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  • Rectal cancer  (6)
  • chlorine-35  (5)
  • 1
    ISSN: 1572-8927
    Keywords: Hydrogen-1 ; nitrogen-15 ; chlorine-35 ; NMR coordination ; Lu(ClO4)3 ; Lu(NO3)3
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology
    Notes: Abstract A coordination study of Lu(III) has been carried out for the nitrate and perchlorate salts in aqueous mixtures of acetone-d6 and Freon-12 by1H,15N and35Cl NMR spectroscopy. At temperatures lower than −90°C, proton and ligand exchange are slow enough to permit the direct observation of1H resonance signals for coordinated and free water molecules, leading to an accurate measure of the Lu(III) hydration number. In perchlorate solution, in the absence of inner-shell ion-pairing, Lu(III) exhibits a maximum coordination number of six over the allowable concentration range of study, contrasting markedly with the report of values of six to nine or greater as determined by a similar NMR method. The absence of contact ion-pairing was confirmed by35Cl NMR chemical shift and linewidth measurements. Extensive ion-pairing was observed in the nitrate solutions as reflected by the lower Lu(III) hydration numbers of two to three in these systems, the observation of two coordinated water signals, and15N NMR signals for two complexes. The1H and15N NMR spectra and the hydration number could be accounted for by the presence of (H2O)4Lu(NO3)2+ and (H2O)2Lu(NO3) 2 1+ .
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  • 2
    ISSN: 1572-8927
    Keywords: Nitrogen-15 ; chlorine-35 ; NMR ; cerium nitrate ; complexation ; water acetone mixtures
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology
    Notes: Abstract A study of the complex formation which occurs between cerium(III) and nitrate ions in aqueous solvent mixtures has been carried out by a direct, low-temperature, nitrogen-15 (15N) NMR technique. At temperatures in the range of −95 to −110°C, ligand exchange is slow enough to permit the observation of separate15N NMR signals for bulk nitrate, and this anion in the cerium(III) principal coordination shell. In water-acetone-Freon-12 mixtures, the spectra reveal the nitrato complexes do not form consecutively. Rather, signals are observed for Ce(NO3)2+, Ce(NO3) 2 1+ , and only two other higher order complexes, even at very high NO 3 − to Ce(III) mole ratios. Signal area evaluations were used to identify the possible higher order complexes. At comparable salt concentrations in aqueous-methanol mixtures, only Ce(NO3)2+ and Ce(NO3) 2 1+ are formed, reflecting a decreased tendency for complexation in media of higher dielectric constant.
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  • 3
    ISSN: 1530-0358
    Keywords: Rectal cancer ; Colonic J-pouch ; Low anterior resection ; Lymph node metastases ; Clearing method ; Japanese General Rules for Clinical and Pathological Studies on Cancer of the Colon, Rectum and Anus
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: It has been reported that functional outcome following low anterior resection of rectal cancer is improved by construction of a colonic J-pouch compared with straight anastomosis. Hence, we tried to justify use of the sigmoid colon in the construction of a J-pouch by the analysis of regional lymph node metastases. METHODS: A total of 182 patients underwent resection for rectal cancer. Node metastases were examined by the clearing method. According to Japanese General Rules for Clinical and Pathological Studies on Cancer of the Colon, Rectum and Anus (JGR), nodes were classified into the perirectal nodes (PR-N), pericolic nodes (PC-N), central intermediate nodes (C-IM-N), central main nodes (C-M-N), lateral intermediate nodes (L-IM-N), and lateral main nodes (L-M-N). RESULTS: Metastatic rate (number of patients with node metastases/ total number of patients) of PR-N was 57.1 percent. Metastatic rate of C-IM-N was 18.7 percent and that of C-M-N was 7.1 percent. Metastatic rates of L-IM-N and L-M-N were 8.8 and 3.3 percent, respectively, and both were highest in the case of lower rectal cancer. Metastatic rate of PC-N was only 1.1 percent. The number of cases without node metastases (n(−) cases) was 78, that with only PR-N metastases (PR-N cases) was 63, that with intermediate but not main node metastases (IM-N cases) was 29, and that with main node metastases (M-N cases) was 12. Five-year survival rate after curative resection was 88.5 percent for n(−) cases, 70.9 percent for PR-N cases, 65.9 percent for IM-N cases, and 41.7 percent for M-N cases. CONCLUSIONS: In low anterior resection, high ligation of the inferior mesenteric artery and dissection of C-M-N, C-IM-N and PR-N are necessary, with the addition of the L-IM-N and L-M-N in the case of lower rectal cancer. Resection of sigmoid colon is not required, and therefore, a J-pouch can be constructed using the sigmoid colon. Nodal classification according to the JGR was predictive of case distribution and five-year survival rate.
