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Background: Indocyanine green fluorescence vision is an upcoming technology in surgery. It can be used in three ways: angiographic and biliary tree visualization and lymphatic spreading studies. The present paper shows the most outstanding results from an health technology assessment study design, conducted on fluorescence-guided compared with standard vision surgery. Methods: A health technology assessment approach was implemented to investigate the economic, social, ethical, and organizational implications related to the adoption of the innovative fluorescence-guided view, with a focus on minimally invasive approach. With the support of a multidisciplinary team, qualitative and quantitative data were collected, by means of literature evidence, validated questionnaires and self-reported interviews, considering the dimensions resulting from the EUnetHTA Core Model. Results: From a systematic search of literature, we retrieved the following studies: 6 on hepatic, 1 on pancreatic, 4 on biliary, 2 on bariatric, 4 on endocrine, 2 on thoracic, 11 on colorectal, 7 on urology, 11 on gynecology, 2 on gastric surgery. Fluorescence guide has shown advantages on the length of hospitalization particularly in colorectal surgery, with a reduction of the rate of leakages and re-do anastomoses, in spite of a slight increase in operating time, and is confirmed to be a safe, efficacious, and sustainable vision technology. Clinical applications are still presenting a low evidence in the literature. Conclusion: The present paper, under the patronage of Italian Society of Endoscopic Surgery, based on an HTA approach, sustains the use of fluorescence-guided vision in minimally invasive surgery, in the fields of general, gynecologic, urologic, and thoracic surgery, as an efficient and economically sustainable technology.

Avoidance of corticosteroids could be beneficial after pediatric liver transplantation (LTx). To test this hypothesis, we performed a randomized prospective study to compare immunosuppression with tacrolimus (TAC) and steroids versus TAC and basiliximab (BAS) after pediatric LTx. Seventy-two patients were recruited, 36 receiving TAC and steroids and 36 TAC and BAS. The primary endpoint was the occurrence of the first rejection episode. Secondary endpoints were the cumulative incidence and severity of rejection, patient and graft survival, and incidence of adverse events. Overall 1-year patient and graft survival rates were 91.4% and 85.5% in the steroid group, and 88.6% and 80% in the BAS group (p = NS). Patients free from rejection were 87.7% in the BAS group and 67.7% in the steroid group (p = 0.036). The use of BAS was associated with a 63.6% reduction in incidence of acute rejection episodes. Overall incidence of infection was 72.3% in the steroid group and 50% in the BAS group (p = 0.035). We conclude that the combination of TAC with BAS is an alternative to TAC and steroid immunosuppression in pediatric LTx, which allows for a significant reduction in the incidence of acute rejection and infectious complications.

Avoidance of corticosteroids could be beneficial after pediatric liver transplantation (LTx). To test this hypothesis, we performed a randomized prospective study to compare immunosuppression with tacrolimus (TAC) and steroids versus TAC and basiliximab (BAS) after pediatric LTx. Seventy-two patients were recruited, 36 receiving TAC and steroids and 36 TAC and BAS. The primary endpoint was the occurrence of the first rejection episode. Secondary endpoints were the cumulative incidence and severity of rejection, patient and graft survival, and incidence of adverse events. Overall 1-year patient and graft survival rates were 91.4% and 85.5% in the steroid group, and 88.6% and 80% in the BAS group (p = NS). Patients free from rejection were 87.7% in the BAS group and 67.7% in the steroid group (p = 0.036). The use of BAS was associated with a 63.6% reduction in incidence of acute rejection episodes. Overall incidence of infection was 72.3% in the steroid group and 50% in the BAS group (p = 0.035). We conclude that the combination of TAC with BAS is an alternative to TAC and steroid immunosuppression in pediatric LTx, which allows for a significant reduction in the incidence of acute rejection and infectious complications.

The complex [(cod)PtI2] (cod = 1,5-cyclooctadiene) reacts with 3 equiv of the hexaphenylcarbodiphosphorane Ph3P&dbd;C&dbd;PPh3 (1) in THF solution to give the novel Pt(II) complex [(η³-C8H11)Pt(C6H4PPh2CPPh3)] (2) along with the salt [HC(PPh3)2]I. In addition to the coordination of the ylidic carbon atom at the Pt atom, 2 contains two further Pt−C σ bonds originating from H to Pt exchange in the ortho position of one phenyl group of the carbodiphosphorane ligand and in the former cod ligand. The resulting C8H11 moiety is coordinated to the Pt atom in an η³ manner via a double bond and a σ bond and contains a further uncoordinated double bond. From a 1:1 reaction mixture in toluene/CH2Cl2 the majority of the crystals consist of the salt [HC(PPh3)2]I·2CH2Cl2 (3) with small amounts of platinum compounds as byproducts. The Pt(0) complex [(PPh3)2Pt(CH2&dbd;CH2)] does not react with 1 but decomposes at elevated temperatures to give the known dinuclear complex [Pt2(PPh3)2(μ-PPh2)2] (4). The complexes 2 and 4 and the salt 3 could be characterized by X-ray analyses and the usual spectroscopic methods.

