-Vis-NIR and EPR spectra. One-electron oxidation of 1, 2, and 3 by addition of 1 equiv. of thianthrenyl radical gave [1]SbCl 6 , [2]SbCl 6 , and [3]SbCl 6 , respectively, which could be assigned to relatively localized phenoxyl radical species. The cyclic and differential pulse voltammograms of [1]SbCl 6 showed two redox waves with a large separation between the first and second redox potentials compared with the separations observed for [2]SbCl 6 and [3]SbCl 6 . This suggests that [1]SbCl 6 is more stabilized than [2]SbCl 6 and [3]SbCl 6 . The NIR band of [1]SbCl 6 showed a larger blue shift than that of [2]SbCl 6 and [3]SbCl 6 . The EPR spectrum of [2]SbCl 6 exhibited an intense signal at the g value of 2 due to partial disproportionation to form the EPR active two-electron oxidized complex [2] 2+ , while the EPR intensity of [1]SbCl 6 was much weaker than that of [2]SbCl 6 . These results indicate that the pendent indole moiety stabilizes the Cu(II)-phenoxyl radical in [1]SbCl 6 most probably by stacking with the phenoxyl moiety, which is further supported by DFT calculations.

A refractory duodenal ulcer with a biliary-duodenal fistula following the administration of bevacizumab.

A 65-year-old woman with recurrent breast cancer was repeatedly treated with bevacizumab, an anti-VEGF antibody. In addition, she was also frequently prescribed a nonsteroidal anti-inflammatory drug for abdominal pain. Melena was revealed 2 months after the final treatment with bevacizumab, and an endoscopic study revealed a duodenal ulcer (DU) that was resistant to anti-ulcer therapy. A cholangiography identified a biliary-duodenal fistula with bile juice leaking from the ulcer base. Therefore, a biliary stent was placed into the common bile duct for 3 months until the DU healed. This is the first case of a refractory DU with a biliary-duodenal fistula in a patient treated with bevacizumab.

[Bile duct injury and severe bleeding after endoscopic papillary large balloon dilation without sphincterotomy: a case report].

We report the case of an 80-year-old woman with multiple choledocholithiasis who suffered severe bleeding after endoscopic papillary large balloon dilation (EPLBD). Astriction by balloon tamponade and a covered, self-expandable, metallic stent failed. However, embolization using a transcatheter arterial coil stopped the bleeding. After hemostasis was achieved, a bile duct injury was observed. We presume that a bile duct stone, which had remained in the lower common bile duct, entered the balloon and the bile duct and caused the bile duct injury. This case emphasizes the need for careful attention during EPLBD.

Delayed stenosis of the small intestine after cardiopulmonary arrest.

A man in his 70s experienced cardiopulmonary arrest (CPA) due to acute myocardial infarction. He was resuscitated and treated with a multimodal approach, and he fortunately survived CPA without neurological damage. However, abdominal pain and vomiting occurred 45 days after the CPA. Small intestinal endoscopy showed pinhole-like stenosis of the ileum. Although balloon dilation was performed through the scope, his symptoms did not improve. Partial small bowel resection was eventually performed 139 days after the CPA. Pathological findings revealed ischemic changes in the mucosa at two spots. We speculate that an ischemic event occurred in the small bowel during CPA.

[A case of advanced gastric cancer with liver abscesses].

A man visited to our hospital because of high grade fever. Computed tomography revealed multilocular space occupying lesion which were suspected liver abscess. Upper gastrointestinal endoscopy showed an advanced gastric cancer with an ulcer on antrum. Antibiotics decreased the level of CRP, concurrently with the reduction of liver space occupying lesion. While he underwent distal gastrectomy, pathological examination demonstrated the existence of bacterial foci and microabscesses on the surface of the gastric cancer. We speculate in this case that liver abscesses were formed by the infection of resident bacteria through portal vein.

Severe skin ulcer caused by taking lenvatinib after proton beam therapy.

A 69-year-old man was treated with lenvatinib after three sessions of proton beam therapy (PBT) for hepatocellular carcinoma. Five months after administration of lenvatinib, a dermatitis with huge skin ulcer formed in the site of PBT irradiation. Lenvatinib was immediately withdrawn, but the skin ulcer continued growing until about 2 weeks later. With topical and antibiotic treatment, the skin ulcer resolved after about 4 months. After administration of lenvatinib, potential skin damage due to PBT at the irradiated site may have become apparent. This is the first report describing skin ulcer by the combination of lenvatinib administration and PBT.

