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M Dubs

Publications and source records attributed to M Dubs.

6 recordsLinked to original sources

Reactions of the four diastereomeric 16-amino-17-hydroxy-3-methoxy-estra-1,3,5(10)-trienes with aromatic ortho-hydroxy and heteroaromatic alpha-aldehydes and with 1, 3-dicarbonyl compounds-molecular structures of condensation products and of copper(II) complexes.

Vicinal amino alcohols of steroids have been used as starting materials for the synthesis of chiral ligands with defined arrangements of functional groups. Condensation of the four diastereomeric 16,17-steroid amino alcohols 1a-1d with aromatic o-hydroxy and heteroaromatic alpha-aldehydes afforded the Schiff bases 2-6. When the 16,17-substituted compounds 2d, 5d, 6a, and 6d were in solution, the isomeric oxazolidines were detectable by (1)H NMR spectroscopy. The formation of oxazolidines could be avoided by using bulky aldehydes. Reduction of the Schiff bases (also in mixtures with oxazolidines) with NaBH(4) yielded the new N-substituted amino alcohols 12-15. The condensation products of 1a-1d with 1,3-dicarbonyl compounds (7 and 8) exhibited the 1-enamino-3-oxo structure ((1)H NMR spectroscopy). By means of X-ray analysis of 2a-2d, 3d, 7a, and 7c, the torsion angles for the 16N, 17O substituents, which are important for a participation of the 17O substituent in the complexation of metal ions, have been determined. Furthermore, a preferred arrangement between the chelate ring and the steroid plane existed in all investigated condensation products attributable to torsion angles 16H-C16-16N-C of 5-61 degrees. This arrangement was also preserved in the copper(II) complex 11 with 16alpha,17beta-trans configuration of the bidentate steroid ligand and a ratio of 2:1 for ligand: copper in contrast with dimeric copper(II) complexes with a tridentate steroid ligand of 16beta, 17beta-cis configuration (ratio of 1:1 for ligand:copper). The crystal structures of the condensation products are also discussed. In most cases, intermolecular hydrogen bonds between 17-hydroxy groups and the chelate oxygen caused polymeric strands.

Aldehydes↗

Intraurethral sphincter prosthesis to treat hyporeflexic bladders in women: does it work?

OBJECTIVE: To assess the efficacy and safety of a new intraurethral sphincter prosthesis to treat hyporeflexic bladders in women. PATIENTS AND METHODS: Between July 1997 and December 1998, 18 women (mean age 45.8 years, range 26-84) with neurogenic voiding disorders and a hyporeflexic bladder were examined prospectively. All but one patient (who used the Crédé manoeuvre) emptied their bladder using clean intermittent catheterization. The women were fitted with a prosthesis consisting of a valve and a pump inside a short self-retaining silicone device, which was activated by a magnetic remote control unit. The evaluation before implantation comprised a medical history, a neurological evaluation, urodynamic recordings and urine cultures. The follow-up after implantation included a monthly clinical assessment, a symptom questionnaire, urine culture, ultrasonographic examinations and replacement of the device if necessary. Urine samples were also cultured if there was any discomfort or fever. RESULTS: At 16 months of follow-up, only six of 18 patients continued to use the implant (mean follow-up 9.6 months) and were satisfied. In 10 patients major incontinence around the catheter, or irritation, led to removal of the device. Two patients were unable to learn how to transfer to the toilet to empty their bladder; therefore, their implant was removed and they were treated with a suprapubic catheter. Two patients died from unrelated causes. Twelve patients had positive bacteriuria while fitted with the device; six of them became symptomatic. Usually, only symptomatic lower urinary tract infections were treated. Technical problems occurred often; 14 catheters showed technical dysfunction and had to be replaced early and three external remote control units broke for no reason. Despite normal short-term cystoscopic findings (three patients), long-term urethral damage cannot be excluded. Indeed, the six patients who remain fitted with the device already show some widening of their urethra. CONCLUSION: This experience with the new device was disappointing; in eight of the 18 patients incontinence appeared or worsened and led to removal of the device. Technical problems were common. The other concern is that significant long-term urethral damage could be expected, as observed with indwelling catheters over time. Thus, although this device may function for a short period, it is unsuitable for long-term use.

Adult↗

Infertility as the first symptom of male genitourinary tuberculosis.

The diagnosis of male genitourinary tuberculosis is seldom apparent until the disease is far advanced. The earliest clinical symptoms in most cases are epididymitis, dysuria, and hematuria. In the present case, evaluation of a 26-year-old male complaining about primary infertility revealed leukocytospermia and a normal sperm count. The diagnosis of genitourinary tuberculosis was based on positive morning urine culture. Infertility is an uncommon first sign of male genitourinary tuberculosis, but may be a clue to early diagnosis, as demonstrated in the present case.

Adult↗

Venous infarctions.

Strokes of venous origin are relatively infrequent. They usually cause venous infarcts which can be observed in 2 main circumstances: cerebral thrombophlebitis or dural arteriovenous (AV) fistulae draining into cerebral veins. The authors study the CT and angiographic aspects of these venous infarcts and their evolution. Conventional angiography remains indispensable to confirm the diagnosis.

Arteriovenous Fistula↗