Your email was sent successfully. Check your inbox.

An error occurred while sending the email. Please try again.

Proceed reservation?

Export
Filter
  • Organic Chemistry  (6)
  • Childhood  (3)
  • 2000-2004  (1)
  • 1995-1999  (4)
  • 1980-1984  (4)
  • 1
    ISSN: 1433-0474
    Keywords: Schlüsselwörter Osteomyelitis ; Kindesalter ; Sonographie ; Skelettzintigraphie ; Kernspintomographie ; Key words Osteomyelitis ; Childhood ; Sonography ; Scintigraphy ; Magnetic resonance tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Objective: Diagnosis of osteomyelitis is difficult in early state of disease. Usually, characteristic X-ray findings cannot be obtained during the first week of disease. Sonography, scintigraphy and magnetic resonance tomography were compared at clinical manifestation of osteomyelitis. Methods: From 1980 to 1997 osteomyelitis was suspected in 138 patients suffering from symptoms for less than 5 days. The diagnosis value of sonography, scintigraphy and magnetic tomography was determined by comparing 66 patients with proven osteomyelitis and 27 patients, in whom osteomyelitis had been ruled out. Results: Sonography distinguished with great specifity (93%) and positive prediktive value (92%). Sensitivity (60%) and negative predictive value (61%) were low. For scintigraphy sensitivity was 80%, specifity was 78%, negative predictive value was 68% and positive predictive value was 87%. Magnetic resonance tomography (sensitivity 90%) had the greatest specificity (100%). Conclusion: Diagnosis of osteomyelitis can be suggested but cannot be ruled out by sonography. By scintigraphy, the diagnosis can neither be suggested nor can be ruled out. Magnetic resonance tomography seems to be the best imaging modality for marking off differential diagnosis. Osteomyelitis can only been diagnosed by imaging modality in common with clinic manifestation and laboratory findings because every imaging modality can lead to wrong interpretation.
    Notes: Zusammenfassung Fragestellung: In der frühen Krankheitsphase der Osteomyelitis ist die Sicherung der Diagnose schwierig, da charakteristische radiologische Befunde erst nach einigen Tagen auftreten. Daher wurde die Aussagekraft von Sonographie, Skelettszintigraphie und Kernspintomographie bei klinischer Manifestation einer akuten Osteomyelitis überprüft. Methode: In den Jahren von 1980–1997 wurden 138 Patienten unter der Verdachtsdiagnose Osteomyelitis stationär aufgenommen, bei denen die Symptome weniger als 5 Tage bestanden. Die Aussagekraft von Sonographie, Skelettszintigraphie und Kernspintomographie wurde bei 66 Patienten mit gesicherter Osteomyelitis und 27 Patienten mit sicherem Ausschluß der Diagnose analysiert. Ergebnisse: Die Sonographie zeichnete sich durch eine große Spezifität (93%) und einen großen positiv prädiktiven Wert (92%) bei geringer Sensitivität (60%) und geringem negativ prädiktiven Wert (61%) aus. Die Skelettszintigraphie besaß eine Sensitivität von 80%, eine Spezifität von 78%, einen negativ prädiktiven Wert von 68% und einen positiv prädiktiven Wert von 87%. Die größte Spezifität (100%) wurde durch die Kernspintomographie erzielt (Sensitivität 90%). Schlußfolgerung: Sonographien können die Verdachtsdiagnose weitgehend sichern, während ein Ausschluß der Diagnose Osteomyelitis nicht möglich ist. Die Skelettszintigraphie eignet sich weder zur Sicherung noch zum Ausschluß der Verdachtsdiagnose. Differentialdiagnosen können v.a. durch die Kernspintomographie abgegrenzt werden. Da jedes bildgebende Verfahren Fehlinterpretationen zuläßt, kann die Diagnose einer Osteomyelitis nur durch Synopse aus klinischem Befund, Labordaten, Erregernachweis, Verlauf und bildgebender Diagnostik gestellt werden.
    Type of Medium: Electronic Resource
    Signatur Availability
    BibTip Others were also interested in ...
  • 2
    ISSN: 0021-8383
    Keywords: Chemistry ; Organic Chemistry
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Chemistry and Pharmacology
    Type of Medium: Electronic Resource
    Signatur Availability
    BibTip Others were also interested in ...