Group-10 metal complexes of biological molecules and related ligands: structural and functional properties.

The complexes of group-10 metals, Ni, Pd, and Pt, with biological molecules and related ligands have been attracting increasing attention in recent years due to their reactivities and functions, such as catalysts and drugs, and their biological relevance. The well-defined structures and kinetic inertness especially of Pt complexes have been used as the sites for weak interactions with other molecules. The Ni complexes have been reported as models not only for Ni enzymes but also for other metalloenzyme active sites for deeper understanding of the reactivities such as oxygen activations and detailed electronic structures. Pd Complexes are widely known for their catalytic activities in conversions of various organic molecules including useful biological molecules, such as Suzuki-Miyaura cross-coupling, while Pt complexes have been intensively studied for their antitumor activities. We focus in this review on our recent results on weak interactions and reactivities of the group-10 metal complexes with biological molecules and related compounds, and discuss their structural features and some new properties pointing to functional possibilities.

Risk factors for the development of esophageal candidiasis among patients in community hospital.

The aim of this study was to clarify risk factors for esophageal candidiasis (EC) in immunocompetent patients in a community hospital. 7736 patients who underwent esophagogastroduodenoscopy at our hospital from April 2012 to July 2018 were enrolled. The relationships between EC and the following factors: age, gender, body mass index, lifestyle, lifestyle-related diseases, medication, and endoscopic findings were analyzed. EC was observed in 184 of 7736 cases (2.4% morbidity rate). Multivariate analysis revealed that significant risk factors for the development of EC were: diabetes mellitus {odds ratio (OR): 1.52}, proton pump inhibitor (PPI) use (OR: 1.69), atrophic gastritis (AG) (OR: 1.60), advanced gastric cancer (OR: 4.66), and gastrectomy (OR: 2.32). When severe EC (Kodsi grade ≥ II) was compared to mild EC (grade I), the most significant risk factors were advanced gastric cancer (OR: 17.6) and gastrectomy (OR: 23.4). When considering the risk of AG and PPI use with EC development, the risk increased as follows: AG (OR: 1.59), PPI use (OR: 2.25), and both (OR: 3.13). PPI use, AG, advanced gastric cancer and post-gastrectomy are critical risk factors for the development of EC. We suggest close monitoring for EC development when PPIs are administered to patients with these factors.

Effects of antithrombotic drugs on the results of fecal immunochemical test in colorectal neoplasms screening.

Fecal immunochemical test (FIT) is widely used as a colorectal cancer screening tool. Antithrombotic drugs may affect the screening performance of FIT for colorectal tumors. The aim of this study was to clarify the effect of antithrombotic agents on FIT accuracy in screening for colorectal neoplasms. This retrospective study enrolled a total of 758 patients who underwent both FIT and total colonoscopy. The effect of antithrombotic drugs on FIT accuracy in detecting colorectal neoplasms (CN), including colorectal cancer (CRC), advanced adenoma (AA), and non-advanced adenoma (NAA), was examined. Of the 758 patients, 144 (19%) received antithrombotic drugs (administration group). In administration group, 61/144 (42%) cases had CN [CRC:14, AA:15, NAA:32] and 217/614 (35%) cases had CN (CRC:43, AA:56, NAA:118) in non-administration group. The prevalence of CN was not significantly different between the two groups (p = 0.1157). There was no significant difference in sensitivity or specificity of the detection of all types of CN with or without taking antithrombotic drugs. Neither the positive predictive value nor negative predictive value of FIT was affected by antithrombotic drug administration. Taking antithrombotic drugs may not have a large impact on sensitivity, specificity, positive predictive value, or negative predictive value of FIT in screening for CN.

CH...Metal(II) axial interaction in planar complexes (metal=Cu, Pd) and implications for possible environmental effects of alkyl groups at biological copper sites.

Intramolecular M(II)...H-C interactions (M(II)=Cu(II), Pd(II)) involving a side chain alkyl group of planar d8 and d9 metal complexes of the N-alkyl (R) derivatives of N,N-bis(2-pyridylmethyl)amine with an N3Cl donor set were established by structural and spectroscopic methods. The methyl group from the branched alkyl group (R=2,2-dimethylpropyl and 2-methylbutyl) axially interacts with the metal ion with the M...C and M...H distances of 3.056(3)-3.352(9) and 2.317(1)-2.606(1) A, respectively, and the M-H-C angles of 122.4-162.3 degrees . The Cu(II) complexes showing the interaction have a higher redox potential as compared with those without it, and the (1)H NMR signals of the interacting methyl group in Pd(II) complexes shifted downfield relative to the ligand signals. Dependence of the downshift values on the dielectric constants of the solvents used indicated that the M(II)...H-C interaction is mainly electrostatic in nature and may be regarded as a weak hydrogen bond. Implications for possible environmental effects of the leucine alkyl group at the type 1 Cu site of fungal laccase are also discussed.