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  • 4
    ISSN: 1530-0358
    Keywords: Clearing method ; High ligation of the inferior mesenteric artery ; Rectal cancer
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: In surgery for rectal cancer, it is unclear whether the inferior mesenteric artery should be ligated at a high or low position. The study contained herein was undertaken to clarify the indications for high ligation of the inferior mesenteric artery. METHODS: Subjects included 198 patients with rectal cancer who underwent resection with high ligation of the inferior mesenteric artery. Nodal metastases were examined by the clearing method. RESULTS: The incidence of metastases to the lymph nodes surrounding the origin of the inferior mesenteric artery (root nodes) was 8.6 percent. Inferior mesenteric artery root nodal metastases occurred more frequently with pT3 and pT4 cancer. The five-year survival rate in patients with inferior mesenteric artery root nodal metastases was 38.5 percent; this rate was significantly lower than in those without inferior mesenteric artery root nodal metastases (73.4 percent). CONCLUSIONS: Although the five-year survival rate in patients with inferior mesenteric artery root nodal metastases was lower than in those without metastases, inferior mesenteric artery root nodal dissection should be performed after high ligation of the inferior mesenteric artery for patients with pT3 and pT4 cancers.
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  • 5
    ISSN: 1530-0358
    Keywords: Rectal cancer ; Low anterior resection ; Colonic J-pouch reconstruction ; Evacuation difficulty ; Pouch inclination ; Pouchography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: Functional outcome after low anterior resection for rectal cancer is improved by the construction of a colonic J-pouch. One disadvantage of this type of reconstruction is evacuation difficulty, which has been associated with large pouches. The purpose of this study was to elucidate the causes of evacuation difficulty in large pouches using pouchography. METHODS: The angle between the longitudinal axis of the pouch and the horizontal line (pouch-horizontal angle) on lateral pouchography was determined in 26 patients with 10-cm J-pouch reconstructions (10-J group) and 27 patients with 5-cm J-pouch reconstructions (5-J group). Measurement were made at three months, one year, and two years after surgery. Clinical function was evaluated using a questionnaire one year postoperatively. RESULTS: The pouch-horizontal angle in the 10-J group was significantly smaller than that in the 5-J group at all three time points. In both groups the pouch-horizontal angle at one year was significantly smaller than that at three months. There were no significant differences between the pouch-horizontal angles at one and two years. An evacuation difficulty was significantly more common in the 10-J group than the 5-J group. CONCLUSIONS: The evacuation difficulty observed in patients with large colonic J-pouch reconstructions may be attributed to the development of a horizontal inclination within one year of surgery.
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  • 6
    ISSN: 1530-0358
    Keywords: Rectal cancer ; Pelvic plexus preservation ; Lymph node metastases ; Clearing method
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: In rectal cancer surgery preservation of urinary and sexual function is attempted by means of operations preserving the autonomic nerves of the pelvic plexus. Emergence of residual cancer because of a more shallow plane of dissection is a problem of concern with these methods, so we examined indications for pelvic plexus preservation. METHODS: We studied 198 patients with rectal carcinoma who underwent abdominopelvic lymphadenectomy. Lymph nodes along the superior hemorrhoidal artery and middle hemorrhoidal artery medial to the pelvic plexus were defined as perirectal nodes, and nodes along the middle hemorrhoidal artery lateral to the pelvic plexus and along the internal iliac artery represented lateral intermediate nodes. Node metastases were examined by the clearing method. RESULTS: Metastasis to perirectal nodes occurred in 12.5 percent in patients with pT1 tumors, 28.9 percent of those with pT2 tumors, and 50.0 percent of those with rectosigmoid junctional cancer. Metastasis to lateral intermediate nodes was absent in patients with pT1 or pT2 tumors and was as low as 2.5 percent in patients with rectosigmoid junctional cancer. CONCLUSIONS: In patients with T1, T2, and rectosigmoid junctional cancer, perirectal node dissection is necessary, but chances of residual cancer should remain minimal when the pelvic plexus is preserved.
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  • 7
    ISSN: 1572-8927
    Keywords: Hydrogen-1 ; nitrogen-15 ; chlorine-35 ; NMR ; erbium nitrate ; complexation ; acetone ; methanol
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology
    Notes: Abstract The extent of inner-shell ion-pair formation of Er3+ with nitrate ion in aqueous mixtures has been studied by nitrogen-15 (15N) NMR spectroscopy. At low temperature, exchange is slow enough to permit the direct observation of15N signals for nitrate ions in the Er3+ solvation shell and in bulk medium. In water-acetone mixtures,15N NMR signals for the mono-and bis complexes are observed at low nitrate to Er3+ mole ratios, but only the bis complex is evident at higher anion concentrations. No spectral evidence for the tris complex was seen at any nitrate concentration. In water-methanol-acetone mixtures, signals for the mono and bis complexes persist even at higher nitrate concentrations, indicating a reduced tendency to ion-pair with increasing dielectric constant. Preliminary15N NMR results are presented for the nitrate complexes of other paramagnetic lanthanide ions.
