Cultivation of a Cu/HMPC catalyst from a hyperaccumulating mustard plant for highly efficient and selective coupling reactions under mild conditions

Cu-containing activated carbon (eco-catalyst, Cu/HMPC, where ‘C’ defines ‘carbon’) was derived from a metal-hyperaccumulating mustard plant (HMP) by a simple chemical activation method. Transmission electron microscopy/selected area diffraction (HRTEM/SAED) results revealed that the Cu/HMPC has mainly three types of morphology [sheet-like morphology (2D), hollow-spheres (3D) and needle-like structures (1D)] which are interconnected. HRTEM-SAED, Raman and X-ray photoelectron spectroscopy (XPS) results confirmed the existence of Cu oxide species in Cu/HMPC. Content of Cu in Cu/HMPC was determined to be 1.03 wt%. The quality of graphitization in Cu/HMPC was discussed by using Raman and XRD results. The BET surface area of Cu/HMPC was determined to be 620.8 m² g⁻¹. The Cu/HMPC actively transformed a wide range of amines to imines under very mild reaction conditions. The catalyst Cu/HMPC gave products in excellent yields (98–61%) with very high TON/TOF values (1512/339–833/35 h⁻¹). To the best of our knowledge, this is the most efficient Cu-based heterogeneous eco-catalyst for the synthesis of imines among those reported to date. The Cu can be recovered from used Cu/HMPC by a simple HCl treatment. Versatility, heterogeneity and reusability of Cu/HMPC were tested. A possible mechanism has been proposed.

Cu/HMPC eco-catalyst with unique interconnected 1D/2D/3D morphology was derived from metal-hyperaccumulating mustard plant for highly efficient and selective coupling reactions.     

Evaluation of factors related to glycaemic control among South Korean patients with type 2 diabetes

Aims

To examine specific self‐care behaviours, depression, and diabetes‐related stress among South Korean patients with type 2 diabetes and to evaluate whether these factors are related to glycaemic control.

Methods

This cross‐sectional study included 171 patients with type 2 diabetes who visited an endocrinology clinic. A structured questionnaire and electronic medical records were used to collect data regarding self‐care behaviours, depression, diabetes‐related distress, and glycaemic control between May 2015 and July 2015.

Results

Compared with the group with good glycaemic control, the group with poor glycaemic control had significantly lower values for medication adherence and significantly greater values for regimen‐related distress. Depression was not significantly associated with glycaemic control. In logistic regression analysis, only medication adherence was independently associated with glycaemic control.

Conclusions

Medication adherence should be continuously emphasized and monitored in clinical practice to effectively manage glycaemic control among patients with type 2 diabetes. Furthermore, consideration of diabetes‐related distress may help improve glycaemic control among patients with type 2 diabetes.     

Variation in intraocular pressure caused by repetitive positional changes during laparoscopic colorectal surgery: a prospective,randomized, controlled study comparing propofol and desflurane anesthesia

Laparoscopic surgery is often prolonged and requires positional changes to facilitate surgical access. Previous studies reported intraocular pressure (IOP) changes in one fixed position. This study investigated the effect of desflurane and propofol anesthesia on IOP during repeated positional changes. A total of 46 patients undergoing laparoscopic colorectal surgery were randomized into desflurane or propofol groups. IOP was measured using a handheld tonometer at seven time points: before induction (baseline), after endotracheal intubation, after pneumoperitoneum, after the first Trendelenburg and right tilt position, after reverse Trendelenburg and right tilt position, after the second Trendelenburg and right tilt position and before endotracheal extubation. Trendelenburg positioning raised IOP in both groups. In the desflurane group, IOP at the first Trendelenburg position was 6.27 and 8.48 mmHg higher than baseline IOP in left and right eye, respectively; IOP at the second Trendelenburg position was 7 and 9.44 mmHg higher than baseline in left and right eye, respectively. In the propofol group, IOP at the first Trendelenburg position was 2.04 and 4.04 mmHg higher than baseline in left and right eyes, respectively. It was 3.04 and 4.87 mmHg higher than baseline in left and right eye, respectively, at the second Trendelenburg position. In the desflurane group, 56.52% patients exhibited high IOP (≥?25 mmHg) compared with 13.04% in the propofol group at the second Trendelenburg position in the right eyes (P?=?0.005). There was a positive correlation between IOP and peak inspiratory pressure (P?<?0.001). Propofol anesthesia mitigated wide variations in IOP caused by repetitive positional changes during laparoscopic colorectal surgery.     

