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At least 343 records · Page 19Linked to original sources
PubMed1993

Epiphyseal impaction as a cause of severe osteoarticular pain of lower limbs after renal transplantation.

A syndrome of severe osteoarticular pain of lower limbs occurring early after renal transplantation (TP) has been recently identified. We describe its prevalence, clinical presentation and outcome. Symptomatic patients have been studied with conventional X-rays, magnetic resonance (MR) imaging, and 99mTechnetium scintigrams of the painful areas. Among 86 patients transplanted over a two-year period, nine (4 men, 5 women; mean age of 40.4 years; range 32 to 59) developed unexplained severe spontaneous osteoarticular pain of lower limbs 19 to 105 (mean 58) days after TP. Pain affected hip(s), knee(s), and/or ankle(s). Clinical examination was usually unremarkable. Favorable outcome was the rule; mean duration of pain was 86 (range 19 to 175) days. Radiographs were abnormal (joint swelling, patchy osteoporosis and/or periosteal reactions) in 41%, MR (epiphyseal fatty marrow replacement by edema and/or hemorrhages) in 83%, and bone scans (one to several epiphyseal foci of increased uptake) in 81% of the symptomatic examined areas. Among joints re-examined 9 to 12 months after resolution of the symptoms, X-rays showed periosteal reactions in 31%, and the bone scans disclosed persistent increased uptake in 53% of the joints, whereas epiphyseal MR abnormalities had completely disappeared in 86%. There was no difference in dialysis duration, post-TP weight gain, evidence of hyperparathyroidism, and steroid and cyclosporine doses between symptomatic and an appropriately selected group of asymptomatic patients. By contrast, serum alkaline phosphatase levels were transiently higher (at the onset of symptoms) in the symptomatic group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2005

Solid-state study of mepivacaine hydrochloride.

Different crystalline forms of the local anaesthetic mepivacaine hydrochloride (MH) were revealed by Fourier transform infrared spectroscopy (FT-IR), not by conventional differential scanning calorimetry (DSC). The existence of two polymorphic anhydrous modifications was discovered and further characterized by X-ray powder diffraction and thermal analysis: Form II, the commercial one, and the more stable Form I, obtained by re-crystallization from Form II. Two pseudopolymorphs were also obtained: Form III, a solvate crystallized from ethanol and Form IV, a solvate crystallized from methanol. Single crystal X-ray diffraction data for both solvates were collected and their structures were determined. Form II, metastable and monotropically related to Form I, generates through desolvation of Form III, very often present in industrial processing, where crystallization from ethanol solution is a common practice. For the sake of clarity, the presence of polymorphic forms should be reported in the drug master files of MH. However, since MH is readily water soluble, the observed polymorphism has no relevance to its typical clinical use as aqueous solutions.

Anesthetics, Local↗
PubMed2002

Characteristic reactions and properties of C-apical O-equatorial (O-cis) spirophosphoranes: effect of the sigma(P)(-)(O) orbital in the equatorial plane and isolation of a hexacoordinate oxaphosphetane as an intermediate of the Wittig type reaction of 10-P-5 phosphoranes.

Novel spirophosphoranes (O-cis) that exhibit reversed apicophilicity having an apical carbon-equatorial oxygen array in a five-membered ring showed enhanced reactivity toward nucleophiles such as n-Bu(4)N(+)F(-) or MeLi in comparison with the corresponding stable isomeric spirophosphoranes (O-trans) having an apical oxygen-equatorial carbon configuration. The enhanced reactivity of the O-cis isomer could be explained by the presence of a lower-lying sigma(P)(-)(O(equatorial)) orbital as the reacting orbital in the equatorial plane, whereas the corresponding orbital is a higher-lying sigma(P)(-)(C(equatorial)) in the O-trans isomer. Density functional theory (DFT) calculation on the actual compounds provided theoretical support for this assumption. In addition, we found that the benzylic anion alpha to the phosphorus atom in O-cis benzyl phosphorane is much more stable than that generated from the corresponding O-trans compounds. The experimental results were considered to be due to the n(C) --> sigma(P)(-)(O) interaction in the O-cis anion, and this was confirmed by DFT calculations. Furthermore, the hexacoordinate anionic species derived from the reaction of the benzylic anion from O-cis benzylphosphorane with an aldehyde was also found to be stabilized as compared with analogous species from the corresponding O-trans isomer. The first X-ray structural characterization of a hexacoordinate phosphate intermediate in the Wittig type reaction using pentacoordinate phosphoranes is reported.