Alpha-glucosidase inhibitor use is associated with decreased colorectal neoplasia risk in patients with type 2 diabetes mellitus receiving colonoscopy: a retrospective study.

PURPOSE: The purpose of this study was to clarify the factors that influence the incidence of colorectal neoplasia in patients with type 2 diabetes mellitus (DM). STUDY DESIGN AND SETTING: Among a total of 1176 patients who underwent total colonoscopy at our hospital, we retrospectively analyzed 168 patients with type 2 DM. Univariate and multivariate logistic regression analyses were then performed to identify the risk factors associated with colorectal neoplasia. RESULTS: A multivariate analysis of these patients demonstrated that male gender (odds ratio [OR] = 4.04, 95% confidence interval [CI] = 1.67-10.37, p = 0.002), taking statins (OR = 4.59, 95% CI = 1.69-13.43, p = 0.003), taking alpha glucosidase inhibitor (α-GI) (OR = 0.35, 95% CI = 0.13-0.87, p = 0.023) and taking low-dose aspirin (LDA) (OR = 0.32, 95% CI = 0.10-0.95, p = 0.040) were independent factors associated with an increased (male gender and statins) or decreased (α-GI and LDA) risk of colorectal neoplasia. CONCLUSIONS: While male gender and taking statins are risk factors, taking α-GI as well as LDA may reduce the risk of colorectal neoplasia in patients with type2 DM.

Dipolar ruthenium(II) ammine complexes as electron transfer mediators of amperometric glucose sensors.

The mediation of dipolar ruthenium(II) ammine complexes containing pyridinium ions [Ru(NH(3))(5)(L(+))](3+)(L(+): pyridinium ions) in glucose oxidation has been investigated by a voltammetric method. These ruthenium(II) complexes had appropriate redox potentials of 0.10-0.18 V vs. Ag/AgCl and high k(s) values of 5.7-17 x 10(6) M(-1) s(-1) which are the second-order rate constants for electron transfer from glucose oxidase in reduced form to [Ru(NH(3))(5)(L(+))](4+). In particular, the k(s) values for [Ru(NH(3))(5)(L(+))](3+) were greater than those of osmium(II)-polypyridine complexes possessing similar redox potentials which are most commonly used. All the dipolar ruthenium(II) complexes used in this study are therefore concluded to be useful for the electron transfer mediators of amperometric glucose sensors.

Development of a Novel Scoring System for Predicting the Risk of Colorectal Neoplasia: A Retrospective Study.

OBJECTIVE: The purpose of this study was to develop a novel scoring system to screen subjects who have a high risk for colorectal neoplasia. STUDY DESIGN AND SETTING: We retrospectively analyzed 1061 subjects undergoing total colonoscopy (TCS) for the first time at Gihoku Kosei Hospital. The characteristics and habits of the subjects were analyzed using a multivariate logistic regression analysis. The risk score was established according to each odds ratio of the individual risk factors, and the correlations between the sum of the risk scores and the prevalence of colorectal neoplasia for each individual were evaluated. RESULTS: Age 45-59 (risk score: 2 points) and ≥60 (3 points), male gender (1 point), and habitual alcohol consumption ≥21g daily (1 point) were extracted as the significant risk factors for colorectal neoplasia. When the risk groups were determined by summing up these risk scores, the prevalence rates of colorectal neoplasia were 8.8% for the low risk group (0-2 points), 30.5% for the low-moderate risk group (3 points), 39.1% for the high-moderate risk group (4 points), and 57.6% for the high risk group (5 points). In comparison with the low risk group, the odds ratio of the low-moderate risk, the high-moderate risk, and the high risk groups were 4.6, 6.7, and 14.1 folds, respectively. CONCLUSION: Our scoring system, which linearly correlates with the prevalence rate of colorectal neoplasia, may be an effective tool for screening the subjects who have a high risk for colorectal neoplasia. These subjects, therefore, should be recommended to undergo TCS.

Properties of the indole ring in metal complexes. A comparison with the phenol ring.

