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Objectives: To investigate whether hemodynamic changes during balloon occlusion test (BOT) predict future heart failure (HF) deterioration after transcatheter atrial septal defect closure (tASD-closure)., Background: Midterm HF deterioration can sometimes occur after tASD-closure in adults. Whether hemodynamic changes during tASD-closure can help identify patients at risk is unknown., Methods: This prospective observational study enrolled 86 consecutive adult patients who underwent tASD-closure. Hemodynamic parameters, including pulmonary capillary wedge pressure (PCWP), were measured at baseline, during BOT, and after tASD-closure. The changes in PCWP during BOT and after tASD-closure were defined as ΔPCWP (Occ-Pre) and ΔPCWP (Post-Pre), respectively. Clinical parameters were evaluated before tASD-closure and during the 3-month follow-up. We assessed the occurrence of HF deterioration (HF requiring hospitalization or additional diuretics) during a 2-year follow-up period and categorized patients into HF (+) and HF (-) groups accordingly. The aforementioned parameters were compared between groups., Results: Midterm HF deterioration occurred in 12 patients (13.9%). Compared to the HF (-) group, the HF (+) group presented a significantly higher ΔPCWP (Occ-Pre) (9.5 ± 4.4 mmHg vs. 3.0 ± 3.3 mmHg; p < 0.001) and ΔPCWP (Post-Pre) (4.0 ± 2.8 mmHg vs. 0.6 ± 1.8 mmHg; p = 0.004). Receiver operating characteristic curve analysis showed that the ΔPCWP (Occ-Pre) cutoff value of 5.5 mmHg had excellent ability to predict HF deterioration (Area under the curve 0.886 [0.779-0.993], p < 0.001; sensitivity 0.917, specificity 0.824)., Conclusions: Increases in PCWP during BOT predict midterm HF deterioration after tASD-closure. Close surveillance may be needed in patients with a ΔPCWP (Occ-Pre) >5 mmHg., (© 2021 Wiley Periodicals LLC.)

Culprit lesions of acute coronary syndrome (ACS) could be classified as plaque rupture (PR), erosion, or calcified nodule (CN). We aimed to determine the relationship among clinical characteristics, morphological plaque features, and long-term prognosis in ACS. Patients with ACS, who underwent pre-intervention optical coherence tomography between April 2013 and July 2018 were retrospectively enrolled, and classified into the three groups based on the culprit lesion morphology. In the 436 patients enrolled, incidences of PR, erosion, and CN in ACS culprit lesions were 46.1, 39.9, and 14.0%, respectively. Plaque erosion was more frequent in men aged < 60 years and CN was more frequent in older adults in both sexes (≥ 80 years) (P < 0.001). Patients with CN had a higher incidence of hemodialysis treatment (P < 0.001) and diabetes (P = 0.003). Multivariate analysis revealed that ST elevation myocardial infarction (STEMI) (P = 0.049) and presence of thin-cap fibroatheroma (TCFA) at the culprit lesion were independently associated with PR; in younger patients (< 60 year), preserved left ventricular ejection fraction and lower incidence of TCFA were correlated with plaque erosion; and older age, non-STEMI, or unstable angina pectoris, higher serum brain natriuretic peptide levels, and lower incidence of TCFA were independently associated with CN. Multivariable analysis revealed that CN (odds ratio [OR] 1.990, P = 0.005), male sex (OR 2.012, P = 0.004), and older age (OR 1.036, P < 0.001) were independently associated with future adverse events during a median follow-up of 757 days. Different patient characteristics and morphological features were associated with the type of culprit lesion in patients with ACS., (© 2021. The Author(s), under exclusive licence to Springer Nature B.V.)

Background: The effect of intraindividual variability in lipid levels on the onset of acute coronary syndrome (ACS) remains uncertain. We evaluated the relationship between intraindividual variability in lipid levels and culprit lesion morphologies by optical coherence tomography (OCT). Methods and Results: Seventy-four consecutive patients with ACS whose cholesterol levels were assessed ≥3 times during outpatient visits before the onset of ACS were enrolled in the study; 222 patients without significant stenotic lesions were used as a control group. Based on OCT findings of culprit lesions, ACS patients were categorized into a plaque rupture ACS (PR-ACS) group (n=44) or a non-plaque rupture ACS (NPR-ACS) group (erosion or calcified nodule; n=30). Visit-to-visit variability in lipid levels was evaluated using the corrected variability independent of the mean (cVIM). Patients with ACS had significantly higher low-density lipoprotein cholesterol (LDL-C) levels and cVIM in LDL-C than the control group. The PR-ACS group had significantly higher mean LDL-C levels and greater cVIM in LDL-C than the control group. The PR-ACS group had a significantly higher cVIM than the NPR-ACS group, despite similar mean LDL-C levels. Multivariate analysis revealed that higher cVIM of LDL-C was an independent predictor of PR-ACS (odds ratio 1.06; P=0.018). Conclusions: In addition to the LDL-C level, greater visit-to-visit variability in LDL-C levels may be associated with the onset of ACS induced by plaque rupture., Competing Interests: None declared., (Copyright © 2021, THE JAPANESE CIRCULATION SOCIETY.)

