A Rare Solitary Fibrous Tumor of the Mesorectum: A Case Report.

Solitary fibrous tumors (SFTs) are rare tumors that predominantly occur in the mesorectum. Few case reports have been published on mesorectal tumors, and this is the seventh case report. A 49-year-old female patient presented with a hypervascularized mesorectal tumor discovered incidentally during a routine medical examination. Using preoperative three-dimensional computed tomography (3D-CT), we identified vessels originating from the superior rectal and lateral sacral arteries, which are important sources of nutrients, and performed the procedure safely and without bleeding. Considering the lack of preoperative diagnosis and rectal blood flow, high anterior resection was performed. The histopathological diagnosis confirmed SFT, and the patient is currently doing well with no recurrence. Although SFT of the mesorectum occurs infrequently, it should be included in the differential diagnosis. In addition, the usefulness of preoperative 3D-CT, including the arterial phase, has been emphasized in such cases. This is the seventh reported case of a rare SFT in the mesorectum. Currently, there is no literature highlighting the usefulness of 3D-CT for SFTs of the mesorectum. However, it is a valuable preparatory tool for preoperative evaluation.

Synthesis, Structure, and Reactivity of Molybdenum- and Tungsten-Indane Complexes with Tris(pyrazolyl)borate Ligand.

The reaction of molybdenum complexes with a tris(pyrazolyl)borate ligand (Et4N[TpMo(CO)3] and Et4N[Tp*Mo(CO)3] (Tp = hydridotris(pyrazolyl)borate, Tp* = hydridotris(3,5-dimethylpyrazolyl)borate)) and InBr3 at a 1:1 molar ratio afforded molybdenum-indane complexes (Et4N[TpMo(CO)3(InBr3)] 1 and Et4N[Tp*Mo(CO)3(InBr3)] 2). In addition, tungsten-indane complexes, Et4N[TpW(CO)3(InBr3)] 3 and Et4N[Tp*W(CO)3(InBr3)] 4, were obtained by the reaction of corresponding tungsten complexes. Complex 4 reacted with H2O to form the hydrido complex Tp*W(CO)3H, in which the W-In bond was cleaved. On the other hand, 4 reacted with three equiv. of AgNO3 to form Et4N[Tp*W(CO)3{In(ONO2)}] 5, in which three substituents on the In were exchanged while retaining the W-In dative bond. Complexes 1-5 were fully characterized using NMR measurements and elemental analyses, and the structures of 1-5 and Et4N[Tp*W(CO)3] were determined via X-ray crystallography. These are the first examples of mononuclear molybdenum- and tungsten-indane complexes with Mo-In and W-In dative bonds.

Synthesis and Characterization of Phosphinecarboxamide and Phosphinecarbothioamide, and Their Complexation with Palladium(II) Complex.

Reactions of isocyanates/isothiocyanates with primary and secondary phosphines without solvent at room temperature afforded phosphinecarboxamide/phosphinecarbothioamide, respectively, in excellent yields. Furthermore, palladium complex Pd(COD)Cl2 was allowed to react with Ph2PC(O)NHPh (1a) to afford [Pd{Ph2PC(O)NHPh-κP}2Cl2] (3). On the other hand, the reaction of Pd(COD)Cl2 with 1 eq. of Ph2PC(S)NHPh (2a) afforded [PdCl2{Ph2PC(S)NHPh-κP,S}] (4). In the case of a 1:2 molar ratio, [PdCl{Ph2PC(S)NHPh-κP,S}{Ph2PC(S)NHPh-κP}]Cl (5) was formed. The newly obtained compounds were fully characterized using multielement NMR measurements and elemental analyses. In addition, the molecular structures of Ph2PC(O)NH(CH2)2Cl (1j), Ph2PC(S)NHPh(4-Cl) (2c), and 3-5 were determined using single-crystal X-ray diffraction.

Oxovanadium(V)-Catalyzed Synthesis of Ureas from Disilylamines and Carbon Dioxide under Ambient Pressure.

