Synthesis and anticonvulsant activity of enaminones. 3. Investigations on 4'-, 3'-, and 2'-substituted and polysubstituted anilino compounds, sodium channel binding studies, and toxicity evaluations

In a continuing evaluation of the aniline-substituted enaminones, the synthesis of additional para-substituted analogs has been made in an attempt to further quantify the electronic (sigma) and lipophilic (pi) requirements for anticonvulsant activity in this series. In addition, meta- and ortho-substituted and polysubstituted compounds have been synthesized and evaluated for anticonvulsant activity. In the para-substituted series, 4-cyano analogs (32 and 33) (+ sigma, - pi), which were highly active via intraperitoneal (ip) injection in mice, were inactive on oral (po) administration in rats. The para-substituted trifluoromethoxy (+ sigma, + pi) analog (8) had significant potency by both routes. Meta substitution limited the activity due to steric factors. Bromo and iodo substituents produced active para-substituted analogs (5 and 17) but were inactive when substituted in the meta position (37 and 41, respectively). Ortho substitution provided no clear relationship due to nonparametric deviations. Neither 1, the prototype enaminone, nor 2, the putative metabolite, produced significant nephrotoxicity or hepatotoxicity. Sodium channel binding of 1 and 8 indicated that 8 displayed relatively potent sodium channel binding but 1 showed weaker effects with IC50 values of 489 and 170 microM respectively against [3H]batrachotoxinin A 20 alpha-benzoate ([3H]BTX-B).

Application of translesional pressure and flow velocity assessment in a severely calcified coronary narrowing in a patient with unstable angina

While the angiographic appearance of coronary stenoses commonly directs interventional decisions, it may correlate imprecisely with hemodynamic or physiologic lesional significance. Previous data would suggest that direct measures of translesional physiology can be helpful in assessing the hemodynamic significance of stable coronary stenoses. In unstable ischemic syndromes, however, the hemodynamic severity of lesions may depend on the presence of variably occlusive intraluminal thrombus superimposed on fluctuating vessel tone. Under these circumstances, physiologic lesional assessment can yield helpful information, which nonetheless must be interpreted with caution in light of the clinical context. Determination of optimal management strategies for such patients remains difficult and must await further investigation of prognosis and outcome.

Interventional physiology. Part XVIII: Influence of intra-aortic balloon counterpulsation and collateral flow reversal during multivessel angioplasty

Flow velocity changes during multivessel angioplasty suggests that collateral flow has an important role in determining safety and ischemic threshold during these procedures. The physiology of collateral flow with and without intra-aortic balloon pumping has been demonstrated in this individual and provides insight into the mechanisms of reduced ischemia during high-risk coronary interventions.

Comparison of quantitative angiographically derived and measured translesion pressure and flow velocity in coronary artery disease

Although quantitative coronary angiography (QCA) has been used to determine lesion severity, angiographically derived parameters of translesional physiology have not been compared with those directly measured in the same patients. Thus, the aim of this study was to correlate QCA-derived translesional pressure and flow data with directly measured data in patients. QCA (DCI-ACA program), translesional pressure gradient (2.2Fr fluid-filled tracking catheter), and intracoronary Doppler flow velocity (0.018-inch FloWire) measurements were simultaneously performed in 28 arteries (25 patients). Mean diameter stenosis was 51 +/- 2.3% (range 29 to 73). No patient had left ventricular hypertrophy or valvular heart disease. The arteries studied were left anterior descending in 14, circumflex in 8, and right coronary in 6 patients. Stenotic flow reserve and baseline and maximal gradients were calculated by the DCI program. Coronary flow reserve and baseline and maximal hyperemic gradients were also directly measured distal to the stenosis after administration of intracoronary adenosine (12 to 18 micrograms). QCA-derived pressure gradients did not correlate with the measured gradients at baseline (r2 = 0.005; p = 0.73) or at maximal hyperemia (r2 = 0.1; p = 0.13). No correlation was found between the QCA-predicted flow reserve and the coronary flow reserve measured distal to the stenosis (r2 = 0.02; p = 0.46). Furthermore, stenotic flow reserve and measured gradient were not significantly correlated (r2 = 0.1; p = 0.16). In this range of stenoses of intermediate severity, there was no correlation between the measured pressure gradient or coronary flow reserve and lesion diameter or cross-sectional area by QCA.(ABSTRACT TRUNCATED AT 400 WORDS)

Part XII: Assessment of serial lesions in the proximal right coronary artery following intracoronary thrombolysis

Assessment of angiographically serial coronary lesions at the time of diagnostic catheterization remains a difficult clinical problem. Doppler flow velocity data is easily obtainable and allows physiologic interrogation of the distal coronary microcirculation, but has limitations in the detection of some flow-limiting stenoses. In cases of serial lesions or distal arterial disease, particularly after thrombolysis, flow velocity data may be insufficient to identify the hemodynamic significance of the coronary lesions. Translesional pressure measurements may be combined with flow velocity data to support an appropriate physiologically based therapeutic approach.

