The first polymer-assisted solution-phase synthesis of deoxyglycosides

[reaction--see text] A glycosylation protocol for the synthesis of 2-deoxyglycosides has been developed which is based on the use of polymer-bound reagents. Glycals are transformed into 2-iodoglycosyl acetates using polymer-bound bis(acetoxy)iodate(I) complex (1). Activation of the anomeric center is achieved by employing polymer-bound silyl triflate (2). In the presence of different glycosyl acceptors, 2-deoxy-2-iodoglycosides are generated in very good yields. Furthermore, it is shown that this method can be embedded in multistep sequences toward glycosylated testosterone and rhodinosyl-olivosyl-olivoside.

Inhibitory effect of ethyl oleate hydroperoxide and alcohol in photosensitized oxidative DNA damage

Xanthone-sensitized photo-oxidation of guanine in calf thymus DNA and in the nucleoside 2'-deoxyguanosine has been investigated in the presence of various additives, with major emphasis on hydroperoxides. The formation of the guanine oxidation products 7,8-dihydro-8-oxoguanine (8-oxoGua), which is a marker for oxidative DNA damage, and 2,2-diamino-4-[(2-deoxy-beta-D-erythro-pentofuranosyl)amino]-5(2H)-oxazo lone (oxazolone) was monitored quantitatively by high performance liquid chromatography electrochemical or fluorescence analysis. Irradiation (350 nm) of calf thymus DNA in the presence of xanthone as sensitizer afforded 8-oxoGua in 1.4% yield. The ethyl oleate hydroperoxide 1a and its alcohol 1b inhibit the formation of 8-oxoGua very efficiently (up to 85%). Even the structurally simple t-butyl hydroperoxide and the physiologically relevant hydrogen peroxide exhibit strong inhibition of photosensitized oxidation of guanine in DNA and in the nucleoside, while t-butanol and the allylic alcohols 3b and 4 do not. Hydroperoxides in general quench type I-sensitized (benzophenone, xanthone) photo-oxidation of guanine, but not that of rose bengal, a predominant type II sensitizer. The inhibiting effect is explained by H abstraction of the electronically excited carbonyl chromophore from the additive. The biological relevance of these findings should be seen in the potential protecting role of lipid hydroperoxides and their corresponding alcohols against oxidative stress.

Formation of 7,8-dihydro-8-oxoguanine in the 1,2-dioxetane-induced oxidation of calf thymus DNA: evidence for photosensitized DNA damage by thermally generated triplet ketones in the dark

Isolated calf thymus DNA was treated with the 1,2-dioxetanes 3-acetoxymethyl-3,4,4-tri-methyl-1,2-dioxetane, 2,3-dimethylbenzofuran dioxetane, 3-hydroxymethyl-3,4,4-trimethyl-1,2-dioxetane (HTMD), 3,3,4,4-tetramethyl-1,2-dioxetane and 3,4,4-trimethyl-1,2-dioxetane (TrMD), which on thermal decomposition generate triplet-excited carbonyl products. To monitor quantitatively the formation of the mutagenic oxidation product 7,8-dihydro-8-oxoguanine (8-oxoGua), a sensitive and selective HPLC electrochemical assay was used after acidic hydrolysis (HF/pyridine) of the dioxetane-treated DNA. High yields of 8-oxoGua (up to ca 4% of the available guanine) were obtained for HTMD and TrMD. Both were investigated in detail with respect to effects of concentration, time and temperature. The oxidative reactivity of 1,2-dioxetanes was compared with several type I (benzophenone and riboflavin) and type II (methylene blue and rose bengal) photooxidants and disodium 1,4-etheno-2,3-benzodioxin-1,4-dipropionate as a chemical source of singlet oxygen. The persistence of 8-oxoGua towards oxidation by HTMD was examined in the reaction with 7,8-dihydro-8-oxo-2'-deoxyguanosine (8-oxodGuo) and with oxidized DNA. It was shown that, indeed, 8-oxoGua is consumed in the oxidized DNA on prolonged exposure to an excess of HTMD. The reaction of 8-oxodGuo with HTMD afforded the two 4R* and 4S* diastereomers of 9-(2-deoxy-beta-D-erythropentofuranosyl)-4, 8-dihydro-4-hydroxy-8-oxoguanine as main oxidation products. Trapping experiments with tert-butanol confirmed that hydroxyl radicals are not involved, whereas the use of the triplet quenchers sodium 9,10-dibromo-anthracene-2-sulfonate and 2,3-diazabicyclo[2.2.1]hept-2-ene established that triplet-excited states are mainly responsible for the observed DNA oxidation through type I action (electron transfer chemistry). The role of singlet oxygen was tested by means of deuterium isotope effects in D2O versus H2O, but no definitive conclusion could be reached in regard to the involvement of 1O2 in these oxidations.(ABSTRACT TRUNCATED AT 250 WORDS)

