(3,5-Dinitro-1,3,5-triazinan-1-yl)methanone

In the title compound, C5H9N5O5, prepared from hexa­mine by acetyl­ation and nitration, the triazine ring adopts a chair conformation with all three substituent groups lying on the same side of the ring

The continual presence of C3d but not IgG glomerular capillary deposition in stage I idiopathic membranous nephropathy in patients receiving corticosteroid treatment

BACKGROUND: Pathologic diagnosis of stage I idiopathic membranous nephropathy (MN-I) requires electron microscopy or immunohistochemistry that shows a glomerular capillary staining pattern of IgG and C3. However, it is not uncommon that renal biopsy did not obtain sufficient material for electron microscopy and that IgG and C3 staining in glomeruli largely lost at biopsy due to corticosteroid treatment. Since C3d is one of the final degradation products of C3 that is more stable in vivo, we determine if C3d staining could be used as a novel immunohistochemical marker for MN-I. METHODS AND RESULTS: 74 MN-I patients with electron microscopy proven MN-I were examined by immunoperoxidase staining of C3d. Intensive C3d staining was present in glomerular capillary like the staining pattern of IgG and C3 in MN-I. Importantly, in 40 MN-I patients who underwent corticosteroid treatment at biopsy the intensity and glomerular capillary pattern of C3d staining remained largely intact while the staining for IgG had substantially reduced and the pattern of glomerular capillary staining became unrecognizable. CONCLUSIONS: C3d glomerular capillary staining may be a novel marker for pathologic diagnosis of MN-I that is continuously present at biopsy in patient who has received corticosteroid treatment. VIRTUAL SLIDES: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/212078007573447

Endovascular Repair of Ascending Aortic Dissection A Novel Treatment Option for Patients Judged Unfit for Direct Surgical Repair

ObjectivesThis paper sought to report the outcomes of patients who are considered unfit for urgent surgical repair of ascending aortic dissections (AADs) who were treated using a novel endovascular repair strategy.BackgroundAAD is best treated by direct surgical repair. Patients who are unable to undergo this form of treatment have poor prognoses. Previously, clinical case reports related to endovascular repair of AAD have been controversial.MethodsBetween May 2009 and January 2011, 41 consecutive patients with AAD were treated in our institution. Fifteen patients were considered poor candidates for direct surgical repair and subsequently underwent the endovascular repair.ResultsThe nature of the referral process to our tertiary care facility made the median time from aortic dissection onset to treatment 25.5 days (range: 6 to 353 days). Dissections in 5 patients (33.3%) were considered acute, and those in 10 patients (66.7%) were considered chronic. The rate of successful stent-graft deployment was 100%, and there were no major morbidities or deaths in the perioperative period. Median follow-up was 26 months (range: 16 to 35 months). One new dissection occurred in the aortic arch at 3 months and was treated with a branched endograft. Significant enlargements of true lumens and decreases of false lumens and overall thoracic aorta were noted after the procedures.ConclusionsEndovascular repair of AAD was an appropriate treatment option in patients who were considered poor candidates for traditional direct surgical repair by the clinical criteria used in our institution. A larger series of cases with longer follow-up is needed to substantiate these results

Low Frequency Coherence Break in The Soft X-ray State of GRS 1915+105

We present results from the analysis of X-ray power density spectra and coherence when GRS 1915+105 is in soft states. We use three data sets that belong to $\mu$, $\phi$ and $\delta$ classes in Belloni et al (2000). We find that the power density spectra appear to be complex, with several features between 0.01 and 10 Hz. The coherence deviates from unity above a characteristic frequency. We discuss our results in different models. The corona size in the sphere-disk model implied by this break frequency is on the order of 10$^4$ GM/c$^2$, which is unphysical. Our results are more consistent with the prediction of the model of a planar corona sustained by magnetic flares, in which the characteristic frequency is associated with the longest time-scale of an individual flare, which is about eight seconds.Comment: latex, 10 pages with 3 figure