Severe Bone Marrow Aplasia Following Macrophage Activation Syndrome in Systemic Lupus Erythematosus.

Macrophage activation syndrome (MAS) is a potentially fatal complication of rheumatic diseases, characterized by activated macrophages with hemophagocytosis and multiple organ damage. We report a case of MAS associated with systemic lupus erythematosus that initially presented with severe liver dysfunction. Although it was improved with steroids and plasmapheresis, severe pancytopenia was subsequently experienced, and the bone marrow showed severe aplasia similar to aplastic anemia. Nevertheless, the administration of immunosuppressants resulted in the recovery of blood counts within two weeks. When severe MAS results in cytokine overproduction, bone marrow aplasia may occur, for which immunosuppressive therapy may be highly effective.

Aerosolized antibiotics therapy for infected traumatic pulmonary pseudocysts: A case report.

Background: Traumatic pulmonary pseudocysts are caused after thoracic trauma. They do not usually require specific therapy when no complications arise, such as infection and bleeding. Complicated pulmonary pseudocysts, however, can be life threatening and require specific treatment. Although treatments of systemic antibiotics and surgery for infected cysts have been reported, to the best of our knowledge, there are no reports on aerosolized antibiotics therapy for infected traumatic pulmonary pseudocysts. Case presentation: We present the case of a 31-year-old woman who was severely injured and suffered a blunt thoracic trauma in a vehicular accident, and required ventilator management in a previous hospitalization. Seven days later, she developed acute respiratory distress syndrome and was transferred to our department. We were unable to maintain proper oxygenation with ventilator management alone and established venous-venous extracorporeal membrane oxygenation. She then developed persistent bacteremia of Pseudomonas aeruginosa owing to infected traumatic pulmonary pseudocysts. On the 21st day of her hospitalization, the drainage for the enlarged cyst led to minor improvements in her respiratory condition. On the 32nd day of hospitalization, in addition to systemic antibiotics therapy, the aerosolized antibiotics therapy (inhalation of tobramycin (135 mg) every 12 h) was administered for the treatment of resistant infected pseudocysts. Her respiratory condition gradually improved, and the infected pseudocysts shrank. On the 43rd day of hospitalization, she was successfully removed from extracorporeal membrane oxygenation. Conclusions: Aerosolized antibiotics therapy may be a potential option for patients with infected traumatic pulmonary pseudocysts when conventional therapies are not successful.

Successful Treatment of Pulmonary Arterial Hypertension in Systemic Sclerosis with Anticentriole Antibody.

Systemic sclerosis (SSc) is characterized by skin sclerosis and multiple organ damages which may cause mortality and is usually accompanied with several specific autoantibodies, each of which is associated with characteristic complications. Among them, anticentriole antibody is recently reported to be highly associated with SSc-associated pulmonary arterial hypertension (SSc-PAH). In general, several vasodilators are used as therapeutic drugs for SSc-PAH, whereas immunosuppressive therapies are not. Here, we report the case of a 62-year-old female with anticentriole antibody-positive SSc-PAH treated with immunosuppressants and vasodilators. She presented with two-year exertional dyspnea and was diagnosed with PAH and SSc owing to the centriole staining pattern and other symptoms without digital sclerosis. Oral vasodilators were initially administered but were not sufficiently effective on dyspnea. Immunosuppressants such as prednisolone and cyclophosphamide were started. Both of them improved mean pulmonary arterial pressure and 6-minute walk distance, and the anticentriole antibody also disappeared. In this case, SSc-PAH with anticentriole antibody was properly diagnosed and immunosuppressants and vasodilators improved the hemodynamics of PAH with anticentriole antibody and stably maintained it and, in addition, reduced the titer of anticentriole antibody. This indicates that anticentriole antibody might represent a good responsive group to therapies among subgroups of patients with SSc-PAH.

Photoinduced electron-transfer bicyclopropenyl-benzene rearrangements of 2,2',3,3'-tetraphenylbicyclopropenyls: a new mechanism via Dewar benzene.

[reaction: see text] The 9,10-dicyanoanthracene-sensitized photoreaction of 1-methyl- and 1,1'-dimethyl-2,2',3,3'-tetraphenylbicyclopropenyl gives the corresponding benzene and Dewar benzene derivatives, indicating that their photoinduced electron-transfer bicyclopropenyl-benzene rearrangements proceed via Dewar benzenes.