Genotoxicity studies of benzofuran dioxetanes and epoxides with isolated DNA, bacteria and mammalian cells

1,2-Dioxetanes, very reactive and high energy molecules, are involved as labile intermediates in dioxygenase-activated aerobic metabolism and in physiological processes. Various toxicological tests reveal that dioxetanes are indeed genotoxic. In supercoiled DNA of bacteriophage PM2 they induce endonuclease-sensitive sites, most of them are FPG protein-sensitive base modifications (8-hydroxyguanine, formamidopyrimidines). Pyrimidine dimers and sites of base loss (AP sites) which were probed by UV endonuclease and exonuclease III are minor lesions in this system. While the alkyl-substituted dioxetanes do not show any significant mutagenic activity in different Salmonella typhimurium strains, heteroarene dioxetranes such any significant mutagenic activity in different Salmonella typhimurium strains, heteroarene dioxetanes such as benzofuran and furocoumarin dioxetanes are strongly mutagenic in S. typhimurium strain TA100. DNA adducts formed with an intermediary alkylating agent appear to be responsible for the mutagenic activity of benzofuran dioxetane. We assume that the benzofuran epoxides, generated in situ from benzofuran dioxetanes by deoxygenation are the ultimate mutagens of the latter, since benzofuran epoxides are highly mutagenic in the S. typhimurium strain TA100 and they form DNA adducts, as detected by the 32P-postlabelling technique. Our results imply that the type of DNA damage promoted by dioxetanes is dependent on the structural feature of dioxetanes. Furthermore, the direct photochemical DNA damage by energy transfer, i.e., pyrimidine dimers, plays a minor role in the genotoxicity of dioxetanes. Instead, photooxidation dominates in isolated DNA, while radical damage and alkylation prevail in the cellular system.

[Quantified determination of dermographism in patients with atopic eczema]

The usual method of checking dermatographism (D), which is typically white in atopic eczema (AE), allows only a qualitative rating. To allow reproducible quantification of D we have developed an easily used instrument, called a Dermographometer. This can be fitted with one to three blunt tapered metal bars of different weights applying a constant stretching pressure over the whole skin areas to be examined or different pressures at isolated points. We used this device to study D in 27 patients with AE and in 20 healthy controls. Of the 27 patients, 21 had white D, 2, red D, and 4, none at each pressure applied. In 18 of the controls D was red. In addition, the two groups differed significantly in the time to onset and the duration of the D elicited, which was much longer in patients with AE. Simultaneous and constant application of distinct grades of pressure for quantitative dermatographometry is a method that can reliably be used for the study of inter- and intraindividual variation in vascular reactivity in the course of various dermatoses, especially.

