ABSTRACT
Venous aneurysms are uncommon. Despite their infrequency, venous aneurysms can present with significant clinical complications such as thrombosis, pulmonary embolism, and death. In this report, we present the case of a thrombosed inferior vena cava aneurysm discovered in a 16-year-old male who had deep vein thrombosis of the right lower extremity. Thrombosis of the inferior vena cava is uncommon in the pediatric population. Therefore, congenital abnormalities such as an inferior vena cava aneurysm should be considered when evaluating pediatric patients who present with deep vein thrombosis.
Subject(s)
Aneurysm/diagnosis , Thrombolytic Therapy , Vena Cava, Inferior/pathology , Venous Thrombosis/diagnosis , Adolescent , Aneurysm/drug therapy , Fibrinolytic Agents/therapeutic use , Humans , Magnetic Resonance Angiography , Male , Phlebography , Tomography, X-Ray Computed , Urokinase-Type Plasminogen Activator/therapeutic use , Venous Thrombosis/drug therapyABSTRACT
Taxol (1) is a highly potent antitumor agent, exerting its mechanism of action by promoting the assembly of stable microtubules in cells. We are reporting on the first synthesis and biological evaluation of taxol derivatives with substituted phenyl rings at the C-13 N-benzoyl-(2'R,3'S)-3'-phenylisoserine side chain of taxol (1). Two taxol derivatives were synthesized, one possessing a N-(p-chlorobenzoyl)-(2'R,3'S)-3'-phenylisoserine side chain (2) and the other one a N-benzoyl-(2'R,3'S)-3'-(p-chlorophenyl)isoserine side chain (3). The synthesis of the novel phenylisoserine side chains was achieved through the asymmetric synthesis of 3-hydroxy-4-aryl-2-azetidinone derivatives via the ester enolate-imine cyclocondensation reaction. The 2-azetidinones 14 and 15 were acylated with p-chlorobenzoyl chloride and benzoyl chloride, respectively, to form the N-acyl beta-lactams 16 and 17. Subsequent coupling of 16 and 17 to 7-(triethylsilyl)baccatin III (6) in the presence of pyridine and DMAP afforded, after removal of the protecting groups, the desired taxol analogues 2 and 3 in excellent yields. The newly synthesized derivatives 2 and 3 were tested in the tubulin assembly assay and also evaluated for their cytotoxicity against B16 melanoma cells. It was found that the taxol derivatives 2 and 3 had activity comparable to taxol (1).