Multipoint lock-and-key particle assembly, consisting of lock particles with multiple anisotropic dents and rod-shaped particles as key particles, is developed for colloidal modeling application. The lock particles were connected with each other at a key particle as their joint in the presence of depletants, forming rigid colloidal molecules imitating rigid polymers (e.g., polymers containing aromatic rings and intramolecular hydrogen bonds). A single-particle level observation was conducted to visualize the colloidal polymerization of the particle assembly. Motion trajectories of the lock particles observed by optical microscopy indicated that the particle diffusivity was dramatically lowered when the lock particle connected with another one, suggesting that particle diffusion was suppressed by particle assembly formation. Because the kinetic and regioselectivity of colloidal polymerization are assumed to be analogous to those at the atomic scale, the proposed lock-and-key assembly can be a promising colloidal model for atomic-scale polymers associated with their micro-Brownian motion.

Background Although patients with a cancer history have a 2 to 3 times higher risk for acute coronary syndrome (ACS), the morphological characteristics of ACS culprit plaque in those patients and their relations with clinical outcomes remain unknown. Methods and Results This retrospective, multicenter, observational cohort study included consecutive patients with ACS who underwent optical coherence tomography-guided emergent percutaneous coronary intervention. Patients were categorized into those without a cancer history, those with a cancer history, and those currently receiving cancer treatment. ACS culprit lesions were classified as plaque rupture, plaque erosion, or calcified nodule using optical coherence tomography. Plaque erosion frequency was significantly higher in culprit lesions of patients with current cancer and patients with cancer history than in those of patients without cancer history (56.3% versus 61.7% versus 36.5%). Calcified nodule incidence was significantly higher in patients without cancer history than in patients with current cancer and patients without cancer history (patients with current cancer: 12.4% versus patients without cancer history: 25.5% versus patients without cancer history: 12.6%, P <0.001). Cancer history was independently associated with nonplaque rupture (plaque erosion or calcified nodule) in ACS culprit lesions (odds ratio, 4.00; P <0.001). Cancer history was independently associated with major adverse cardiovascular events (hazard ratio [HR], 1.98; P =0.002). Nonplaque rupture in ACS culprit lesions was independently associated with major adverse cardiovascular events (HR, 1.60; P =0.011). Conclusions Patients with a cancer history had significantly worse clinical outcomes after ACS than those without a cancer history. Those with a cancer history had significantly higher plaque erosion and calcified nodule incidences in the ACS culprit lesions, which might partly explain their worse clinical outcomes. Registration URL: www.umin.ac.jp/ctr/index.htm. Unique Identifier: UMIN000038442.

Aim: This study aimed to determine the main risk factors for falls in patients with Alzheimer disease (AD) by comparing balance, cognition, and visuospatial ability between those who have experienced a fall and those who have not., Methods: Forty-seven AD patients were admitted to a ward for patients with dementia (22 men and 25 women). The balance of patients was evaluated using the Functional Reach Test (FRT), the one-leg standing duration, and the Timed Up and Go (TUG) test. The Mini-Mental State Examination-Japanese (MMSE-J) was used to evaluate cognition. For visuospatial ability assessment, the Clock-Drawing Test (CDT) as well as overlapping figure identification and shape discrimination in the Visual Perception Test for Agnosia (VPTA) were used. The patients were allocated to either the fall group or the nonfall group based on their history of falls in the past year. The relationships between patients' characteristics and evaluation outcomes were compared and examined. Logistic regression analysis was performed using a fall as the objective variable. The area under the curve (AUC) and the cutoff value were calculated., Results: Of the 47 participants, 22 had experienced falls within the past year (46.8%). The results of the FRT, one-leg standing duration, the TUG, the CDT, and the VPTA were significantly lower in the fall group. No significant difference between the MMSE-J scores of the fall group and those of the nonfall group was observed. The results of the logistic regression analysis indicated that falls in AD patients were significantly associated with the FRT. It was found that a shorter FRT distance (cm) had a significant impact on falls. For the FRT, the fall-related AUC was 0.755. At a cutoff value of 24.5 cm, the level of sensitivity was 68.0%, and the level of specificity was 77.3%., Conclusions: The findings of this study indicate that balance and visuospatial abilities are risks factors for falls in AD patients. In contrast, cognitive impairment was not a risk factor for falls. It was demonstrated that the FRT could be an appropriate risk predictor for falls in AD patients. In particular, falls in AD patients were strongly affected by a reduced dynamic balance., Competing Interests: The authors have no conflict of interests to declare., (Copyright © 2021 by S. Karger AG, Basel.)

