Epileptic seizures represent a common signal of intracranial tumors, frequently the presenting symptom and the main factor influencing quality of life. Treatment of tumors concentrates on survival; antiepileptic drug (AED) treatment frequently is prescribed in a stereotyped way. A differentiated approach according to epileptic syndromes can improve seizure control and minimize unwarranted AED effects. Prophylactic use of AEDs is to be discouraged in patients without seizures. Acutely provoked seizures do not need long-term medication except for patients with high recurrence risk indicated by distinct EEG patterns, auras, and several other parameters. With chronically repeated seizures (epilepsies), long-term AED treatment is indicated. Non-enzyme-inducing AEDs might be preferred. Valproic acid exerts effects against progression of gliomatous tumors. In low-grade astrocytomas with epilepsy, a comprehensive presurgical epilepsy work-up including EEG-video monitoring is advisable; in static non-progressive tumors, it is mandatory. In these cases, the neurosurgical approach has to include the removal of the seizure-onset zone frequently located outside the lesion.
Enolether 2 lassen sich rnit aktivierten Saurechloriden wie den Chloressigsaurechloriden 1 a und 1 b, Cyanacetylchlorid (6c) oder Malonylchloriden 6a, b unter milden Bedingungen in guten Ausbeuten acylieren. Die Abhangigkeit der Produktbildung und der Ausbeuten vom Acylierungspotential der eingesetzten Saurechloride wird aufgezeigt. Die erhaltenen potentiellen PKetoaldehyde 4,5 bzw. 1,3,5-Tricarbonylverbindungen 8 sind wertvolle Zwischenprodukte fur die Synthese von Heterocyclen. Enol Ethers, XIII') Acylation of Enol Ethers with Reactive Carbonyl ChloridesEnol ethers 2 are acylated under mild conditions with activated acyl chlorides, e.g. chloroacetyl chlorides la, b, cyanoacetyl chloride (6c), and malonic acid chlorides 6a, b in good yields. The products formed and the yield depend on the acylation potential of the acyl chlorides. The potential p-keto aldehydes 4,5, and 1,3,5-tricarbonyl compounds 8 obtained are valuable intermediates for heterocyclic synthesis.Enamine und Enolether haben als Derivate von Carbonylverbindungen besonders bei der gezielten C -C-Verknupfung groRe Bedeutung in der Synthese erlangt. In der praparativen Anwendung erganzen sich die beiden Verbindungsklassen; die nucleophileren Enamine z. B. sind besonders gut Alkylierungen, Acylierungen und Carboxylierungen zuganglich 3), wahrend die weniger reaktiven Enolether rnit den Acetalen von Aldehyden und Ketonen sowie mit Orthoameisensaureester in guten Ausbeuten unter C -C-Bindungskniipfung reagieren4s5). In der praparativen Anwendung erganzen sich Enolether und Enamine auch insofern vorteilhaft, als sie in Abhangigkeit von den zugrundeliegenden Carbonylverbindungen von sehr unterschiedlicher Stabilitat und Zuganglichkeit sind. Ketone lassen sich meist bequem in relativ stabile Enamine uberfiihren, wahrend Aldehydenarnine wegen ihrer Empfindlichkeit nur schlecht zu handhaben sind6a). Enamine des Acetaldehyds z. B. lassen sich nur unter volligem AusschluR von Feuchtigkeit und Luftsauerstoff als wenig stabile Verbindungen darstellen6b). Umgekehrt verhalt es sich dagegen rnit der Zuganglichkeit und Stabilitat von Enolethern. Aldehydenolether sind leichter zuganglich und auch stabiler als Enolether von Ketonen; Vinylether -die Enolether des Acetaldehyds -sind sogar grofitechnische Produkte.Bekanntlich gelingt die Acylierung freier Aldehyde mit Carbonsaurederivaten wegen der bevorzugten Selbstkondensation der Aldehyde -basisch bzw. sauer katalysierte Aldolreaktion -0
Dirithromycin (3) isomerizes upon dissolution in different solvents. From X-ray analysis of V-T 108, an analogue of dirithromycin, and comparative 1H and 13C NMR,and MSdata, the isomer ofdirithromycin was confirmed to be the C-16-(S)-epimer. The ratio of the two epimers at equilibrium conditions was approximately 8 : 2 (R/S) in methanol at room temperature.To improve the therapeutic properties of erythromycin, a series of tetrahydro-l,3-oxazines 2 was synthesized by condensation of 9(S)-erythromycylamine 1 with substituted acetaldehydes1*. From these, dirithromycin (3) (2, R= CH3OCH2CH2O-)was selected for further investigations. The structure of 3 was confirmed by X-ray analysis2). Thereby, the (^-configuration of the newly introduced chiral center at C-16 could be established in dirithromycin. Preliminary ObservationsCrystallization of the condensation product of 1 with 2-methoxyethoxyacetaldehyde from acetonitrile gave pure 3, as determined by X-ray analysis and *H NMRspectra. Dissolution of 3 in different solvents leads to an equilibrium of 3 with a new compound3a, detected by TLC. The rate of formation of 3a depends on solvent, time, and temperature.*H NMRinvestigations showed the equilibration rate in methanol to be low (approx 5%within 24 hours) compared to other solvents as acetone, chloroform or toluene. The ratio of3 to 3a at equilibrium conditions at room temperature was estimated to be approximately 8 : 2. The isolation of pure 3a by TLC failed because rechromatography of the isolated spot revealed again
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