We studied clinical features and pathologic findings in 52 consecutively autopsied patients with multiple myeloma in our center between 1979 and 1998. Distant extraosseous involvement was found in 33 patients (63.5%). Thirty-one patients (59.6%) were proven to have infection at autopsy, among which pneumonia was most common site of infection. Amyloidosis was shown in 8 patients. Second malignancies were observed in 4 cases. The three major causes of death were hemorrhage, infection, and renal failure, which accounted for death in approximately 70% of the patients. Advances in the anticancer and antimicrobial chemotherapies might have decreased deaths due to myeloma itself or infection. Am. J. Hematol. 67:1-5, 2001.
Over the past decade, the use of hypervalent iodine reagents [1] has gained importance as a safe alternative to heavy-metal reagents for performing a variety of organic transformations. In view of recent demands for ecologically friendly chemical processes in the agrochemical and pharmaceutical industries, polymer-supported hypervalent iodine reagents should be a new and useful tool as a result of their versatility, low toxicity, high yields, simple work-up procedures, and recyclability. Accordingly, Togo and co-workers, [1h, 2] Ley and co-workers, [3] and we [4] demonstrated that both poly(diacetoxyiodo)styrene (PDAIS) [5] and polybis(trifluoroacetoxyiodo)styrene (PBTIS) exhibit reactivities similar to those of phenyliodine diacetate (PIDA) and phenyliodine bis(trifluoroacetate) (PIFA), respectively, and utilized them as environmentally benign replacements for I III reagents such as PIDA, PIFA, and iodosyl benzene (PhIO) (Scheme 1).Despite the utility and versatility of these polymersupported reagents, they still have several drawbacks: 1) the loading efficiency of I III sites is difficult to control, which has made the marketing of polymer-supported iodine reagents difficult; 2) the degradative loss of resin is accompanied by benzylic oxidation of the polystyrene chain after repeated use; and 3) they are much less reactive than the corresponding monomeric forms owing to steric hindrance of the reactive sites as well as their low solubility in various solvents. Therefore, slightly vigorous conditions and/or an excess amount of reagents are generally needed. Herein we report the preparation and characterization of a novel, recyclable, and nonpolymeric hypervalent iodine(iii) reagent, 1,3,5,7-tetrakis[4-(diacetoxyiodo)phenyl] adamantane (1), and its derivatives. As a part of our continuing research into the development of new hypervalent iodine compounds, we planned to synthesize an unprecedented tetrahedral I III compound 1, which should be a precursor to build a unique hypervalent iodine-based supramolecular structure as well as a new oxidizing agent. We prepared 1,3,5,7-tetrakis(4-iodophenyl)-adamantane (2) in good yield in two steps from commercially available 1-bromoadamantane according to a literature procedure.[6] Oxidation of 2 by conventional methods [7] with peracetic acid (30 % H 2 O 2 and acetic anhydride), sodium perborate (NaBO 3 ) in acetic acid, or sodium periodate (NaIO 4 ) unexpectedly gave 1 in low yield, accompanied by poorly soluble and unidentifiable polymeric products. After further investigations, we finally succeeded in synthesizing 1 in 97 % yield by using m-chloroperbenzoic acid (MCPBA) in CH 2 Cl 2 /AcOH (1:1) under dilute conditions (Scheme 2).Adamantane 1 was fully characterized by single-crystal Xray analysis [8] as well as elemental and spectroscopic analysis. A single crystal of 1 suitable for X-ray crystallographic analysis was obtained through slow growth by the vapor diffusion from CH 2 Cl 2 /AcOH/hexanes. Figure 1 reveals the geometry around the iodine in 1 to be a p...
Lung cancer cases (66 650 males and 20 890 females) registered in the Annual of Pathological Autopsy Cases in Japan, between 1958 and 1997, were analyzed with regard to sex, age and histology. They were subdivided into decades (periods I to IV), and compared with the Japanese mortality statistics, with which they were in good correspondence. Although the autopsy rate is decreasing, more than 10% of the total lung cancer deaths in Japan were registered by 1990. Among autopsied cases, the incidence of lung cancer cases increased from 6% to 12% in males and from 3% to 6% in females. From period III, lung cancer in males became the most frequent, and was the second most frequent cancer in females after gastric cancer. As for the histological distribution, adenocarcinoma was the most frequent and squamous cell carcinoma was the next most frequent in both sexes. Recently, a significant increase in adenocarcinoma and a significant decrease in squamous cell carcinoma have been observed in both sexes. The peak ages shifted from the 60s to the 70s and a significant rise in the mean ages were observed. The male-to-female ratios and the ratio curves by histological and age group were high for squamous cell carcinoma and small cell carcinoma, while they were low for the total and adenocarcinoma. With the recently acquired data on lung cancer in Asian countries, and from the male-to-female ratios and the status of smoking rates, lung cancer in the world at present was divided into three groups; North America, Europe and Asia. The possibility of one group changing to resemble another and of groups converging in the near future is suggested.Key words: Lung cancer autopsy cases -Age and sex -Histological types -Male-to-female ratio -Cigarette smoking In North America 1, 2) and some European countries, 3,4) due to successful anti-smoking policies, the lung cancer rate is currently decreasing. In Japan, the lung cancer rate is still increasing, 5,6) and the transition of lung cancer cases to the older generation is continuing.5, 6) Japan also has a high percentage of adenocarcinoma in both sexes. 7,8) Since 1958, the Japan Society of Pathology has published "the Annual of Pathological Autopsy Cases in Japan" (the Annual), 9) which contains a brief summary of almost all autopsy cases in major Japanese hospitals.Although the autopsy rate is decreasing in Japan, the Annual 9) still keeps a nationwide record of almost all autopsies performed. The largest amounts of data covered 5.3% of all the deaths in 1985 and 14.0% of the total number of lung cancer deaths in 1980.5) In the present study, all the lung cancer cases registered from 1958 to 1997 were analyzed, the changes were studied by decade, and the results were compared with other Japanese studies and reports from other countries. The autopsy cases in the Annual 9) were in good correspondence with the Japanese mortality statistics 5) and had a high percentage of accurate histological data (99.13% for 1997). The characteristics of lung cancer in Japan, and the recent changes and l...
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