Interactions between hydrated Ce 3+ and various carboxylates are of fundamental interest. Anomalously strong interactions with Ce 3+ occur when diglycolic acid (DGA) is added into a Ce 3+ aqueous solution, unlike various other carboxylic acids. Herein, the complex-formation constants of Ce 3+ with these acids are evaluated via absorption and emission spectra. Hydrated Ce 3+ emits fluorescence with unity quantum yield; however, addition of various carboxylates statically quenches the fluorescence when Ce 3+ -carboxylate complexes form because the fluorescence lifetime is constant irrespective of the carboxylate concentration. In the observed static quenching, the complex-formation constants obtained from the absorption and emission spectra ( K abs and K em ) agree well. The binding of Ce 3+ by the conjugate Lewis bases, i.e., carboxylates, is approximately inversely proportional to the pH. Adding DGA into the system also statically quenches the fluorescence, but far more efficiently, even in a much weaker solution. We rigorously deduce K abs and K em of Ce 3+ with DGA without any approximation using comparable concentrations. Careful fittings provide equivalent K em and K abs values, and by varying the pH and ionic strength, we confirm that this equivalence is an inherent property of the Ce 3+ -DGA system. The Lewis acid-base theory cannot explain why DGA binds to Ce 3+ ∼1000 times more strongly than the other carboxylates. This anomalously strong binding may be due to a chelate effect caused by the DGA's central oxygen atom, which forms a five-membered ring with the conjugate Lewis bases of DGA; double chelate rings can also form, while bis-deprotonated DGA binds to Ce 3+ , facilitated by the central oxygen. Therefore, DGA enables efficient quenching through the chelate effect when it binds to Ce 3+ ., Competing Interests: The authors declare no competing financial interest., (© 2020 American Chemical Society.)

Background: In-stent neoatherosclerosis (NA) is a risk for future cardiovascular events through atherosclerotic progression in non-stented lesions. Using optical coherence tomography, this study assessed the efficacy of intensive therapy with 10 mg/day rosuvastatin plus 1,800 mg/day eicosapentaenoic acid (EPA) vs. standard 2.5 mg/day rosuvastatin therapy on native coronary plaques in patients with NA., Methods and results: This was a subgroup analysis of the randomized LINK-IT trial, which was designed to compare changes in the lipid index in NA between intensive and standard therapy for 12 months. In all, 42 patients with native coronary plaques and NA were assessed. Compared with standard therapy, intensive therapy resulted in greater decreases in serum low-density lipoprotein cholesterol concentrations and greater increases in serum 18-hydroxyeicosapentaenoic acid concentrations, with significantly greater decreases in the lipid index and macrophage grade in both NA (-24 vs. 217 [P<0.001] and -15 vs. 24 [P<0.001], respectively) and native coronary plaques (-112 vs. 29 [P<0.001] and -17 vs. 1 [P<0.001], respectively) following intensive therapy. Although there was a greater increase in the macrophage grade in NA than in native coronary plaques in the standard therapy group, in the intensive therapy group there were comparable reductions in macrophage grade between NA and native coronary plaques., Conclusions: Compared with standard therapy, intensive therapy prevented atherosclerotic progression more effectively in native coronary plaques in patients with NA.

Aim: The clock drawing test (CDT) is widely used as a visual spatial ability test and screening test for dementia patients. The appearance frequency of qualitative errors obtained through the qualitative analysis of CDT may be related to the participant's falls. The aim of this study was to clarify the difference in the number of people who presented with qualitative errors in the CDT between a fall and non-fall group of patients with Alzheimer's disease (AD)., Methods: The CDT was implemented for 47 patients with AD. A quantitative analysis was conducted, and a qualitative analysis was performed for errors. The patients were divided into two groups based on their history of falls over the past year. The results of the CDT quantitative analysis were tested using the Mann-Whitney U test, and Fisher's exact test was employed to determine the difference in the number of people who presented with error types between the two groups (fall group, non-fall group) in the CDT qualitative analysis., Results: In the quantitative analysis, a significant difference was found for the total scores, with the total CDT score of the fall group ( n = 22) significantly lower than that of the non-fall group ( n = 25) ( p = 0.006, effect size: φ = 0.40). In the qualitative analysis, a significantly higher number of patients in the fall group than in the non-fall group presented with a conceptual deficit ( p = 0.001, φ = 0.51). No differences were found in the number of patients in the two groups who presented with the other five error types., Conclusions: These results showed that a lower score in the CDT quantitative analysis might suggest an increased risk of falls. It was also clarified that a larger number of patients in the fall group than in the non-fall group presented with a conceptual deficit of the qualitative error types in the CDT. Therefore, these results suggest that the appearance of a conceptual deficit may be an index for the selection of patients with AD prone to falling when implementing fall prevention measures., Competing Interests: The authors declare no conflict of interest., (Copyright © 2019 by S. Karger AG, Basel.)

