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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Diseases of the colon & rectum 40 (1997), S. 179-183 
    ISSN: 1530-0358
    Keywords: Crohn's disease ; Duodenum ; Fistula ; Stenosis ; Ulcers ; Strictureplasty
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: This study was designed to assess clinical and pathologic features of duodenal Crohn's disease (CD) and address its management according to different patterns of disease. METHODS: Twelve cases of duodenal involvement in CD are reported out of 336 patients treated between 1978 and 1993. They represent 3.6 percent of all cases. Three patients had a duodenal fistula, and nine had an intrinsic duodenal lesion. The duodenal fistula was in all cases a manifestation of recurrent CD involving an ileocolic anastomosis and the third portion of the duodenum. RESULTS: Treatment consisted of resection of the fistula's source and primary closure of duodenal breach. Of nine patients with intrinsic CD, five had stenosis and the remaining four had peptic ulcer-like lesions. Duodenal stenosis was treated with strictureplasty in three cases and duodenojejunostomy in two. No patient with ulcer-like lesions underwent surgery. CONCLUSIONS: Differences encountered in intrinsic duodenal lesions apparently reflect two different clinical patterns. Stenosis is not usually associated with multifocal disease and is often the first evidence of disease. Ulcer-like lesions are not specific; they do not evolve into stenosis as do ulcers in other sites of the disease, spontaneously disappear and relapse, and do not require surgery, except for complications. They are always associated with other locations of the disease.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Diseases of the colon & rectum 40 (1997), S. 234-239 
    ISSN: 1530-0358
    Keywords: Crohn's disease ; Strictureplasty ; Terminal ileitis ; Enterocolic anastomosis ; Surgical technique
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: Terminal ileitis is the most frequent presentation of Crohn's disease. Resection of the terminal ileum and cecum with ileocolic anastomosis has always been considered the “gold standard” in the surgical treatment of this condition. This study illustrates an alternative technique referred to as “side-to-side enterocolic anastomosis.” METHODS: It consists of a longitudinal section of the terminal ileum starting 1 to 2 cm away from the beginning of the stricture and continued for a similar length on the ascending colon. A side-to-side anastomosis is then fashioned, in a kind of Finney-shaped strictureplasty. A series of five patients is reported. RESULTS: Average length of the anastomosis was 18.4 (range, 12–25) cm. Postoperative course was uneventful. Colonoscopy and large-bowel enema performed on some patients six months after surgery revealed a complete morphologic regression of the disease. All patients are presently in good condition, with no evidence of recurrence after an average follow-up of 8.9 (range, 6–15) months. CONCLUSIONS: “Side-to-side enterocolic anastomosis” can be a possible alternative option for the surgical management of Crohn's disease of the terminal ileum, providing at least regression of the morphologic aspects of the disease. Contraindications are presence of abscesses, fistulas, or rigid and fibrotic stricture. This technique can be considered a further example of nonresectional surgery such as strictureplasty. This makes it possible to conceive surgical treatment of Crohn's disease without resection in selected cases for the whole length of the small bowel and suggests the introduction of the new definition of “conservative surgical management of small-bowel Crohn's disease.”
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-1262
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé. On a suggéré que certaines données cliniques et morphologiques étaient susceptibles de modifier l'évolution de la maladie de Crohn, en particulier quant à l'incidence des récidives après chirurgie. Une série de 233 patients ont été suivis prospectivement. Au cours d'une période de 15 ans, ces patients ont subi deux interventions de résection soit, la résection du foyer primaire et la résection d'une récidive de la maladie de Crohn. Le suivi minimum de ces patients est de 18 mois. Les facteurs de risque d'une récidive ont étéétudiés. Parmi ceux-ci on note la durée de l'évolution de la maladie avant la chirurgie primaire, le mode de présentation clinique au début (maladie transmurale ou non transmurale) le siège initial, la présence de lésions microscopiques sur les tranches de section, le type de geste chirurgical (anastomose versus stoma), la survenue de complications postopératoires et l'âge du patient. Seule la durée d'évolution avant le geste chirurgical initial a étéétablie comme représentant un facteur significatif en faveur d'une récidive.
