Enhancing the diagnostic accuracy of the IgE crosslinking-induced luciferase expression (EXiLE) method for walnut allergy.

Background: Walnut () frequently triggers nut allergies in the United Kingdom and in the United States, with increasing cases in Japan. While oral food challenges (OFCs) are the definitive method for diagnosing these allergies, they pose the risk of symptom provocation, necessitating safer alternative tests. Our aim here was to evaluate the diagnostic utility of IgE (immunoglobulin E) crosslinking-induced luciferase expression (EXiLE) for walnut allergy compared with the walnut-specific IgE (sIgE) test, Jug r 1-sIgE test, and skin prick test (SPT).

Usefulness of gibberellin-regulated protein specific IgE measurement in patients with systemic symptoms of apple allergy with exercise.

Patients with peach allergy who experience severe symptoms, including anaphylaxis, reportedly have a higher positivity for peach gibberellin-regulated protein (GRP)-specific immunoglobulin (Ig) E than those with only oral symptoms. However, a study in Italy investigating apple allergy (another Rosaceae fruit) found no clear association between apple GRP-specific IgE levels and clinical disease types. This study aimed to evaluate the clinical utility of GRP-specific IgE measurement in Japanese patients with apple allergy.

Ion-Pair Extraction with Tetracyanocyclopentadienides: A Method for Estimating Extraction Efficiency.

Ion-pair extraction with tetracyanocyclopentadienides (TCCPs) is an effective method for isolating ammonium cations; however, predicting the extractability of ammonium-TCCP ion pairs is challenging. Herein, the measured extraction coefficients (LogK) of ammonium-TCCP ion pairs allowed the values of A (an index for anion extractability) for the TCCP anions to be determined (-3.1 to -1.

Synthesis of Fused Tricyclic Amines Bearing Tetrasubstituted Carbons Using an Alkylation-Cyclization-Isomerization-3-aza-Cope Cascade Reaction.

A new cascade reaction sequence that involves alkylation, cyclization, isomerization, and 3-aza-Cope rearrangement was discovered. The stereogenic centers of the starting piperidines were transferred to the bicyclic enamine products, and a range of electron-withdrawing groups on the alkyne moieties, from ketones to amides, were tolerated under the reaction conditions. The bicyclic enamines underwent trifluoroacetic acid (TFA)-mediated cyclization to form tricyclic amines bearing tetrasubstituted carbons.

Relationship between instrumental activities of daily living decline during hospitalization and one-year mortality in elderly patients with heart failure: A multi-center prospective cohort study.

Background: It remains unclear whether instrumental activities of daily living (IADL) decline during hospitalization is related to mortality rates. This study examined the relationship between IADL decline during hospitalization and the one-year mortality rate in elderly heart failure (HF) patients.

Methods: Five hundred seventy-six consecutive patients who were hospitalized for acute decompensated HF and underwent rehabilitation were divided into groups based on changes in IADL during hospitalization: IADL maintained and IADL decline.

p-Methoxy- and 2,4-Dimethoxybenzyl N-Acetylcarbamate Potassium Salts: Versatile Reagents for N-Alkylacetamide and p-Methoxy- and 2,4-Dimethoxybenzyl Carbamates.

The acetamide moiety is a general functional group present in many natural and pharmaceutical products. Herein, we report two new reagents, p-methoxybenzyl N-acetylcarbamate potassium salt (PM-BENAC-K) and 2,4-dimethoxybenzyl N-acetylcarbamate potassium salt (2,4-DM-BENAC-K), which are refined versions of the benzyl N-acetylcarbamate potassium salt (BENAC-K). These compounds, which we reported as simple equivalents of N-acetamide nucleophiles, are stable and easy-to-handle powders that react with a variety of alkyl halides and sulfonates to afford substituted products in good yields.

Determination of Severe Peach Allergens, Gibberellin-Regulated Protein, and Lipid Transfer Protein, Using Monoclonal Antibodies.

In this study, monoclonal antibodies against two major fruit allergens-gibberellin-regulated protein (GRP) and lipid transfer protein (LTP)-were established. Sandwich enzyme-linked immunosorbent assays (ELISAs) for the quantification of peach GRP and LTP were constructed using these antibodies. Both ELISAs reacted with the respective antigens when heated at 100ºC for 20 min, but not when reduced with sodium sulfite, indicating that GRP and LTP are heat-stable, while disulfide bonds play an important role in their native steric structures.