Tryptophan (Trp), an essential amino acid, has an indole ring with a high electron density and is frequently seen at the proximal position of the metal site in metalloproteins. For example, the indole ring of Trp has been reported to interact weakly with Cu(I) in a Cu chaperone CusF. Another aromatic amino acid, tyrosine (Tyr), has a phenol ring, which is an important metal binding site in various metalloproteins. Although the structures of the aromatic rings are different, they both have a weakly acidic moiety and perform some similar roles in biological systems, such as radical formation and electron transfer. In this review, we focus on these and other properties of the indole and phenol rings in metal-containing systems.

Structures and Stabilities of Ternary Copper(II) Complexes with 3,5-Diiodo-L-tyrosinate. Weak Interactions Involving Iodo Groups.

Structures and stabilities of the ternary copper(II) complexes Cu(DA)(AA), where AA refers to 3,5-diiodo-L-tyrosinate (I(2)tyr) or L-tyrosinate (Tyr) and DA refers to 1,10-phenanthroline (phen), 2,2'-bipyridine (bpy), 2-(aminomethyl)pyridine (ampy), histamine (hista), or ethylenediamine (en), have been investigated by potentiometric, spectroscopic, and X-ray diffraction methods. The stability constants have been determined by potentiometric titrations at 25 degrees C and ionic strength I = 0.1 M (KNO(3)). The equilibrium constants K for a hypothetical equilibrium, Cu(DA)(Ala) + Cu(en)(AA) Cu(DA)(AA) + Cu(en)(Ala) where Ala refers to L-alanine, have been calculated from the determined overall stability constants of the ternary complexes for estimating the stability enhancement due to the stacking interaction between the aromatic rings in Cu(DA)(AA). Large positive log K values have been obtained for the Cu(DA)(I(2)tyrOH) and Cu(DA)(I(2)tyrO(-)) systems (DA = phen or bpy, OH and O(-) refer to the protonated and deprotonated forms of the phenol moiety, respectively), indicating that the complexes are stabilized by effective stacking. Differences between the log K values for Cu(DA)(I(2)tyr) and Cu(DA)(Tyr) systems indicate that the iodine substituents greatly contribute to the stability enhancement. A distinct circular dichroism (CD) magnitude anomaly was also observed for the systems with large log K value, supporting the existence of the stacking interaction in Cu(DA)(AA). Two complexes, [Cu(bpy)(I(2)tyrO(-))(H(2)O)].2H(2)O (1) and [Cu(bpy)(I(2)tyrOH)(NO(3))].CH(3)OH (2), have been isolated as crystals and analyzed by the X-ray diffraction method. Both 1 and 2 crystallized in the orthorhombic space group P2(1)2(1)2(1) with four molecules in a unit cell of dimensions a = 9.2339(4), b = 16.9230(8), and c = 14.8584(5) Å for complex 1, and a = 11.2240(8), b = 11.715(1), and c = 17.966(2) Å for complex 2. The central Cu(II) ion for both complexes has a similar distorted five-coordinate square-pyramidal geometry with the equatorial positions occupied by the two nitrogen atoms of bpy and the nitrogen and oxygen atoms of I(2)tyr, and the apical position is occupied by a water molecule (for 1) or a nitrate ion (for 2). The opposite site to the axial water or nitrate oxygen atom is intramolecularly occupied by the side chain aromatic ring, which is approximately parallel to the copper coordination plane with the average spacing of 3.31 or 3.30 Å for complex 1 or 2, respectively, directly exhibiting the effective stacking interaction between the aromatic rings in the solid state. Distances between the iodine and one of the pyridine rings of bpy (3.79 Å for 1 and 3.56 Å for 2) are shorter than the van der Waals distance (3.85 Å), implying that the iodine substituent may be involved in a weak bonding interaction with the pyridine ring. Effects of the iodine substituents on the stacking interactions between the diiodophenol side ring and the coordinated aromatic diamine and their possible biological relevance have been discussed.

Weak Interactions in Ternary Copper(II) Complexes with Iodotyrosinates. Biological Significance of the Iodines in Thyroid Hormones.