Aldehydes↗
PubMed2003

Synthesis and properties of rhenium carbonyl complexes of alpha,alpha'-bis[(1-pyrenyl)pyrazol-1-yl]alkane ligands.

The reaction between (1-acetyl)pyrene and dimethylformamide dimethylacetal followed by condensation of the resulting product mixture with hydrazine affords 3(5)-(1-pyrenyl)pyrazole (2) in good yield. The easily separable bis[(1-pyrenyl)pyrazole]methane derivatives CH(2)(3-pz(pyrene))(2) (3a, pz = pyrazolyl ring) and CH(2)(3-pz(pyrene))(5-pz(pyrene)) (3b) were prepared by metathetical reactions between pyrazole and CH(2)Cl(2), while CH((n)()Pr)(pz(pyrene))(2) (4) was prepared by transamination of 2 with butyraldehyde diethylacetal. Compounds 2-4 are luminescent under irradiation with UV light and have pyrenyl monomer-based emissions centered near 400 nm. Compounds 3a and 4 each react with Re(CO)(5)Br in a 1:1 molar ratio to form highly insoluble complexes Re(CO)(3)Br[(pz(pyrene))(2)CH(2)] (5) and Re(CO)(3)Br[(pz(pyrene))(2)CH((n)()Pr)] (6). Complex Re(CO)(3)Br[(pz)(2)CMe(2)] (7) was also prepared. X-ray structural studies of 6 show extensive pi-stacking of pyrenyl groups to form two-dimensional sheets. Pulsed field gradient spin-echo NMR (PGSE-NMR) experiments show that the complexes are monomeric in tetrachloroethane. Variable-temperature, difference NOE and 2-D NMR experiments demonstrate that isomers are present in solution that differ by restricted rotation about the pyrazolyl-pyrenyl bond. The pyrenyl-based emissions centered near 400 nm are quenched by complexation to the Re(CO)(3)Br moiety in 5 and 6.

Journal Article↗
PubMed1995

Late pulmonary sequela following burns: persistence of hyperprocalcitonemia using a 1-57 amino acid N-terminal flanking peptide assay.

Seven patients were evaluated at a mean duration of 8.4 yr after sustaining inhalational injury associated with burns. At the time of re-examination, the patients were asymptomatic and had normal chest X-rays, and arterial blood gases. Three of the seven patients had abnormally elevated serum calcitonin levels. The spirometry (FEV1) measurements showed an inverse trend to that of the serum calcitonin levels. The elevated calcitonin levels had an abnormal predominance of the procalcitonin component as assessed by several region specific antisera. The serum calcitonin also showed a significant correlation with the hormone level which had been obtained at the time of prior discharge from the hospital (r = 0.91). Although there appears to be no or minimal chronic pulmonary sequela to inhalational injury in burns by pulmonary testing, we speculate that the hyperprocalcitonemia in some of the patients may reflect a long-term hyperplastic response of the bronchio-epithelial pulmonary neuroendocrine cells. The potential significance of this and other lung-associated endocrine markers is discussed.

Biomarkers↗
PubMed2005

Interactions of metal-metal-bonded antitumor active complexes with DNA fragments and DNA.

This Account summarizes the DNA binding properties of anticancer active dinuclear Rh, Re, and Ru compounds. The combined results of NMR spectroscopy, X-ray crystallography, and various biochemical tools provide incontrovertible evidence that dinuclear complexes are favorably poised to bind to purine nucleobases, DNA fragments, and double-stranded DNA. Moreover, direct DNA photocleavage in vitro is effected by dirhodium compounds in the presence of electron acceptors in solution or directly attached to the dirhodium core. This research has provided valuable insight in the interactions of dinuclear compounds with DNA, knowledge that is an excellent backdrop for rational design of promising dinuclear drugs.

Antineoplastic Agents↗
PubMed1999

Fluoride Reactions with Hydrotris(pyrazolyl)borate Rhenium Oxo Complexes: Re-F vs B-F Bond Formation.