Immunological and nutritional predictive factors in patients receiving pembrolizumab for the first-line treatment of non-small cell lung cancer.

Purpose: Immune checkpoint inhibitors (ICIs) have prolonged the survival of patients with various carcinomas, including non-small cell lung cancer (NSCLC), and have caused a paradigm shift in cancer treatment. Although programmed death-ligand 1 (PD-L1) expression in tumor cells is a predictive marker of therapeutic efficacy, additional predictive markers are required. This study aimed to explore the role of immunological and nutritional parameters in the prediction of treatment response.

Discharge disposition and 1-year readmission in acute-phase hospitalized patients with heart failure: a retrospective observational multi-center study.

Patients hospitalized for acute heart failure (HF) tend to experience declines in physical function and activities of daily living (ADL) due to bed rest and restricted mobilization. This could result in some patients being transferred to rehabilitation hospitals. This study aims to examine the relationship between discharge disposition and 1-year readmission and mortality rates in HF patients.

Investigation of the sensitization rate for gibberellin-regulated protein in patients with Japanese cedar pollinosis.

Background: Pollen-food allergy syndrome (PFAS) usually manifests as an itching sensation in the mouth and throat immediately after eating fresh fruits and vegetables. However, some patients with PFAS experience systemic symptoms including anaphylaxis. In Europe, cypress gibberellin-regulated protein (GRP) has been noted to cause allergenicity and exhibit cross-reactivity with peach GRP.

Biomimetic Construction of a -2,7-Dimethyloxepane Ring via 7- Cyclization.

-2,7-Dimethyloxepane is a unique structure observed in natural ladder-shaped polycyclic ethers (LSPs), such as Caribbean ciguatoxins, gymnocin-B, and brevisulcenal-F that exhibit potent biological activities. Thus, the successful construction of this seven-membered ring is desirable, but its ring strain and the 1,3-repulsion between its two methyl groups makes this process difficult. Herein, we prepared -2,7-dimethyloxepanes via 7 cyclizations of vinyl epoxides that break Baldwin's rules.

Relationship between average daily rehabilitation time and decline in instrumental activity of daily living among older patients with heart failure: A preliminary analysis of a multicenter cohort study, SURUGA-CARE.

Background: Limitation of instrumental activity of daily living (IADL) is independently associated with an adverse prognosis in older heart failure (HF) patients.

Aims: This multicenter study aims to examine the relationship between average daily rehabilitation time (ADRT) and risk of IADL decline during acute hospitalization in older patients with HF.

Methods: Four hundred eleven older patients who were hospitalized due to acute HF and underwent rehabilitation were divided into three groups based on the tertile of the ADRT: short, intermediate, and long groups.

Fulminant amebic colitis in a patient with concomitant cytomegalovirus infection after systemic steroid therapy: A case report.

Background: Amebic colitis is an infection caused by and most commonly observed in regions with poor sanitation. It is also seen as a sexually transmitted disease in developed countries. While amebic colitis usually has a chronic course with repeated exacerbations and remissions, it may also manifest as a fulminant form that rapidly progresses and leads to severe, life-threatening complications, such as intestinal perforation, peritonitis, and sepsis, that have a high mortality rate.

Transbronchial needle aspiration with endobronchial ultrasonography and ultrathin bronchoscopy for peripheral pulmonary lesions.

Background: Although the efficacy of lung cancer treatment has improved, it is dependent on a reliable diagnosis via bronchoscopy. Transbronchial biopsy using ultrathin bronchoscopy can help detect small peripheral pulmonary lesions (PPLs), with a high diagnostic yield. However, the diagnosis rate using forceps biopsy when the radial endobronchial ultrasonography (rEBUS) probe is adjacent to a lesion tends to be low.

Gold(I)-Catalyzed Cyclization-3-Aza-Cope-Mannich Cascade and Its Application to the Synthesis of Cephalotaxine.

