Thrombolytic removal of intraventricular haemorrhage in treatment of severe stroke: results of the randomised, multicentre, multiregion, placebo-controlled CLEAR III trial

Background: Intraventricular haemorrhage is a subtype of intracerebral haemorrhage, with 50% mortality and serious disability for survivors. We aimed to test whether attempting to remove intraventricular haemorrhage with alteplase versus saline irrigation improved functional outcome. Methods: In this randomised, double-blinded, placebo-controlled, multiregional trial (CLEAR III), participants with a routinely placed extraventricular drain, in the intensive care unit with stable, non-traumatic intracerebral haemorrhage volume less than 30 mL, intraventricular haemorrhage obstructing the 3rd or 4th ventricles, and no underlying pathology were adaptively randomly assigned (1:1), via a web-based system to receive up to 12 doses, 8 h apart of 1 mg of alteplase or 0·9% saline via the extraventricular drain. The treating physician, clinical research staff, and participants were masked to treatment assignment. CT scans were obtained every 24 h throughout dosing. The primary efficacy outcome was good functional outcome, defined as a modified Rankin Scale score (mRS) of 3 or less at 180 days per central adjudication by blinded evaluators. This study is registered with ClinicalTrials.gov, NCT00784134. Findings: Between Sept 18, 2009, and Jan 13, 2015, 500 patients were randomised: 249 to the alteplase group and 251 to the saline group. 180-day follow-up data were available for analysis from 246 of 249 participants in the alteplase group and 245 of 251 participants in the placebo group. The primary efficacy outcome was similar in each group (good outcome in alteplase group 48% vs saline 45%; risk ratio [RR] 1·06 [95% CI 0·88–1·28; p=0·554]). A difference of 3·5% (RR 1·08 [95% CI 0·90–1·29], p=0·420) was found after adjustment for intraventricular haemorrhage size and thalamic intracerebral haemorrhage. At 180 days, the treatment group had lower case fatality (46 [18%] vs saline 73 [29%], hazard ratio 0·60 [95% CI 0·41–0·86], p=0·006), but a greater proportion with mRS 5 (42 [17%] vs 21 [9%]; RR 1·99 [95% CI 1·22–3·26], p=0·007). Ventriculitis (17 [7%] alteplase vs 31 [12%] saline; RR 0·55 [95% CI 0·31–0·97], p=0·048) and serious adverse events (114 [46%] alteplase vs 151 [60%] saline; RR 0·76 [95% CI 0·64–0·90], p=0·002) were less frequent with alteplase treatment. Symptomatic bleeding (six [2%] in the alteplase group vs five [2%] in the saline group; RR 1·21 [95% CI 0·37–3·91], p=0·771) was similar. Interpretation: In patients with intraventricular haemorrhage and a routine extraventricular drain, irrigation with alteplase did not substantially improve functional outcomes at the mRS 3 cutoff compared with irrigation with saline. Protocol-based use of alteplase with extraventricular drain seems safe. Future investigation is needed to determine whether a greater frequency of complete intraventricular haemorrhage removal via alteplase produces gains in functional status

A Sulfhydryl-Reactive Ruthenium (II) Complex and Its Conjugation to Protein G as a Universal Reagent for Fluorescent Immunoassays

To develop a fluorescent ruthenium complex for biosensing, we synthesized a novel sulfhydryl-reactive compound, 4-bromophenanthroline bis-2,2′-dipyridine Ruthenium bis (hexafluorophosphate). The synthesized Ru(II) complex was crosslinked with thiol-modified protein G to form a universal reagent for fluorescent immunoassays. The resulting Ru(II)-protein G conjugates were identified by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). The emission peak wavelength of the Ru(II)-protein G conjugate was 602 nm at the excitation of 452 nm which is similar to the spectra of the Ru(II) complex, indicating that Ru(II)-protein G conjugates still remain the same fluorescence after conjugation. To test the usefulness of the conjugate for biosensing, immunoglobulin G (IgG) binding assay was conducted. The result showed that Ru(II)-protein G conjugates were capable of binding IgG and the more cross-linkers to modify protein G, the higher conjugation efficiency. To demonstrate the feasibility of Ru(II)-protein G conjugates for fluorescent immunoassays, the detection of recombinant histidine-tagged protein using the conjugates and anti-histidine antibody was developed. The results showed that the histidine-tagged protein was successfully detected with dose-response, indicating that Ru(II)-protein G conjugate is a useful universal fluorescent reagent for quantitative immunoassays

Paper: a cheap yet effective chiral stationary phase for chromatographic resolution of metallo-supramolecular helicates

Simple paper chromatography using brine as an eluent affords the two enantiomers of metallo-supramolecular triple-helicates. The technique may be scaled up for preparative resolution by using cellulose columns in conventional column chromatography

3d transition metal complexes with a julolidine–quinoline based ligand: structures, spectroscopy and optical properties

A Schiff base type ligand with the combination of the julolidine and the quinoline groups has been reported as a potential chemosensor in detecting the cobalt(II) ion among other heavy and transition metal ions in solution. However, no crystal structure of such a ligand with any metal ions has been reported. In this work, its complexation with 3d transition metal ions (Mn(II), Co(II), Ni(II), Cu(II) and Zn(II)) has been investigated with five new complexes being synthesised, and spectroscopically and structurally characterised. [Mn2L2(CH3OH)2(CH3COO)2]•CH3OH (1) {HL (C22H21N3O) = ((E)-9-((quinolin-8-ylimino)methyl)-1,2,3,5,6,7-hexahydropyrido[3,2,1-ij]quinolin-8-ol)} shows a dinuclear structure with two Mn : L : acetate (1 : 1 : 1) units bridged by two methanol molecules. [CoL2(NO3)]•CH3OH•H2O (2) and [NiL2]•H2O (3) exhibit mononuclear structures with a Co : L or Ni : L ratio of 1 : 2. [CuL(CH3COO)]•1/3CH3OH (4) demonstrates a mononuclear structure and the Cu ion has a square planar coordination polyhedron with a L ligand and a highly non-symmetrical acetate anion. [Zn2L2(CH3COO)2]•CH3OH (5) has two types of dinuclear units, both with two ZnL units bridged by two acetate anions but in three different bridging coordination modes. Their vibrational modes, absorption and photoluminescence properties have also been investigated. © 2016 the Partner Organisation

Self-assembly of a unique 3d/4f heterometallic square prismatic box-like coordination cage

AbstractWe present the synthesis and characterization of a unique, slightly distorted square prismatic, box-like coordination cage of type [Cu6Dy8L8(MeOH)8(H2O)6](NO3)12·χsolvent obtained via the supramolecular assembly between a non-centrosymmetric Dy(III) metalloligand and Cu(II) nitrate. Magnetic susceptibility measurements indicate that the complex behaves as a single-molecule magnet. © 2016 Royal Society of Chemistr

A large spin-crossover [Fe4L4]8+ tetrahedral cage

AbstractA large discrete face-capped tetranuclear iron(II) cage, [Fe4L4](BF4)8·n(solvent), was synthesised via metal-ion directed self-assembly. The cage is formed from a rigid tritopic ligand that incorporates chelating imidazole-imine functional groups. The cage displays temperature induced spin-crossover and LIESST effects and is amongst the largest iron(II) tetrahedral cages with such properties reported. The synthesis, structure and magnetic properties of this new metallo-cage are presented. © 2015 The Royal Society of Chemistr