A 59-year-old man with a history of giant cell myocarditis was admitted to our hospital with recurrent giant cell myocarditis triggered by a 1 mg/day taper in his prednisolone dose. During the initial episode, he had undergone rescue implantation of a temporary left ventricular assist device followed by the administration of dual immunosuppressive therapy with prednisolone and concomitant cyclosporine. Triple combination immunosuppressive therapy maintained with additional mycophenolate mofetil successfully controlled recurrent myocarditis, enabled a reduction in the prednisolone dose, and achieved the functional recovery of the left ventricle.

Aim: The aim of this study was to determine Activities of Daily Living/Instrumental Activities of Daily Living (ADL/IADL) evaluations that will enable better understanding of the severity of Alzheimer's disease (AD)., Methods: AD patients were evaluated by Functional Independence Measure (FIM), Hyogo Activities of Daily Living Scale (HADLS), and Assessment of Motor and Process Skills (AMPS) to identify the assessments that will enable highly precise discrimination of AD Clinical Dementia Rating (CDR) 2 (moderate) and CDR3 (severe) using receiver operating characteristic (ROC) curve and discriminant analyses., Results: The participants were 75 AD patients (CDR2 = 50, mean age = 80.3 ± 5.9 years; CDR3 = 25, mean age = 78.3 ± 9.0 years). The evaluation methods consisted of FIM, HADLS, and AMPS. The results were divided into FIM-M, FIM-C, HADLS-ADL, HADLS-IADL, AMPS-motor skills, and AMPS-process skills. The values for the area under the curve (AUC) were compared by ROC curve and discriminant analyses. AUC values for FIM-C and AMPS-process skills were 0.956 and 0.947, respectively. With these two evaluations only, values ≥0.9 were shown. Moreover, the AUC of the discrimination score (combination of the FIM-C and AMPS-process skills) was significantly higher than those for FIM-M, FIM-C, HADLS-ADL, HADLS-IADL, and AMPS-motor skills., Conclusions: The results demonstrated that evaluation by FIM-C and AMPS-process skills methods was useful for discriminating between CDR2 (moderate) and CDR3 (severe) AD. Moreover, the results indicated that these two evaluation methods enabled more accurate determination of severity and the spared capabilities of AD patients.

Background We evaluated the importance of high-density lipoprotein (HDL) functionality for target-lesion revascularization in patients treated with coronary stents using a rapid cell-free assay system to evaluate the functional capacity of HDL to accept additional cholesterol (cholesterol-uptake capacity; CUC). Methods and Results From an optical coherence tomography (OCT) registry of patients treated with coronary stents, 207 patients were enrolled and their HDL was functionally evaluated by measuring the CUC. Follow-up OCT was performed (median duration, 24.5 months after stenting) to evaluate the presence of neoatherosclerosis. Clinical follow-up was performed to assess target-lesion revascularization for a median duration of 42.3 months after stent implantation. Neoatherosclerosis was identified in 37 patients (17.9%). Multivariate logistic regression analysis revealed that a decreased CUC was independently associated with neoatherosclerosis (odds ratio, 0.799; P<0.001). The CUC showed a significant inverse correlation with incidence of target-lesion revascularization (odds ratio, 0.887; P=0.003) and with lipid accumulation inside stents, suggesting that neoatherosclerosis contributes to the association between CUC and target-lesion revascularization. Conclusions Impaired HDL functionality, detected as decreased CUC, might lead to future stent failure by provoking atherogenic changes of the neointima within stents. Both quantitative and qualitative assessments of HDL might enable the improved prediction of clinical outcomes after stent implantation.

