Zirconium Metal-Organic Frameworks Assembled from Pd and Pt PNNNP Pincer Complexes: Synthesis, Postsynthetic Modification, and Lewis Acid Catalysis.

Carboxylic acid-functionalized Pd and Pt PNNNP pincer complexes were used for the assembly of two porous Zr metal-organic frameworks (MOFs), 2-PdX and 2-PtX. Powder X-ray diffraction analysis shows that the new MOFs adopt cubic framework structures similar to the previously reported Zr6O4(OH)4[(POCOP)PdX]3, [POCOP = 2,6-(OPAr2)2C6H3); Ar = p-C6H4CO2-, X = Cl-, I-] (1-PdX). Elemental analysis and spectroscopic characterization indicate the presence of missing linker defects, and 2-PdX and 2-PtX were formulated as Zr6O4(OH)4(OAc)2.4[M(PNNNP)X]2.4 [M = Pd, Pt; PNNNP = 2,6-(HNPAr2)2C5H3N; Ar = p-C6H4CO2-; X = Cl-, I-]. Postsynthetic halide ligand exchange reactions were carried out by treating 2-PdX with Ag(O3SCF3) or NaI followed by PhI(O2CCF3)2. The latter strategy proved to be more effective at activating the MOF for the catalytic intramolecular hydroamination of an o-substituted alkynyl aniline, underscoring the advantage of using halide exchange reagents that produce soluble byproducts.

Small Bowel Evisceration Through a Perforated Stercoral Ulcer.

Stercoral ulcers are localized areas of loss of colonic mucosal integrity. They result from pressure necrosis of the colonic mucosa, secondary to chronic constipation and fecal inspissation. These ulcers are rare and, are associated with serious complications, including bleeding and perforation. We present the case of a 50-year-old woman who presented with small bowel evisceration through the anal canal secondary to extraperitoneal perforation of the rectum. The patient underwent emergent exploratory laparotomy with reduction of the bowel, followed by second look laparotomy in 24 hours. A full thickness defect in the rectum was identified and Hartmann's procedure was performed. The patient's postoperative course was uneventful. Extraperitoneal perforation and evisceration of bowel is a rare clinical entity. These cases are diagnosed early due to the obvious clinical presentation and however may be misdiagnosed as prolapse. They necessitate urgent and careful surgical planning, to ensure preservation of bowel and complete recovery.

Case report: Neuroendocrine breast carcinoma with a germline EGFR T790M mutation.

Background: The epidermal growth factor receptor (EGFR) p.Thr790Met (T790M) mutation was discovered as a resistance mechanism in patients with lung cancer treated with first- and second-generation tyrosine kinase inhibitors. Further studies revealed the EGFR T790M mutation in treatment-naive non-small cell lung carcinoma (NSCLC) and as a rare germline mutation strongly associated with NSCLC. Somatic EGFR T790M mutations have been reported in a limited population of patients with triple-negative breast cancer. There are no previous reports of a germline EGFR T790M mutation found in a patient with breast cancer. Case presentation: We present a rare case of a 42-year-old woman with a rapidly progressing 8 cm mass in the right lateral breast. An additional right breast mass with multiple lymph nodes characteristic or suspicious of metastasis was found. Ultrasound-guided biopsy showed high-grade, poorly differentiated invasive neuroendocrine carcinoma of the right breast and metastatic carcinoma of a right axillary lymph node. Genetic testing revealed a germline EGFR T790M mutation. The patient underwent neoadjuvant chemotherapy, right mastectomy with lymph node dissection, adjuvant radiation to the right chest wall and axilla, and adjuvant chemotherapy. Conclusion: This is the first reported case of a patient with high-grade neuroendocrine carcinoma, triple-negative breast cancer and a germline EGFR T790M mutation. Further investigation is needed to find a possible correlation between the cancer in this patient and her mutation. Since there are no current guidelines, further research is also needed to define screening protocols for patients with germline EGFR T790M mutations. Additional treatment options and cancer risk could also be found with further research, which would benefit all patients with a germline EGFR T790M mutation.

Sudden Death in a Child With Ocular Lesions.

This case report describes a patient treated for ocular lesions who died suddenly at age 8 years and was diagnosed postmortem with Carney complex.

Confocal microscopy in Meretoja syndrome.

PURPOSE: To study the correlation between severity of clinical systemic symptoms and the degree of stromal haze and visibility of epithelial and stromal nerves on scanning slit confocal microscopy examination in Meretoja syndrome. METHODS: Three patients with Meretoja syndrome were examined by slit-lamp microscopy and scanning slit confocal microscopy. RESULTS: Increased symptoms and abnormal slit-lamp findings correlated positively with confocal microscopic stromal haze intensity and inversely with visibility of epithelial and stromal nerves on confocal examination. A prominent deposit, presumably amyloid, was observed contiguous to a stromal nerve of an affected cornea. In a severely affected cornea, no stromal or epithelial nerves were seen. CONCLUSION: The results of this study suggest that Meretoja syndrome causes corneal nerve damage and eventual degeneration that correlates with the degree of clinical involvement.

Macular ischemia associated with imatinib mesylate therapy for chronic myeloid leukemia.

PURPOSE: Imatinib mesylate (Gleevec, East Hanover, NJ) is a drug approved for the treatment of patients with Philadelphia chromosome-positive chronic myeloid leukemia (CML) or Kit-positive gastrointestinal stromal tumors. A case of ischemic maculopathy associated with imatinib mesylate therapy is reported. METHODS: A 62-year-old woman with a 16-year history of CML was treated with imatinib mesylate, initially at a daily dose of 400 mg that was decreased to 300 mg due to systemic side effects. Several weeks after beginning imatinib mesylate therapy, she developed blurred vision (greater in the left eye than in the right eye). RESULTS: Fundus examination of both eyes revealed retinal telangiectasia with intraretinal hemorrhages and perifoveal retinal telangiectasia. Fluorescein angiography showed macular ischemia (greater in the left eye than in the right eye). Late perifoveal leakage was present surrounding the macular ischemic zone. Visual acuity was reduced to 20/30 in the right eye and 20/100 in the left eye, which did not improve over 10 months of follow-up. CONCLUSION: Imatinib mesylate may be associated with ischemic maculopathy that can severely compromise vision. It may be necessary for patients receiving this therapy to be monitored for associated visual symptoms and funduscopic abnormalities.