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  • 1
    Electronic Resource
    Electronic Resource
    An integrated approach to three-dimensional information management with MACCS-3D (1991)
    s.l. : American Chemical Society
    Journal of chemical information and modeling 31 (1991), S. 408-414 
    Details
    ISSN: 1520-5142
    Source: ACS Legacy Archives
    Topics: Chemistry and Pharmacology
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1021/ci00003a007
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  • 2
    Electronic Resource
    Electronic Resource
    Colorectal metastases to the liver: Present status of management (1990)
    Springer
    Diseases of the colon & rectum 33 (1990), S. 688-694 
    Details
    ISSN: 1530-0358
    Keywords: Colorectal liver metastases ; Hepatic resection ; Locoregional chemotherapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The management of patients with hepatic metastases from colorectal carcinoma is controversial. While a “no treatment” attitude still persists, other patients undergo systemic chemotherapy with very limited results. Other possible options are hepatic resection and locoregional treatments. One hundred twenty-three patients with hepatic metastases from colorectal cancer were treated at the authors' institution over a period of 15 years. Thirty-nine patients underwent hepatic resection while 84 underwent various forms of locoregional treatment. Several patients in the latter group were registered in one national (RNSI) Phase 2 study and one international (EORTC Phase 3 trial. The authors' experience confirms the opinion that hepatic resection can be performed with the aim of curing in patients with isolated metastases. A five-year survival rate can be achieved in 25 to 30 percent of the resectable patients. Patients with unresectable extrahepatic disease or multiple bilateral metastases are usually excluded from resection. In other cases, hepatic resection should be carried out when technically possible. The value of adjuvant chemotherapy to the remaining liver has to be tested in prospective randomized trials. Patients with diffuse metastases can benefit from locoregional infusion of chemotherapeutic agents. Symptoms improve in most patients; objective responses vary from 53 to 83 percent of the cases, which is a higher rate than that reported for systemic chemotherapy. Survival may be prolonged in respect to untreated patients but this has not been demonstrated yet by prospective randomized studies. Current trends are continuous infusion of chemotherapeutic agents and experimentation of new drugs or drug combinations. Future improvements may be achieved by adding hepatic arterial ischemia, hyperthermia, or radiation therapy. As these kinds of treatments are still experimental, they should be applied to the patients only in the context of prospective clinical trials.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02150746
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  • 3
    Electronic Resource
    Electronic Resource
    Role of proctography in severe constipation (1990)
    Springer
    Diseases of the colon & rectum 33 (1990), S. 707-712 
    Details
    ISSN: 1530-0358
    Keywords: Constipation ; Anorectal Manometry ; Proctogram ; Rectum ; Anorectal angle
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract As referred to in the literature, patients complaining of constipation may have a spastic or, in the case of chronic straining, weak pelvic floor. Twenty-two severely constipated patients who did not improve after a high fiber diet were submitted to whole gut transit time (TT), proctographic, and anorectal manometric studies. A control group consisting of five subjects for TT, five subjects for proctogram, and ten subjects for manometry was also studied. Transit time was delayed ( P 〈 0.001) in all patients. Manometry in the constipated group showed a high rectal threshold (64.1 vs. 17.1 ml of air,P 〈 0.01), but no other significant difference. Proctograms in 10 of 22 patients (Group A) showed no differences in the anorectal angle (ARA) and in its distance from the pubococcygeal line (DLPC) in respect to the control group; 12 of 22 patients (Group B) had a paradoxical closure of the ARA at straining in respect to resting position (101.2† vs. 120.1†), and a higher DLPC than Group A and the control group in all positions studied. There was no difference in TT for rectal stasis of radiopaque markers between the two pathologic groups. Patients in Group B were older than patients in Group A (55.3 vs. 42.9 years,P 〈0.05). In conclusion, proctograms showed alterations of the pelvic floor, but there was no correlation between proctographic data and rectal or colonic stasis of the radiopaque markers, or clinic severity of constipation, but a correlation between ages did exist.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02150750
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  • 4
    Electronic Resource
    Electronic Resource
    Efficacy of dilatations for anastomotic colorectal stenoses: prognostic factors (1994)
    Springer
    International journal of colorectal disease 9 (1994), S. 149-152 
    Details
    ISSN: 1432-1262
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Les auteurs rapportent l'expérience sur 30 patients porteurs de sténose anastomotique colo-rectale traités par 62 séances de dilatation et tentent de préciser quelles sont les caractéristiques anastomotiques qui peuvent influencer sur le succès de la dilatation. Les patients ont été divisés en deux groupes: le groupe A chez lequel la dilatation a été réalisée avec succès et le groupe B chez lequel la dilatation a été infructueuse. Dans l'ensemble, la dilatation a été efficace chez 73,3% des cas avec seulement une complication importante. Les facteurs pronostiques considérés furent la déhiscence anastomotique, la radiothérapie adjuvante, la présence d'une colostomie lors de la dilatation, l'emplacement, la morphologie, la longuer de la sténose, la présence d'une récidive tumorale, le type d'anastomose et le type de dilatation. La radiothérapie, la récidive néoplasique locale et une large déhiscence anastomotique constituent les facteurs pronostiques et indépendants les plus importants. Si ces facteurs sont présents ensemble, ils sont associés avec une probabilité d'échec de la dilatation de près de 100% alors que s'ils sont absents les trois, la probabilité d'échec n'est que de 5%.