[Purpose] We investigated whether the activities of daily living and instrumental activities of daily living independence in patients with Alzheimer's disease are positively affected by the main nursing caregiver consciously aiming to provide only minimal nursing care. [Participants and Methods] The participants comprised 105 patients (men: 46, women: 59, mean age: 80.1 ± 6.7 years). We conducted interviews to establish whether the main nursing caregivers consciously aimed to provide only minimal nursing care (care consciousness), and participants were thus divided into two groups. Hyogo Activities of Daily Living Scale scores of the groups with and without care consciousness were compared by dementia severity. [Results] In patients with mild Alzheimer's disease, activities of daily living and instrumental activities of daily living independence in the group with care consciousness were significantly higher than in the group without care consciousness. In patients with moderate Alzheimer's disease, instrumental activities of daily living independence was significantly higher in the group with care consciousness than in the group without care consciousness. [Conclusion] Thus, positive effects on the activities of daily living and instrumental activities of daily living independence are observed when the main nursing caregivers consciously aim to provide only minimal nursing care to patients with Alzheimer's disease.

Background: Although a recent clinical trial demonstrated that alirocumab, a proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor, significantly reduces the incidence of acute coronary events, the impact of alirocumab on plaque stabilization remains uncertain. The Efficacy of ALirocumab for Thin-cap fibroatheroma in patients with coronary Artery disease estImated by optical coherence tomogRaphy (ALTAIR) study will investigate the effect of alirocumab on thin-cap fibroatheroma (TCFA) in Japanese patients who underwent recent percutaneous coronary intervention (PCI)., Methods and Design: ALTAIR is a phase IV, open-label, randomized, parallel-group, single-center study involving blinded optical coherence tomography (OCT) image analysis in Japanese adults hospitalized for PCI and having suboptimal control of low-density lipoprotein cholesterol (LDL-C) levels (>70mg/dL) despite statin therapy. Patients will be randomized (1:1) to the alirocumab arm (alirocumab 75mg every 2 weeks added to rosuvastatin 10mg/day) or the standard-of-care arm (rosuvastatin 10mg/day, with initiation and/or dose adjustment of non-statin lipid-lowering to achieve an LDL-C target of <70mg/dL). OCT imaging will be conducted at baseline and at week 36 (post-treatment). The primary objective is to compare the alirocumab and standard-of-care arms regarding the change in TCFA fibrous-cap thickness after 9 months of treatment., Conclusion: The outcomes of ALTAIR (ClinicalTrials.gov identifier: NCT03552432) will provide insights into the effect of alirocumab on plaque vulnerability following PCI in patients with suboptimal LDL-C control despite stable statin therapy., (Copyright © 2018 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.)

A novel luminescent clamshell-like platinum(II) complex with rac-tartrate, rac-[{Pt II ( 4 Me 2 bpy)} 2 (μ-tart)] (Pt 2 ; 4 Me 2 bpy: 4,4'-dimethyl-2,2'-bipyridine; tartH 2 2- : tartrate), was synthesized, and its vapo-, thermo-, and solvatochromic behavior was studied. The complex was isolated in four crystal forms, namely, Pt 2 ·4H 2 O (color under ambient light: yellow, λ em = 573 nm, intramolecular Pt···Pt separation: 3.55 Å), Pt 2 ·4MeOH (red, 650 nm, 3.33 Å), anhydrate Pt 2 (red, no luminescence, 3.70 Å), and Pt 2 ·2H 2 O (orange, 595 nm, 3.60 Å). Vapo- and heat-responsive crystal-to-crystal phase transitions were observed by time- and/or temperature-dependent powder X-ray diffraction, and the molecular and crystal structures of the above crystal forms were determined by either single-crystal X-ray crystallography or Rietveld refinement of powder X-ray diffraction. Vapor diffusion of MeOH to Pt 2 ·4H 2 O induced a reversible phase transition to Pt 2 ·4MeOH. This structural transformation significantly changed the intramolecular Pt-Pt interactions, affecting the absorption and emission colors. Accordingly, the luminescence chromism originates from alternation of the luminescent nature between a triplet metal-ligand-to-ligand charge-transfer state ( 3 (ML tart )L bpy CT) of Pt 2 ·4H 2 O and a triplet metal-metal-to-ligand charge-transfer state ( 3 MML bpy CT) of Pt 2 ·4MeOH. Heating Pt 2 ·4H 2 O induced a phase transition to anhydrate Pt 2 , and under atmospheric conditions, anhydrate Pt 2 transformed spontaneously to Pt 2 ·2H 2 O. Vapor diffusion of H 2 O to Pt 2 ·2H 2 O caused reconstruction of Pt 2 ·4H 2 O. The thermochromism originates from changes in the intermolecular interactions between stacked complexes. The solvatochromism was evaluated using the Kamlet-Taft solvatochromic equation, the acceptor number, and the E T (30) scale for the solvent, and the hydrogen-bond acidity of the solvent contributed significantly to the solvent-dependent absorption properties.

