In the same manner that the Nasobem, Stiimpke's mythical creature, teaches his child the peculiar way of life of the species Nasobema lyricum, the work of Seebach et al. on the self-regeneration of stereocenters has been governed by a fanciful idea. On the way, many tricks have been learned and much knowledge gained. Finally, they have come back down to earth and find themselves once again in the unimaginative world of enantiomer separation for the synthesis of enantiomerically pure compounds. In order to replace a substituent at a single stereogenic center of a chiral molecule without racemization, a temporary center of chirality is first generated diastereoselectively, the original tetragonal center is then trigonalized by removal of a substituent, a new ligand is introduced, again diastereoselectively, and finally, the temporary center is removed. By means of these four steps (the "Self-Regeneration of Stereocenters", SRS), 2-and 3-amino-, hydroxy-, and sulfanylcarboxylic acids have been successfully alkylated with formation of tertiary carbon centers and without the use of a chiral auxiliary. Use of this methodology has allowed the potential of these inexpensive chiral building blocks to be expanded considerably. This article aims to demonstrate (using, in part, examples from natural product syntheses) that chiral heterocyclic acetals with enamine, enol ether, enolate, dienolate, enoate, radical, and acyliminium functionalities and also those that are potential reactants for Michael additions and pericyclic processes (for example, electron-rich and electronpoor dienophiles and dienes) are now easily accessible, more often than not, in both enantiomeric forms. Stereogenic nitrogen atoms of aziridines, boron atoms of cyclic or linear systems, and stereogenic planes of x-complexes can also be used as the temporary chirality element in other approaches to the realization of the SRS principle. Enantiomerically pure derivatives of, for example, glycine, hydroxy-and sulfanylacetic acid, 3-aminopropanoic acid, and 3-oxocarboxylic acids can be prepared by resolution of racemic mixtures via diastereoisomeric salts or by chromatography on a chiral column. Hence, the extensive reactivity of compounds developed to test the SRS principle and, above all, the outstanding stereoselectivities of the reactions can be put to good use even when no suitable chiral precursor is availabl-ven though this amounts to an abandonment of the principle! The readily available 2-tertbutyl-l,3-imidazolidin-3-one, -0xazolid-in-5-one, -dioxin-3-one, and -hydropyrimidinone (all of which contain a single stereogenic center at the acetal C atom) can thus be used in the preparation of a vast range of 2-amino-and 3-hydroxycarboxylic acids, and no chiral auxiliary has to be removed or regenerated during these procedures. (One example is the synthesis of 4-fluoro-MeBmt, a derivative of the C, amino acid found in cyclosporin.) In the final chapter we will discuss the most useful findings gained from investigations into both the self-regeneration of ste...

SUMMARY We retrospectively studied 252 operated and 47 unoperated patients with isolated aortic valve disease. Aortic valve replacement (AVR) was recommended to all patients based on clinical and hemodynamic data. Preoperative hemodynamic and angiographic data were similar in operated and unoperated cohorts. Seventy-one percent of patients received a Bjork-Shiley prosthesis. Operative mortality was 7% for the entire surgical series. For patients with predominant aortic stenosis (AS), survival at 3 years was 87% in operated and 21% in unoperated patients (p < 0.001). For patients with predominant aortic insufficiency (Al), the 5-year survival rate was 86% in operated and 87% in unoperated patients (NS). AVR improved long-term survival in patients with AS who had normal or impaired left ventricular (LV) function. In patients with Al and normal LV function, survival was not improved after AVR, but those with LV dysfunction who were operated on tended to survive longer (NS). Long-term survival of unoperated patients with AI was better than that in unoperated patients with AS.We conclude that AVR improves long-term survival in patients with AS who have normal or abnormal LV function, and that AVR does not change long-term survival in patients with Al, although those with LV dysfunction tended to survive longer. valve, symptoms (angina pectoris, syncope, congestive heart failure), the presence or progression of cardiac enlargement on serial chest radiographs, and abnormally low ejection fraction (EF) (54% or less as defined previously2). Categorizing patients according to predominant lesion showed that 144 patients had predominant AS (peak-to-peak transvalvular pressure gradient of 45-150 mm Hg with or without associated aortic regurgitation) and 155 patients had predominant Al (massive regurgitation documented by aortic root angiography,3 with or without peak-to-peak transvalvular pressure gradient of less than 30 mm Hg). Cardiac CatheterizationAll patients underwent right-and left-heart catheterization within 6 months before operation. A #8.5F Brockenbrough catheter was positioned by transseptal puncture into the left ventricle and a pigtail catheter (#7F) was advanced retrogradely into the aortic root. Pressures were recorded on an Oscillomink directwriting system with Statham transducers before injection of contrast material. LV end-diastolic pressure was measured after the "a" wave. The cardiac index was determined by the Fick method. Valve areas were not calculated, because cases with associated angiographically visible mild-to-moderate aortic regurgitation were placed in this AS group. Single-plane 35-mm cineangiograms of the left ventricle were filmed (50 ml Urografin 76) at 50 frames/sec, in the 300 right anterior oblique projection with a Phillips image-intensifier system. Aortic root angiography was performed to estimate the degree of aortic regurgitation.

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N-terminal pyroglutamate (pGlu) formation from glutaminyl precursors is a posttranslational event in the processing of bioactive neuropeptides such as thyrotropin-releasing hormone and neurotensin during their maturation in the secretory pathway. The reaction is facilitated by glutaminyl cyclase (QC), an enzyme highly abundant in mammalian brain. Here, we describe for the ¢rst time that human and papaya QC also catalyze N-terminal glutamate cyclization. Surprisingly, the enzymatic Glu 1 conversion is favored at pH 6.0 while Gln 1 conversion occurs with an optimum at pH 8.0. This unexpected ¢nding might be of importance for deciphering the events leading to deposition of highly toxic pyroglutamyl peptides in amyloidotic diseases. ß 2004 Published by Elsevier B.V. on behalf of the Federation of European Biochemical Societies.

In this study, the carbamate structure of pseudoirreversible butyrylcholinesterase (BChE) inhibitors was optimized with regard to a longer binding to the enzyme. A set of compounds bearing different heterocycles (e.g., morpholine, tetrahydroisoquinoline, benzimidazole, piperidine) and alkylene spacers (2 to 10 methylene groups between carbamate and heterocycle) in the carbamate residue was synthesized and characterized in vitro for their binding affinity, binding kinetics, and carbamate hydrolysis. These novel BChE inhibitors are highly selective for hBChE over human acetycholinesterase (hAChE), yielding short-, medium-, and long-acting nanomolar hBChE inhibitors (with a halflife of the carbamoylated enzyme ranging from 1 to 28 h). The inhibitors show neuroprotective properties in a murine hippocampal cell line and a pharmacological mouse model of Alzheimer's disease (AD), suggesting a significant benefit of BChE inhibition for a disease-modifying treatment of AD.