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  • 1
    ISSN: 1433-0385
    Keywords: Schlüsselwörter: Inkontinenz ; Rectumcarcinom ; Manometrie ; Prognose ; Anus. ; Keywords: Incontinence ; Rectal cancer ; Anorectal manometry ; Prognosis ; Anus.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract. Aim: To determine clinical and physiologic parameters enabling the prognosis of continence after protective ileostomy closure secondary to rectal resection for rectal cancer. Method: Patients who had undergone rectal resection (n = 65, of whom 24 had had radiochemotherapy) were evaluated by clinical examination, anorectal manometry and orthograde contrast enema before ileostomy closure. Continence was evaluated by clinical findings 91 ± 52 weeks after stoma closure with the help of standardized questionaires and classified according to the Wexner continence score. The relationship between findings before stoma closure and continence score was calculated with Pearson's correlation coefficient. Results: Correlations were found to be significant between the continence score and the level of anastomosis (r = –0.58, p 〈 0.001), median resting pressure (r = –0.52, p 〈 0.001), rectal compliance (r = –0.43, p 〈 0.001). Additionally, radiochemotherapy impairs continence (p = 0.0001). Correlations were not significant between continence and functional sphincter length, squeeze pressure, threshold for perception, urge and maximal tolerable volume, and continence for semiliquid contrast medium. Conclusion: Incontinence after rectum resection is multifactorial: the level of anastomosis, resting pressure, rectal compliance and radiochemotherapy all play a dominant role. Based on these findings, the continence score can be calculated before closure of a diverting ileostomy by applying multivariate analysis with the help of the following formula: Continence score = 18.23–0.94 · level of anastomosis – 0.18 · resting pressure + 3.72 · radiochemotherapy.
    Notes: Zusammenfassung. Ziel dieser Studie war eine Evaluation von klinischen und physiologischen Parametern zur Vorhersage des Kontinenzgrades nach Rückverlagerung der protektiven Loop-Ileostomie nach Rectumresektion wegen eines Carcinoms. Methode: 65 Patienten wurden klinisch mittels anorectaler Manometrie und orthograder Röntgenkontrastmitteldarstellung vor der Ileostomieresektion untersucht. Bei 24 Patienten war eine Radiochemotherapie durchgeführt worden. Der klinische Status wurden 91 ± 52 Wochen nach der Ileostomieresektion mittels eines standardisierten Fragebogens erhoben und der Kontinenzgrad nach dem Wexner-Kontinenzscore bewertet. Der postoperative Kontinenzscore wurde mit den Befunden vor Stomarückverlagerung korreliert und ein Pearson-Korrelationskoeffizient berechnet. Ergebnisse: Es ergab sich eine signifikante Korrelation des Kontinenzgrades mit der Anastomosenhöhe (r = –0,58, p 〈 0,001), dem mittleren Ruhedruck (r = –0,52, p 〈 0,001) und der rectalen Compliance (r = –0,43, p = 0,001). Die Kontinenz war nach Radiochemotherapie schlechter (p = 0,0001). Es fand sich keine signifikante Korrelation zwischen Kontinenzgrad und funktioneller Sphincterlänge, Kneifdruck, Perceptionsschwelle, Drangschwelle, maximal tolerablem Volumen und Kontinenz für semiliquides Kontrastmittel. Schlußfolgerung: Inkontinenz nach Rectumresektion ist multifaktoriell. Anastomosenhöhe, mittlerer Ruhedruck, rectale Compliance und Radiochemotherapie (RCT) spielen eine dominante Rolle. Basierend auf diesen Befunden ist über die Berechnung einer multivariaten Regressionsanalyse eine Abschätzung des Kontinenzgrades vor Ileostomieresektion mit folgender Formel möglich: Prognose-Wexner-Score = 18,23–0,94 · Anastomosenhöhe – 0,18 · Ruhedruck + 3,72 · RCT.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Langenbeck's archives of surgery 373 (1988), S. 173-181 
