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  • 1
    Electronic Resource
    Electronic Resource
    Colostomy closure (1996)
    Springer
    Diseases of the colon & rectum 39 (1996), S. 605-609 
    Details
    ISSN: 1530-0358
    Keywords: Colostomy closure ; Hartmann's pouch ; Stoma ; Complications
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: We retrospectively reviewed the records from our past five years of experience with colostomy closure at a large multispecialty hospital to determine postoperative morbidity. RESULTS: From March 1988 to April 1993, 46 patients underwent colostomy closure. Patients ranged in age from 24 to 87 (mean, 41.8) years, and 25 (54 percent) were women. Stomas had been created during emergency operations in 40 patients (87 percent); most operations (54 percent) were for complications of acute diverticulitis. Of the 46 procedures, 40 (87 percent) were end colostomies, and 6 were loop colostomies. Stomas were closed at a range of 11 to 1,357 days after creation (mean, 207 days; median, 116 days). Twenty-six patients (57 percent) underwent colostomy closure alone, and the remainder underwent additional procedures ranging from appendectomy to hepatic lobectomy. Duration of operations ranged from 1 to 9.5 (mean, 4.2) hours, and estimated blood loss averaged 400 ml. Overall hospital stay for closure was 6 to 62 (mean, 11.5) days. Inpatient complications occurred in 15 percent of patients, including congestive heart failure (2 percent), cerebrovascular accident (4 percent), pneumonia (2 percent), enterocutaneous fistula (2 percent), and pulmonary embolus with death (2 percent). The most common longterm complication was midline wound hernia, which occurred in 10 percent of surviving patients. Overall, complications occurred in 24 percent.CONCLUSIONS: Colostomy closure is a major operation; however, with good surgical judgment and technique, associated morbidity and mortality can be minimized.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02056935
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  • 2
    Electronic Resource
    Electronic Resource
    Incidence of small-bowel obstruction and adhesiolysis after open colorectal and general surgery (1999)
    Springer
    Diseases of the colon & rectum 42 (1999), S. 241-248 
    Details
    ISSN: 1530-0358
    Keywords: Adhesions ; Complications ; Small-bowel obstruction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: The study contained herein was undertaken to establish the incidence of small-bowel obstruction, adhesiolysis for obstruction, and additional abdominal surgery after open colorectal and general surgery. METHODS: A retrospective cohort study was performed using patient-specific Health Care Financing Administration data to evaluate a random 5 percent sample of all Medicare patients who underwent surgery in 1993. Of these, 18,912 patients had an index abdominal procedure. Two-year follow-up data documented outcomes of hospitalizations with obstruction, adhesiolysis for obstruction, and/or additional open colorectal or general surgery. RESULTS: Within two years of incision, excision, and anastomosis of intestine (International Classification of Diseases (ICD)-9 code 45), 14.3 percent of patients had obstructions, 2.6 percent required adhesiolysis for obstructions, and 12.9 percent underwent additional open colorectal or general surgery. After other operations of intestine (ICD code 46), 17 percent of patients had obstructions, 3.1 percent required adhesiolysis for obstructions, and 20.2 percent underwent additional open colorectal or general surgery. After operations of rectum, rectosigmoid, and perirectal tissue (ICD code 48), 15.3 percent of patients had obstructions, 5.1 percent required adhesiolysis for obstructions, and 16.4 percent underwent additional open colorectal or general surgery. After other operations on the abdominal region (ICD code 54), 12.4 percent of patients had obstructions, 2.3 percent required adhesiolysis for obstructions, and 8.8 percent underwent additional open colorectal or general surgery. CONCLUSIONS: In this retrospective study of Medicare patients, we learned that bowel obstruction, adhesiolysis for obstructions, and additional abdominal surgery occurred more often after abdominal surgery than was previously published.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02237135
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  • 3
    Electronic Resource
    Electronic Resource
    Effect of previous surgery on abdominal opening time (2000)
    Springer
    Diseases of the colon & rectum 43 (2000), S. 1749-1753 
    Details
    ISSN: 1530-0358
    Keywords: Adhesions ; Operative technique ; Complications ; Economics