Here, a commercially available easy-to-handle oxovanadium(V) compound is demonstrated to serve as an efficient catalyst for the synthesis of ureas from disilylamines and carbon dioxide under ambient pressure. The catalytic activation of carbon dioxide proceeds without any additives, demonstrating a broad substrate scope and easy scalability to validate this catalytic activation of carbon dioxide. This catalytic system can be applied to the synthesis of unsymmetric ureas and chiral urea with retention of chirality.

Imaging diagnosis of aberrant proper hepatic and gastroduodenal arteries prior to pancreaticoduodenectomy: A case report.

In hepatobiliary and pancreatic surgery, an understanding of hepatic artery anomalies is of great importance to surgeons. Cases of the proper hepatic artery originating from the superior mesenteric artery and the gastroduodenal artery originating from the celiac trunk are extremely rare. To our knowledge, there are no reports of these arterial variants being diagnosed before hepatobiliary and pancreatic surgery. A 73-year-old woman underwent subtotal stomach-preserving pancreaticoduodenectomy and lymphadenectomy for duodenal carcinoma. Preoperative vascular construction with 3-dimensional computed tomography showed variants of the proper hepatic artery and gastroduodenal artery. The proper hepatic artery originated from the superior mesenteric artery, and the gastroduodenal artery originated from the celiac trunk. Intraoperative findings and preoperative vascular construction from 3-dimensional computed tomography were found to be matched exactly; both the proper hepatic artery and gastroduodenal artery were preserved. By diagnosing a rare arterial variant preoperatively, we were able to perform the surgery safely. In hepatobiliary and pancreatic surgery, understanding any potential variation of the hepatic artery before surgery is crucial to ensure the best patient outcomes.

Risk Factors for Anastomotic Leakage after Colorectal Surgery with Double-staple Technique Anastomosis: Impact of the Agatston Score.

OBJECTIVES: Anastomotic leakage is associated with severe morbidity, mortality, and functional defects. Its risk factors remain unclear. However, blood perfusion may be a potential major risk factor. It has been reported that the Agatston score is an index for blood flow perfusion evaluation. Therefore, we evaluated the clinical indicators associated with anastomotic leakage, including the Agatston score, in patients who underwent colorectal surgery. METHODS: We retrospectively analyzed 147 patients who underwent elective colorectal surgery with the double-staple technique anastomosis for colorectal cancer between April 2015 and March 2020. The primary outcome was the presence or absence of anastomotic leakage. Univariate and multivariate analyses were employed to identify pre- and intraoperative risk factors. RESULTS: Of the 147 patients analyzed, anastomotic leakage occurred in 12 (8.16%). Male gender, history of angina and myocardial infarction, preoperative white blood cell count, the Agatston score, extent of bleeding, operation time, and intraoperative fluid volume were significantly related to a higher incidence of anastomotic leakage in univariate analysis. Multivariate analysis demonstrated that the incidence of anastomotic leakage was high in patients with a high Agatston score. CONCLUSIONS: The Agatston score can predict the incidence of anastomotic leakage in patients following colorectal surgery. Thus, perioperative measures to prevent anastomotic leakage are recommended when a high Agatston score is observed. A prospective trial is required to demonstrate, with a high level of evidence, that the Agatston score can be useful as a risk score for anastomotic leakage following colorectal surgery.

Appendicitis with submucosal fecalith mimicking a submucosal tumor: a case report.

BACKGROUND: Submucosal fecalith(s) mimicking submucosal tumors of the gastrointestinal lumen are rare. Moreover, accurate preoperative diagnosis of these entities is exceedingly difficult, and the mechanism(s) of their formation remains unclear. CASE PRESENTATION: A 40-year-old woman visited the authors' hospital due to lower abdominal pain and diarrhea. She had previously been treated for endometriosis. Laboratory investigation revealed increased C-reactive protein levels. Abdominal contrast-enhanced computed tomography revealed thickening of the appendix wall and dilation of the small intestine. The patient was diagnosed with paralytic ileus caused by appendicitis, and interval appendectomy was scheduled. She underwent laparoscopic-assisted appendectomy after conservative treatment. Partial cecal resection was selected due to the presence of an elastic mass in the cecum. The final pathological diagnosis was submucosal fecalith, not submucosal tumor. On day 5, the patient was discharged without any postoperative complications. CONCLUSIONS: In cases of appendicitis with fecalith(s) that appear as submucosal tumor(s) on colonoscopy, submucosal fecalith mimicking submucosal tumor should be considered in the differential diagnosis.