[Disorders of thermoregulation in adaptation to external cold and heat stimuli in patients with atopic eczema]

Patients suffering from atopic eczema (AE) often exhibit disturbances of various neurovegetative (in particular, vasomotoric) skin functions. Thus, in 21 patients with AE we studied the response of the skin of one forearm to standardized 15-min exposure of the other arm to a cold and a warm bath (17 degrees-18 degrees C and 40 degrees-41 degrees C respectively). The results were compared with those in 23 age- and sex-matched healthy controls under similar environmental conditions. In most patients, during exposure of one forearm to warmth the skin temperature of the contralateral forearm remained unchanged or decreased slightly, whereas exposure to cold induced either a slight rise in skin temperature or an almost indiscernible decrease. In contrast to the normal temperature reaction of the non-exposed forearm to warmth exposure of the contralateral arm in most controls, our findings in atopic patients indicated a "rigid" or even "paradoxical" response to thermic stimuli. This abnormal pattern of thermoregulation may reflect an intrinsic disturbance of the peripheral and hypothalamic autonomous system involved in the pathogenetic conditions of AE.

[Are shifts in circadian cortisol rhythm an endocrine symptom of atopic eczema?]

Marked nocturnal pruritus in patients with atopic eczema (AE) may depend partly on alterations in circadian neuroendocrine rhythms, e.g. cortisol rhythm. We analysed the serum cortisol levels every 2 h between 8 p.m. and 8 a.m. and at 2 p.m. (profile I) in 20 adult in-patients with florid AE not pretreated with any systemic corticosteroid or ACTH therapy (profile I). The results were compared with those recorded in 19 healthy women. In 14 patients we checked the profiles again after marked improvement of AE (profile II). On profile I, the lowest cortisol levels were after midnight for 9 of the 20 patients, while on profile II this was true for 12 of the 14 tested. The mean cortisol levels over the period examined were found to be approximately the same for patients and controls for profile I, yet the mean level on profile II was found to be lower. The mean time interval between minimum and maximum cortisol levels was shorter in patients with AE than in controls (8.5 h), and was shorter still on profile II (4.6 h). The shift in the serum cortisol minimum after midnight resulted in an extremely steep rise in the cortisol level between the level in the late hours of the night, and the 24 h-maximum in the early morning hours.(ABSTRACT TRUNCATED AT 250 WORDS)

[Classification and scope of clinical variations of Melkersson-Rosenthal syndrome]

Apart from the apparent trias of oro-facial swellings, facial paresis, and lingua plicata (LP), Melkersson-Rosenthal syndrome (MRS) comprises a variety of complex signs and symptoms. During the last 18 years, 73 patients suffering from MRS were admitted to our hospital. Re-examination of 42 out of these patients and evaluation of all data available proved preceding facial paresis(es) in only 34% of all cases and LP of various degrees in 52%. In more than 80%, however, we found vasomotoric, sialo-secretory, or other neurovegetative "minor signs", locally and/or temporally connected with swellings of either skin or mucosa. Since such minor signs are essential for the diagnosis and the understanding of both "complete" and "incomplete" forms of MRS (either associated with or without typical cheilitis granulomatosa), we worked out a classification of MRS considering the dermal, neurological, and neurovegetative affections observed in our cases and according to the relevant literature. A systematic classification like this, which takes into account the diagnostic signification of the findings, allows exact recognition of "incomplete" forms of MRS and represents a conditio sine qua non with regard to family studies and the follow-up of patients concerned.

[Site-specific incidence of benign and precancerous leukoplakias and cancers of the oral cavity]

The distribution patterns of benign and precancerous oral leukoplakias as well as oral cancer were investigated in 547 patients. The most frequently affected site was the buccal mucosa, the rarest localization was the floor of mouth. 96% of buccal lesions were benign, 4% were precancerous or cancerous. In contrast, 68% of the lesions on the floor of the mouth were precancerous or cancerous. Our results indicate, that the localization of leukoplacic lesions in the oral cavity is an important hallmark of their dignity.

[Glossodynia--indication for patch testing?]