  • 3
    ISSN: 0021-8383
    Keywords: Chemistry ; Organic Chemistry
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Chemistry and Pharmacology
    Notes: Synthesis of 2-Aminoalkan-(1)-oles and 2-Dimethylaminoalkan-(1)-oles
    Additional Material: 2 Tab.
    Type of Medium: Electronic Resource
    Signatur Availability
    BibTip Others were also interested in ...
  • 4
    ISSN: 1437-9813
    Keywords: Key words Peritonitis ; Perforated appendicitis ; Endotoxin ; Surgical measures ; Childhood
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The pathogenesis of peritonitis due to hollow-viscus perforation is currently accepted as being mainly based on the local and systemic release of pro- and anti-inflammatory mediators triggered by the presence of bacteria and bacterial products in the abdominal cavity. Therefore, treatment consists in focal restoration, intraoperative debridement and lavage, and postoperative measures such as drainage, continuous peritoneal lavage, or scheduled reoperation aiming at the removal of infectious agents from the peritoneal cavity to prevent persisting peritonitis and sepsis. In order to evaluate the pathophysiologic relevance of the bacterial and endotoxin load of the peritoneal exudate, we examined the peritoneal fluid of 20 children with perforated appendicitis for qualitative and quantitative analysis of bacteria, antibiotic concentrations, and endotoxin content. The time period ranged in 12-h intervals from intraoperatively to day 5. Eighteen of 20 fluid specimens (90%) showed endotoxin levels above 1.5 endotoxin units EU/ml (standard 〈0.1 EU/ml). The most common bacterial species isolated was Escherichia coli, mostly in high concentrations. Despite persisting high endotoxin concentrations and bacterial loads in the peritoneal cavity during the 5 postoperative days, the children recovered uneventfully and the systemic signs of infection disappeared rapidly. In conclusion, neither the bacterial nor the endotoxin load of the peritoneal cavity proved to be associated with the clinical course. Therefore, we hypothesize that during peritonitis compartmentalization of the focus of infection prevents further systemic reactions and ultimately leads to removal of the infectious agents by endogenous mechanisms. At least in peritonitis due to perforated appendicitis in children, adjuvant surgical measures in addition to appendectomy and intraoperative debridement are not necessary.
    Type of Medium: Electronic Resource
    Signatur Availability
    BibTip Others were also interested in ...
  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Pediatric surgery international 14 (1998), S. 175-177 
    ISSN: 1437-9813
    Keywords: Key words Intussusception ; Postoperative ; Childhood
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Over a period of 10 years, five children developed postoperative intussusception after intra-abdominal procedures at the Department of Pediatric Surgery of the Johannes Gutenberg University Mainz. Two appendectomies, one ileal resection for a Meckel's diverticulum, one operative procedure for Hirschsprung's disease plus intestinal neuronal dysplasia type B, and one hiatoplasty with jejunostomy preceded the intussusception. Three of the five children were older than 2 years. The clinical symptoms consisted primarily of abdominal distension, diffuse abdominal pain, bilious vomiting, and rectal bleeding in one case. Preoperative diagnosis was achieved in four cases by abdominal ultrasound. Plain abdominal radiographs demonstrated dilated loops of small intestine with air-fluid levels in four of the five cases. In the case without radiographic findings, the jejunojejunal intussusception was missed even by a bowel follow-through. The intussusceptions were ileocolic (3), ileoileal (1), and jejunojejunal (1). A hydrostatic procedure to reduce an ileocolic intussusception was not successful. Operative treatment of the intussusception was performed in three cases within 5 days, once at 32 days, and once 3 months after the primary operation, in all cases by laparatomy and simple manual reduction without intestinal resection. In contrast to idiopathic intussusception, noninvasive hydrostatic procedures are not indicated in postoperative intussusception, since protection of intestinal anastomoses from hydrostatic pressure and exclusion of other causes of postoperative ileus are mandatory.
    Type of Medium: Electronic Resource
    Signatur Availability
    BibTip Others were also interested in ...