    ISSN: 1435-2451
    Keywords: Merkel cell tumor ; Trabecular carcinoma ; Neuroendocrine tumor ; Neuron-specific enolase ; Cytokeratins ; Clinical findings in 339 cases ; Surgery ; Radiotherapy ; Chemotherapy ; Local recurrence ; Lymphatic metastasis ; Hematogenous metastasis ; Prognosis ; Follow-up
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Es wird über vier Fälle eines Merkelzelltumors mit unterschiedlichem klinischen Verlauf und Lokalisation im Gesicht und am Stamm berichtet. Bezüglich der Klinik wurden 339 Fälle eines Merkelzelltumors aus der Literatur ausgewertet. Beim Merkelzelltumor handelt es sich um einen von den Merkelschen Zellen ausgehenden neuroendokrinen Hauttumor. Er findet sich zu 47% im Kopf-Halsbereich, hat eine durchschnittliche Größe von 25 mm, liegt typischerweise über dem Hautniveau und zeichnet sich klinisch durch seine rötlich-livide Farbe aus. Aufgrund der Metastasierung und des infiltrativen Wachstums ist er als maligne einzuordnen. In 27% bestehen Lymphknotenmetastasen, in 51 % kommt es zu Lokalrezidiven und in 32% treten Fernmetastasen auf. Die Therapie der Wahl besteht in einer frühzeitigen Excision mit einem Sicherheitsabstand, wie er bei malignen Hauttumoren üblich ist. Eine Strahlensensibilität liegt vor; ob auch eine chemotherapeutische Beeinflußbarkeit besteht, ist jedoch nicht sicher.
    Notes: Summary Four cases of Merkel cell tumor located in the face or on the trunk are presented. In a literature review 339 cases were found and analysed. The Merkel cell tumor is a neuroendocrine tumor of the skin derived from the Merkel cells. It is located most often in the face and neck area. Typically, it is an exophytic node, has a red-blue color and measures 25 mm in diameter on the average. Since it is metastasizing it is a malignant tumor. Regional node metastases were found in 27%, local recurrences occur in 51%, and distant metastases were seen in 32% of the cases. The best therapy is excision with wide margins as is the rule for a malignant skin tumor. While the tumor reacts to radiotherapy, chemotherapy seems to be of no help.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Langenbeck's archives of surgery 371 (1987), S. 85-101 
    ISSN: 1435-2451
    Keywords: Bronchial carcinoma ; Bronchoplastic procedures ; Angioplastic procedures ; Surgical techniques ; Prognosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Bronchoplastische und angioplastische Operationen beim Bronchialcarcinom stellen eine parenchymsparende Alternative zur Pneumonektomie dar. Diese Eingriffe sind vor allem bei Patienten mit einer eingeschränkten Lungenfunktion und zentralem Sitz des Neoplasmas indiziert. In einer retrospektiven Studie wurden insgesamt 248 broncho- und angioplastische Operationen aus den Jahren 1973–1983 ausgewertet. Stichtag der Überlebenszeitanalysen bildete der 1. Januar 1986. Die Mindestbeobachtungsdauer des Spätschicksals auch der erst 1983 operierten Patienten beträgt daher zwei Jahre. Für alle Patienten (n = 248) ergab sich eine 5-Jahres-Überlebensrate von 22% bei einer 30-Tage-Letalität von 13%. Die 5-Jahres-Überlebenszeit aller radikal operierten Bronchusmanschetten (Stadium I und II der TNM-Klassifikation,n = 44) beträgt 42% bei einer 30-Tage-Letalität von 7%. Bei allen bronchoplastischen Operationen in den Stadien I und II (n = 88) findet sich eine 5-Jahres-Überlebenszeit von 38% bei einer 30-Tage-Letalität von 14%. Verbessertes Nahtmaterial und Operationstechniken haben im Verlauf des Untersuchungszeitraums zu einer Senkung der Operationsletalität von 23% auf 8% geführt. Innerhalb der ersten 30 postoperativen Tage verursachten folgende Komplikationen einen letalen Ausgang: Hämoptoe (n = 5), Anastomoseninsuffizienz (n = 3), Rechtsherzversagen (n = 5), Lungenembolie (n = 4) und Sepsis (n = 1).