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: The purpose of this study was to document prospectively the time required to gain access to the abdomen to perform a planned procedure in patients with and without previous surgery. METHODS: Patients were obtained from the consecutive cases of 11 surgeons at three colorectal surgery centers. Opening time (skin incision to retractor placement) was measured and recorded in the operating room by the circulating nurse or by an independent researcher. Demographic data including the number and type of previous operations and the presence and severity of adhesions were recorded by the staff surgeon. A comparison of opening times between patients with and without previous abdominal operations was conducted. RESULTS: One hundred ninety-eight patients had abdominal operations. Fifty-five percent had previous abdominal procedures. Patients with prior surgery required a mean of 21 minutes to open their abdomens, whereas patients without prior surgery required a mean of 6 minutes (P〈0.01). The median times were 17 and 6 minutes, respectively. Eighty-three percent of patients with prior surgery had adhesions, whereas only 7 percent of patients had adhesions on their initial operation. Patients with prior surgery also had higher grade adhesions (P〈0.001). Irrespective of previous surgery, comparing patients with adhesions with those without, patients with adhesions required a mean of 22 minutes to open, whereas the lack of adhesions resulted in a mean opening time of 6 minutes. CONCLUSIONS: Previous surgery and the presence of adhesions add significant time to opening the abdomen.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02236862
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  • 4
    Electronic Resource
    Electronic Resource
    Solid-State CP/MAS 13C-NMR Spectra of Oligolides derived from 3-hydroxybutanoic acidFor an early review article in which the preparation of these oligolides was first mentioned, see [la]. An extended abstract of a lecture given on the subject was published in [1b]. An extensive general article entitled ‘Poly(hydroxyalkanoates), the Fifth Class of Physiologically Important Organic Biopolymers?’ was submitted for publication [1c].Details about preparation and structure determination of these oligolides were published elsewhere [2a-d] or will be included in a paper in preparation [2e]. (1993)
    New York, NY : Wiley-Blackwell
    Helvetica Chimica Acta 76 (1993), S. 915-923 
    Details
    ISSN: 0018-019X
    Keywords: Chemistry ; Organic Chemistry
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Chemistry and Pharmacology
    Notes: The solid-state CP/MAS 13C-NMR spectra (cross-polarization/magic-angle spinning 13C-NMR) of eight lower cyclic and one linear oligomers and several polymers of (R)-3-hydroxybutanoic acid (3-HB) are reported. The polymeric samples of different origin and molecular weight give remarkably similar and well resolved spectra, indicating considerable similarity in the conformations of the molecules and homegeneity in the solid-state environment. The crystalline cyclic oligomers 1-8 containing 3-9 units of 3-HB give very well resolved spectra. The number of nonequivalent positions in the solid state can be identified and is in accord with structures from X-ray diffraction where these were determined. The spectra of the oligolides become increasingly similar to those of the polymer as the ring size increases. This spectral evidence supports the view of a homogeneous and well defined conformation for the polymeric material (as proposed previously, based on other experiments).
    Additional Material: 3 Ill.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1002/hlca.19930760215
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  • 5
    Electronic Resource
    Electronic Resource
    Organozinnverbindungen, XIX. Zur Synthese von stannylierten Alkinen (1968)
    Weinheim : Wiley-Blackwell
    Liebigs Annalen 716 (1968), S. 19-28 
    Details
    ISSN: 0075-4617
    Keywords: Chemistry ; Organic Chemistry
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Chemistry and Pharmacology
    Notes: Stannylierte Alkine RnSn(C = C - R′)4-n mit n = 0, 2, 3 (Tabb. 2, 3) werden einfach und schonend dargestellt durch azeotropen Wasser-Entzug aus dem freien Alkin und Dialkyl(bzw. -aryl)-zinnoxid oder Trialkyl(bzw. -aryl)-zinnoxid. Der Rest R′ kann funktionelle Gruppen tragen, z.B. OCH3, CONH2, CO2CH3 und CN. Das Verfahren ist auch auf Pb- und Hg-Alkin-Verbindungen anwendbar. Der Mechanismus von Knüpfung und Hydrolyse der C≡C-Sn-Gruppe wird untersucht. Sowohl aus vergleichenden IR-Studien wie aus Valence-Bond-Berechnungen (VB + CI-Methode) folgt, daß am Bindungssystem eine Struktur C≡C-Sn beteiligt ist.
    Additional Material: 4 Tab.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1002/jlac.19687160104
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  • 6
    Electronic Resource
    Electronic Resource
    Organozinnverbindungen, XX. Synthesen mit stannylierten Alkinen (1968)
    Weinheim : Wiley-Blackwell
    Liebigs Annalen 716 (1968), S. 29-36 
    Details
    ISSN: 0075-4617
    Keywords: Chemistry ; Organic Chemistry
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Chemistry and Pharmacology
    Notes: Stannyl-alkine reagieren mit Phenylisocyanat überraschenderweise zu 5-Alkylidenhydantoinen 3, mit Diphenyl-tetrazin in einer Diels-Alder-Reaktion zu Pyridazinen 6, mit Jod zu Jod-alkinen; Carbonsäure-chloride führen zu Alkinyl-ketonen, polarisierte Carbonyl-Verbindungen analog einer Grignard-Reaktion zu substituierten Propargylalkoholen.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1002/jlac.19687160105
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