Treatment for Churg-Strauss Syndrome: Induction of Remission and Efficacy of Intravenous Immunoglobulin Therapy

ABSTRACTChurg-Strauss syndrome (CSS) is characterized by the presence of asthma, eosinophilia, and small-vessel vasculitis with granuloma. It is a distinct entity, as determined from all classifications of systemic vasculitis. The poor prognostic factors in CSS are renal insufficiency, cardiomyopathy, severe gastrointestinal (GI) tract, and central nervous systems (CNS) involvement. The initial management of CSS should include a high dose of a corticosteroid: prednisone at 1 mg/kg/day or its equivalent for methylprednisolone with tapering over 6 months. In patients with severe or rapidly progressing CSS, the administration of methylprednisolone pulse at 1 g/body/day for 3 days is recommended. When corticosteroid therapy does not induce remission, or when patients have poor prognostic factors, immunosuppressive cytotoxic therapy is indicated. However, some patients with severe CSS often show resistance to conventional treatment. We think that IVIG therapy is a hopeful candidate for second-line treatment for CSS patients, particularly in the case of neuropathy and/or cardiomyopathy, which are resistant to conventional therapy. However, there is not much evidence supporting the effectiveness of IVIG in CSS, and the mechanisms underlying the action of IVIG remain unclear. Now we are performing clinical trials of IVIG therapy for CSS patients who are resistant to conventional treatment, through a nationwide double-blinded placebo-controlled study in Japan

HbA1c and telemedicine during COVID-19

Aims/Introduction: To investigate whether the COVID-19 pandemic affected behavioral changes and glycemic control in patients with diabetes and to conduct a survey of telemedicine during the pandemic. Materials and Methods: In this retrospective study, a total of 2,348 patients were included from 15 medical facilities. Patients were surveyed about their lifestyle changes and attitudes toward telemedicine. Hemoglobin A1c (HbA1c) levels were compared among before (from June 1 to August 31, 2019) and in the first (from June 1 to August 31, 2020) and in the second (from June 1 to August 31, 2021) year of the pandemic. A survey of physician attitudes toward telemedicine was also conducted. Results: The HbA1c levels were comparable between 2019 (7.27 ± 0.97%), 2020 (7.28 ± 0.92%), and 2021 (7.25 ± 0.94%) without statistical difference between each of those 3 years. Prescriptions for diabetes medications increased during the period. The frequency of eating out was drastically reduced (51.7% in 2019; 30.1% in 2020), and physical activity decreased during the pandemic (48.1% in 2019; 41.4% in 2020; 43.3% in 2021). Both patients and physicians cited increased convenience and reduced risk of infection as their expectations for telemedicine, while the lack of physician–patient interaction and the impossibility of consultation and examination were cited as sources of concern. Conclusions: Our data suggest that glycemic control did not deteriorate during the COVID-19 pandemic with appropriate intensification of diabetes treatment in patients with diabetes who continued to attend specialized diabetes care facilities, and that patients and physicians shared the same expectations and concerns about telemedicine

FBG-BASED VIBRATION SENSOR USING GRAVITY EFFECTS FOR LARGE INFRASTRUCTURES

A simple mechanism for a vibration sensor based on fiber Bragg grating (FBG) is proposed. The mechanism utilizes the gravity force to allow the maximum sensitivity of the sensor into vertical direction while the minimum sensitivity for other two transverse directions. The sensor consists of a FBG cable and several masses to form a vibration system. The cable is extended to introduce a certain tensile force and acts as a spring. The sensitivity of the sensor is more than 1 µstrain/gal for vertical direction. This simple sensor has been developed for damage detection of large structures. Several prototypes were fabricated. And extensive shaking table tests were conducted to examine the performance

Theoretical Investigation of Knowles Hydroamination Based on Systematic Exploration of Oxidation/Reduction Pathways for Photoredox-Catalyzed Radical Process