Photoinduced Electron-Transfer Cope Rearrangements of 3,6-Diaryl-2,6-octadienes and 2,5-Diaryl-3,4-dimethyl-1,5-hexadienes: Stereospecificity and an Unexpected Formation of the Bicyclo[2.2.0]hexane Derivatives.

Under the 9,10-dicyanoanthracene-sensitized photoinduced electron-transfer conditions, (Z,Z)-, (E,E)-, (E,Z)-3,6-diaryl-2,6-octadiene and (d,l),(meso)-2,5-diaryl-3,4-dimethyl-1,5-hexadiene stereospecifically undergo the Cope rearrangement to give a Cope photostationary mixture. Remarkably, the photoinduced electron-transfer Cope rearrangements of the 4-methylphenyl derivatives are concurrent with the formation of trans- or endo,cis-1,4-bis(4-methylphenyl)-2,3-dimethylbicyclo[2.2.0]hexane in a Cope photostationary mixture. Observed stereospecificity of the Cope rearrangement and the formation of the bicyclo[2.2.0]hexane derivatives demonstrate the intermediacies of both the chair and boat 1,4-diaryl-1,2-dimethylcyclohexane-1,4-diyl and cation radical intermediates in a Cope rearrangement cycle. Photoreactions of trans- and exo,cis-1,4-diaryl-5,6-dimethyl-2,3-diazabicyclo[2.2.2]oct-2-enes further support the interventions of the diyl intermediates in the Cope rearrangement cycle. By photoacoustic analysis, a cation radical cyclization-diradical cleavage mechanism is proposed for the photoinduced electron-transfer Cope rearrangement of the title dienes.

Evidence for significant through-space and through-bond electronic coupling in the 1,4-diphenylcyclohexane-1,4-diyl radical cation gained by absorption spectroscopy and DFT calculations.

Photoinduced single-electron-transfer promoted oxidation of 2,5-diphenyl-1,5-hexadiene by using N-methylquinolinium tetrafluoroborate/biphenyl co-sensitization takes place with the formation of an intense electronic absorption band at 476 nm, which is attributed to the 1,4-diphenylcyclohexane-1,4-diyl radical cation. The absorption maximum (lambda(ob)) of this transient occurs at a longer wavelength than is expected for either the cumyl radical or the cumyl cation components. Substitution at the para positions of the phenyl groups in this radical cation by CH(3)O, CH(3), F, Cl, and Br leads to an increasingly larger redshift of lambda(ob). A comparison of the rho value, which was obtained from a Hammett plot of the electronic transition energies of the radical cations versus sigma(+), with that for the cumyl cation shows that the substituent effects on the transition energies for the 1,4-diarylcyclohexane-1,4-diyl radical cations are approximately one half of the substituent effects on the transition energies of the cumyl cation. The observed substituent-induced redshifts of lambda(ob) and the reduced sensitivity of lambda(ob) to substituent changes are in accordance with the proposal that significant through-space and -bond electronic interactions exist between the cumyl radical and the cumyl cation moieties of the 1,4-diphenylcyclohexane-1,4-diyl radical cation. This proposal gains strong support from the results of density functional theory (DFT) calculations. Moreover, the results of time-dependent DFT calculations indicate that the absorption band at 476 nm for the 1,4-diphenylcyclohexane-1,4-diyl radical cation corresponds to a SOMO-3 --> SOMO transition.

Thermoluminescence and a new organic light-emitting diode (OLED) based on triplet-triplet fluorescence of the trimethylenemethane (TMM) biradical.

The results of an investigation of the thermoluminescence (TL) and electroluminescence (EL) of arylated methylenecyclopropanes 1, systems whose photoinduced electron-transfer (PET) chemistry has been thoroughly studied, are described. In both the TL and EL experiments with 1, electronically excited triplet trimethylenemethane (TMM) biradicals (3)2** are generated by back electron transfer (charge recombination) of a TMM radical cation (hole) 2*+, formed by isomerization of the substrate radical cation (hole, 1*+). The application of this chemistry to the design of new organic light-emitting diodes (OLEDs) is described. The mechanistic features of this reaction system have the potential of overcoming significant problems (e.g., quantum efficiency, difficulty obtaining long wavelength emission, and device durability) normally associated with OLEDs that rely on the use of organic closed-shell hydrocarbons.