Two new ɑ-pyrone derivatives from the endophytic Diaporthe sp. ECN371.

Diaportholides A (1) and B (2), two polyketides with ɑ-pyrone moieties, were isolated from the cultures of an endophytic Diaporthe sp. ECN371 isolated from Orixa japonica, together with four known polyketides, phomopsolide B (3), phomopsolidones A (4) and B (5), and 5-[(1R)-1-hydroxyethyl]-γ-oxo-2-furanbutanoic acid (6). The structures of 1 and 2 were determined by extensive analysis of NMR and MS spectroscopic data. Furthermore, the structure of 2 was confirmed by analyzing the single-crystal X-ray diffraction data. The luciferase reporter gene assay revealed that among all isolated compounds (1-6), 3, a known ɑ-pyrone derivative, exhibited agonistic activity against the peroxisome proliferator-activated receptor ɑ, which is an important regulator of lipid metabolism in humans.

Functional outcomes of transurethral thulium laser enucleation versus bipolar transurethral resection for benign prostatic hyperplasia over a period of 12 months: A prospective randomized study.

OBJECTIVE: To evaluate functional outcomes over a year for benign prostatic hyperplasia treated with thulium laser enucleation of the prostate or bipolar transurethral resection of the prostate. METHODS: In this study, we prospectively included 140 patients who were treated for benign prostatic hyperplasia from April 2017 to February 2019. A randomization list was used for non-blind assignment to treatment groups (thulium laser enucleation of the prostate or bipolar transurethral resection of the prostate). The International Prostate Symptom Score, International Prostate Symptom Score quality of life, Overactive Bladder Symptom Score, uroflowmetry and International Index of Erectile Function-5 were used for the assessment of outcomes. Scores were taken before treatment, and at 1, 3, 6, 9 and 12 months after treatment. RESULTS: Preoperatively, characteristics of patients in the thulium laser enucleation of the prostate group (n = 70) and the bipolar transurethral resection of the prostate group (n = 70) did not significantly differ. The thulium laser enucleation of the prostate group had a lower median decrease in hemoglobin (0.10 g/dL vs 0.69 g/dL, P < 0.0001) and shorter median catheterization (2 days vs 3 days, P < 0.0001) than the bipolar transurethral resection of the prostate group. Both groups had significantly improved International Prostate Symptom Score, International Prostate Symptom Score quality of life, Overactive Bladder Symptom Score, maximum flow rate and residual urine compared with preoperative values. In the thulium laser enucleation of the prostate group, erectile function was significantly impaired at 1 month post-treatment compared with pretreatment, but improved to baseline at 3 months; however, the transurethral resection of the prostate group did not recover. However, total energy (P = 0.001) and laser irradiation time (P = 0.025) were significantly different between the patients who had preserved erectile function and those who did not after the treatment in the thulium laser enucleation of the prostate group. CONCLUSIONS: Thulium laser enucleation of the prostate is superior to bipolar transurethral resection of the prostate in resection efficacy, hemostasis, catheterization time and preservation of erectile function. However, excessive laser irradiation time in thulium laser enucleation of the prostate has the possibility to delay improvement of overactive bladder symptoms and decrease sexual function.

Correction to: Sesquiterpenes with new carbon skeletons from the basidiomycete Phlebia tremellosa.

The article Sesquiterpenes with new carbon skeletons from the basidiomycete Phlebia tremellosa, written by Ken ichi Nakashima, Junko Tomida, Takao Hirai, Yoshiaki Kawamura and Makoto Inoue was originally published Online First without Open Access.

Sesquiterpenes with new carbon skeletons from the basidiomycete Phlebia tremellosa.

Three new sesquiterpenes, phlebidiol, phlebioic acid, and phlebiolide, as well as the known compound tremetriol, were isolated from cultures of the basidiomycete Phlebia tremellosa. The structures of all isolated compounds were established by extensive spectroscopic analyses, including those involving extensive two-dimensional nuclear magnetic resonance. The absolute configurations of phlebidiol, phlebioic acid, and phlebiolide were determined by comparisons of experimental and calculated electronic circular dichroism spectra. Phlebidiol and phlebioic acid have previously unreported carbon skeletons, for which we propose the skeletal names "seco-sterpurane" and "phlebiane," respectively. Phlebiolide is also the second published example of a merulane sesquiterpene.

Helicobacter cinaedi bacteremia resulting from antimicrobial resistance acquired during treatment for X-linked agammaglobulinemia.

This is the first report of penicillin/cephalosporin-resistant Helicobacter cinaedi arising from prolonged treatment. H. cinaedi, common among immunocompromised patients, caused recurrent bacteremia and cellulitis in a 19-year-old Japanese man with X-linked agammaglobulinemia. The minimal inhibitory concentration of these drugs was raised, which subsequently resulted in clinical failure. Prolonged suboptimal treatment may cause bacterial resistance to ß-lactam antibiotics in H. cinaedi. It is possible that this resistance may have contributed to the treatment failure.

Clinical Outcomes of Transurethral Enucleation with Bipolar for Benign Prostatic Hypertrophy.

OBJECTIVE: This study compared outcomes of transurethral enucleation with bipolar (TUEB) with transurethral resection in saline (TURis). METHODS: Thirty patients who underwent TURis were compared with 30 who underwent TUEB. Perioperative treatment outcomes, preoperative and 1-month postoperative International Prostrate Symptom Scores (IPSS), quality of life (QOL) index, maximum flow rate, average urinary flow, post- void residual urinary volume, and complications were compared. RESULTS: There were no significant differences in IPSS, measurements of urinary flow, or duration of catheterization. However, the improvement of QOL index after surgery was significantly greater in the TUEB group than the TURis group. The TUEB group had significantly longer surgical time, but tended to have greater enucleated tissue weight than the TURis group. There was no significant difference in enucleated tissue weight per unit time between the groups. The TUEB group also tended to have less hemoglobin decrease at postoperative day 1; this tendency was more prominent in patients with an estimated prostate volume of ≥ 50 ml. No significant differences in postoperative complications were observed. CONCLUSIONS: This study confirmed that the previously reported safety and efficacy of TUEB are comparable to those of TURis. TUEB appears especially safe for those with a large benign hypertrophic prostate.