Anomalous origin of the middle colic artery from the ileocecal artery affecting laparoscopic ascending colon cancer resection.

The anomalies of the middle colic artery have rarely been reported and reviewed in literature. However, in case such anomalies are observed in clinical practice, surgery must still be performed safely. This report presents the case of a 78-years-old female who underwent ileocecal resection and hepatectomy due to ascending colon cancer with liver metastasis. Preoperative abdominal contrast-enhanced computed tomography showed an anomaly of the middle colic artery. Since such anomaly is extremely rare, preoperative evaluation of vascular structure is important for safely performing the surgery.

Correction: Oxovanadium(v)-catalyzed amination of carbon dioxide under ambient pressure for the synthesis of ureas.

[This corrects the article DOI: 10.1039/D1RA04125H.].

Branching form of celiac artery to be aware of in laparoscopic surgery: A case report using MDCT angiography.

The anomalies of the celiac artery have been reported and reviewed in literature. Hence, it is not uncommon to clinically encounter its various types. This report presents the case of a 76-year-old male who underwent laparoscopic distal gastrectomy. Preoperative abdominal contrast-enhanced computed tomography showed an anomaly of the celiac artery, which was extremely rare, with various other anomalies of the artery.

Oxovanadium(v)-catalyzed amination of carbon dioxide under ambient pressure for the synthesis of ureas.

Carbon dioxide is regarded as a reliable C1 building block in organic synthesis because of the nontoxic, abundant, and economical characteristics of carbon dioxide. In this manuscript, a commercially available oxovanadium(v) compound was demonstrated to serve as an efficient catalyst for the catalytic amination of carbon dioxide under ambient pressure in the synthesis of ureas. The catalytic transformation of chiral amines into the corresponding chiral ureas without loss of chirality was also performed. Furthermore, a gram-scale catalytic urea synthesis under ambient pressure was successfully achieved to validate the scalability of this catalytic activation of carbon dioxide.

[A Case of Sigmoid Colon Cancer Recurrence at the Hand-Sewn Anastomosis Site Originated from Tumor Implantation].

We report a case of anastomotic recurrence following laparoscopic sigmoidectomy with hand-sewn anastomosis, which was attributable to the implantation of exfoliated cancer cells. A 78-year-old man diagnosed with early colon cancer underwent endoscopic submucosal dissection(ESD); however, ESD was suspended due to infiltrated muscle fibers. Subsequently, he underwent laparoscopic sigmoidectomy with hand-sewn anastomosis, accompanied by D3 lymph node dissection. Histopathological findings revealed a well-differentiated tubular adenocarcinoma, pT2(MP), tub1>tub2>por2, ly0, v1, PM0, DM0, RM0, N0M0, pStage Ⅰ. The follow-up CT 6 months after surgery, showed enhanced wall thickening and irregular surface of the sigmoid colon. Colonoscopy revealed a type 2 tumor located on the anastomotic line. Based on the diagnosis of anastomotic recurrence, the patient underwent partial colectomy. Histopathological findings were similar to those of the primary tumor and suggested implantation of exfoliated cancer cells as the origin of anastomotic recurrence. Cancer cells had infiltrated all layers. In conclusion, we recommend the performance of appropriate operative procedures to prevent anastomotic recurrence, such as the cleaning of the anastomosed intestinal tract. Careful follow-up in colon cancer patients is of the utmost importance and the risk of anastomotic recurrence should always be considered.

Proton spin relaxation study with pulsed NMR on the plasticization of Na+ ion-selective electrode membranes prepared from PVCs with different degrees of polymerization.

