Syncopal-type reactions tend to be delayed and result in falls among elderly blood donors.

BACKGROUND: Delayed syncopal-type complications are infrequent among blood donors, but sometimes have critical consequences, such as severe injury. We retrospectively investigated the characteristics of donors with delayed syncopal-type complications or falls. STUDY DESIGN AND METHODS: We defined a delayed reaction (DR) as syncopal-type complications occurring >20 min after needle removal. Subjects were stratified by sex, age, estimated blood volume (EBV), body mass index (BMI) and frequency of donation. Multiple logistic regression analysis and propensity score weighted M estimation were performed to evaluate the covariate-adjusted risk of syncopal DRs among donors giving 400 ml of whole blood (WB). The DR rate was calculated as the number of DRs divided by the number of all syncopal-type reactions after needle removal. The risk of falls was assessed similarly. Donors who discontinued before completing phlebotomy (donation of 400 ml) were excluded. RESULTS: Among 3818 syncopal-type reactions after needle removal, there were 359 DRs and 93 falls. Elderly donors and female donors with syncopal-type reactions had a significantly higher risk of DRs (P for trend < 0·001). Elderly donors with syncopal-type reactions also had a higher risk of falls (P for trend < 0·001). Among all donors with syncopal-type reactions, the risk of DRs or falls was not correlated with EBV, BMI or donation frequency. CONCLUSION: In female donors and elderly donors (donating 400 ml of WB), syncopal-type reactions tended to be delayed. Elderly donors with syncopal-type reactions had a significantly higher risk of falls.

Anesthesia management of arthroscopic ankle arthrodesis for a hemophilia patient after living-donor liver transplantation.

Hemophilia is an X-linked recessive inherited coagulation disorder. We report the anesthesia management of a hemophilia patient who underwent arthroscopic ankle arthrodesis after living-donor liver transplantation due to cirrhosis. The 35-year-old male patient with hemophilia B was diagnosed with cirrhosis due to hepatitis C virus at the age of 23 years and underwent biologically-related partial liver transplantation at the age of 29 years. As a result, the activity of factor IX activity became normal and blood product treatment became unnecessary, but the patient required long-term immunosuppression. Perioperative coagulation factor activity monitoring was performed and an immunosuppressive drug that had been preoperatively administered were continued. General anesthesia was administered by inhalation. There was no significant fluctuation in perioperative factor IX activity. This case illustrates that even in patients with hemophilia B after living-donor liver transplantation undergoing an orthopedic surgical procedure, anesthesia management can safely be performed without perioperative coagulation factor replacement.

Synthesis of zinc bacteriochlorophyll-d analogues with various 17-substituents and their chlorosomal self-aggregates in non-polar organic solvents.

Zinc 3(1)-demethyl-bacteriopheophorbides-d possessing various 17-propionate residue (17(2)-COOCH2-) were prepared as models of light-harvesting pigments in major photosynthetic antennae of green bacteria. The synthetic compounds were monomeric in polar organic solvents to give the same visible absorption spectra, but self-aggregated in non-polar organic solvents to afford large oligomers with broadened and red-shifted absorption bands. The peak positions were identical for all the self-aggregates but the widths of the redmost (Qy) bands were dependent upon the substituents. More hydrophobic and less sterically hindered hydrocarbon moieties as the esterifying group sharpened oligomeric Qy bands, giving less inhomogeneous supramolecular structures due to stabilization of the self-aggregates. In the reverse esters (17(2)-CH2OCO-) structurally isomeric to the above compounds, the same optical behavior was observed. Movement of the oxo group from the 17(3)- to 17(5)-position (17(2)-COOCH2--->17(2)-CH2OCO-) slightly increased the widths of self-aggregated Qy bands without change of the peak positions, where minor less self-aggregated components would enhance in the solution due to a little more stabilization of such species by the 17(4)-carbonyl group.

Self-aggregation of synthetic zinc chlorophyll derivatives possessing multi-perfluoroalkyl chains in perfluorinated solvents.

