Diagnostic importance of electrophysiologic tests in Bell's palsy: report on a longterm follow-up study in 100 cases (author's transl)

The present study is based upon the results of repeated electrodiagnostic tests carried out in a series of 100 cases of Bell's palsy (Determination of Rheobase and Chronaxy). The first symptoms of denervation can be observed during the second week after the onset of the paralysis. This seems to be the critical period in which the ultimate consequences of the lesion are determined: partial or total recovery or complete irreversible denervation. In cases showing a rapid increase of chronaxy during the 2nd week, prognosis is rather poor because a difference of 240% between the affected and the normal side indicates a progressive denervation. Cases in which the difference of chronaxy values during the 2nd week is increased upto 240% (i.e. partial denervation) recover incompletely in 15% of the cases. Estimation of prognosis in Bell's palsy and timing of a facial nerve decompression must be based on reliable facts, such as the results of repeated electrodiagnostic tests (modified measurement of Rheobase and Chronaxy) carried out at least every secont but preferably every day during the first 3 weeks after the onset of the paresis.     

Vestibular diagnosis in Menière''s disease

The interraterreliability of the AMP system (developed by the Arbeitsgemeinschaft für Methodik und Kokumentation in der Psychiatrie (AMP)) has been studied for the first time concerning the level of scales. The investigation was carried out using 80 ratings from two raters concerning a group of acute schizophrenic patients. The results pointed out the extreme usefulness of the AMP system also with respect to interraterreliability. Furthermore, a comparison between the group studied (ICD 295) and a group of schizophrenic patients (ICD 295) from the literature indicated a special AMP profile for groups of schizophrenic patients, the paranoid subgroup (295.3) being predominant.     

Epidermolysis bullosa junctionalis progressiva in three siblings

Three siblings of Swiss origin with epidermolysis bullosa junctionalis progressiva are described. The following clinical features were present from school age: dystrophy of the nails, non-scarring blistering of the skin, mild skin atrophy, hypodontia and dental caries. Light microscopy showed subepidermal blistering. Direct immunofluorescence was negative. On indirect immunofluorescence staining of a fresh spontaneous blister, bullous pemphigoid antigen and laminin were localized to the blister roof, and collagen IV and collagen VII to the blister base, indicating junctional splitting. Electron microscopy revealed a normal dermo-epidermal junction zone, including normal hemidesmosomes. There were no deposits of electron-dense amorphous material.     

Chiral Bis(N‐arylamino)phosphine‐oxazolines: Synthesis and Application in Asymmetric Catalysis

N‐Arylation or N‐alkylation of chiral 1,2‐diamines followed by ring closure with phosphorus trichloride (PCl₃) and subsequent coupling with an oxazoline alcohol resulted in a new class of N,P ligands. The corresponding iridium tetrakis[3,5‐bis(trifluormethyl)phenyl]borate (BAr_F) complexes were found to be efficient catalysts for the enantioselective hydrogenation of unfunctionalized olefins and α,β‐unsaturated carboxylic esters.     

Heterogeneous Enantioselective Hydrogenation of Activated Ketones Catalyzed by Modified Pt‐Catalysts: A Systematic Structure‐Selectivity Study

A systematic structure‐selectivity study was carried out for the enantioselective hydrogenation of activated ketones with chirally modified Pt/Al₂O₃ catalysts. For this, 18 modifiers containing an extended aromatic system able to form a strong adsorption complex with the Pt surface, and a suitable chiral group with an amino function capable to interact with the keto group of the substrate ( HCd, Qd, HCn, Qn , and semi‐synthetic derivatives, as well as synthetic analogues) were prepared and tested on 8 different activated ketones in AcOH and toluene under standard conditions. It was found that relatively small structural changes of the substrate and/or modifier structures strongly affected the enantioselectivity, and that no “best” modifier exists for all substrates. The highest ees for all substrates were obtained with quinuclidine‐derived modifiers in combination with naphthalene or quinoline rings, either in AcOH (substrates 1 – 5 and 8 , all carrying an sp³ carbon next to the keto group) or toluene ( 6 and 7 , with an sp² carbon next to the ketone). The presence and nature of the substituent R' at the quinuclidine significantly affected the ee (positive and negative effects). Certain combinations of an aromatic system and an amino function were preferred: For the quinuclidine moiety, quinoline and to a somewhat lesser extent naphthalene were a better match, while for the pyrrolidinylmethyl group anthracene was better suited. Methylation of the OH group often had a positive effect for hydrogenations in AcOH but not in toluene. With the exception of 8 , higher ees were obtained for the Cd / Qn series [leading to (R)‐products] than for the Cn / Qd series [leading to (S)‐products]. In several cases, opposite structure‐selectivity trends were detected when comparing reactions in toluene and AcOH, indicating a significant influence of the solvent.     

Threonine‐Derived Phosphinite‐Oxazoline Ligands for the Ir‐Catalyzed Enantioselective Hydrogenation

A series of chiral phosphinite‐oxazolines was synthesized in four steps starting from carboxylic acids and threonine methyl ester. In the asymmetric hydrogenation of a number of alkenes, iridium complexes of these ligands induced significantly higher enantioselectivities than the corresponding serine‐derived complexes. Enantiomeric excesses of 89 to 99% were obtained for unfunctionalized alkenes with turnover numbers of up to 5000.     

A new planar chiral bipyridine-ligand: pyrid-2-yl[2](1,4)benzeno[2](5,8)quinolino-phane

The synthesis of the new planar chiral heterocyclic nitrogen ligand pyrid-2-yl[2](1,4)benzeno[2](5,8)quinolino-phane ( 1 with [2.2]paracyclophane-skeleton is described. The enantiomeric resolution is achieved by HPLC. The CD-spectra of 1 and of its chiral quinoline precursor are recorded. The enantiomerically pure title compound 1 is used in copper-catalyzed asymmetric cyclopropanation of styrene and in asymmetric iridium-catalyzed transfer-hydrogenation of acetophenone.     

Basal cell adenocarcinoma of the parotid gland: a rare tumor entity. Case report and review of the literature

Basal cell adenocarcinoma is a rare entity that was first defined as a malignant salivary gland tumor in 1991. We present another case report and discuss pathology, pathogenesis, differential diagnosis, therapy and prognosis on the basis of currently available literature. Although histomorphologic features of the tumors are similar to basal cell adenomas, proof of an infiltrative and destructive growth is essential for diagnosis. Adenoid cystic carcinoma and basaloid squamous carcinoma must also be considered in any differential diagnosis. Tumor development within a pre-existing basal cell adenoma and de novo development are discussed. Most of the tumors appear to be benign clinically. Facial pain is rare and facial nerve palsy was noted in only one case. Metastases have occurred in less than 10% of patients, with only one involving the lung. Due to their biologic behavior and prognosis, basal cell adenocarcinomas should be classified as low-grade carcinomas. The therapy of choice is parotidectomy with preservation of the facial nerve. Neck dissection has to be added in cases with cervical metastases. Radiation is advisable in patients with recurrent disease. Since there is a nearly 30% local recurrence rate, intensive follow-up is necessary.     

Synthesis and catalysis

Research projects of the Department of Chemistry, University of Basel are reviewed ranging from the synthesis of complex natural products to the development of metalorganic catalysts and organocatalysts.