The discovery of a new gold(I)-catalyzed cascade reaction involving cyclization onto a vinylammonium, 3-aza-Cope rearrangement, and Mannich cyclization is reported. A variety of fused nitrogen heterocycles were prepared from simple cyclic tertiary amines using 1-5 mol % of a AuCl(PPh)/Ag[C(CN)] cocatalyst system. The developed reaction was used in a study aimed at synthesizing cephalotaxine.

Long-term response to osimertinib in elderly patients with lung adenocarcinoma harbouring de novo T790M: a case report and literature review.

Osimertinib is a potent and irreversible epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) that selectively acts on both EGFR-sensitive and T790M-resistant mutations. Patients with pre-treatment T790M mutations (de novo T790M) respond poorly to existing EGFR-TKIs, whereas osimertinib has positive effects. However, the safety data for first-line osimertinib treatment in patients aged >75 years are insufficient.

Pseudomesotheliomatous carcinoma of lung adenocarcinoma diagnosed using transesophageal ultrasound-guided bronchoscopic aspiration.

Endoscopic ultrasound with bronchoscope-guided fine-needle aspiration (EUS-B-FNA), a minimally invasive procedure, may be useful for the diagnosis of pseudomesotheliomatous (PMC) carcinoma because a sufficient amount of tissue can be obtained for diagnosis. This is the first report of PMC diagnosed using EUS-B-FNA. Our findings suggest that EUS-B-FNA may reduce the risk of dissemination for PMC.

Spontaneous pneumothorax during nintedanib therapy in patients with systemic sclerosis-associated interstitial lung disease.

Interstitial lung disease (ILD) is a common complication of systemic sclerosis (SSc). Nintedanib, an antifibrotic drug, has recently been approved for treating SSc-ILD. Although there have been no reports suggesting the development of pneumothorax with nintedanib use, its safety in patients with impaired lung function is unclear.

Long-term response to afatinib in an elderly patient with uncommon epidermal growth factor receptor mutation-positive lung adenocarcinoma.

Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors are the standard treatment for patients with non-small cell lung cancer (NSCLC) harboring EGFR mutations. Uncommon mutations, excluding exon 19 deletions and exon 21 L858R, comprise 7%-23% of EGFR mutation-positive NSCLC. The treatment of uncommon EGFR mutation-positive NSCLCs is controversial.

Sedation with fentanyl and midazolam without oropharyngeal anesthesia compared with sedation with pethidine and midazolam with oropharyngeal anesthesia in ultrathin bronchoscopy for peripheral lung lesions.

Background: In advanced lung cancer, precision medicine requires repeated biopsies via bronchoscopy at therapy change. Since bronchoscopies are often stressful for patients, sedation using both fentanyl and midazolam is recommended in Europe and America. In Japan, bronchoscopies are generally orally performed under midazolam and oropharyngeal anesthesia.

Lung adenocarcinoma with tumor resolution and dystrophic calcification after salvage surgery following immune checkpoint inhibitor therapy: A case report.

A clinical trial of immune checkpoint inhibitors for advanced non-small cell lung cancer reported an overall survival plateau with a long tail to the survival curve, suggesting that immune checkpoint inhibitors prolong survival. However, little evidence supports the efficacy of immune checkpoint inhibitors as neoadjuvant chemotherapy. We performed salvage surgery on a patient who was treated with an anti-programmed cell death protein-1 (PD-1) antibody and whose tumor size had not changed over time.

Comparison of ultrathin bronchoscopy with conventional bronchoscopy for the diagnosis of peripheral lung lesions without virtual bronchial navigation.

Background: For the precise management of advanced lung cancers, bronchoscopy with a high diagnostic yield and abundant tumor specimens are required. In recent years, new devices and techniques have been rapidly developed, including the endobronchial ultrasound (EBUS) using a guide sheath, virtual bronchoscopic navigation (VBN), and ultra-thin bronchoscope (UTB), for the diagnosis of peripheral pulmonary lesions (PPLs). These techniques increase the diagnostic yield for PPL, thus requiring fewer biopsy specimens.

Tegafur/gimeracil/oteracil-induced eosinophilic pneumonia.

Clinicians should be aware that eosinophilic pneumonia is one of the types of drug-induced lung injury that can be caused by tegafur/gimeracil/oteracil (TS-1).