A comparison of liver tumor diagnoses from seven PCB studies in rats

Through a policy assumption, all polychlorinated biphenyls (PCBs) are considered probable human carcinogens by most regulatory agencies based on experimental studies in rodents where an increased incidence of liver tumors has been observed. Recognizing that new consensus criteria for the diagnoses of liver tumors in rats had been promulgated, a reevaluation of liver tumor diagnoses from seven PCB studies in rats was undertaken. These seven studies, in which rats were fed PCB mixtures containing 42, 54, or 60% chlorine, were considered to be the best studies from which to evaluate the cancer potential of PCB mixtures. The reevaluation results, where consistent diagnoses now exist across all studies, clearly indicate major differences in carcinogenic potential based on degree of chlorination. Studies of mixtures with 60% chlorination consistently resulted in a high incidence of liver tumors, whereas studies in which rats were fed mixtures with 54 or 42% chlorination showed no statistically significant increases in liver tumors. These data indicate that continuation of a science policy of assuming that all PCBs are probable human carcinogens with a potency equivalent to the mixture that contains 60% chlorine has no scientific foundation and should be reconsidered.

Continuous coronary flow velocity monitoring during coronary interventions: velocity trend patterns associated with adverse events

Continuous measurement of blood flow velocity during interventional procedures has the potential to provide an early warning of coronary flow instability, which can lead to abrupt closure or other adverse events before angiography. The magnitude and fluctuations of the average velocity over time (trend) was studied by using a 0.018-inch Doppler-tipped angioplasty guide wire in 32 patients after coronary angiography (n = 20), atherectomy (n = 2), urgent stent (n = 6), urgent vein graft thrombolysis (n = 4), or acute myocardial infarction (n = 2). The patients (mean age 60 +/- 11 years) had postprocedural in-laboratory flow monitoring for a mean of 19 +/- 11 (range 8 to 36) minutes. The coronary artery monitored was the left anterior descending in 13, circumflex in 6, right coronary artery in 9, and saphenous vein graft in 4. Seven patients had flow-related events during continuous flow velocity monitoring before serial angiographic study. These events included coronary vasospasm (abrupt flow acceleration), vasovagal flow cessation, cyclical flow variations resulting from accumulation of intraluminal thrombus, and rapid decline of flow velocity. The last two patterns were associated with abrupt vessel closure during angioplasty. Continuous flow velocity monitoring is easily incorporated into routine interventional procedures and provides an early indication of unstable flow and the potential for abrupt vessel closure and other adverse events.

Nuclear magnetic resonance studies of anticonvulsant enaminones

1H nuclear magnetic resonance (NMR) spectra of enaminones were determined and compared to the anticonvulsant activity of the compounds. Although the precise employment of the NMR data to predict anticonvulsant activity of the enaminones could not be established, general inferences were made. The NMR data confirmed that the enaminones existed predominantly in the amino tautomer, and no evidence was found for the imino tautomer. The ketamine form of the enaminones was supported by the observed spin-spin splittings of the NH with the alpha-protons on certain enaminones. The NH of secondary enaminones was very important in conferring anticonvulsant activity to the enaminones. The peak for the NH proton which could be seen between delta (ppm) 4.50 and 9.70 was present in all of the active enaminones. The tertiary enaminones, which were devoid of the NH proton, were uniformly inactive. It appeared that a combination of steric and electronic effects, lipophilicity, and hydrogen bonding were necessary for the anticonvulsant activity of the enaminones. The cyclic enaminones existed in the trans-S-trans fixed conformation, and the NMR data supported our hypothesis that enantioselectivity is retained in synthesizing enaminones from cyclic, diasteriomeric 1,3-diketones. In addition, the AB system and many unique features were observed in some enaminones. The para, meta, and ortho substituted patterns were observed for monosubstituted phenyl protons, and the NMR patterns for di- and trisubstituted phenyl groups were elucidated.

Ancrod infusion for anticoagulation during and after PTCA in a patient with heparin-induced thrombocytopenia

Ancrod is a rapid-acting defibrinogenating agent derived from the venom of the Malayan pit viper which has been used successfully as an alternative to heparin sulfate for anticoagulation during peripheral vascular procedures and coronary artery bypass surgery. We describe the first use of ancrod for anticoagulation before and during percutaneous transluminal coronary angioplasty (PTCA) in a patient with heparin-associated thrombocytopenia.