The proton spin-spin relaxation times (T2) of ion-selective electrode membranes with differences in the polymerization degree of the incorporated poly(vinyl chloride) (PVC) polymers were investigated. T2 measurements were performed using Hahn-Echo, Solid-Echo and Carr-Purcell-Meiboom-Gill (CPMG) pulse sequences. Analyses of the T2 measurements by Hahn-Echo pulse sequences could realize the estimation of the homogeneity and compatibility for a series of ion-selective electrode membranes and reveal a relationship with the electromotive force (EMF) response in the low-concentration region of the Na+ ions. On the other hand, the normalized derivative spectra from T2 measurements by Solid-Echo and CPMG pulse sequences could approximately visualize the degree of plasticization for such potentiometric polymeric membranes. Moreover, differences in the polymerization degrees of the incorporated PVCs were scarcely found to affect the selectivity coefficients of the Na+-ISEs based on bis(12-crown-4).

[MSI-H Small Bowel Cancer with Peritoneal Dissemination Successfully Treated with Pembrolizumab-A Case Report].

A 52-year-old man was diagnosed with small bowel adenocarcinoma(T4aN1M0, Stage ⅢA, according to the Japanese colorectal cancer classification)and treated with partial resection of the small bowel in June 2014. He also received adjuvant chemotherapy(XELOX: 8 courses)after surgery. Three and a half years after the operation, peritoneal dissemination recurred, and he received bevacizumab plus XELOX therapy. The regimen was adjusted to a total of 11 courses because of the disease progression. The primary lesion showed MSI-H. The patient was started on pembrolizumab therapy in April 2019. The tumor responded well to pembrolizumab(maximum therapeutic effect: PR, 31% reduction), but a new lesion appeared 6 months after the start of this regimen. He continued pembrolizumab therapy for 14 months without adverse events since it appeared to be clinically effective. Although MSI-H small bowel cancers are rare, accurate screening is essential to not miss the opportunity to administer pembrolizumab.

Convenient synthesis of phosphinecarboxamide and phosphinecarbothioamide by hydrophosphination of isocyanates and isothiocyanates.

Reactions of isocyanates with primary and secondary phosphines without solvent at room temperature afforded the corresponding phosphinecarboxamide (RN(H)COPR'2) in excellent yields. This reaction system is applicable for isothiocyanates. The compounds newly obtained were fully characterized using multielement NMR spectroscopy. In addition, the molecular structure of Cl(CH2)2N(H)COPPh2 was studied by single-crystal X-ray diffraction.

Alkoxide ligand controlled self-assembling of (imido)vanadium(V) compounds having a tetrahedral VO3N geometry.

The reaction of (1S,2S)-(-)-1,2-diphenylethylenediamine with VO(OiPr)3 in the presence of NaH was found to afford the binuclear (imido)vanadium(V) triisopropoxide, [(OiPr)3V(N-meso-1,2-DPE-N)V(OiPr)3] (DPE = diphenylethylene), (1aRS/SS). Using (1R,2R)-(+)-1,2-diphenylethylenediamine as a starting material, one-step reaction also proceeded to form the binuclear (imido)vanadium(V) triisopropoxide, [(OiPr)3V(N-meso-1,2-DPE-N)V(OiPr)3], (1aRS/RR). The single-crystal X-ray structure determination of 1aRS/SS revealed the hydrogen-bonded self-assembled structure utilizing the advantage of anti-conformation through the intermolecular hydrogen bonds of C-H···O pattern between phenyl and isopropoxide moieties, wherein each vanadium atom is coordinated in a nearly tetrahedral VO3N geometry (τ4 = 0.017 and 0.057). On the contrary, a discrete (imido)vanadium(V) tris(triphenylsiloxide) unit, which possesses a nearly tetrahedral VO3N arrangement around the vanadium metal center (τ4 = 0.060), was observed in the crystal structure of the (4-methoxyphenylimido)vanadium(V) tris(triphenylsiloxide), [(p-MeOC6H4N)V(OSiPh3)3], (1b) with bulky triphenylsiloxide ligands.

Linear [3]Spirobifluorenylene: An S-Shaped Molecular Geometry of p-Oligophenyls.

