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PURPOSE Adrenocortical carcinoma (ACC) is a rare condition associated with poor prognosis. This study aimed to evaluate the clinicopathologic characteristics and prognosis of 7 patients with ACC. PATIENTS AND METHODS The clinicopathologic characteristics, treatment, and survival of 7 patients with pathologically confirmed ACC treated at our institution between January 2002 and December 2012 were retrospectively examined. RESULTS The study cohort comprised 4 male and 3 female patients (median age at diagnosis, 63 years [range, 36-71 years]). The median tumor size was 7.0 cm (range, 4.0-13.0 cm), and the median follow-up duration was 22 months (range, 9-107 months). One patient had stage I ACC, 4 had stage III, and 2 showed metastasis. The patient with stage I disease underwent laparoscopic adrenorectomy and those with stage III disease underwent adrenorectomy with the excision of adjacent organs. Four of these 5 patients are alive without recurrence at a median of 55 months (range, 22-107 months) after surgery. Of the 2 patients with metastases, 1 received combined chemotherapy with etoposide, adriamycin, and cisplatin plus mitotane without surgical resection but died 19 months later, and the other, with a solitary lung metastasis, underwent adrenorectomy and metastatectomy followed by adjuvant treatment with mitotane and is alive without recurrence at 9 months after treatment. The 3-year cause-specific survival rate was 56%. CONCLUSIONS Patients with advanced-stage tumors showed long-term survival with complete tumor resection at diagnosis; hence, this seems to be most beneficial treatment option for patients with ACC.

Bridging parts X between two amide skeletons of C2-symmetric diphosphine ligands 1 were varied using various kinds of diacyl chlorides. The ligand 1c derived from phthaloyl chloride, which was remarkably effective in the asymmetric induction on palladium-catalyzed asymmetric allylic substitutions of 2-cyclohexenyl pivalate or acetate, exhibited a moderate level of enantioselectivity, 72% ee, in the transformations of 1,3-diphenyl-2-propenyl pivalate. The newly developed ligands 1g–i having one carbon spacers X demonstrated higher degrees of enantiomeric excess up to 93% ee. Interestingly, the present reactions catalyzed by Pd–1c–e,g–j complexes afforded the product 4 with the opposite absolute configuration S compared with the reactions using VALAP, which has the same chiral source as that of 1. The ligands 1a,b,f exhibited the induction of R configuration although the yields were very low. The production of S-4 was discussed on the basis of the Pr/Mr chirality model.

A new C 2 -symmetric diphosphine ligand 8a was readily prepared in one step by treatment of the synthetic precursor of VALAP, 7 , with phthaloyl chloride. Remarkably high levels of asymmetric induction, over 99% ee, were achieved using 8a in palladium-catalyzed asymmetric allylic transformations of sterically less demanding cyclohexenyl substrates 9 . The ligand system was easily extended to the development of analogous chiral auxiliaries 8b , c by the identical procedure but using isophthaloyl chloride and succinyl chloride. However, the ligands 8b , c exhibited much lower catalytic activity. In contrast to the asymmetric allylic substitutions, 8c demonstrated significant improvement of enantioselectivity, up to 64% ee, in rhodium-catalyzed asymmetric hydrosilylations of acetophenone 11a compared to 35% ee using 8a . In this way, the versatility of the present ligand system played an important role in variations of substrates and reaction types.

A 26-year-old man was introduced to our hospital with a complaint of macrohematuria. Endoscopic examination showed a small tumor in the anterior urethra. Microscopic examination of a biopsy specimen taken under lumbar anesthesia showed amyloid deposition in the urethral submucosa. On Congo red staining, amyloid was visualized as orange material, showing characteristic birefringence under polarized light. Amyloidosis of the urethra was diagnosed. Because the patient refused to undergo duodenal or rectal biopsy, the possibility of systemic amyloidosis could not be completely excluded. No recurrence has been noted since the endoscopic examination, and no further symptoms have been reported.

Absorption experiments of CO 2 and NH 3 in water were performed using a crossflow cascade packed column with 4, 8, and 12 stages. Packings used were 12-mm ceramic Raschig rings and 47-mm S-O Tellerettes. The flow behavior of the fluid in the cascade column was examined. The effect of baffle spacing arrangement on the absorption of CO 2 and NH 3 was investigated using the data on mass-transfer coefficients, gas-phase pressure drops, and mean residence times of the aqueous phase. The optimum operating conditions and baffle arrangements were identified for the design of crossflow cascade columns that could achieve efficiencies equivalent to those of conventional countercurrent packed beds

A new C 2 -symmetric diphosphine ligand 8a was readily prepared in one step by treatment of the synthetic precursor of VALAP, 7 , with phthaloyl chloride. Remarkably high levels of asymmetric induction, over 99% ee, were achieved using 8a in palladium-catalyzed asymmetric allylic transformations of sterically less demanding cyclohexenyl substrates 9 . The ligand system was easily extended to the development of analogous chiral auxiliaries 8b , c by the identical procedure but using isophthaloyl chloride and succinyl chloride. However, the ligands 8b , c exhibited much lower catalytic activity. In contrast to the asymmetric allylic substitutions, 8c demonstrated significant improvement of enantioselectivity, up to 64% ee, in rhodium-catalyzed asymmetric hydrosilylations of acetophenone 11a compared to 35% ee using 8a . In this way, the versatility of the present ligand system played an important role in variations of substrates and reaction types.

Bridging parts X between two amide skeletons of C2-symmetric diphosphine ligands 1 were varied using various kinds of diacyl chlorides. The ligand 1c derived from phthaloyl chloride, which was remarkably effective in the asymmetric induction on palladium-catalyzed asymmetric allylic substitutions of 2-cyclohexenyl pivalate or acetate, exhibited a moderate level of enantioselectivity, 72% ee, in the transformations of 1,3-diphenyl-2-propenyl pivalate. The newly developed ligands 1g–i having one carbon spacers X demonstrated higher degrees of enantiomeric excess up to 93% ee. Interestingly, the present reactions catalyzed by Pd–1c–e,g–j complexes afforded the product 4 with the opposite absolute configuration S compared with the reactions using VALAP, which has the same chiral source as that of 1. The ligands 1a,b,f exhibited the induction of R configuration although the yields were very low. The production of S-4 was discussed on the basis of the Pr/Mr chirality model.