An 82-year-old man with severe aortic stenosis and idiopathic pulmonary fibrosis (IPF) underwent transcatheter aortic valve implantation (TAVI) under general anesthesia. However, following a successful TAVI procedure, he developed progressive respiratory failure because of the exacerbation of IPF. Despite the use of immunosuppressants, the patient could not be saved and he died of respiratory failure. Although TAVI is a less invasive procedure compared to conventional surgical aortic valve replacement, it is currently selected for management of severely ill, frail, and elderly patients. This case highlights the potential risk of IPF exacerbation following a TAVI procedure performed under general anesthesia. < Learning objective: Transcatheter aortic valve implantation (TAVI) procedures have been increasingly performed for high-risk patients, including those with high frailty and pulmonary dysfunction. Although TAVI is less invasive compared to open surgery, it may cause critical exacerbation of idiopathic pulmonary fibrosis when performed under general anesthesia. Multidisciplinary care beyond "heart team" would be necessary for prevention, as well as for detecting the early signs of exacerbation of idiopathic pulmonary fibrosis.>.

The asymmetric unit of the title anhydrate compound, (NH 4 ) 2 [VO(C 3 H 2 O 4 ) 2 (H 2 O)], consists of two independent complex anions and four ammonium cations. In the complex anions, the V IV atoms are each coordinated by two malonate ligands, one water mol-ecule and one oxide O atom in a distorted octa-hedral geometry. The equatorial plane is formed by the malonate O atoms, while the axial positions are occupied by water and oxide O atoms. The difference between the two independent complexes is the relative conformation of the malonate ligands. The two ligands in one complex anion are in a syn conformation, while in the other they adopt an anti conformation. In the crystal, the complex anions inter-act with the counter-cations and adjacent anions through O-H⋯O, N-H⋯O and C-H⋯O hydrogen bonds. Stacks of alternating layers consisting of either anti or syn isomers, formed with the aid of the hydrogen bonding, are observed. DFT calculations for the anti and syn isomers show a similar thermodynamic stability to each other. The crystal used for this analysis was an inversion twin with the ratio of the twin components being 0.270 (13):0.730 (13).

Even in modern clinical cardiology, basic auscultation skill is not obsolete and is still important because it can always provide a clue to an underlying pathophysiology. We demonstrate an unusual mechanism of pathological wide splitting of the second heart sound due to external compression of the pulmonary trunk in a patient with a giant coronary arterial aneurysm of the proximal left anterior descending artery. Echocardiography, when combined with a three-dimensional anatomical analysis with cardiac computed tomography, was useful for elucidating the mechanism of the abnormal heart sounds.

Changes in luminescence due to solution-mediated phase transition (SMPT) and crystal-to-crystal phase transitions of a novel cyclometalated platinum(II) complex with isoquinoline-1-carboxylate (Iq-1-COO - ) [Pt(bzq)(Iq-1-COO)] (bzq - : benzoquinolinate) were studied experimentally and theoretically. Recrystallization of the complex allowed three crystal forms depending on the solvent: red polymorph R DMF (λ emi = 689 nm), yellow polymorph Y DMSO (λ emi = 641 nm), and red pseudopolymorph RB CHCl 3 (λ emi = 721 nm). Crystals of R DMF in the DMF solution at room temperature showed SMPT to yellow crystals Y DMF (λ emi = 627 nm), in which R DMF first dissolved partly into the solution, and then the dissolved complex crystallized as Y DMF . RB CHCl 3 exhibited crystal-to-crystal phase transitions to R DMF and Y DMF by being heated to 150 °C and stored in atmospheric conditions, respectively. Molecular structures of each of the four crystal forms, analyzed by X-ray crystallography, showed different planarities because of the dihedral angles between the bzq - and Iq planes being 3.15, 4.80, 8.35, and 17.7° for RB CHCl 3 , R DMF , Y DMSO , and Y DMF , respectively. The planar complexes in R DMF and RB CHCl 3 constructed dimers through intermolecular Pt-Pt and π-π interactions, whereas the distorted complexes in Y DMF and Y DMSO remained as monomers. Density functional theory (DFT) calculations, which reveal the relation between the molecular structure and thermodynamic stability, suggest that the SMPT is triggered by thermodynamic transformation from the metastable planar structure to the stable distorted structure. The intradimer interactions in R DMF and RB CHCl 3 induced red-shifts in the absorption and emission colors from those of Y DMF and Y DMSO ; thus, the photophysical properties of RB CHCl 3 and R DMF originate from the MML Iq CT state in contrast with the ML Iq CT/L bzq L Iq CT character for Y DMF and Y DMSO . DFT and time-dependent DFT (TD-DFT) calculations in the ground and excited states provide insight into the structural, electronic, and optical properties.