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  • 8
    ISSN: 1530-0358
    Keywords: Low anterior resection ; Ultralow coloanal anastomosis ; Rectal cancer ; Colonic J-pouch ; Optimum pouch size ; Prospective randomized study
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: Functional outcome after low anterior resection with ultralow coloanal anastomosis for rectal cancer is improved by construction of a colonic J-pouch vs. straight anastomosis. Optimum size of this pouch has yet to be determined. Therefore, we initiated a prospective, randomized trial using 5-cm and 10-cm pouches to determine this size. METHODS: Patients with tumors 5 to 10 cm from the anal verge were included in the study. Before a low anterior resection anastomosis was performed, patients were randomized to either a 5-cm J-pouch group (5-J group) or a 10-cm J-pouch group (10-J group). Functional assessments were performed one year postoperatively. Clinical functions were evaluated using a functional scoring system. Physiologic functions, such as sphincter and reservoir function, were evaluated by anorectal manometry and evacuation function by the balloon expulsion and saline evacuation tests. RESULTS: Forty patients among 43 randomized patients were assessed for functional outcome one year postoperatively (5-J group, n=20; 10-J group, n=20). The functional score was similar for the two groups, although reservoir function in the 5-J group was significantly less than in the 10-J group. Sphincter function was similar between the two groups. Evacuation function in the 5-J group was significantly superior to that in the 10-J group. CONCLUSIONS: The 5-cm J-pouch conferred adequate reservoir function without compromising evacuation.
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  • 9
    ISSN: 1530-0358
    Keywords: Anastomotic level ; Anterior resection ; Indications for colonic J-pouch reconstruction ; Rectal cancer
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: Functional outcome after anterior resection for rectal cancer is improved by colonic J-pouch reconstruction compared with straight anastomosis. The indications for colonic J-pouch reconstruction have yet to be determined. Therefore, we attempted to determine the level at which J-pouch reconstruction provides an advantage over straight anastomosis. METHODS: A total of 48 patients who underwent 5-cm colonic J-pouch reconstruction (J-pouch group) and 80 patients who underwent straight anastomosis (straight group) underwent functional assessment one year postoperatively. RESULTS: The functional outcome in the J-pouch group was significantly better than that in the straight group when the distance of the anastomosis from the anal verge was less than 8 cm. The difference was particularly obvious when the level of the anastomosis was below 4 cm. However, functional outcome in the straight group when the anastomosis was between 9 and 12 cm from the anal verge was also satisfactory and did not differ from that in the J-pouch group when the anastomosis was between 5 and 8 cm from the anal verge. CONCLUSIONS: Colonic J-pouch reconstruction is indicated when the distance of anastomosis from the anal verge is less than 8 cm, and it is essential when the distance is less than 4 cm.
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  • 10
    ISSN: 1572-8927
    Keywords: Carbon-13 ; nitrogen-15 ; chlorine-35 ; NMR ; samarium(III) ; isothiocyanate ; Sm3+ − NCS− complexes ; water–acetone–Freon ; water–methanol
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology
    Notes: Abstract Multinuclear magnetic resonance studies of trivalent lanthanide inner-shell ion-pairing with nitrate and isothiocyanate are continuing. For NCS− solutions in water–acetone–Freon mixtures at low temperature, generally −100 to −125°C, ligand exchange is slow enough to permit the observation of 13C and 15N NMR signals for coordinated and free anions. For samariuni(III) solutions, four coordinated NCS−signals, displaced about +35 ppm and +250 ppm from free anion, are observed in the 13C and 15N NMR spectra, respectively. The 13C and 15N NMR data are complementary, showing a signal area concentration dependence and measured coordination numbers consistent with the formation of Sm(NCS)2+ through Sm(NCS) 4 1 . The coordination numbers reach a maximum of about three moles of NCS− per mole of Sm(III) with both nuclides, a result confirmed by spectral appearance showing the dominance of Sm(NCS)3 at the highest concentration studied. An analysis of the chemical shifts indicates that binding occurs at the nitrogen atom of NCS−. In water–methanol, due to the higher dielectric constant of such mixtures, coordination was less extensive. A competitive binding study with Ci− by 35Ci NMR demonstrated conclusively the superior coordinating ability of NCS−.
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