SYNTHESIS OF ZANTHOXYLINE AND ITS RELATED COMPOUNDS: REVISION OF THE REPORTED STRUCTURE

Benzo[c]phenanthridine alkaloid, zanthoxyline, was synthesized through an intramolecular biaryl coupling reaction of N-naphthylbenzamide derivative using a palladium reagent. Comparison of the NMR data for the synthetic product with that reported previously revealed that the proposed structure was incorrect. Synthesis of the related compounds suggested that the correct structure of zanthoxyline is the previously known decarine

BUROSUMAB IN TUMOR-INDUCED OSTEOMALACIA

Patients with tumor-induced osteomalacia (TIO), an acquired paraneoplastic condition characterized by osteomalacia due to hypophosphatemia, exhibit a similar clinical picture to those with X-linked hypophosphatemic rickets/osteomalacia (XLH). The human monoclonal anti-fibroblast growth factor 23 (FGF23) antibody burosumab (KRN23) increases serum phosphate and improves bone turnover, fracture healing, pain, and physical function in XLH patients by inhibiting circulating FGF23; thus, burosumab is expected to be an effective treatment for TIO. We report here an interim analysis of a multicenter, open-label, intraindividual dose-adjustment study of burosumab (0.3 to 2.0 mg/kg every 4 weeks) in Japanese and Korean TIO patients. The primary endpoint was the fasting serum phosphate level at each visit. Key secondary endpoints were changes over time in bone biomarkers, pharmacodynamic markers, bone histomorphometric parameters, motor function, and patient-reported outcomes. Safety was assessed based on treatment-emergent adverse events (TEAEs). Thirteen patients received burosumab treatment, of whom 4 underwent bone biopsy. The mean dose after week 112 was approximately 1.0 mg/kg. After the first burosumab administration, mean serum phosphate levels increased and remained above the lower limit of normal and in the normal range from weeks 14 to 112. Bone biomarkers initially increased, reaching maximum values at week 16 or 24, and then gradually decreased. After burosumab treatment, patients were able to walk further (evaluated by the 6-minute walk test), reported decreased pain levels, and showed a tendency toward healing of baseline fractures and pseudofractures. Two patients discontinued, one each due to disease progression and consent withdrawal. Burosumab was generally well tolerated, with no treatment-related TEAEs of grade ≥3 and no treatment-related serious AEs. In conclusion, the interim results of this first study of burosumab to treat TIO patients indicate that this drug has the potential to provide clinical benefit for patients with unresectable tumors. The full study results are eagerly anticipated

A Pilot Study for Establishment on Educational Guidelines of Pre-clinical Practice of Pediatric Dentistry among all Japanese Dental Schools : (2) The effort of educational workshop

全ての歯学教育機関において, 質が高く均質な小児歯科医療を実践できる歯科医師を養成することを目的として, 平成18・19年度日本小児歯科学会教育問題検討委員会により, 教育ワークショップが開催された。ワークショップは2日間の日程で, 29歯科大学・大学歯学部から42名の小児歯科学の教育に関わる教員が参加した。課題として, ラバーダム装着, 保護者へのブラッシング指導, フッ化物歯面塗布, 予防塡塞および咬合誘導を取り上げた。その結果, 以下の有意義な成果を認めた。 1. 各大学の基礎実習の教育内容に関する有益な情報が得られた。 2. 課題とした実習項目について, 全ての大学で共通の一般目標と到達目標を設定することができた。 3. 課題とした実習項目について, 全ての大学で共通して教育すべき標準的な実習内容を明らかにすることができた。For sophisticated instruction of dental educators, it is essential to establish educational guidelines for pre-clinical practice of pediatric dentistry among all dental schools in Japan. However, there is too little information on this problem. Therefore, with the aim of realizing a good quality of pre-clinical practice, an educational workshop was organized by the Japanese society of pediatric dentistry. This workshop was held over two days at Hiroshima University in Hiroshima, Japan. Forty-two dental educators from all the dental schools in Japan participated in this workshop. The foIlowing 5 topics were discussed: rubber-dam, oral hygiene counseling for parents/guardians, fluoride therapy, fissure sealant and space maintenance and space regaining. The efforts of this workshop were as follows : 1. This workshop provided useful information about pre-clinical practice of pediatric dentistry of all the dental schools in Japan. 2. All participants understood the ideal and common objectives of instruction of the topics. 3. The bases of educational contents on the topics were discussed and identified. In conclusion, this article provided on outline of dental education of pediatric dentistry and contributes to a better understanding of the importance of educational guidelines. Continuous interchange of ideas is going to be expected to develop the quality of education and the ability of instruction

Mediastinal extracardiac fetal rhabdomyoma; case report

AbstractA 9-month-old girl with a small suprasternal mass was referred for treatment after fine needle aspiration of the mass elsewhere suggested rhabdomyosarcoma. On admission, magnetic resonance imaging (MRI) identified a 58 × 42 mm oval mass in the anterior mediastinum close to the common carotid artery and aortic arch. Surgical intervention was initially considered to be too risky, but after a trial of chemotherapy failed to reduce the size of the tumor, complete local excision was planned through a vertical median thoracic incision with median sternotomy. Surgery was performed when she was 10 months old. Due to severe adhesions, the left clavicle, first rib and the sternoclavicular joint needed to be partially resected to allow the tumor to be completely excised with safety. Operating time was 3 h; intraoperative blood loss was 123 mL requiring intraoperative transfusion. Histopathology and immunohistochemistry were consistent with an intermediate form of fetal rhabdomyoma. The postoperative course was uneventful and she is currently alive with no evidence of disease 4 years later. Fetal rhabdomyoma is rare and our case presented with a small, asymptomatic, suprasternal mass. While the distinction between rhabdomyoma and rhabdomyosarcoma can be difficult, a multidisciplinary approach enabled surgery to be performed successfully