Comparison of the accuracy of noninvasive hemoglobin monitoring for preoperative evaluation between adult and pediatric patients: a retrospective study

We measured noninvasive hemoglobin (SpHb) levels during the pre-anesthesia visit in patients planning elective surgery. Differences between SpHb and laboratory-measured hemoglobin (Hb_lab) were compared between adult and pediatric patients. In the pre-anesthesia visiting office, we routinely monitor noninvasive Hb levels with oxygen saturation and heart rate using Masimo Radical-7® Pulse CO-Oximetry (Masimo Corp., Irvine, CA, USA). We attached the R1 20 (body weight, 10–50 kg) or R1 25 (body weight?>?30 kg) probe on the index finger. After signal stabilization, SpHb and perfusion index (PI) were recorded. We retrospectively reviewed the recorded data and included patients who visited the anesthesiologist within 24 h after venous sampling. Bias was calculated by subtracting Hb_lab from SpHb. We compared the biases of adult and pediatric patients (<?18 years) and evaluated correlation coefficients between the bias and Hb_lab. Records of 105 patients were reviewed and 100 data points of 50 patients in each group were analyzed. The median?±?interquartile range bias was ??2.6?±?2.2 and ??1.2?±?1.5 g/dL in adult and pediatric patients, respectively (P?<?0.001); the corresponding mean?±?standard deviation PIs were 4.4?±?3.1 and 5.9?±?2.7, respectively (P?=?0.19). Bias was inversely proportional to Hb_lab irrespective of age. The correlation coefficient between the bias and Hb_lab was ??0.81 in adults and ??0.54 in pediatric patients (P?<?0.001). SpHb and Hb_lab measured during pre-anesthesia visits showed a smaller difference in pediatric than in adult patients. Lower Hb_lab corresponded to higher accuracy.     

Opsoclonus-myoclonus syndrome following long-term use of cyclosporine

Background: Cyclosporine A (CsA) is a widely used immunosuppressive agent that may provoke unexpected neurologic complications. The mechanism is unclear and variable intervals have been reported between CsA administration and onset of the related side effects. Here, we describe a case of delayed-onset CsA neurotoxicity presenting as opsoclonus-myoclonus syndrome (OMS).

Case details: A 37-year-old woman with a two-week period of opsoclonus and upper extremity myoclonus was admitted to our hospital. The patient had been taking CsA for 17 years after receiving a kidney transplant. Further evaluation did not reveal any other abnormalities. Seven days after switching from CsA to tacrolimus, in the absence of additional immune-modulating therapy, her neurologic symptoms improved considerably.

Conclusion: This is the case of delayed, long-term complications of CsA presenting as OMS. Symptoms resolved by substituting CsA with another immunomodulating drug. The etiology of the neurologic complications may involve paradoxically-enhanced delayed-type hypersensitivity.     

Functional classification of aortic regurgitation using cardiac computed tomography: comparison with surgical inspection

In patients with aortic regurgitation (AR), a precise preoperative assessment of aortic valve (AV) pathology is important if AV repair or sparing operation is an alternative option. The aim of this study was to assess the diagnostic accuracy of computed tomography (CT) for evaluating the AR mechanism compared with surgical inspection. 59 patients with AR who underwent AV surgery and preoperative cardiac CT were evaluated. AR mechanism was classified into type 1 (aortic dilatation or cusp perforation), type 2 (prolapsed cusp) and type 3 (cusp retraction). Agreement between CT and surgical inspection was obtained. Correlation between aortic regurgitant orifice (ARO) and imaging parameters were evaluated. On surgical inspection, type 1 AR was noted in 22 patients, type 2 in 16 and type 3 in 21. Agreement regarding the AR mechanism on CT was excellent (intra-class correlation coefficient, 0.81). At the patient level, the Cohen’s κ value for CT findings with surgical inspection was of 0.89. At the cusp level, moderate agreement was noted between CT and surgical inspection. In the per-cusp analysis, CT had a sensitivity of 72.6%, specificity of 85.1%, positive predictive value of 73.8% and negative predictive value of 84.3% for the detection of aortic cusp abnormality. The diameter, perimeter and area of aortic annulus had moderate correlation with ARO (r?=?0.54–0.66, P?<?0.001). CT-derived classification of AR mechanism showed excellent agreement with surgical inspection.