    Notes: Summary The various forms of bronchoplastic and angioplastic procedures are the best means of avoiding pneumonectomy. Essential indications are limited respiratory reserve and central site of a malignancy. In a retrospective study 248 broncho- and angioplastic operations carried out in the years 1973 to 1983 were analyzed. Reference date for the analysis of survival was January 1986. In consequence the minimum period of follow-up was two years. For all patients (n = 248) the 5-year-survival was 22% with a 30-day-lethality of 13%. The 5-year-survival of all bronchial sleeve resections operated radically (stage I and II of the TNM-classification) (n = 44) was 42% with a 30-day-lethality of 7%. The 5-year-survival of all bronchoplastic operations of stage I and II (n = 88) was 38% with a 30-day-lethality of 14%. Improved suture material and surgical techniques caused a reduction of operative lethality from 23% to 8% during the described period. In the first thirty postoperative days the following complications caused death: Hemoptysis (n = 5), insufficiency of the anastomosis (n = 3), right heart failure (n = 5), pulmonary embolism (n = 4) and sepsis (n = 1).
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Langenbeck's archives of surgery 365 (1985), S. 169-178 
    ISSN: 1435-2451
    Keywords: Ampullary/pancreatic cancer ; Staging ; TNM ; Therapy ; Prognosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Von 1974 bis 1982 wurden an der Chirurgischen Universitätsklinik Münster 607 Patienten mit Erkrankungen des Pankreas behandelt, von denen 256 an einem Pankreas- und 42 an einem Papillencarcinom erkrankt waren. Alle wurden nach einem dort eigens entwickelten TNM-System für das Pankreascarcinom eingeteilt. Es ergab sich bei den durchgeführten kurativen Resektionen (n = 73), die für die das Papillencarcinom einen Anteil von 78,6% und für das Pankreascarcinom von 15,6% an den Gesamtoperationen hatten, ein deutliches Überwiegen der frühen Stadien für ersteres (T1N0M0/T2N0M0 〉 60%), der späteren Stadien für letzteres (T1N0M0/T2N0M0 = 25%). Die Fernmetastasenhäufigkeit bezogen auf alle Patienten unterschied sich mit 9,5% bzw. 43,4% ebenfalls signifikant (p 〈 0,05). Bei einem niedrigen Median der Überlebenszeiten für die palliativen Eingriffe ergab sich für die Whipple-OP ein Median von 40,3 Monaten, für die totale Pankreatektomie von 28,0 Monaten. Für das Stadium T1N0M0/T2N0M0 war der Median 〉 63 Monate.
    Notes: Summary From 1974 to 1982 607 patients with diseases of the pancreas were treated at the Surgical University Clinic of Münster/West Germany. 256 of those suffered from pancreatic and 42 from ampullary cancer. All patients were grouped according to a TNM-System for pancreatic cancer developed for that particular purpose. Of the curative resections performed (n = 73) with a resection rate of 78.6% for ampullary and 15.6% for pancreatic cancer, a distinct preponderance of early stages (T1N0M0/T2N0M0 〉 60%) was noticed for the first, of late stages for the latter (T1N0M0/T2N0M0 = 25%). The frequencies of distant metastases for all operations also differed significantly, being 9.5% respectively 43.4% at the time of operation (p 〈 0.05). At the low mean survival time for palliative operations an mean survival time of 40.3 months for the Whipple operation was evaluated, of 28.0 months for total pancreatectomy. At the stage T1N0M0/T2N0M0 the mean survival time was 〉 63 months.