An S-shaped p-oligophenyl derivative was synthesized, as exemplified by linear [3]spirobifluorenylene (R,P,R/S,M,S)-1, which consisted of two p-sexiphenyls tied at the spiro-carbons of three spirobifluorenes. The direct linking of spirobifluorenes results in the formation of strained p-oligophenyl chains, which support each other to maintain the strained structure. This curved structure was successfully constructed by Suzuki-Miyaura cross-coupling of the corresponding spirobifluorene building blocks. Chiral (R,P,R)-1 and (S,M,S)-1 were also synthesized using chiral monomers, and their chiroptical properties were investigated by CD and CPL spectroscopy. The benzene rings in (R,P,R/S,M,S)-1 are distorted with the largest bend angle of 11.6°. The strain energy of (S,M,S)-1 was estimated to be 88.4 kcal/mol, which lies between those for [6] and [7]CPP. Through-space orbital interactions (spiroconjugation) were evaluated by TD-DFT calculations, and the results suggest the contribution of a 15 nm red-shift in (S,M,S)-1 in comparison with the single strand molecule 10. In addition, spiroconjugation is discussed in terms of molecular orbitals, and the splitting of both HOMO and LUMO was revealed by the calculations. The LUMO splitting is particularly interesting, since it is in contrast to the degenerate LUMOs in a simple spirobifluorene. Desymmetrization based on the distortion of the spirobifluorene moieties induces the LUMO splitting.

A C3-substituted cyclotriveratrylene derivative with 8-quinolinyl groups as a fluorescence-enhanced probe for the sensing of Cu2+ ions.

C 3-Substituted cyclotriveratrylene (CTV) derivatives were considered suitable candidates for recognition compounds due to their unique structures. In this study, a C3-substituted CTV derivative with three fluorogenic 8-quinolinyl groups (1) was designed and prepared as a fluorescent probe. The synthesized CTV derivative 1 exhibited a selective response of fluorescence enhancement toward Cu2+ ions among the examined cations. The sensing ability of CTV derivative 1 toward Cu2+ ions was superior to that of the previously reported C3-substituted CTV derivative with three 2-quinolinyl groups (2). It is, thus, suggested that the CTV structure plays an important role in selective sensing ability toward Cu2+ ions since the mono-quinoline compound 5 showed fluorescence properties toward the Cr3+, Fe2+ and Fe3+ ions in addition to Cu2+ ions. In other words, the high Cu2+ ion-selectivity of CTV derivative 1 was demonstrated even in the presence of other co-existing examined cations. Moreover, it was found that CTV derivative 1 could work as a reversible fluorescence-enhanced probe toward Cu2+ ions by the simple addition of Et3N.

Solvent and Temperature Effects on Dynamics and Chiroptical Properties of Propeller Chirality and Toroidal Interaction of Hexaarylbenzenes.

Because of the unique interaction of radial aromatic blades, propeller-shaped hexaarylbenzenes (HABs) attract much research interest and find various practical applications. By introducing a small point-chiral group at the tip of aromatic blade(s), HAB becomes propeller-chiral to exhibit strong Cotton effects. Because of the dynamic nature of propeller chirality, the chiroptical properties of HAB critically responded to minute changes in the environment. Using a series of chiral HABs with one to six ( R)-1-methylpropyloxy substituent(s) introduced at the blade tip, we elucidated how the smallest chiral auxiliary at the HAB periphery progressively and cooperatively boosts the overall chiroptical properties and also how subtle changes in temperature and solvent structure affect the propeller dynamics and thus the chiroptical responses. The unique features of propeller-chiral HABs further enabled us to switch on/off their circularly polarized luminescence.

Synthesis and Isomerization Behavior of a Macrocycle with Four Photoresponsive Moieties.

The macrocycle 1 containing four photoresponsive fluorenylidene moieties was designed. The EZEZ form of 1, 1 EZEZ, was selectively produced. Reversible photochemical isomerization between 1 EZEZ and 1 ZZZZ was achieved, the extent of which was dependent on the light source used. Furthermore, the intermediate 1 EZZZ was selectively isomerized to 1 ZZZZ thermally and photochemically.