Coronary flow velocity during coronary angioplasty in regions of myocardial infarction

In patients undergoing angioplasty for angina after myocardial infarction, patterns of post-stenotic coronary blood flow velocity depend not only on satisfactory dilation of the flow-limiting lesion, but also on the vasoregulatory capacity of infarcted myocardium. The case examples demonstrate both normal and persistently abnormal flow velocity patterns following successful coronary angioplasty for post-infarction ischemia. Recognition of collateral flow patterns, easily available using the Doppler angioplasty guidewire, may provide valuable information predicting the viability of post-infarcted myocardium and the resolution of abnormal distal coronary flow patterns.

Synthesis and evaluation of amino analogues of valproic acid

Valproic acid, an antiepileptic drug, is extensively metabolized in humans. Two putative metabolites, 2-n-propyl-3-aminopentanoic acid (3-aminovalproic acid, 3-amino-VPA; 2a) and 2-n-propyl-4-aminopentanoic acid (4-amino-valproic acid, 4-amino-VPA; 4a), which may result from the transamination of the respective keto acids 1a and 3a may explain the unusual extended seizure protection elicited by valproic acid. The title compounds were synthesized as their diasteriomeric ethyl esters 2b and 4b and submitted for anticonvulsant evaluation by the Antiepileptic Drug Development Program of the National Institute of Neurological and Communicative Disorders and Stroke. The results verified our hypothesis, as 4b was active in the subcutaneous pentylenetetrazol (scMet) evaluation at 30 mg/kg. Both compounds were highly toxic at 300 mg/kg.

Synthesis, reactions, and preliminary evaluations of enaminone esters

The objective of this work was to design enaminone esters that would possess potential medicinal properties. The reaction between beta-hydroxyketo esters and primary or secondary amines yielded secondary or tertiary enaminone esters, respectively. The UV spectra of the enaminone esters were determined in acidic, alkaline, and neutral media; the spectra have a hypsochromic shift in acidic media in comparison with neutral media. The enaminone esters provided nucleophilic and electrophilic sites for a variety of reactions. Thus, the enaminone esters were converted into enaminone amides and O-alkylation products exclusively. Although the enaminone esters were generally resistant to reduction by metal hydrides, one unhindered enaminone ester was reduced to an alcohol with sodium borohydride. Another enaminone ester reacted with guanidine to give the corresponding quinazolinone. Due to the variety of nucleophilic and electrophilic sites in the enaminone system, enaminone esters possess a great potential as reaction intermediates and medicinal compounds. Preliminary evaluations of the enaminone esters revealed a histaminergic effect, uterine relaxant properties, and anticonvulsant activity.

Cyclization reactions leading to beta-hydroxyketo esters

The purpose of the research was to synthesize beta-diketo esters and to evaluate them for anticonvulsant activity. The reaction of methyl vinyl ketone with dimethyl malonate in the presence of potassium carbonate gave an uncyclized product that underwent a Claisen condensation to yield methyl 2-hydroxy-4-oxocyclohex-2-en-1-oate (5a). Similarly, other cyclized beta-hydroxyketo esters were prepared, and their spectrometric data confirmed that the enol tautomers were preferred to the beta-diketo tautomers. The synthetic work clarified the reaction pathway for the Michael addition of malonate esters to enones. Of the intermediates and products tested for anticonvulsant activity, dimethyl 2,2-bis-(3-oxobutyl)malonate (9a) was found to possess anticonvulsant property. However, it is emphasized that the beta-hydroxyketo esters could be useful intermediates in the synthesis of enaminone anticonvulsants.

A kinematic technique for describing wrist joint motion: analysis of configuration space plots

This paper describes an experimental method for determining the minimum number of degrees of freedom of a human joint. Application of this technique to the wrist suggests that the normal, intact wrist joint uses only two degrees of freedom to move in a plane that is not aligned with the anatomic planes. The technique may be useful in identifying emerging joint pathologies and in simplifying kinematic models of joint function.