Zinc 3(1)-hydroxy-13(1)-oxo-chlorins possessing two, three, four and six perfluorooctyl chains were synthesized from naturally occurring chlorophyll-a. Only the synthetic zinc chlorin possessing six perfluorooctyl chains was directly dissolved in perfluorinated solvents due to its high fluorine content in molecular weight (over 50%). In this solution, visible absorption spectra gave a red-shifted Q(y) band at 723 nm (compared to 648 nm in THF) and showed the formation of well-ordered self-aggregates. No monomeric form was observed in the solution from any fluorescence emission spectra from visible absorption spectra. In the aggregate solution, no precipitation occurred during either standing for a long period or heating at 70 degrees C. This showed that the supramolecular structure was stabilized by F-F interactions on its surface among the perfluorooctyl chains on the 17-position and perfluorinated solvents. The core part of the supramolecular structure was constructed by a special intramolecular bond of Zn ... O3(2)-H ... O=C13(1), which was confirmed from resonance Raman spectral analysis.

Self-aggregation of zinc chlorophylls possessing perfluoroalkyl chains in fluorous solvents: Selective extraction of the self-aggregates with fluorous phase and accelerated formation of the ordered supramolecules in this phase.

Zinc 3(1)-hydroxy-13(1)-oxo-chlorins possessing various perfluorooctyl groups in the 17-propionate were prepared by modifying naturally occurring chlorophyll-a. The synthetic compound having four perfluorooctyl groups readily self-assembled to form large J-aggregates, which were dissolved in fluorous phases with more ordered supramolecular structures than in a hydrocarbon solvent.

The 17-propionate function of (bacterio)chlorophylls: biological implication of their long esterifying chains in photosynthetic systems.

Molecular structures of (bacterio)chlorophylls [= (B)Chls] in photosynthetic apparatus are surveyed, and a diversity of the ester groups of the 17-propionate substituent is particularly focused on in this review. In oxygenic photosynthetic species including green plants and algae, the ester of Chl molecules is limited to a phytyl group. Geranylgeranyl and farnesyl groups in addition to phytyl are observed in (B)Chl molecules inside photosynthetic proteins of anoxygenic bacteria. In main light-harvesting antennas of green bacteria (chlorosomes), a greater variety of ester groups including long straight chains are used in the composite BChl molecules. This diversity is ascribable to the fact that chlorosomal BChls self-aggregate to form a core part of chlorosomes without any specific interaction of oligopeptides. Biological significance of the long chains is discussed in photosynthetic apparatus, especially in chlorosomes.

Oligomethylene spacer length dependent interaction of synthetic galactolipids incorporated in phospholipid layers with ricin.

As models of naturally occurring glycolipids, structurally well-determined amphiphilic compounds were prepared. The synthetic molecules have beta-D-galactopyranosyl or alpha-D-mannopyranosyl and two dodecyl groups as terminal hydrophilic sugar and hydrophobic hydrocarbon moieties, respectively. The two long alkyl chains are connected by 3,5-dioxybenzamide through ether linkages to give a lipid analog purified easily due to its absorbance of ultraviolet light. In the synthetic glycolipids, the glycoside and lipid parts are covalently bound via an oligomethylene spacer. The glycolipids could be easily incorporated into liposomes of L-alpha-phosphatidylcholine. The monoglycosyl moiety of the synthetic glycolipids possessing a hexamethylene spacer was present on the surface of the liposomes and interacted specifically with a lectin to give liposomal assemblies. Such agglutination of these liposomes induced by lectins was determined by analyses of turbidity and particle size based on dynamic light scattering and laser diffraction methods. The other liposomes possessing a shorter ethylene or longer decamethylene linker gave few lectin-induced agglutinates, indicating that these spacers were not effective for the presentation of the galacto-terminal on the liposomal surfaces. Similar spacer-dependent recognition of ricin with a galactolipid-incorporated phospholipid monolayer was confirmed by surface plasmon resonance technique on a substrate.

[Study of the kid-kINDL questionnaire scores for children with developmental disorders in normal classes and their parents].