  • 6
    ISSN: 0018-019X
    Keywords: Chemistry ; Organic Chemistry
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Chemistry and Pharmacology
    Notes: The Photochemistry of Tetraalkyl Substituted γ-Keto-olefinesThe photochemistry of 7,8-dihydro-β-ionone (1) in solution is shown to depend on temperature, polarity and viscosity of the solvent. UV. irradiation (λ ≥ 245 nm) in pentane at +25° converts 1 to the isomeric ethers 3 (16%), 5A (48%) and 5B (22%), whereas at -65° 7,8-dihydro-γ-ionone (26) is obtained in 12% yield together with 13% of 3, 12% of 5A and 9% of 5B. The 1n,π*-excitation of 1 in acetonitrile gives similar results. In the more viscous 1,2,3-triacetoxypropane the photoisomerization 1 → 26 takes place even at + 60° (10% yield, cf. 40% at -15°). In alcoholic solvents, however, no formation of 26 is detected, but the hitherto unknown [2+2]-photocycloaddition 1 → 11 can be observed (4% at -7°, 15% at -65S° in 2-propanol). An intermediate e may be involved (Scheme 14). In addition to the photoreactions 1 → 3, 5A, 5B and 11 the isomerization of 1 to the novel spirocyclic ketone 28 takes place in alcoholic solvents only.Photoisomerization 1 → 3 is presumably a photo-ene process involving a stereoselective intramolecular H-transfer. This type of photoisomerization is restricted to cyclic γ-keto-olefines. The tetraalkylated acyclic γ-keto-olefines 14 and 15 photoisomerize exclusively by [2+2]-cycloaddition, independent of the solvent.On 1n,π*-excitation the δ,∊-unsaturated bicyclic ketone 44 undergoes Norrish-Type-II photofragmentation to the diene 45 or isomerizes to the γ, ∊-unsaturated ketone 17. Competition between these two reactions is strongly temperature dependent: photolysis in pentane at -72° yields quantitatively 45, whereas at + 35° only 30% of 45 and 68% of 17 are obtained.UV. irradiation of the novel spirocyclic ketone 28 gives as primary photoproduct the isomeric aldehyde 29, and in a secondary photoreaction the isomeric oxetanes 30A and 30B. Experiments with deuteriated substrates show that the isomerization of type 28 → 29 is stereocontrolled.
    Additional Material: 2 Tab.
    Type of Medium: Electronic Resource
    Signatur Availability
    BibTip Others were also interested in ...
  • 7
    ISSN: 0018-019X
    Keywords: Chemistry ; Organic Chemistry
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Chemistry and Pharmacology
    Notes: A simple and efficient new method for the highly stereoselective (at C (17) and C (20)) introduction of steroid side chains which are suitably functionalized for further elaboration is presented. The ene reaction of (17 Z)-ethylidene steroids, which are readily obtained from 17-keto steroids via a Wittig reaction, with various enophiles such as formaldehyde and acrylate esters leads to useful intermediates which contain the natural steroid configuration at C (20). Catalytic hydrogenation of the Δ16-double bond occurs from the α-face to stereospecifically generate the correct configuration at C (17). An additional chiral center at C (23) is also introduced stereoselectively by the use of methyl 2-chloroacrylate as the enophile.
    Type of Medium: Electronic Resource
    Signatur Availability
    BibTip Others were also interested in ...
  • 8
    ISSN: 0018-019X
    Keywords: Chemistry ; Organic Chemistry
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Chemistry and Pharmacology
    Notes: Synthesis of ‘Push-Pull’ Enynes‘Push-pull’ enynes 1a-1f are easily available by Pd catalyzed coupling of stannyl-ynamines 15 and silylynamines 16 with β-iodo-enones 8 (Schemes 7 and 8).
    Additional Material: 2 Tab.
    Type of Medium: Electronic Resource
    Signatur Availability
    BibTip Others were also interested in ...
  • 9
    ISSN: 0018-019X
    Keywords: Chemistry ; Organic Chemistry
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Chemistry and Pharmacology
    Notes: Reaction of ‘Push-Pull’ Enynes with Acids. First Observation of a Rearrangement of 5-Chloro-5-(dialkylamino)pentadienals‘Push-pull’-enynes 7 react easily with HCl as well as with AcOH to give 5-amino-5-chloropentadienals 8 and 5-(acetoxy)-5-aminopentadienals 13 as well as the corresponding ketones. In view of a postulated rearrangement of compounds 8 and 13 (Scheme 2), both types of compounds have been treated with traces of acid. While no definite reaction is observed in case of 13, HCl-addition products 8 easily and quantitatively rearrange to give 2H-pyran-2-iminium chlorides 10 which are the postulated intermediates of the rearrangement 8→12 (Scheme 2).
    Additional Material: 2 Ill.
    Type of Medium: Electronic Resource
    Signatur Availability
    BibTip Others were also interested in ...
Close ⊗
This website uses cookies and the analysis tool Matomo. More information can be found here...