Six novel phosphorescent cyclometalated platinum(ii) complexes with α-aminocarboxylato ligands, [Pt(II)(ppy)L] (ppy = 2-phenylpyridinato, L(-) = Gly, Ala, Leu, Ile, Phe, Sar), were synthesized, and the structures were determined by X-ray crystallography. [Pt(II)(ppy)L] (L(-) = Gly, Ala) in crystals are in monomeric structures and stack through π-π interactions to form columns, and the features of the luminescence are similar to each other and those in solution, suggesting little influence of the π-π interactions on the luminescence. [Pt(II)(ppy)Leu] has a dimeric structure through the Pt-Pt interaction. [Pt(II)(ppy)Sar] showed two pseudo-polymorphs, one of which contains both monomeric and dimeric forms, while the other consists of only dimeric units. Intra-dimer π-π interactions were observed in both the dimeric units. [Pt(II)(ppy)L] (L(-) = Leu, Ile, Phe) in the solid state displayed different spectral patterns of luminescence from those in solution, suggesting that the dimeric structures through the Pt-Pt interaction in the solid state are dissociated into the corresponding monomeric ones in solution. The complexes except [Pt(II)(ppy)Phe] in the solid state exhibited reversible luminescent mechanochromism in response to the mechanical grinding and treatment with a few drops of solvent. These phenomena are induced by the change in the energy level of the triplet state due to the change in the extent of intermolecular interactions, which appeared due to the crystalline-amorphous phase conversion.

Catalytic polymerization of styrene with a series of dinuclear nickel(II) complexes [{Ni(acac)}2{μ-C6H2-(N-Ph-R)4}] (R = 4-Et (1a), 4-OEt (1b), 2-OEt (1c), 2-Et (1d), and 2,6-Et2 (1e)) in the presence of methylaluminoxane was studied under various conditions to evaluate the substituent effect. The activity of 1a-1e, except 1c, increased with an increase in the reaction temperature, and the highest activity (7.46 × 10(5) g PS mol(-1) Ni h(-1)) was obtained using 1e at 70 °C. The electronic and steric properties of the ligand influenced the activity at room temperature, 50 °C, and 60 °C, steric factors barely, whereas electronic factors slightly dominated the activity at 70 °C. The activity with 1c remained constant at all temperatures, probably due to the masking of the active center by the formation of inactive N,N',O-chelate species. The obtained polymers were atactic polystyrenes with molecular weights and molecular weight distributions in the range of 15,000-43,400 and 1.71-2.14, respectively. While a clear dependence of the molecular weight and molecular weight distribution on the temperature was observed, no significant dependence on the substituent was noted.

In the neutral complex mol-ecule of the title compound, fac-[CrCl3(tpa)] [tpa is tris-(pyridin-2-yl)amine; C15H12N4], the Cr(III) ion is bonded to three N atoms that are constrained to a facial arrangement by the tpa ligand and by three chloride ligands, leading to a distorted octa-hedral coordination sphere. The average Cr-N and Cr-Cl bond lengths are 2.086 (5) and 2.296 (4) Å, respectively. The complex mol-ecule is located on a mirror plane. In the crystal, a combination of C-H⋯N and C-H⋯Cl hydrogen-bonding inter-actions connect the mol-ecules into a three-dimensional network.

A new ortho-rhom-bic polymorph of the title compound, C30H24N4, with a density of 1.315 Mg m(-3), has been obtained. The mol-ecule is centrosymmetric with the centroid of the cyclo-hexa-1,4-diene ring located on an inversion center. The two unique benzene rings are almost perpendicular to each other [dihedral angle = 86.70 (6)°] and are oriented at dihedral angles of 30.79 (5) and 68.07 (5)° with respect to the central cyclo-hexa-diene ring. In the crystal, π-π stacking is observed between the central cyclo-hexa-1,4-diene-1,4-di-amine unit and a phenyl ring of a neighboring mol-ecule [centroid-centroid distance = 3.7043 (7) Å]. The crystal structure of the triclinic polymorph [Ohno et al. (2014 ▶). Acta Cryst. E70, o303-o304] showed chains running along the b-axis direction through weak C-H⋯π inter-actions.

In the title compound, C30H24N4, the central benzo-quinonedi-imine moiety is approximately planar, with a maximum deviation of 0.044 (14) Å. The four terminal phenyl rings are twisted by 44.95 (11), 54.90 (10), 44.98 (10) and 50.68 (11)° with respect to the mean plane the benzo-quinonedi-imine unit. In the crystal, mol-ecules are linked by weak C-H⋯π inter-actions into supra-molecular chains running along the b-axis direction.