Rhenium-oxo-fluoride complexes are readily prepared using hydrotris(3,5-dimethyl-1-pyrazolyl)borate [HB(3,5-Me(2)pz)(3)(-), Tp] as a supporting ligand. For instance, treatment of TpRe(O)(OH)Cl with concentrated aqueous HF cleanly forms the chloro-fluoride complex TpRe(O)(F)Cl. Related fluoro-iodide, fluoro-triflate, and difluoride complexes are also described. In contrast, a variety of reactions of analogous compounds with the unsubstituted hydrotris(1-pyrazolyl)borate ligand [HB(pz)(3)(-), Tp] have failed to produce fluoro complexes. Extended refluxing of TpRe(O)I(2) with an excess of NaF in acetonitrile in the air gives a modest yield of an unusual rhenium &mgr;-pyrazolyl &mgr;-oxo dimer, {[kappa(2)-H(F)Bpz(2)]Re(O)}(2)(&mgr;-pz)(2)(&mgr;-O) (5) (pz = pyrazolyl). The X-ray crystal structure of 5 shows that one pyrazolyl of each Tp ligand has been substituted for fluoride. The different reactivity of the Tp and Tp complexes is apparently due to the greater steric protection of the boron afforded by the Tp() ligand. Crystallographic data for 5: monoclinic; space group Cc; a = 19.103(4) Å, b = 10.482(2) Å, c = 14.240(3) Å, beta = 114.82(3) degrees; Z = 4; R = 3.73%, R(w) (observed data) = 4.73%; GOF = 1.20.

Journal Article↗
PubMed2000

[Pseudarthroses after distal radius fractures. What is the role of the distal radioulnar joint?].

Non-union following distal radial fracture is extremely rare. Therefore, the patterns are not completely understood. Recently, it was suggested that an associated distal ulna shaft fracture increases the risk to develop a non-union for comminuted fractures of the distal radius. The purpose of this study was to review our 15 cases with this condition to investigate the role of an associated distal ulna shaft fracture and/or an associated lesion of the distal radioulnar joint. The second goal was to evaluate the success of the surgical treatment in relation to the extent of the metaphyseal subchondral bone supporting the articular surface distal to the site of the non-union. We reviewed our 15 cases which were operated on for non-union of the distal radius since 1992. In all cases, the radiographs could be reviewed. Twelve patients could actually be re-examined. The investigated criteria were: initial, pre- and postoperative X-ray findings, other medical conditions, range of motion, grip strength, and pain relief. Clinical outcome was evaluated using the DASH-questionnaire. According to the AO classification system, there were two type A3 and 13 type C3 fractures. There were seven associated distal ulna fractures. The distal radioulnar joint was involved in twelve cases. The other medical conditions in the patients with non-union after distal radial fracture included allergy, hypothyroidism, diabetes mellitus, peripheral neuropathy, and bronchial asthma. Four patients were tobacco smokers. Only one patient was initially treated non-operatively. In all cases, the distal radius was restored preserving wrist motion. Bony union was achieved in 14 cases. The range of motion has improved in all planes. Grip strength increased but still remained over 50% below the level of the opposite side. Postoperatively, the majority of patients was pain free. In four cases, complications were seen postoperatively. Three of these patients had less than 6 mm of metaphyseal subchondral bone beneath the articular surface. Three of the four patients were tobacco smokers. Inadequate treatment of a comminuted distal radial fracture associated with a special local situation--such as an additional distal ulna shaft fracture and/or an associated lesion of the distal radioulnar joint--combined with a general medical condition, adversely affects fracture healing, increasing the risk for non-union. From the review of the records of these 15 cases, we recommend that non-union with more than 5 mm of subchondral bone supporting the articular surface distal to the non-union site undergo reconstruction of the radius. Non-union with less than 5 mm subchondral bone supporting the articular surface requires an individual decision. A good bone stock and stable fixation allows for reconstruction of the radius, otherwise wrist fusion is a useful salvage procedure.

Adult↗
PubMed2004

Endoclipping for gastric perforation after endoscopic polypectomy: an alternative treatment to avoid surgery.

A 47-year-old woman underwent endoscopic polypectomy of a villous adenoma in the lesser curvature of the gastric antrum. Shortly after the procedure, she complained of severe abdominal pain. An abdominal x-ray showed air under the diaphragm, suggestive of gastric perforation. On re-endoscopy, the cavity at the site of polypectomy was closed using endoscopically applied metallic clips. She was treated with intravenous hyperalimentation, omeprazole, and antibiotics for 10 days. Ingestion of food was started 10 days after admission, and she was discharged without any complaints. She is free of symptoms on follow-up after 8 months, and endoscopy showed complete healing of the perforation. The procedure is the third described for the stomach in the English literature and emphasizes the use of endoclipping in selected cases of small and well-defined perforations.

Adenoma, Villous↗
PubMed2000

[Osteolysis after total knee prosthesis].