Systematic exploration of reaction paths based on quantum chemical calculations revealed the entire mechanism of Knowles’s light-promoted catalytic intramolecular hydroamination via radical processes. Bond formation/cleavage competes with single electron transfer (SET) from the catalyst/substrate to substrate/catalyst. All these processes were theoretically described by reactions through transition states in the same electronic state and non-radiative transitions through the seam of crossings (SX) between different electronic states. This study determined the energetically favorable reaction path by combining the reaction path searches and the SX geometry searches, and then discusses the entire reaction mechanism. Such a calculation was achieved by establishing a novel computational approach that represents SET as a non-adiabatic transition between substrate\u27s PESs for different charge states adjusted based on the catalyst\u27s redox potential. Finally, we uncovered the whole picture of the reaction process, in which N atom of the substrate is oxidized by photoredox catalyst via SET, the resulting aminium radical is added to alkene, and the hydroamination product is produced after SET process accompanying protonolysis with MeOH. The present calculations showed that the reduction and proton transfer proceed concertedly. Also, in the reduction process, there are SET paths leading to both the product and the reactant, and the redox potentials of the catalyst change the contribution of the SET path leading to the product

Radical Difunctionalization of Gaseous Ethylene Guided by Quantum Chemical Calculations: Selective Incorporation of Two Molecules of Ethylene

Ethylene, of which about 170 million tons are produced annually worldwide, is a fundamental C-2 feedstock that is widely used on an industrial scale for the synthesis of polyethylenes and polyvinylchlorides. Compared to other alkenes, however, the direct use of ethylene for the synthesis of fine chemicals such as pharmaceuticals and agrochemicals is limited, probably due to its small and gaseous character. We, herein, report a new radical difunctionalization strategy of ethylene, aided by quantum chemical calculations. Computationally proposed imidyl and sulfonyl radicals can be introduced into ethylene in the presence of an Ir photocatalyst under irradiation with blue light-emitting diodes (LEDs) (lambda(max) = 440 nm). The present reaction systems led to the selective incorporation of two molecules of ethylene into the substrate, which could be rationally explained by computational analysis

積層型シート状酵素バイオ電池の構築

We have constructed a sheet-type glucose/dioxygen enzymatic biofuel cell with multi-stacked structure, in which one biocathode is sandwiched with two bioanodes in parallel. The energy density of the biofuel cell reached 14.1 mWh cm−3. The cell has achieved the acceptable performance on re-fueling, and the stability of the cell before use was drastically improved by adding raffinose

Synthesis of Symmetric/Unsymmetric DPPE Derivatives via the Radical Difunctionalization of Ethylene: A Theory-Driven Approach

1,2-Bis(diphenylphosphino)ethane (DPPE) and its synthetic analogues are important structural motifs in organic synthesis, particularly as novel diphosphine ligands with a C2-alkyl-linker chain. Since DPPE is known to bind to many metal centers in a bidentate fashion to stabilize the corresponding metal complex via the chelation effect originating from its entropic advantage over monodentate ligands, it is often used in transition-metal-catalyzed transformations, and many unique reactions have been developed using this bidentate ligand. Symmetric DPPE derivatives (Ar12P−CH2−CH2−PAr12) are well-known and readily prepared, but electronically and sterically unsymmetric DPPE (Ar12P−CH2−CH2−PAr22; Ar1 ≠ Ar2) ligands have been less explored, mostly due to the difficulties associated with their preparation. In this study, we disclose a novel synthetic method for not only symmetric but also unsymmetric DPPE derivatives using two phosphine-centered radicals and gaseous ethylene, the latter of which is a useful and fundamental C2 unit that is ubiquitous in industrial processes. The thus obtained unsymmetric DPPE ligands can coordinate to several transition-metal salts in a bidentate fashion to form the corresponding complexes, one of which exhibits distinctly different characteristics than the corresponding symmetric DPPE–metal complex. A feasible radical reaction pathway toward DPPE was successfully designed using the artificial force induced method (AFIR) method, a DFT-based automated reaction path search tool