100 patients suffering from glossodynia without pathologic changes of the oral mucosa and 16 patients with suspected allergic contact stomatitis underwent patch testing using standard patch test and dental materials. The results were compared with those of patients in dental occupations suffering from hand eczema. As there is no clinical relevance of allergens in patients with glossodynia, patch testing seems to be unnecessary. On the other hand, patch test results of patients with stomatitis and dentures often suggest a causal allergy. In most of those cases, this was confirmed by complete healing after changing the denture bases, whereas in glossodynia such replacements never brought about a convincing improvement of the symptoms.

[Thermographico-histologic study of the lymph drainage areas in malignant melanoma]

In an investigation including 176 patients with malignant melanoma (MM) of the skin, the preoperative infrared telethermograms (IR-TT) obtained from the draining lymph node area were compared with the clinical and histologic data on lymph nodes removed by dissection. In 19 out of 92 cases with high-risk MM subjected to primary tumor excision and draining lymph node dissection, metastatic involvement of one or more lymph nodes was found histologically. In 18 of 19 cases (= 95%) with metastatic spread of MM, there was a considerable degree of hyperthermic radiation in the respective axillary or inguinal area. On palpation, only 13 of 19 patients (= 68%) showed conspicuous lymph node enlargement. The histologic sections of the lymph nodes of the above 18 patients with both regional spread of MM and hyperthermia were reexamined in order to compare the extent of tumor involvement with the q-classification of IR-TT. There was a remarkable correlation between an increase in the number of macrometastases (and conversely, a drop in the number of micrometastases) and the grades of regional hyperthermia.

[Infrared thermography in malignant melanoma. Diagnostic potential and limits]

Using infrared thermography, 264 in patients who were clinically suspected of having primary malignant melanoma (mM) of the skin were examined with regard to the thermographic pattern of both tumor and peritumoral skin area. In 84% of the patients with histologically confirmed mM deviations from normothermic pattern (mainly hyperthermic) were found of the tumor itself and/or the peritumoral area. All nodular mM proved to be hyperthermic. Pigmented skin tumors other than mM (e.g., angioma, basalioma, nevus cells, mole, histiocytoma) predominantly exhibited local isothermia or only minor thermographic changes. The infrared radiation intensity of the mM depended on the individual surface attributes of the tumors. As a rule, the larger mM are warmer than small mM. When comparing histological staging of a mM with thermographic classification, the pT values were strongly correlated with the thermographic values, ranging from Q1 to Q4. The highest measurements of infrared radiation were obtained in the nodular and acrolentiginous mM, as compared to the other melanoma types. There is evidence that mM exhibiting marked local hyperthermia have a particularly to poor prognosis.

[Treatment of Raynaud's phenomenon in scleroderma with a new stable prostacyclin derivative]

In a single-blind trial 25 patients with progressive scleroderma and Raynaud's phenomenon intravenous infusions of iloprost, a prostacyclin derivative (carbaprostacyclin), were given daily for five hours during a six-day hospital stay, after a comparable initial single placebo infusion. Duration, frequency and intensity of Raynaud symptoms improved in more than 75% of the patients. This improvement was objectified by telethermometry which demonstrated acral hyperthermia and significantly briefer rewarming after standardized cooling of the hands. In addition, there was more rapid healing of ulcerations and necroses of the digital pulp. A significant inhibition of ADP- and collagen-dependent platelet aggregation was demonstrated during the iloprost infusion. Side effects, such as headache, nausea and tiredness occurred only transitorily during the infusion, were individually highly variable, and then only at higher concentrations. A dosage of 2 ng/kg X min was tolerated by all patients.

[HLA typing of patients with herpes simplex recidivans and postherpetic erythema exsudativum multiforme]

62 patients suffering from recurrent herpes simplex, with ten out of them showing postherpetic erythema multiforme, have been investigated with special reference to histocompatibility standardisation. In comparison with a control group (n = 170), our patients revealed a high and statistically significant level of HLA-B5 (p less than 0,01). Postherpetic erythema multiforme seems to be associated with HLA-A9.