    Notes: Abstract. It has been suggested that certain clinical and morphological features can modify the outcome of Crohn's disease, particularly regarding recurrence after surgery. A series of 233 patiens was followed prospectively. They underwent a resectional surgical procedure for both primary and recurrent Crohn's disease during a fifteen-year period with a minimum follow-up of eighteen months. Possible risk factors for recurrence were studied. They included duration of disease before primary surgery, the type of clinical presentation at onset (whether ``Perforating'' or ``Non-perforating''), the initial anatomical location, the presence of microscopic disease at the resection edges, the type of surgical procedure (anastomosis vs stoma), post-operative surgical complications and the age of the patient. The duration of the disease before the initial operation was the only significant factor related to the recurrence rate.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    European journal of clinical pharmacology 52 (1997), S. 293-298 
    ISSN: 1432-1041
    Keywords: Key words Naproxen ; Cytochrome P450; human liver microsomes ; vaccinia virus ; cDNA expression
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Abstract Objective: A series of studies was undertaken to determine the cytochrome P450 isoform(s) involved in naproxen demethylation and whether this included the same isoforms reported to be involved in the metabolism of other NSAIDs. Methods: (S)-Naproxen was incubated with human liver microsomes in the presence of a NADPH-generating system and the formation of desmethylnaproxen was measured by high-performance liquid chromatography (HPLC). To further clarify the specific isoforms involved, experiments were conducted with preparations expressing only a single P450 isoform (vaccinia virus-expressed cells and microsomes derived from a lymphoblastoid cell line, each transfected with specific P450 cDNAs) as well as inhibition studies using human liver microsomes and putative specific P450 inhibitors. Results: In human liver microsomes (n=7), desmethylnaproxen formation was observed with a mean kM of 92 (21) μmol · l−1, Vmax of 538 pmol · min−1 · mg−1 protein and Cint2 (reflective of a second binding site) of 0.36 μl · min−1 · mg−1 protein. This Cint2 term was added since Eadie-Scatchard analysis suggested the involvement of more than one enzyme. Studies using putative specific P450 inhibitors demonstrated inhibition of this␣reaction by sulfaphenazole, (apparent Ki= 1.6 μmol · l−1), warfarin (apparent Ki=27 μmol · l−1), piroxicam (apparent Ki=23 μmol · l−1) and tolbutamide (apparent Ki=128 μmol · l−1). No effect was observed when α-naphthoflavone and troleandomycin were employed as inhibitors, but reaction with furafylline produced, on average, a maximum inhibition of 23%. At a naproxen concentration of 150 μmol · l−1, formation of desmethylnaproxen was observed in cells expressing P450 1A2, 2C8, 2C9 and its allelic variant 2C9R144C. To further characterize these reactions, saturation kinetics experiments were conducted for the P450s 1A2, 2C8 and 2C9. The kM and Vmax for P450 1A2 were 189.5 μmol · l−1 and 7.3 pmol · min−1 · pmol−1 P450, respectively. Likewise, estimates of kM and Vmax for P450 2C9 were 340.5 μmol · l−1 and 41.4 pmol · min−1 · pmol−1 P450, respectively. Reliable estimates of kM and Vmax could not be made for P450 2C8 due to the nonsaturable nature of the process over the concentration range studied. Conclusion: Multiple cytochrome P450 isoforms (P450 1A2, 2C8 and 2C9) appear to be involved in naproxen demethylation, although 2C9 appears to be the predominant form.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1590-3478
    Keywords: Depression ; Stroke ; Rating Scale ; Post-Stroke Depression
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Sommario Gli autori descrivono una nuova scala, denominata Post-Stroke Depression Rating Scale (PSDRS) costruita specificamente per la valutazione della depressione e della sintomatologia ad essa correlata nei pazienti colpini da stroke. Essi presentano alcuni dati sull'attendibilità e validità diagnostica della PSDRS e riportano i primi risultati ottenuti somministrando la nuova scala a 68 pazienti colpiti da stroke e a 10 pazienti affetti da depressione endogena. Il confronto fra i risultati ottenuti alla PSDRS dai pazienti classificati come “Depressione Maggiore” conseguente a stroke o di natura funzionale sembra indicare che le due forme di depressione sono soltanto in parte sovrapponibili. Nei pazienti classificati come depressione maggiore post-stroke, parte della sintomatologia sembra duvuta o all'effetto diretto della lesione o alla reazione psicologica nei confronti della disabilità e degli handicaps provocati dalla lesione stessa.