Structures and spectroscopic studies have been carried out on ternary copper(II) complexes, Cu(DA)(AA), with aromatic amino acids (AA = 3,5-diiodo-L-tyrosinate (L-I(2)tyr), 3-iodo-L-tyrosinate (L-Ityr), L-tyrosinate) and diamines (DA = 1,10-phenanthroline, 2,2'-bipyridine (bpy), 2-(aminomethyl)pyridine, histamine (hista), or ethylenediamine). The charge transfer (CT) absorption bands observed in the near UV region and the CD spectral magnitude anomaly observed in the d-d region indicated an effective aromatic ring stacking interaction between the side-chain phenol ring of AA and the aromatic diamine DA in the complexes in solution. Two complexes, [Cu(bpy)(L-Ityr)(H(2)O)].NO(3).CH(3)OH.H(2)O (1) and [Cu(hista)(L-I(2)tyrO(-))(H(2)O)](2).2H(2)O (2), where O(-) represents the deprotonated form of the phenol hydroxyl group, were isolated as single crystals, and their structures were determined by X-ray analysis. Both 1 and 2 crystallized in the monoclinic space group P2(1), with a = 7.549(1) Å, b = 11.431(1) Å, c = 14.292(2) Å, beta = 100.08(1) degrees, and Z = 2 for 1 and a = 9.9642(9) Å, b = 15.825(1) Å, c = 12.451(1) Å, beta = 91.565(7) degrees, and Z = 2 for 2. The molecular structures of 1 and 2 revealed the intramolecular aromatic ring stacking between DA and the iodinated phenol ring of Ityr and I(2)tyrO(-), respectively, in correspondence with the solution spectral observations. The stacking with hista was found to be weaker than that with bpy from the interplanar distances in 1 and 2 and the CT band intensities in solution. The molecular and crystal structures revealed some intermolecular iodine-aromatic ring and iodine-oxygen interactions as well as some hydrogen bonds involving the phenol hydroxyl group.

Spectroscopic and structural characterization of copper(II) and palladium(II) complexes of a lichen substance usnic acid and its derivatives. Possible forms of environmental metals retained in lichens.

The metal binding properties of a phenolic lichen substance usnic acid (UA) and its acetyl and enamine derivatives 9-O-acetylusnic acid (MAUA), 7,9-di-O-acetylusnic acid (DAUA), Delta(2,11)-enaminousnic acid (EUA), and N-substituted Delta(2,11)-enaminousnic acids have been studied by synthetic and spectroscopic methods, and the structures of copper(II) and palladium(II) complexes have been established by the X-ray diffraction method. Cu(II) reacted with UA and DAUA to give the binary complexes Cu(UA)(2) x H(2)O and Cu(DAUA)(2), respectively, and Cu(bpy) (bpy=2,2'-bipyridine) formed ternary complexes with UA and DAUA. Pd(II) also reacted with UA, DAUA, EUA, and N-substituted Delta(2,11)-enaminousnic acids to give the corresponding binary complexes. All the isolated complexes are insoluble in water and soluble in most organic solvents. They exhibited very strong absorption and circular dichroism spectral peaks in the UV region. The (1)H-NMR spectrum in CDCl(3) of the Pd(II) complex of N-phenyl-Delta(2,11)-enaminousnic acid (PEUA), Pd(PEUA)(2) x C(6)H(6), showed that the C(4)-proton signal suffered a large upfield shift (0.86 ppm) due to the ring current effect of the N-phenyl moiety. X-Ray crystal structure analysis has been performed for Cu(bpy)(UA)(ClO(4)) x CH(3)OH, Pd(MEUA)(2) x C(6)H(6), and Pd(PEUA)(2) x C(6)H(6). Cu(bpy)(UA)(ClO(4)) x CH(3)OH has a square-pyramidal structure with the two nitrogen atoms of bpy and the two oxygen atoms of the mono-deprotonated B ring of UA in the equatorial positions, while Pd(II) binds with two molecules of MEUA or PEUA in the trans configuration through the nitrogen and oxygen atoms with deprotonation. The N-phenyl ring of PEUA in Pd(PEUA)(2).C(6)H(6) was revealed to be located close to the C(4) proton as indicated by (1)H-NMR. Isolation of Cu(2)(bpy)(2)(UA)(NO(3))(2) x 2H(2)O suggests that UA has two metal binding sites that can form polymeric complexes. The present results substantiate the metal binding ability and the structures of the complexes of usnic acid and other substances from lichens as biomonitors of environmental metal ions.

Effects of a Side Chain Aromatic Ring on the Reactivity of Copper(I) Complexes with Dioxygen.

Stabilization of the bis(µ-oxo)dicopper(III) intermediate is achieved by using a bidentate N-donor ligand with pendent indole rings: N,N-bis[(3-indolyl)methyl]-N-[(2'-pyridyl)methyl]amine (BIP). The intermediate decomposes to give products arising from N-dealkylation and a product with a spiro ring composed of two indole rings. This latter product probably results from a radical-coupling reaction.