Reaction of silyl thioketones with lithium diethylphosphite : First observation of thia-brook rearrangement

Reaction of silyl thioketone 7 with lithium diethylphosphite at –98 °C afforded an S-attack product 8 and a formal C-attack products 10 and 11, which were formed by S-to-C migration of the phosphoryl group in 8 followed by C-to-S migration of the silyl group (thia-Brook rearrangemnet), in a ratio depending on the conditions. The relative facility of the thia-Brook rearrangement was compared with that of the Brook rearrangement using the (t-butyldimethylsilyl) diphenylmethyl derivatives 22 and 23

Long survival case of trisomy 13 mosaicism in a 7-year-old male

Trisomy 13 is a complication of various congenital abnormalities of the heart, brain, etc. Regarding the vitalprognosis, many die within a year from birth. We herein report on the case of a 7-year 1-month-old boywith mosaicism trisomy 13 with the two considerations mentioned below as the cause for long-term survivalin this case. The first is that there were no serious associated abnormalities to the heart, brain, or otherorgans, and the second is that a tracheotomy was carried out on a repeated respiratory infection with respiratoryfailure. Long-term in-home care was possible for the child and he was observed playing with toys bytouching them. Trisomy 13 has a poor vital prognosis, so some argue that active treatment should be restrained.However, for cases with no severe associated abnormalities, long-term survival may be possiblewith active treatment

ドッキョウ イカ ダイガク ショウニカ ニオケル ザイタク ジンコウ コキュウキ リョウホウ ノ ゲンジョウ

獨協医科大学小児科学における2005年6月から2008年6月の3年1 ヶ月間の在宅人工呼吸療法の現状について報告した.導入された在宅人工呼吸器の延べ台数は合計10台で,稼働台数は毎年増加傾向を認めた.当院で本療法を導入した児の基礎疾患では,重度の中枢神経疾患に慢性呼吸不全を併発した例が多いことが特徴的であった.院内で在宅人工呼吸療法を用いた在宅管理のトレーニングを導入した後,実際に在宅治療に移行できた症例は10例中6例であり,今後の課題が残された.今後,在宅医療件数は増加することが見込まれている.円滑な在宅医療の実現のためには患児はもとより介護する家族に対する早急な社会的な支援体制の構築が望まれる.We herein report on the current state of home-care typeof mechanical respirator treatment implemented over 3years and 1 month from June 2005 to June 2008 in the pediatricdepartment of the Dokkyo University School of Medicine.A total 10 home-care mechanical respirators were introduced,and there was a trend involving an increaseevery year. The underlying diseases of the children forwhom this treatment was introduced were characterized bymany cases in which a severe central neurological diseaseoccurred in combination with chronic respiratory failure.Since introducing this treatment in our hospital, there havebeen few cases that could be smoothly transferred to hometreatment, and further investigations therefore need to beconducted.In the future, it is expected that number of home treatmentwill increase, and the development of immediate socialsupport system for, not only the affected infants, but alsothe families taking care of them is desired

Fluctuations in C-Reactive Protein in a Hepatoblastoma Patient with Thrombocytosis

We observed the changes in serum levels of interleukin 6 (IL-6) and C-reactive protein (CRP) in a patient with hepatoblastoma exhibiting thrombocytosis. The concomitant changes of IL-6 and CRP concentrations after the initiation of chemotherapy, in the absence of infection, suggested that the IL-6, which is synthesized in hepatoblastoma cells and induces thrombocytosis, also stimulated CRP production in the present case. IL-6 is thought to play an important role in thrombocytosis in hepatoblastoma