PURPOSE OF THE STUDY: The aim of our work was to study X-rays showing osteolysis after 5 years and more in 122 prosthesis and to try and assess such complication, often described in the United States but seldom in Europ. MATERIAL: We are dealing here with 122 retaining posterior cruciate ligament, mostly cementless prothesis implanted between 1985 and 1992 84 chromium-cobalt prosthesis (PCA and Themis) implanted in 34 males and 88 females with an average age of 67 (45-81), 87,7 p. 100 had femoral cementless components and 70 p. 100 tibial cementless components. METHODS: All patients were examined and had X-rays at an average of 6,9 years. Specially considered were X-rays showing a possible osteolysis. We looked for possible complication (external laxity, anterior femoral dislocation and polyethylene wear), assessment of the mechanical axis and for clinical results (Hungerford score) RESULTS: Revisions: 19 arthroplasties were revised for PE wear tibial loosening metallosis or patella problems The postoperative score according to Hungerford was 84,5 p. 100 for PCA prosthese and 87 p.100 for the Themis. On the X-rays were only few osteolysis to be found: 9 cases (7,3 p. 100). For the PCA series: 3 femoral osteolysis, 1 tibial at 12 years, and one patellar osteolysis. For the Themis series: no femoral osteolysis, 3 tibial and one patellar osteolysis. Osteolysis are apparent on X-rays in profile for the femur and the patella, and in both profile and frontal X-rays for the tibia. Clinicaly 4 osteolysis really asymptomatic were not re-operated. 5 were revised: one 11 years later for femoral and tibial loosening, two for a patellar loosening, the other two patients had to be reoperated on for metallism (titanium's femoral component) and for those two instances osteolysis were discovered during the complication. DISCUSSION: Osteolysis after TKA appears unusual in our experience without bearing on frequency finded by american authors with a lesser follow-up (Engh 11,1 p. 100 after 4,5y, Peters 16 p. 100 after 2,9 y, Robinson 9,18 p. 100 after 4,6 y). American litteratur analysis shows that the important number of osteolysis is due to: - either to dual-metal using (Co-Cr component with Titanium screws for exemple), - or bad quality of polyethylene (compressed), - or a bad design of former prosthesis. CONCLUSION: Interface illness, linked to the production of wear debris, osteolysis after total knee arthroplasty is rarer than after a hip one, probably because size of debris is different, larger in knee than in hip. It is likely that the improvement of PE quality, design of prosthesis, as well as a better knowledge of osteolysis mechanism will allow to delay this complication wich is in a long term ineluctable.

Aged↗
PubMed1993

[A case of advanced gastric cancer with liver and lung metastasis effectively treated by combined chemo-immunotherapy of MMC, 5'-DFUR, OK-432].

A sixty-eight-year-old male patient was diagnosed as having inoperable advanced gastric cancer with liver and lung metastasis. The patient was treated by combined chemo-immunotherapy of MMC 10 mg/M, 5'-DFUR 800 mg/day and OK-432 5 KE/2 W. Six months after commencing chemotherapy, CT-scan and upper GI series revealed that metasized liver tumors and stomach lesion were remarkably decreased in size and no cancer cell was confirmed by endoscopic biopsy. Further, the metastatic lung tumor has disappeared on chest X-ray. The patient had been well without any evidence of tumor re-progression for over one year, but from July the liver tumor began to metastasize again and the patient eventually died of liver metastasis on Jan. 1, 1993.

Adenocarcinoma↗
PubMed1989

A re-examination of the crystal structure of A-DNA using fiber diffraction data.

Classical A-DNA helices with h = 0.25 nm may represent the greatest mass per unit length attainable by polynucleotide duplexes. The X-ray diffraction pattern from polycrystalline and well-oriented fibers of calf thymus DNA in its A-form has been carefully re-examined. Indexing on the basis of a C-face-centered monoclinic unit cell of dimensions a = 2.170 nm, b = 3.990 nm, c = 2.803 nm and beta = 96.82 degrees is superior to alternatives that have been proposed. Two right-handed. Watson-Crick base-paired, helical DNA chains with 2 X 11 nucleotides per 2.803 nm pitch, each carrying C3'-endo furanose rings, pass through the unit cell. The crystallography requires the two chains in the duplex to be antiparallel and conformationally identical but the 11 nucleotides in each pitch may be distinct. However, a secondary structure with a mononucleotide asymmetric unit provides as good an X-ray agreement as one with 11 distinct nucleotides. This relative lack of variability is quite different from what is observed in fibrous B-DNAs.

Animals↗
PubMed2001

The potencial role of rare earths in the pathogenesis of interstitial lung disease: a case report of movie projectionist as investigated by neutron activation analysis.