Synthesis and CLOGP correlation of imidooxy anticonvulsants

Continuing structure-activity studies on the anticonvulsant activity of analogs of N-(benzyloxy)-2-azaspiro[4.4]nonane-1,3-dione (2a), which displayed anti-electroshock seizure (MES) activity and a protective index (TD50/ED50) of > 4.5 are reported. An in-depth analysis of this moiety was studied employing the Topliss structure activity and the Craig plot analytical approaches as well as a semiempirical method. CLOG P analysis was also applied to this series after experimentally determining the NOR fragment. All compounds were minimized and these physicochemical parameters correlated to anticonvulsant activity. Several interesting substituted benzyloxy compounds emerged from this study: the 2',4'-dichloro (2b), 4'-(trifluoromethyl) (2c), 2'-bromo (2d), 3'-chloro (2o), 2'-chloro (2r), 2'-fluoro (2p), and 3'-fluoro (2w) analogs, all of which had comparable, or better activity than the parent unsubstituted analog (2a). X-ray crystal analysis of the active 2a versus inactive N-benzyl-2-azaspiro[4.4]nonane-1,3-dione (10) is discussed.

Synthesis and anticonvulsant activity of enaminones. 2. Further structure-activity correlations

This report continues the in-depth evaluation of methyl 4-[(p-chlorophenyl)amino]-6-methyl-2-oxocyclohex-3-en-1-oate , 1 (ADD 196022), and methyl 4-(benzylamino)-6-methyl-2-oxocyclohex-3-en-1-oate, 2, two potent anticonvulsant enaminones. These compounds were evaluated employing the amygdala kindling model. Neither 1 nor 2 was active against amygdala kindled seizures, further supporting the corneal kindled model as a definitive tool for antielectroshock seizure evaluation as previously reported. Additional intraperitoneal (ip) data on 1 revealed toxicity at 24 h at 100 mg/kg. Several active analogs have been prepared with the view to minimizing toxicity. In a special ip rat screen developed by the Antiepileptic Drug Development (ADD) Program, these newer analogs were evaluated for protection against maximal electroshock seizures (MES) at 10 mg/kg and neurotoxicity at 100 mg/kg. From this screen, several compounds were shown to be safer alternatives, the most notable was methyl 4-[(p-bromophenyl)amino]-6-methyl-2-oxocyclohex-3-en-1-oate, 13. Compound 13 had an ip ED50 of 4 mg/kg in the rat and a TD50 of 269 mg/kg, providing a protective index (TD50/ED50) of > 67. By variation in the ring size, additional aromatic substitutions and the synthesis of acyclic analogs, these newer compounds provide a more definitive insight into the structure-activity correlation. CLOGP evaluation and molecular modeling studies are also provided to further elaborate the molecular characteristics of potential anticonvulsant enaminones.

Re-aiming the canon

Although it is unlikely that the national goals for educational reform--such as that, by the year 2000, U.S. students will be first in the world in science and mathematics achievement--can be achieved, a vigorous effort must be made to reach those goals as rapidly as possible. Reform will come not from a massive expansion of what we now do but from a basic shift in the manner in which we educate students in grades K-16 in the sciences and mathematics. Important elements in that basic shift must include an increase in teaching of science, mathematics, and technology (SMT), to about 20%-25% of the curriculum; SMT must include rich hands-on experiences, with an emphasis on concepts and understanding, rather than on facts and memorization, and on how science as a way of knowing differs from other ways of knowing; SMT must consider human problems; and SMT must deal with the basic problem facing humanity--how we must adjust our behavior so as not to exceed, on a worldwide basis, the carrying capacity of the environment.

Influence of model and marker on digesta kinetic estimates for sheep

Several models and markers are available for digesta kinetic studies. In this study, kinetic estimates derived from chromium-mordanted hay or pellets were compared to estimates derived from rare earth markers (Yb, Dy, or Er) applied individually to samples. Twelve yearling rams (52 kg) were given ad libitum access to either hay or a commercial pelleted diet in a crossover experiment. Digesta kinetic estimates were obtained both by nonlinear analysis with two age-independent rates (G1G1) or with gamma time dependency in the fast compartment (G2G1 to G4G1) and by linear regression of natural log transformed fecal marker concentrations (LN method of estimate). Model did not influence total tract (P > .21) or ruminal mean retention times (P > .87). Partitioning of total retention time was similar (P > .21) for the LN, G3G1, and G4G1 models, but the G1G1 and G2G1 models did not adequately fit these data. Nonlinear models overestimated, and LN underestimated, fecal DM output by 9% (SEM = 4.7) for the hay diet. All the nonlinear models provided fecal DM output estimates that were within 5% of actual fecal DM output, but the LN model underestimated it by 18% (SEM = 3.3) for the pelleted diet. Ruminal outflow rate was slower (P < .01) and both ruminal and total mean retention time estimates were longer (P < .01) for Cr than for the rare earths. Despite the marker chosen, relative diet effects were similar. The three rare earth markers gave identical results for digesta kinetic estimates, indicating that they are useful for simultaneous study of more than one ingredient or particle, but direct comparison of rare earth and Cr-mordant passage rates is not advisable.