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The Amplatzer-N-butyl cyanoacrylate-Amplatzer sandwich technique for occluding the distal ureter is safe and effective with a quick (probably due to the N-butyl cyanoacrylate) and durable (probably due to the Amplatzer plugs) clinical response.

[reaction: see text] A novel safety-catch linker for the solid-phase synthesis of small-molecule libraries containing electrophilic reactive groups has been developed. Upon cleavage from solid support, the linker generates a Michael acceptor (an acrylamide) on each library member. Utilization of a two-resin system in the final cleavage step provides crude products in high purity, allowing direct use in biological assays following filtration and evaporation.

A 77-year-old woman, immobile due to advanced rheumatoid arthritis, presented to the emergency department with a 3-day course of a progressively painful and purple left lower extremity (Fig. 1a). On examination, the limb was discolored, swollen, warmer than the right leg, and very tender. The distal pulses were entirely absent, and only a faint left femoral pulse was palpable. Phlegmasia cerulea dolens (from Latin for inflamed, blue, and painful) was the clinical impression [1] and confirmed with Doppler ultrasound, which demonstrated an occlusive thrombus in the left femoral vein. Sensation and motor function of the limb remained intact. She was started on a heparin drip, and brought to interventional radiology for endovascular therapy. Fig. 1b shows a venogram of the left iliofemoral segment with extensive occlusive deep venous thrombus (DVT) that extended to the left popliteal vein (not shown).Catheter directed lysis was performed overnight resulting in Dopplerable distal pulses and improved symptoms; however, interval venography (not shown) revealed significant residual thrombus burden. The digital subtraction venogram of the left iliofemoral segment in Fig. 1c depicts improved patency and flow following subsequent endovascular mechanical thrombectomy. Fig. 1d shows the improvement in the patient's left leg 12 h later (36 h after presentation). Her pain resolved, and her distal pulses became palpable. She was discharged on warfarin. Although prolonged immobility was the presumptive risk factor for her, consultation with a hematologist/oncologist

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