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J Am Chem Soc 130:84558459 Yokokawa F, Shioiri T (2002) Total synthesis of somamide A, an Ahp (3-amino-6-hydroxy-2-piperidone)-containing cyclic depsipeptide

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There is biological plausibility for pancreatic complications due to the supraphysiological stimulation of the pancreas, leading to hyperplasia
