A survey of acid catalysts for use in two-step, one-flask syntheses of meso-substituted porphyrinic macrocycles.

[reaction: see text] Diverse Lewis acids and Bronsted acids were examined in the two-step, one-flask synthesis of meso-tetraphenylporphyrin, N-confused tetraphenylporphyrin, and tetraphenylsapphyrin. The scope of acid catalysis was found to be very broad, with 35 of 45 acids providing TPP in yields ranging from 5% to 58%. NC-TPP was also widely observed in yields of 1-40%, and TPS was infrequently observed in yields of <1%. Additionally, conditions were found for direct preparation of magnesium TPP and copper TPP.

An efficient one-flask synthesis of N-confused tetraphenylporphyrin.

[formula: see text] N-Confused meso-substituted porphyrin is a porphyrin isomer previously available from one-flask porphyrin syntheses as a low-yield byproduct (< 7.5%). We have found that methanesulfonic acid catalyzed condensation of pyrrole and benzaldehyde followed by DDQ oxidation provides N-confused tetraphenylporphyrin (NC-TPP) in up to 39% yield in analytical scale experiments. Preparative synthesis provided an isolated yield of 35% (800 mg). This represents a > 5-fold yield improvement and makes significant quantities of NC-TPP readily available.

The impact of requiring patient authorization for use of data in medical records research.

BACKGROUND: In 1996, the Minnesota legislature passed a medical data privacy act requiring patient authorization for the use of medical records in research. Other state legislatures and Congress are considering similar legislation. The impact of this statute on a researcher's ability to obtain complete and representative data is unknown. METHODS: This was a cross-sectional study of all patients visiting the outpatient clinic, emergency department, or hospital of the Olmsted Medical Center (OMC), for an appointment or admission during January 1997 or February 1997. Patients were asked to give consent for the use of their medical records for research. Our objective was to gather information on the number and characteristics of patients who refused authorization. RESULTS: Of the 15,997 patients: 90.6% granted authorization; 3.6 refused authorization; 4.5% were undecided; and 1.3% were not asked for authorization. Refusal rates were highest among patients visiting the center for mental health concerns, trauma, or eye care, and among women aged 39 years or older. Undecided rates were highest in women presenting for pregnancy care. CONCLUSIONS: Refusal rates were low for this community practice. However, higher refusal rates in some subgroups, such as older women or patients with mental health concerns, may increase the chance of selection bias in studies involving these patients.

Should a geriatric nurse practitioner become part of a multispecialty group?

The addition of a geriatric nurse practitioner to the staff of a medical group that visits nursing home residents appears to offer benefits to the professional staff, the nursing home staff, and the nursing home residents, according to interviews with nursing home personnel and the physicians and administrators of the multispecialty group providing medical services to the nursing homes.

Fatal acute dissection of the right hepatic artery after appendectomy.

A 53-year-old normotensive man underwent an appendectomy for suppurative appendicitis with peritonitis and Escherichia coli bacteremia. On the third postoperative day, he became severely dyspneic, developed bright red blood flow from his abdominal drains, collapsed, and died. At autopsy, a ruptured intramedial dissection of the right hepatic artery was found. Hepatic artery dissections are rare, but may be associated with abdominal operation, peritonitis, hypertension, or preexisting arterial disease.

Aspiration cytology and E2 content in ovarian tumors.

This study demonstrates the reasonable reliability of fine needle aspiration cytology in ovarian tumors: 91% of benign and 84.5% of malignant tumors were diagnosed correctly by aspiration cytology. The concentration of estradiol-17 beta in cyst fluid may be helpful in distinguishing follicle cysts from neoplastic cysts. Cytologic differentiation of aspirated ovarian tumors was reasonably accurate. With respect to the approximately 1.6% of severe pelvic inflammations in our patients, we suggest that there are few indications for the use of aspiration cytology in ovarian tumors. In spite of a worldwide trend towards cytologic diagnoses by means of aspiration biopsy, there are still few studies on the aspiration biopsy of ovarian tumors. This is surprising because fine needle puncture of ovarian tumors is neither more trouble-some nor more complicated than the well-established cytologic biopsy of the prostate. This paper reports on the reliability of this method and its capability in the differentiation of various types of ovarian tumors. The differentiation of ovarian cysts is of particular interest.

Cytologic uniformity of breast cancer from different localizations: a pattern analysis study.

Using cytologic pattern analysis it is shown that regions of different histologic structure in one breast cancer are of cytologic homogeneity. The so-called PFORM -- the quotient of the total outline length of DNA-particles to the nuclear area -- gives an objective cytologic parameter which is independent of DNA content of cancer cells. This objective parameter together with the subjective cytologic parameters described earlier may be a better basis for describing the biologic behavior of breast cancer than histologic structure which is inhomogeneous very often in a lump.

Differential cytology of breast cancer.

The aim of the study was to investigate the possibility of predicting the histologic type of different breast cancers by semi-quantitative screening of cytologic criteria. Cytologic material was obtained by the aspiration technique. The frequency of ten cytologic criteria was correlated to five histologic types of breast cancer. Hitherto, it has not been possible to define histologic types of breast carcinomas on the basis of cytologic criteria alone. While the occurrence of cellularity, intercellular cohesion, foam cells and necroses often varies from slide to slide within one particular carcinoma, other features such as nuclear diameter, polymorphism, anisonucleosis, apocrine carcinoma cells, and enlarged nucleoli are more or less uniformly distributed. The application of these cytologic criteria thus uniformly represented in a tumour may prove to be a more reliable method for classifying breast carcinomas than the use of histologic growth patterns which are often inhomogenous within each individual neoplasm.