    Notes: Abstract The authors report their experience of 30 patients with colorectal anastomotic stenosis treated by 62 dilatation sessions in order to evaluate which anastomotic characteristics could influence the success of dilatation therapy. Patients were subdivided into group A (dilatation successful) and group B (dilatation unsuccessful). Overall, dilatation was successful in 73.3% of cases, with only one important complication. The prognostic factors considered were anastomotic dehiscence, adjuvant radiotherapy, presence of colostomy at dilatation, site, morphology and length of the stenosis, presence of neoplastic recurrence, type of anastomosis and type of dilatation. Radiotherapy, local neoplastic recurrence and large anastomotic dehiscence were the more important independent prognostic factors. If present together, they were associated with an almost 100% probability of failure and, vice versa, if they were absent this probability was 5%.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00290192
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  • 5
    Electronic Resource
    Electronic Resource
    Femoral nerve damage after abdominal rectopexy (1994)
    Springer
    International journal of colorectal disease 9 (1994), S. 32-34 
    Details
    ISSN: 1432-1262
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Une lésion iatrogénique du nerf fémoral a déjà été décrite après hystérectomie mais n'a jamais été rapportée après rectopexie abdominale. Nous rapportons 6 cas d'atteinte du nerf fémoral survenus dans un collectif de 24 patients dont 21 ont été opérés d'un prolapsus rectal complet et dont 3 ont été opérés d'une intussusception. Quatre patients présentaient des lésions unilatérales et 2 des lésions bilatérales. Les 6 patients ont été investigués cliniquement et par électromyographie. L'EMG a permis d'établir un score allant de 0 (dénervation complète) à 5 (constatations normales). Durant la période postopératoire immédiate tous les patients se sont plaints d'une diminution de la perception tactile sur la surface antérieure de la cuisse et du genou ainsi que d'une faiblesse du quadriceps. L'EMG a montré une dénervation complète chez un patient, une dénervation importante chez 3 malades et une dénervation modérée ou réduite chez 2 patients. Chez 5 patients la symptomatologie s'est normalisée en 3 à 12 mois en postopératoire alors qu'un malade ne présentait qu'une amélioration. Un EMG de contrôle réalisé chez 4 patients a montré une normalisation complète chez 3 d'entre eux. 2 malades ont refusé un EMG de contrôle. Nous pensons que l'atteinte du nerf fémoral résulte de l'emploi d'une large lame d'écarteur orthostatique qui comprime directement ou indirectement le nerf fémoral.
    Notes: Abstract Iatrogenic femoral nerve damage has already been described after hysterectomy, but never after abdominal rectopexy. We report the occurrence of femoral nerve injury in six of twenty-four patients operated on for complete rectal prolapse (n=21) or rectorectal intussusception (n=3). Four patients had unilateral and two bilateral lesions. All six patients had clinical and electromyographic (EMG) assessment. EMG findings were given a score from 0 (complete denervation) to 5 (normal findings). During the immediate postoperative period all patients complained of reduced cutaneous sensation of the anterior surface of the thigh and knee, and quadriceps weakness. EMG showed complete denervation in one patient, marked denervation in three, and slight or moderate denervation in the remaining two. In five patients there was complete clinical resolution at 3 to 12 months postoperatively, while one showed an improvement only. EMG control performed in four patients showed a full recovery in three. Two patients refused this examination. We believe femoral nerve damage was caused by the large-bladed self-retaining retractors used, which directly or indirectly compressed the femoral nerve.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00304297
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  • 6
    Electronic Resource
    Electronic Resource
    Can proctological procedures resolve perianal pruritus and mycosis? (1992)
    Springer
    International journal of colorectal disease 7 (1992), S. 18-20 
    Details
    ISSN: 1432-1262
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé 23 malades avec un prurit anal associé avec une mycose anale ont subi un traitement primaire d'une maladie anale concomitante. Cette maladie anale était soit des hémorroides (n=9), une fissure (n=8), un spasme anal sans fissure (n=5), et un prolapsus muqueux interne (n=1). La recherche de parasites dans les selles était négative. Le test de tolérance glucidique et le nombre de globules blancs sanguins étaient normaux dans tous les cas. La culture des prélèvements cutanées de la région périanale était positive pour le Candida seulement chez 16 patients, pour les Dermophites chez 6 patients et la combinaison des 2 chez un seul patient. A la suite d'un traitement proctologique approprié, le prurit a disparu ou a été nettement amélioré chez 20 patients. Les 3 patients restants ont nécessité un traitement antifongique avec econasol. 2 d'entre eux cependant ont continué à se plaindre de prurit. On suggère que chez les patients qui ont un prurit anal associé à une mycose périanale la thérapeutique antimycotique ne soit utilisée qu'en cas d'infection fongique persistante après un traitement des affections proctologiques associées.
    Notes: Abstract Twenty-three patients with pruritus ani associated with anal mycosis underwent primary treatment of a concurrent anal disorder. The anal disorders included haemorrhoids (n=9), fissure (n=8), anal spasm without fissure (n=5), and occult mucosal prolapse (n=1). Pretreatment investigation of faeces for parasites was negative. The glucosal tolerance test and white blood cell count were normal in all cases. Culture of skin smears from the perianal region was positive for Candida only in 16 patients, Dermatophytes only in 6 and a combination of both in 1 patient. Following the appropriate proctological procedure, pruritus resolved or markedly improved in 20 patients. The remaining three patients required antifungal treatment with econazole. Two of these, however, continued to complain of pruritus. It is suggested that in patients with pruritus ani associated with perianal mycosis, antimycotic therapy should be used only if fungal infection persists after treatment of the underlying proctological disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01647655
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