The structure of regalamine
SummaryOn the basis of UV, IR, NMR, and mass spectra and chemical transformations the structure of 11,12-dihydroxy-2-methoxy-1,12-epoxyhexahydrohomoproaporphine has been proposed for regalamine.
Alkaloide Von Bulbocodium vernum L Inhaltstoffe der Liliaceae‐Wurmbaeoideae. 75. Mitteilung
From whole plants of Bulbocodium vernum L. the flavone luteoline (I) and the alkaloids colchicine (II), N-formyl-N-deacetylcolchicine (III), 3-demethylcolchicine (V), (+)-bulbocodine (IX) and (−)-kreysigine (XI) were isolated in crystals. The presence of 2-demethylcolchicine (IV), s- (VII) and γ-lumicolchicine (VIII), demecolcine (VI) and five not identified alkaloids was demonstrated by thin-layer chromatography. On the basis of ultraviolet, infrared and mass spectra, PMR.-analysis (Overhauser effect), and circular dichroism, the (6a-R, 8a-S)homo-proaporphine structure IX, with one methoxy group at C-2, has been assigned to (+)-bulbocodine. The (6a-R)-structure (XI) was deduced for (−)-kreysigine by comparing its optical rotation and circular dichroism which the values of (−)-multifloramine (X), the structure of which is known.
Community refinement of glaucoma referrals
AbstractAim To describe a Manchester-based glaucoma referral refinement scheme designed to reduce the number of false-positive referrals to the hospital eye service. To report on the first years results of this scheme and its financial costs to the NHS.Methods Patients with suspected glaucoma, instead of being referred to their GP and then on to the hospital eye service, were referred to a group of specially trained community optometrists working to an agreed set of referral criteria. Those patients who did not meet the referral criteria were returned to the referring optometrist, while those who met the referral criteria were referred directly to Manchester Royal Eye Hospital. The patient's GP was informed in all cases.Results The number of suspect glaucoma cases referred to the Manchester Royal Eye Hospital was reduced by 40%. This figure is close to the percentage of false-positive referrals measured at Manchester Royal Eye Hospital prior to the onset of this study. The information accompanying referral has been improved and the scheme produces a small financial cost saving to the NHS of approximately £17 per patient.Conclusion Community refinement of suspect glaucoma offers some important benefits over the current referral pathway.