Die Umsetzung von C(NMe2)4mit Ni(CO)4in THF führt zum Carbamoylkomplex [C(NMe2)3][(CO)3NiC(O)NMe2] (1); als Nebenprodukte werden die violette Clusterverbindung [C(NMe2)3]2[Ni5(CO)12] · THF (2· THF) und das rote Kokristallisat [C(NMe2)3]3[Ni6(CO)12][O2CNMe2] (3) isoliert. Alle Verbindungen konnten durch eine Kristallstrukturanalyse charakterisiert werden. Die Kationen von 3sind fehlgeordnet, nicht jedoch die von 1und 2. Die Elementarzelle von 1enthält zwei kristallographisch unabhängige Anionen (I und II), die sich im Diederwinkel zwischen der Ebene des Carbamoylliganden und der Ebene CCarbamoyl–Ni–CO unterscheiden. Dieser beträgt 0° im Anion I und 18° im Anion II.

The reaction of Na2[Fe(CO)4] with Br2CF2in n‐pentane generates a mixture of the compounds (CO)3Fe(μ‐CO)3–n(μ‐CF2)nFe(CO)3(2, n = 2; 3, n = 1) in low yields with 3as the main product. 3is obtained free from 2by reacting Br2CF2with Na2[Fe2(CO)8]. The non‐isolable monomeric complex (CO)4Fe=CF2(1) can probably considered as the precursor for 2. 3reacts with PPh3with replacement of two CO ligands to form Fe2(CO)6(μ‐CF2)(PPh3)2(4). The complexes 2–4were characterized by single crystal X‐ray diffraction. While the structure of 2is strictly similar to that of Fe2(CO)9, the structure of 3can better be described as a resulting from superposition of the two enantiomers 3 aand 3 bwith two semibridging CO groups. Quantum chemical DFT calculations for the series (CO)3Fe(μCO)3–n(μ‐CF2)nFe(CO)3(n = 0, 1, 2, 3) as well as for the corresponding (μ‐CH2) derivatives indicate that the progressively larger σ donor and π acceptor properties for the bridging ligands, in the order CO < CF2< CH2, favor a stronger Fe–Fe bond.

The reduction of Fe2(CO)9 with elemental lithium in THF solution at room temperature generates the dinuclear complex [Li2(THF)6Fe2(CO)8] (1), in which the Li atoms are bonded to the oxygen atoms of bridging CO groups. Dissolution of 1 in toluene leads to loss of two THF molecules to give the polymeric complex [Li2(THF)4Fe2(CO)8]n (2); dimeric units (n = 2) are formed with the help of a planar Li2O2 ring, and these units are further linked by Li−O contacts to terminal carbonyl groups. Alkylation of 1 with MeSO3CF3 yields the known dinuclear compound [(CO)3Fe(μ-C(Me)O)2Fe(CO)3] (4). Treatment of 1 with Me3SnCl leads to splitting of the Fe−Fe bond, resulting in cis-[CO)4Fe(SnMe3)2] (6) as the main product. The X-ray structures of 1, 2, and 4 are presented along with the structure of the sodium salt [Na2(THF)4Fe2(CO)8]n (5), which has only terminal CO groups.

Quantum chemical calculations at the NL-DFT (B3LYP) and CCSD(T) levels of theory have been carried out for the carbon complex (CO)4FeC. The bonding situation was analyzed with the NBO partitioning scheme and with the topological analysis of the electron density distribution. The results have been compared with the bonding situations in (CO)4FeCH2, I(CO)3FeCH, and Fe(CO)5. The trigonal-bipyramidal complex (CO)4FeC with an axial Fe−C bond is a minimum on the singlet potential energy surface, while the equatorial form is a transition state. The Fe−C bond has a large dissociation energy, De = 84.1 kcal/mol at B3LYP/II and De = 94.5 kcal/mol at CCSD(T)/II. The carbon ligand is a strong π-acceptor and an even stronger σ-donor. The analysis of the electronic structure suggests that (CO)4FeC should behave like a carbon nucleophile. Geometry optimization of the donor−acceptor complex (CO)4FeC−BCl3 yielded a strongly bonded compound, which has a calculated C−B bond energy of De = 25.6 kcal/mol at B3LYP/II. Lewis acid stabilized carbon complexes such as (CO)4FeC−BCl3 might become isolated under appropriate conditions.