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  • 5
    ISSN: 1434-1948
    Keywords: NLO materials ; Second harmonic generation ; Two-photon fluorescence ; Solvatochromism ; Electrochemistry ; Sesquifulvalene ; Sandwich complex ; Chemistry ; General Chemistry
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Chemistry and Pharmacology
    Notes: In order to investigate nonlinear optical properties, in particular second harmonic generation (SHG) of organometallic complexes, numerous dipolar monocationic sesquifulvalene complexes of the general form [Mc-Z-C7H6]+ have been synthesised (Mc = metallocenyl), wherein the metallocenyl moiety Mc acts as an electron donor, and the tropylium cation C7H6+ as an electron acceptor. The mutual electronic influence of the donor and the acceptor groups is warranted by a linking spacer Z, which is a single bond [Mc = CpFeC5H4 (4a); Mc = CpRuC5H4 (4b)], an unsaturated bridge containing olefins [Z = (E-CH=CH)n: n = 1, Mc = CpFeC5H4 (25a), Mc = CpRuC5H4 (25b); n = 2, Mc = CpFeC5H4 (26); n = 3, Mc = CpFeC5H4 (27)], or thiophene units [Z = 2,5-C4H2S, Mc = CpFeC5H4 (28); Z = 5,5′-(2,2′-C4H2S)2, Mc = CpFeC5H4 (29); Z = 2-(5-E-CH=CH)C4H2S, Mc = CpFeC5H4 (30)]. For the salts of 4a·BF4, 4b·PF6 and 25a·PF6 X-ray structure determinations have been performed [4a·BF4: orthorhombic, Pnma, = 21.75(2), b = 9.900(2), c = 6.881(3) Å, V = 1482.0(15) Å3, Z = 4; 4b·PF6: monoclinic, P2(1)/c, a = 8.104(3), b = 18.206(14), c = 11.228(4) Å, β = 107.59(3), V = 1579.1(15) Å3, Z = 4; 25a·PF6: triclinic, P1bar, a = 10.067(6), b = 10.496(6), c = 11.418(6) Å, α = 94.07(4), β = 110.96(4), γ = 102.88(5)°, V = 1083.1(11) Å3, Z = 2]; the solid state structures indicate an almost coplanar arrangement of the organic π-system. Cyclic voltammetry studies reveal an irreversible one-electron reduction and an electrochemically reversible one-electron oxidation step for the ferrocenyl derivatives, whereas the ruthenocenyl derivatives demonstrate an irreversible two-electron oxidation. The redox potentials clearly indicate that the oxidation occurs at the metallocene unit, and the reduction is localised on the tropylium entity. In the electronic absorption spectra two intense bands are observed in the region 400 〈 λ 〈 900 nm which undergo strong negative solvatochromic shifts. The origin of the high-energy absorption band is assumed to be an interligand charge-transfer (LL-CT) transition, and the low-energy absorption band is assigned to a donor-acceptor charge-transfer (DA-CT) transition. Whereas the LL-CT is continuously shifted to lower energy with increasing spacer length, the energy of the DA-CT approaches a limiting value. A comparable phenomenon is also observed for the difference between the oxidation and reduction potentials obtained from electrochemical studies. Investigations concerning the nonlinear optical properties of the dipolar cationic sesquifulvalene complexes by means of hyper-Rayleigh scattering (HRS) indicate that the ferrocenyl derivatives fluoresce due to two-photon absorption whereas the ruthenocenyl congeners exhibit second harmonic generation with considerably larger first hyperpolarizability which is partly resonance-enhancement based.