[Clinical picture, therapy and prognosis of orolabial cancer with special reference to regional lymphatic drainage]

Upon classification according to the TNM system, most lip carcinomas fell into low T-categories whereas cancers of the oral cavity fell in high T-categories. The proportion of cases with palpable lymph nodes did not differ between the two sites although the extent of the palpation findings (N-category) did differ. In general differences in clinical behavior between the two locations were more apparent when a complex evaluation of all findings was undertaken. Lymph node metastases were divided into two categories whereby a more differentiated calculation of the frequency of metastasis was possible. The interpretability and accuracy of the palpation findings of regional lymph nodes corresponding to the TNM-classification is rather limited with respect to the occurrence of metastases. Patients with fixed lymph nodes or histologically confirmed or clinically certain metastases have a poor prognosis. The frequency of appearence of temporally-determined recurrences and late metastases as well as the average interval until appearence were essentially the same.

The influence of lymph node metastasis and ulceration of primary melanoma on germinal centers within draining lymph nodes: a histomorphometric study

Microscopic counts and histoelectronic measurement of germinal centers in regional lymph nodes of melanoma patients showed a significant progressive increase in average number, as well as area, of germinal centers with occurrence of (adjacent) metastasis and presence of primary-tumor ulceration. The findings confirm in a quantitative manner the stage-dependent effect of progressive liberation of tumor antigen [10] on lymph node centers of humoral immune response.

Cell proliferation in lichen planus of the buccal mucosa

Abstract not available

[The stress situation in ambulatory oral surgical interventions]

On the basis of results from various studies, the authors show that the psychic initial condition and the psychophysical stress during the operation are of paramount importance to the rise of complications.

[Oral leukoplakia. II. Results of a year-long polyclinical pilot study]

A pilot study was carried out on close on 4000 uniformly examined and documented patients of the Erlanger maxillo-facial Policlinic. This resulted in the extensive collection of data useful as a basis for future follow-up studies on leucoplakia patients. Leucoplakia was found in 123 patients (3,1%) including 7 precancerous lesions and 6 mucosal carcinomata. Age and sex distribution of leucoplakia patients and various potential influential factors were statistically compared with a control group of an equal number of outpatients. For each of the factors examined, chronic smoking, chronic alcohol consumption, enoral habits, the connection with the occurrence of leucoplakia was highly significant (alpha less than 0,001).

[The use of nuclear medicine methods for the control of regional cytostatic therapy of neoplasms in the orofacial region]

Complementary to the well-known clinical, radiographic, histologic and biochemical methods for the control of the regional cytostatic chemotherapy of malignant tumours in the orofacial region, the authors describe by help of a case report the possible uses of nuclear-medical methods of examination. The following nuclear-medical methods of examination were employed: 1. bone scintigraphy, 2. perfusion scintigraphy, 3. tumour scintigraphy. The advantages of nuclear-medical methods consist in the relatively low load to which the patient is subjected and in the possibility of assessing qualitatively and quantitatively (in combination with current control methods) the distribution of the perfused chemotherapeutic agent and of evaluating the therapeutical success.

[Studies on the treatment of male infertility with kallikrein]

70 subfertile patients were given oral (600 K.U./daily) or parenteral (3 X 40 K.U./weekly) Kallikrein-treatment for seven weeks. Statistical evaluation of the findings yielded positive changes (level of significance alpha less than 1%) in cases of reduced spermatozoa count, motility, and morphology. In respect to clinical diagnosis the most satisfactory effects were achieved in cases of the vegetative congestion syndrome, which includes functional disturbances of the epididymis, the testicular outlet of spermatozoa, and the last phase of spermatid maturation. In cases of testis parenchyma disorders a true effect was not noted. Probably Kallikrein influences the function of epididymis and SERTOLIcells, which can be concluded by the results of the spermatological examinations in the course of the treatment. Because of the short duration of treatment, it is impossible to decide, wether the proliferation of the germinal epithelium is increased as well. A negative effect was observed in cases of chronic inflammations of the genital tract, the inflammatory process being activated by Kallikrein, which was not unexpected.