The KINDL-questionnaire is able to measure degrees of health and adaptability in relation to quality of life (QOL) in children. The questionnaire can be completed by children, adolescents, and their parents (parent-version). We had translated Kid-KINDL questionnaire into Japanese as Questionnaire for Measuring QOL in Japanese Elementary School Children, and reported their reliability and validity. This study investigates Japanese elementary school version of the Kid-KINDL questionnaire scores consisting of 6 dimensions (4 items each;total score, 100) for children with developmental disorders without mental retardation including high-functioned pervasive developmental disorder, attention deficit/hyperactivity disorder and learning disorder, and the parent-version scores for their mothers. Twenty individuals in normal class and their mothers participated after informed consents were obtained. Their total QOL scores were significantly lower than those in control group. Four of 6 dimensions consisting of emotional well-being, self-esteem, family, friends and school had significantly lower points. Their mothers' points in total QOL scores and all dimensions except for family dimension were significantly lower than those in control group. In comparison of scores between children with mild developmental disorders and their mothers, children estimated lower in self-esteem and family dimensions instead mother estimated lower in health, emotional well-being and school dimensions. There was no difference in total scores between them. Children with mild developmental disorders and their mothers estimate lower points of QOL scores than those of the normal control group. There are different perceptions in 5 of 6 dimensions between the children and their mothers.

Self-aggregation of synthetic zinc chlorophyll derivative possessing a perfluoroalkyl group in a fluorinated solvent.

Zinc 3(1)-hydroxy-13(1)-oxo-chlorin possessing a perfluoroheptyl group on the 17-propionate was prepared by modifying chlorophyll a. The synthetic compound self-aggregated in 0.1% (v/v) THF and HCFC225cb (CClF2CF2CHClF) to give similar large oligomers to natural light-harvesting antennae of green photosynthetic bacteria and their models. Visible absorption, circular dichroism, and fluorescence emission spectra showed that F-F interaction between the perfluoroheptyl side chain and the fluorinated solvent (HCFC225cb) stabilized the supramolecular structure. The core part of the supramolecular structure was constructed by a special bond of Zn...O3(1)-H...O=C13(1) and pi-pi stacking, and the 17-propionates were at the peripheral part.

Self-aggregation of synthetic protobacteriochlorophyll-d derivatives.

3(1)-Racemically pure zinc 3(1)-hydroxy-13(1)-oxo-porphyrins (zinc methyl 17,18-dehydro-bacteriopheophorbides-d) as well as their 3(1)-demethyl form were prepared by modifying chlorophyll-a through oxidation by 2,3-dichloro-5,6-dicyano-benzoquinone. From visible, circular dichroism and infrared spectral analyses, these synthetic pigments self-aggregated in 1%(vol/vol) tetrahydrofuran and cyclohexane to give large oligomers by an intermolecular bonding of 13-C=O...H-O(3(1))...Zn(central) and pi-pi interaction of the porphyrin chromophores. The supramolecular structures are similar to those of the corresponding chlorins and a core part of extramembranous light-harvesting antennas of photosynthetic green bacteria. The 17,18-dehydrogenation of a chlorin to porphyrin moiety did not disturb its self-aggregation and the synthetic zinc porphyrins are good models for naturally occurring self-aggregative bacteriochlorophylls.

Determination of 3(1)-stereochemistry in synthetic bacteriochlorophyll-d homologues and self-aggregation of their zinc complexes.

Zinc complex of methyl 3(1)-octadecyl-bacteriopheophorbide-d was prepared from modification of naturally occurring chlorophyll-a. The 3(1)-epimerically pure samples were obtained by HPLC separation and their stereochemistry including the absolute configuration at the secondary alcoholic 3(1)-position was determined by combination of esterification to methoxy(trifluoromethyl)phenylacetate and NMR spectroscopy (Mosher's method). Both the epimers were monomeric in a polar organic solvent and self-aggregated in a non-polar solvent to give oligomers as well as dimers possessing red-shifted visible absorption bands. Visible spectra of the non-polar organic solutions were dependent upon the 3(1)-chirality and such a diastereoselective control on the self-aggregation led to the formation of self-aggregates with different supramolecular structures.