    Additional Material: 8 Ill.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Weinheim : Wiley-Blackwell
    Berichte der deutschen chemischen Gesellschaft 2000 (2000), S. 771-781 
    ISSN: 1434-1948
    Keywords: Cooperative effects ; Coordination modes ; Nickel ; Bimetallic complexes ; π interactions ; Chemistry ; General Chemistry
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Chemistry and Pharmacology
    Notes: Different cooperative binding modes of nitriles within the bimetallic pocket of a pyrazolate-based compartmental dinickel(II) site have been studied. The H3O2-bridged dinuclear complex 1 reacts with cyanamide to yield 4, in which a secondary hydrogencyanamido(1-) bridge spans the two metal centers at an unusually short metal-metal distance imposed by the primary ligand matrix. In 5, a single 2-cyanoguanidine (cnge) molecule is N-bound to one nickel(II) ion through its nitrile part and is coordinated to the adjacent metal site through an amido nitrogen. The characteristics of the coordination spheres of the metal centers suggest an additional side-on π-bonding interaction of the nitrile moiety with the second high-spin nickel(II) ion. This unusual interaction is corroborated by comparing the IR bands for the ν(C≡N) stretching vibration of 5 with those of complex 6, which has two end-on bound cnge molecules, and those of the related mononuclear complex 7, which lacks a second nickel(II) ion. The nature of the π-bonding interaction in 5 is further analyzed by DFT calculations on relevant model systems. Even though the π-bonding is found to be very weak, it does include some backbonding from occupied 3d MOs at the second high-spin nickel(II) ion to the π* MOs of the nitrile. Such an unconventional π-interaction is suggested to be enforced by the constrained fixation of the nitrile unit within the highly organized coordination pocket of the bimetallic framework. In contrast, the bifunctional 2-hydroxybenzonitrile is accommodated by the distinct binding of the nitrile and phenolate functions to the different metal centers in 8, which confirms that the simultaneous binding of both an OR-function and an end-on bound nitrile is indeed feasible within the active site pocket. Such a situation is reminiscent of the bimetallic effect that has been assumed to enable the cooperative hydration of nitriles at the dinickel(II) site of 1. Complexes 4·(ClO4)2, 5·(ClO4)2, 6·(ClO4)3, 7·(ClO4)(BPh4), and 8·(ClO4)2 have been characterized structurally by X-ray crystallography.
    Additional Material: 10 Ill.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1434-1948
    Keywords: Lanthanide(III) ; Ytterbium ; Aryloxides ; Fluorine ; C-F Activation ; Chemistry ; General Chemistry
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Chemistry and Pharmacology
    Notes: Reaction of [Yb(OAr)2(THF)3] (OAr = OC6H2-2,6-tBu2-4-R; R = H, Me, tBu) with perfluorodecalin in THF at room temperature results in C-F activation and formation of the first heteroleptic aryloxofluorolanthanoid complexes, [Yb(OAr)2F(THF)]2. Oxidation of bis(cyclopentadienyl)ytterbium(II) with perfluoro(methylcyclohexane) or perfluorodecalin in DME surprisingly gives unsolvated [YbCp2F]3. The analogous reaction of bis(methylcyclopentadienyl)ytterbium(II) yields unsolvated [Yb(MeCp)2F]4, whilst in THF, the oxidation provides [Yb(MeCp)2F(THF)]2. Treatment of [YbCp2F(THF)]2 with triphenylphosphane oxide gives [YbCp2F(OPPh3)]2. X-ray structure determinations revealed [Yb(OAr)2F(THF)]2 (R = H or tBu) to be centrosymmetric fluoride-bridged dimers with five-coordination for ytterbium. Examination of the structures of the cyclopentadienyl complexes showed that [YbCp2F]3 is trimeric with formal eight-coordination for ytterbium and a planar (YbF)3 ring, whereas [Yb(MeCp)2F]4 is an eight-coordinate tetramer having a puckered (YbF)4 ring with F-Yb-F angles of ca. 90° and Yb-F-Yb angles close to 180° [178.9(4), 168.4(3)°]. Both [Yb(MeCp)2F(THF)]2 and [YbCp2F(OPPh3)]2 are nine-coordinate fluoride-bridged dimers.
    Additional Material: 6 Ill.
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  • 8
    ISSN: 0044-8249
    Keywords: Chemistry ; General Chemistry
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Chemistry and Pharmacology
    Additional Material: 1 Ill.
    Type of Medium: Electronic Resource
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  • 9
    Electronic Resource
    Electronic Resource
    Weinheim : Wiley-Blackwell
    Zeitschrift für die chemische Industrie 100 (1988), S. 454-455 
    ISSN: 0044-8249
    Keywords: Chemistry ; General Chemistry
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Chemistry and Pharmacology
    Type of Medium: Electronic Resource
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  • 10
    Electronic Resource
    Electronic Resource
    Weinheim : Wiley-Blackwell
    Zeitschrift für die chemische Industrie 100 (1988), S. 956-957 
    ISSN: 0044-8249
    Keywords: Chemistry ; General Chemistry
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Chemistry and Pharmacology
    Type of Medium: Electronic Resource
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