The mononuclear title complex, [VCl2O(C3H8S)2], features a V(IV)=O double bond [1.5845 (15) Å] in an overall trigonal-bipyramidal coordination environment defined by two Cl(-) and the S atoms of two (CH3CH2)(CH3)S ligands. In the crystal, pairs of mol-ecules form centrosymmetric dimers via C-H⋯O hydrogen bonds between the methyl C-H group and the oxidovanadium O atom of a neighbouring mol-ecule.

The hemerythrin-type dinuclear title complex, [Ru2(CH3COO)2O(C10H8N2)2(C5H5N)2](PF6)2, consists of two Ru(III) ions with a six-coordinate octa-hedral geometry, bridged by an oxide and two acetate ligands, with a bidentate 2,2'-bipyridine ligand and a pyridine ligand bonding at terminal positions. The Ru-Ru distance and Ru-O-Ru angle are 3.2838 (3) Å and 121.79 (7)°, respectively, and the average Ru-N(pyridine) bond length is 2.164 (8) Å. Several C-H⋯F, C-H⋯O and C-H⋯N inter-actions generate a three-dimensional network in the crystal structure. π-π stacking inter-actions [centroid-centroid distance = 3.6389 (3) Å] between inversion-related 2,2'-bipyridine rings are also observed.

The title salt, C(20)H(42)N(4)S(2) (2+)·2ClO(4) (-), was obtained from the reaction of bis-(diethyl-amino)-carbeniumdithio-carboxyl-ate, (Et(2)N)(2)C(2)S(2), with Fe(ClO(4))(2)·6H(2)O in CH(2)Cl(2). The title compound, in which one of the S atoms of (Et(2)N)(2)C(2)S(2) is bound to a 1,1-bis-(diethyl-amino)-ethane moiety, has two carbenium C atoms, and the charge compensation is provided by two perchlorate anions. The N(2)C-CS(2) bond length is 1.512 (4) Å, corresponding to a C-C single bond, and the dihedral angle between N(2)C- and -CS(2) planes [72.0 (2)°] is smaller than that of (Et(2)N)(2)C(2)S(2) [82.0 (1)°]. The crystal structure features C-H⋯S hydrogen bonds.

The dinuclear compound, [Nb(2)Cl(6)(C(2)H(6)S)(1.7)(C(2)H(6)Se)(1.3)], features an Nb(III)=Nb(III) double bond [2.6878 (5) Å]. The mol-ecule lies on a twofold rotation axis that passes through the middle of this bond as well as through the bridging dimethyl sulfide ligand. The Nb(III) ion exists in an octa-hedral coordination environment defined by two terminal and two bridging Cl atoms, and (CH(3))(2)Se/(CH(3))(2)S ligands. The (bridging) ligand lying on the twofold rotation axis is an ordered (CH(3))(2)S ligand, whereas the terminal ones on a general position are a mixture of (CH(3))(2)Se and (CH(3))(2)S ligands in a 0.647 (2):0.353 (2) ratio (the methyl C atoms are also disordered).

The absolute configuration of the octa-hedral fac-CoN(3)O(3) title complex, [Co(C(5)H(8)NO(2))(3)]·3H(2)O, has been determined by single-crystal X-ray analysis. A three-dimensional network of hydrogen bonds is observed between the proline carboxyl-ate groups and the three uncoordinated water mol-ecules.

The receptor for advanced glycation end products (RAGE) is associated with cancer progression in several human cancers. In this study, we examined the roles of RAGE in the angiogenesis of oral squamous cell carcinoma (OSCC). RAGE concentration was examined in 20 OSCC tumors by enzyme-linked immunosorbent assay (ELISA). The microvessel density (MVD) and lymph vessel density (LVD) were examined by immunostaining. Concentrations of vascular endothelial growth factor (VEGF) and VEGF-C were examined in tumor tissues by ELISA. Tumoral RAGE concentration was associated with higher tumor MVD (P = 0.0123) and tumor VEGF concentration (P = 0.0344), but not with LVD and VEGF-C concentration. Treatment with RAGE ligand, high-mobility group box (HMGB)-1 increased the secretion of VEGF but not that of VEGF-C in human OSCC cell lines, HSC-3 and HSC-4. The effect of HMGB-1 was abrogated by RAGE down-regulation by antisense S-oligodeoxynucleic acid. These results suggest that RAGE expression is closely associated to angiogenesis in OSCC.