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Radical Reactivity: Electrophilic Radicals01:02

Radical Reactivity: Electrophilic Radicals

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Radicals adjacent to electron‐withdrawing groups are called electrophilic radicals. These radicals readily react with nucleophilic alkenes. For example, the malonate radical, in which the radical center is flanked by two electron‐withdrawing groups, reacts readily with butyl vinyl ether, which consists of an electron‐donating oxygen substituent. The reaction between electrophilic malonate radical and nucleophilic vinyl ether is favored because the radical has a...
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Radical Reactivity: Nucleophilic Radicals01:16

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Radicals adjacent to electron-donating groups are called nucleophilic radicals. These radicals readily react with electrophilic alkenes. The SOMO–LUMO interactions are the driving force for the reaction, where the high-energy SOMO of the electron-rich, nucleophilic radicals interacts with the low-energy LUMO of the electron-deficient, electrophilic alkenes. Such SOMO–LUMO interactions are the basis of reactive radical traps, affecting the selectivity in radical reactions. For...
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Radicals01:27

Radicals

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Roots, often written as radicals, identify the quantity that must be raised to a specific exponent to produce a given value. A radical expression consists of two main components: the radicand, which is the value placed inside the root symbol, and the index, which indicates the degree of the root being taken. The notation n√a indicates the principal nth root of a. If n equals 2, the operation is the square root, while n = 3 defines the cube root. When n is even, a negative radicand does...
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Radical Equations01:26

Radical Equations

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Radical equations are mathematical expressions in which the variable is found within a radical, most commonly a square root or cube root. These equations frequently arise in science, engineering, and real-world measurements involving nonlinear relationships. To solve a radical equation, the standard procedure is to isolate the radical expression and then eliminate the radical by raising each side to a power equal to the index of the radical. This process may lead to extraneous...
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Radical Autoxidation01:20

Radical Autoxidation

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The oxidation of an organic compound in the presence of air or oxygen is called autoxidation. For example, cumene reacts with oxygen to form hydroperoxide. Autoxidation involves initiation, propagation, and termination steps. Many organic compounds are susceptible to autoxidation—especially ethers in the presence of oxygen, which form hydroperoxides. Even though this reaction is slow, old ether bottles contain small amounts of peroxide, which leads to laboratory explosions during ether...
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Radical Formation: Abstraction00:47

Radical Formation: Abstraction

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The electron of an atom can be abstracted from a compound by a relatively unstable radical to generate a new radical of relatively greater stability. For example, an initiator which forms radicals by homolysis can abstract a suitable species like a hydrogen atom or a halogen atom from a compound to generate a new radical. This ability of radicals to propagate by abstraction is a crucial feature of radical chain reactions.
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Radical Prostatectomy or Watchful Waiting in Prostate Cancer - 29-Year Follow-up.

Anna Bill-Axelson1, Lars Holmberg1, Hans Garmo1

  • 1From the Department of Surgical Sciences (A.B.-A., L.H., M.H.), Regional Cancer Center Uppsala Örebro (H.G.), and the Department of Pathology (C.B.), Uppsala University Hospital, Uppsala, the School of Health and Medical Sciences, Örebro University, and the Department of Urology, Örebro University Hospital, Örebro (S.-O.A., O.A., J.-E.J.), the Department of Medical Epidemiology and Biostatistics (H.-O.A.), Karolinska Institutet, Stockholm, and the Division of Clinical Cancer Epidemiology, Sahlgrenska Academy, Gothenburg (G.S.) - all in Sweden; the School of Medicine, Division of Cancer Studies (L.H., H.G.), and the School of Cancer and Pharmaceutical Sciences (L.H.), King's College London, London; the Department of Urology, Helsinki University Hospital (K.T.), and the Department of Pathology, University of Helsinki (S.N.), Helsinki; the Department of Epidemiology, Harvard T.C. Chan School of Public Health, Boston (H.-O.A.); and the Clinical Effectiveness Research Group, Institute of Health and Society, University of Oslo, Oslo (H.-O.A.).

The New England Journal of Medicine
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PubMed
Summary

Radical prostatectomy significantly reduces prostate cancer mortality and extends life expectancy by nearly 3 years for men with localized disease. High Gleason scores and extracapsular extension predict a worse prognosis.

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Area of Science:

  • Urology
  • Oncology
  • Clinical Trials

Background:

  • Radical prostatectomy is known to reduce mortality in localized prostate cancer.
  • Evidence from randomized trials with long-term follow-up is limited.

Purpose of the Study:

  • To evaluate the long-term effects of radical prostatectomy versus watchful waiting on mortality and metastasis in localized prostate cancer.
  • To assess the prognostic value of histopathological measures in predicting outcomes.

Main Methods:

  • A randomized trial involving 695 men with localized prostate cancer comparing watchful waiting to radical prostatectomy.
  • Long-term follow-up data collected through 2017, with intention-to-treat and per-protocol analyses.
  • Estimation of cumulative incidence, relative risks, and years of life gained; Cox proportional-hazards model for prognostic evaluation.

Main Results:

  • Radical prostatectomy resulted in a significant reduction in prostate cancer death (relative risk, 0.55; P<0.001) and an absolute risk reduction of 11.7%.
  • A mean of 2.9 extra years of life were gained with radical prostatectomy at 23 years of follow-up.
  • Extracapsular extension and Gleason scores >7 were highly predictive of prostate cancer death.

Conclusions:

  • Radical prostatectomy offers significant survival benefits for men with localized prostate cancer and good life expectancy.
  • Histopathological features like Gleason score and extracapsular extension are critical prognostic indicators.
  • The study provides robust long-term evidence supporting radical prostatectomy for selected patients.