AbstractRejection and efficacy of rescue therapy with tacrolimus were evaluated in 50 children who underwent primary, ABO‐compatible, liver transplantation. Six patients who died within the first week and one child who underwent retransplantation from an ABO‐incompatible donor were excluded from the study. No patient or graft were lost due to rejection. We observed 48 episodes of rejection in 33 patients. Fourteen patients required conversion to tacrolimus for steroid‐resistant rejection with resolution of rejection. One of these children developed PTLD. Other indications for conversion were neurotoxicity and hirsutism. One patient developed blindness of unknown origin after the conversion. Other side effects of tacrolimus were minor and resolved by lowering the dose. Five patients developed rejection after conversion; all achieved resolution with either steroid therapy or increase of tacrolimus dose. In conclusion, our study confirms that tacrolimus is an effective rescue therapy for paediatric liver transplantation.

Die Titelverbindung (1) wurde in Form farbloser Kristalle bei der Umsetzung von InCl3mit [C(NMe2)3][(CO)4FeC(O)NMe2] in THF erhalten. Die Kristallstruktur (monoklin, C2/c) zeigt das Vorliegen getrennter Ionen mit einem fehlgeordneten und einem nicht fehlgeordneten Kation. Im Dianion bilden die CO‐Gruppen des trigonal‐bipyramidal koordinierten Eisenatoms und die Chloratome des tetraedrisch koordinierten Indiumatoms eine gestaffelte Konformation mit einer relativ kurzen Fe–In‐Bindungslänge von 252 pm. Quantenchemische DFT‐Rechnungen von [CO)4FeInCl3]2–zeigen, dass die Fe–In‐Bindung einen stark ionischen Charakter aufweist und dass das Anion als ein Addukt von [Fe(CO)4]2–an InCl3aufgefasst werden sollte.

The carbodiphosphorane Ph3P&dbd;C&dbd;PPh3 (1) readily reacts with Ni(CO)4 in toluene to give the substitution product (CO)3NiC(PPh3)2 (2). If the reaction is carried out in THF solution, additionally red crystals of the dicarbonyl complex (CO)2NiC(PPh3)2 (3) are formed. 2 smoothly converts into 3 when dissolved in THF. The compounds have been characterized by single-crystal X-ray diffraction. Quantum chemical calculations at the DFT level of theory (B3LYP) are given for the geometries of model compounds 1a−3a with PH3 ligands instead of PPh3, which are in good agreement with the experimental results for 1−3. The metal−ligand bond energies are also predicted at B3LYP. The calculated Ni−C(PH3)2 bond energy of 3a (D0 = 33.7 kcal/mol) is nearly the sum of the Ni−C(PH3)2 (D0 = 20.9 kcal/mol) and first Ni−CO bond energy of 2a (D0 = 16.3 kcal/mol). The analysis of the metal−ligand bonding using the CDA method shows that there is mainly ligand → metal donation and much less metal → ligand back-donation between Ni and C(PH3)2 in 2a. Donation and back-donation become stronger and back-donation becomes more important in 3a than in 2a.

Fe2(CO)9reacts with Cl2C(COOEt)2to give the paramagnetic complex Fe[ClC(COOEt)2]3in high yield. The magnetic and spectroscopic properties of this complex are discussed.

The carbamoyl complex [(CO)4FeC(O)NMe2][C(NMe2)3] (1) reacts with boron halides of the type BrBR2(R = Me, Ph, NMe2) at low temperature to give the boroxycarben complexes 2, which decompose at ambient temperature to the aminoboranes 3 and Fe(CO)5. The 1NMR and IR spectra of the new compounds 2 are reported.

The effects of mancozeb (fungicide) and lindane (insecticide) were investigated in active soil ciliates, testaceans, rotifers, and nematodes. The effects were evaluated 1, 7, 15, 40, 65, and 90 days after application of a standard and a high (10x) dose. Individual numbers were estimated with a direct counting method. Mancozeb, even at the high dose, had no pronounced acute or long-term effects on absolute numbers of the taxa investigated. The number of ciliate species, which decreased 1 day after treatment with the normal dose (0.05

The reaction of Fe2(CO)9with boron bromide or boron iodide yields Fe(CO)5, Fe(CO)4X2and [Fe(CO)4BX]n(X  Br, J). The same type of products is formed if R2NBBr2(R  CH3, C2H5) is employed as the boron halide; the dialkylamino group remains attached to the boron. Besides nonvolatile [Fe(CO)4BNR2]n, volatile monomeric (CO)4FeBNR2is obtained in low yields, containing the unusual ligand R2NB. Some spectroscopic properties of the novel coordination compounds are reported and some of heir chestry is discussed.

The thioacetamids S = C(CH3)(NHR) (R = H, 1a; R = Ph, 1b) react with Fe2(CO)9to form the iron tetracarbonyl complexes 2 and 3 with S-bonded ligands. IR, 1H, 13C and mass spectra of these new compounds are reported

The reaction of (I) and (II) gives the known complex (III), in the analogous reaction with (IV), (V) is obtained.