Nine tropane alkaloid aromatic esters (1-9) were isolated from the roots of Erythroxylum pervillei by following their potential to reverse multidrug-resistance with vinblastine-resistant oral epidermoid carcinoma (KB-V1) cells. All isolates, including seven new structures (3-9), were evaluated against a panel of human cancer cell lines, and it was found that alkaloids 3 and 5-9 showed the greatest activity with KB-V1 cells assessed in the presence of vinblastine, suggesting that these new compounds are potent modulators of P-glycoprotein. Confirmatory results were obtained with human ovarian adenocarcinoma (SKVLB) cells evaluated in the presence of adriamycin and synergistic studies performed with several cell lines from the NCI tumor panel. The structures of the new compounds were determined using spectroscopic techniques. Single-crystal X-ray analysis was performed on the monoester, tropane-3 alpha,6 beta,7 beta-triol 3-phenylacetate (1).
Both patients and clinicians can underestimate the seriousness and potential complications of osteomyelitis of wounds to the hand. Osteomyelitis is often caused by delayed or inadequate treatment of wounds, but it is rare in the hand because of the extensive blood supply in this region. Once established, however, it is associated with significant morbidity and functional loss. Nearly half of all fingers affected by osteomyelitis ultimately require amputation and many others remain stiff or persistently symptomatic.
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