C-arm Cone-beam CT-guided Needle Biopsies through the Erector Spinal Muscle for Posterior Thoracic Pulmonary Lesions

This study investigated retrospectively the diagnostic yield and complication rate of transthoracic needle biopsies for posterior thoracic pulmonary lesions using C-arm cone-beam computed tomography （CBCT）. The risk factors for pulmonary hemorrhage were evaluated. Our study included 113 patients with 113 posterior pulmonary lesions （mean longest diameter: 30.6mm, and mean depth: 4.7mm） through the erector spinal muscles using a 19/20-gauge coaxial system. The diagnostic performances of procedures for malignant lesions and the incidence of complications after biopsies were also assessed. The patient-related and procedure-related variables were investigated. Risk factors for pulmonary hemorrhage were analyzed with a multivariate logistic regression analysis. Findings revealed 99 malignant, 13 benign, and one intermediate lesion. Sensitivity, specificity, and diagnostic accuracy rates were 100％ （99/99）, 92.3％ （12/13）, and 99.1％ （111/112）, respectively. Air embolization, hemothorax, hemoptysis, pneumothorax, and pulmonary hemorrhage, occurred in 0, 2, 12, 48, and 70 procedures. The averaged spinous process-pleura depth and the traversed lung parenchyma depth achieved by the introducer needles were 54.2mm and 27.4mm, respectively. The needle position at the pleural puncture site within the intercostal space was in middle （31％） and inferior （69％） areas. The incidence of pulmonary hemorrhage was significantly higher in smaller lesions （p＝0.001）. Manual evacuation was performed in five procedures for patients with pneumothorax. The chest tube placement （trocar＞8 Fr） was performed in two procedures in patients with hemothorax and pneumothorax. In conclusion, the biopsy method with a posterior intercostal approach for posterior thoracic pulmonary lesions yielded high diagnostic accuracy and few major complications

Alternative Starting Position for CT Coronary Angiography

We examined whether the superior margin of the left main bronchus is the best landmark for the starting position of computed tomography coronary angiography（CTCA）. We retrospectively evaluated 693 consecutive CTCAs. From the scout scanogram, the superior margin of the left main bronchus was noted. The relationships among and distance between the superior margin of the left main bronchus and the left coronary system were analyzed. The superior margin of the left main bronchus extended caudally to the superior margin of the left coronary system in 13 patients（1.9％）. The addition of 1cm to the superior margin of the left main bronchus kept it caudal to the superior margin of the left coronary system in only one patient（0.1％）. On the scout scanogram, 1cm above the superior margin of the left main bronchus is the most appropriate starting position for CTCA

Immunoreactive Creatine Kinase-MB and Creatine Kinase Isozyme Concentrations During Treatment of Hypothyroid Patients

Peer Reviewe

Concise Synthesis of 2-Benzazepine Derivatives and Their Biological Activity

2-Benzazepines, which are potentially good candidates for new drug therapies to treat skin wounds, were readily prepared from substituted cinnamylamide via an intramolecular Friedel–Crafts reaction. With few steps and effective reactions, the procedure enables a rapid derivatization of 2-benzazepines. Moreover, optically active 4-substituted-2-benzazepines were prepared from chiral α-substituted cinnamylamides, which were readily prepared by asymmetric α-alkylation of chiral cinnamyl oxazolidinone amides. We have easily prepared a library of more than 20 derivatives and examined the biological activity of the compounds

Kinetic Study of the 7-<i>endo</i> Selective Radical Cyclization of <i>N</i>-<i>tert</i>-Butyl‑<i>o</i>‑bromobenzylmethacryl Amides: Kinetic Investigation of the Cyclization and 1,7-Hydrogen Transfer of Aromatic Radicals

A kinetic investigation of the radical cyclization of <i>N</i>-<i>tert</i>-butyl-<i>o</i>-bromobenzyl­methacryl amides to give 2-benzazepines via 7-<i>endo</i> selective cyclization was undertaken. The aryl radical generated from the amide precursor by treatment with Bu₃SnH gave the three compounds, which are a 7-<i>endo</i> cyclized adduct, a 6-exocyclized adduct, and a reduced product. The cyclization reactions under various Bu₃SnH concentrations were traced by GC analysis. The 7-<i>endo</i>/6-<i>exo</i> selectivity was constant irrespective of variation in Bu₃SnH concentration. These results revealed that regioselectivity is controlled in a kinetic manner and that there is no possibility of a neophyl rearrangement. The use of Bu₃SnD revealed that 1,7-hydrogen transfer, in which an aryl radical abstracts a hydrogen atom from the methallylic methyl group, occurs during the reaction. Hydrogen abstraction from toluene, the reaction solvent, was also observed. The 1,7-transfer rate depended on the Bu₃SnX (X = H or D), and the reaction kinetics was examined. The <i>k</i>_H/<i>k</i>_D value for the hydrogen abstraction of aryl radical from Bu₃SnX (X = H or D) was estimated using 4-bromoanisol. The utilization of these values revealed the overall reaction kinetics and relative rates for the cyclization and reduction by Bu₃SnX (X = H or D). Kinetic parameters for hydrogen abstraction from toluene by aryl radicals were also estimated

Guidelines for the use and interpretation of assays for monitoring autophagy

In 2008 we published the first set of guidelines for standardizing research in autophagy. Since then, research on this topic has continued to accelerate, and many new scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Accordingly, it is important to update these guidelines for monitoring autophagy in different organisms. Various reviews have described the range of assays that have been used for this purpose. Nevertheless, there continues to be confusion regarding acceptable methods to measure autophagy, especially in multicellular eukaryotes. A key point that needs to be emphasized is that there is a difference between measurements that monitor the numbers or volume of autophagic elements (e.g., autophagosomes or autolysosomes) at any stage of the autophagic process vs. those that measure flux through the autophagy pathway (i.e., the complete process); thus, a block in macroautophagy that results in autophagosome accumulation needs to be differentiated from stimuli that result in increased autophagic activity, defined as increased autophagy induction coupled with increased delivery to, and degradation within, lysosomes (in most higher eukaryotes and some protists such as Dictyostelium) or the vacuole (in plants and fungi). In other words, it is especially important that investigators new to the field understand that the appearance of more autophagosomes does not necessarily equate with more autophagy. In fact, in many cases, autophagosomes accumulate because of a block in trafficking to lysosomes without a concomitant change in autophagosome biogenesis, whereas an increase in autolysosomes may reflect a reduction in degradative activity. Here, we present a set of guidelines for the selection and interpretation of methods for use by investigators who aim to examine macroautophagy and related processes, as well as for reviewers who need to provide realistic and reasonable critiques of papers that are focused on these processes. These guidelines are not meant to be a formulaic set of rules, because the appropriate assays depend in part on the question being asked and the system being used. In addition, we emphasize that no individual assay is guaranteed to be the most appropriate one in every situation, and we strongly recommend the use of multiple assays to monitor autophagy. In these guidelines, we consider these various methods of assessing autophagy and what information can, or cannot, be obtained from them. Finally, by discussing the merits and limits of particular autophagy assays, we hope to encourage technical innovation in the field