    Notes: Abstract The authors describe a new scale, the Post-Stroke Depression Rating Scale (PSDRS), specifically constructed to investigate the emotional, affective and vegetative disorders of stroke patients. They also report some preliminary data concerning the validity and reliability of the new scale and of its sections and the first results obtained administering the PSDRS to 68 stroke patients and 10 subjects affected by a “functional” form of major depression. The comparison between the results obtained on the PSDRS by patients classified (on the basis of DSM III diagnostic criteria) as having major depression of either vascular or functional origin seems to show an incomplete overlap between these two forms of depression. In patients classified as having major post-stroke depression, part of the symptomatology seems to be due either to the direct effect of the brain lesion or to the psychological reaction of the patient to the disabilities and handicaps provoked by the lesion.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Neurological sciences 21 (2000), S. 324-328 
    ISSN: 1590-3478
    Keywords: Key words Reduplicative misidentification syndromes ; Memory disorders ; Focal brain damage
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Reduplicative misidentifications syndromes (RMS) are rare memory disorders characterized by the subjective conviction that a place, person or event is duplicated. Even if RMS often follow a right frontal lesion, several studies have stressed the importance of bilateral hemispheric pathology. Moreover, from a psychological perspective, there is uncertainty if this symptom should be considered just as a kind of confabulation or if it should be associated with personal psychosocial and behavioral aspects. We report a patient who developed normal pressure hydrocephalus and RMS one year after a post-traumatic right frontal lesion. At the first neuropsychological evaluation, we found mild impairment of all function, associated with the presence of reduplicative paramnesia. After the ventricle-peritoneal shunt intervention, we observed a progressive improvement of all functions but the frontal ones. The memory deficit became less specific and the RMS disappeared. We therefore postulate that a focal right frontal lesion is not sufficient to cause RMS per se. Our clinical report suggests that paramnesic events held on reasonable ground, not being just a kind of confabulation.
    Type of Medium: Electronic Resource
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  • 7
    Electronic Resource
    Electronic Resource
    New York, NY [u.a.] : Wiley-Blackwell
    Applied Organometallic Chemistry 6 (1992), S. 241-246 
    ISSN: 0268-2605
    Keywords: Butyltin ; analysis ; graphite furnace ; atomic absorption ; sediments ; mussels ; Chemistry ; Organic Chemistry
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Chemistry and Pharmacology
    Notes: We have devised a new method for bis(tributyltin)oxide (TBTO) determination in marine sediments and mussels. This technique involves an n-hexane/methylene chloride mixture extraction and extract purification with a sodium hydroxide wash in order to eliminate interfering compounds. TBTO is then extracted again by nitric acid and converted into an inorganic tin species; the analysis has been effected using Zeeman graphite furnace-atomic absorption spectrophotometry. The method detection limit for the matrices examined is 0.004 μg TBTO g-1 (wet weight) and is sufficient for the analysis in real samples. The percentage recovery of TBTO from sediments and mussels samples is higher than 85% and 95% respectively. This method has been applied to TBTO level determination in sediments and mussels (Mytilus galloprovincialis) sampled in the harbour area in Taranto, where mussel culture activities are much developed; the TBTO levels obtained in sediments and mussels were in the range 15-47 ng g-1 (wet weight) and 11-30 ng g-1 (wet weight) respectively. Such values are comparable with those found in other harbour areas in the Mediterranean Sea.
    Additional Material: 2 Ill.
    Type of Medium: Electronic Resource
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