A 60-year-old male subject who worked as a movie projectionist and who was exposed for 12 years to rare earths (RE) containing dusts from cored arc light carbon electrodes was investigated. Chest X-ray films and pulmonary function tests showed an interstitial lung disease, emphysema and a severe obstructive impairment with marked decrease of carbon monoxide diffusion capacity. The histological examination of a transbronchial biopsy confirmed the diffuse interstitial lung fibrosis. Neutron activation analysis (NAA) of the biopsy showed concentrations of cerium (Ce), lanthanum (La), neodimium (Nd), samarium (Sm), terbium (Tb) and ytterbium (Yb) which were high compared to the corresponding elements in the transbronchial biopsies of 5 unexposed subjects as a control group. Thorium (Th) (which is generally present as an impurity of the RE compounds) was also determined in order to estimate the radiation dose in the lung of the worker. On the basis of the clinical observations, of the analytical results by neutron activation analysis of RE and of the presence of Th in the transbronchial biopsy, as well as of the differential diagnosis, which tended to exclude other occupational or non-occupational lung diseases, a relation between the observed interstitial lung fibrosis and occupational exposure to RE is highly probable.

Biopsy↗
PubMed2000

New synthetic routes to biscarbonylbipyridinerhenium(I) complexes cis,trans-[Re(X2bpy)(CO)2(PR3)(Y)n+ (X2bpy = 4,4'-X2-2,2'-bipyridine) via photochemical ligand substitution reactions, and their photophysical and electrochemical properties.

Photochemical ligand substitution of fac-[Re(X2bpy)(CO)3(PR3)]+ (X2bpy = 4,4'-X2-2,2'-bipyridine; X = Me, H, CF3; R = OEt, Ph) with acetonitrile quantitatively gave a new class of biscarbonyl complexes, cis,trans[Re(X2bpy)(CO)2(PR3)(MeCN)]+, coordinated with four different kinds of ligands. Similarly, other biscarbonylrhenium complexes, cis,trans-[Re(X2bpy)(CO)2(PR3)(Y)]n+ (n = 0, Y = Cl-; n = 1, Y = pyridine, PR'3), were synthesized in good yields via photochemical ligand substitution reactions. The structure of cis,trans-[Re(Me2bpy)(CO)2[P(OEt)3](PPh3)](PF6) was determined by X-ray analysis. Crystal data: C38H42N2O5F6P3Re, monoclinic, P2(1/a), a = 11.592(1) A, b = 30.953(4) A, c = 11.799(2) A, V = 4221.6(1) A3, Z = 4, 7813 reflections, R = 0.066. The biscarbonyl complexes with two phosphorus ligands were strongly emissive from their 3MLCT state with lifetimes of 20-640 ns in fluid solutions at room temperature. Only weak or no emission was observed in the cases Y = Cl-, MeCN, and pyridine. Electrochemical reduction of the biscarbonyl complexes with Y = Cl- and pyridine in MeCN resulted in efficient ligand substitution to give the solvento complexes cis,trans-[Re(X2bpy)(CO)2(PR3)(MeCN)]+.

Journal Article↗
PubMed2001

Oxygen atom transfer from nitrogenous ReVO reagents to diphosphines and subsequent transformations. Rhenium(III) products and reaction models.

The concerned diphosphines are Ph2P(CH2)nPPh2 (1), abbreviated PnP, and the ReVO reagents are ReOCl3L (2) and ReOCl3L' (3), where L and L' are the azopyridine and pyridine-imine ligands p-ClC6H4N=NC5H4N and p-MeC6H4N=CHC5H4N, respectively. One atom transfer from 2 to 1 has afforded Re(OPnP)Cl3L (4a, n = 1; 4b, n = 2; 4c, n = 3). Of these 4b and 4c are stable, but 4a undergoes spontaneous isomerization to Re(PlPO)Cl3L (5) in solution. Two-atom transfer studied with both 2 and 3 has afforded binuclear LCl3Re(OPnPO)ReCl3L (8a, n = 2; 8b, n = 3) and L'Cl3Re(OPnPO)ReCl3L' (9a, n = 2; 9b, n = 3) for n = 2, 3 and mononuclear Re(OP1PO)Cl3L (11) and Re(OP1PO)Cl3L' (12) for n = 1. The mixed system L'Cl3Re(OP2PO)ReCl3L (10) has been prepared from 3 and 4b. The complex Re(PPh3)Cl3L (7a) is furnished by the reaction of Re(OPPh3)Cl3L (6a) or 4b or 11 with PPh3. The species have been characterized with the help of spectral, electrochemical, and X-ray structural data. All the complexes have mer geometry except 5 and 7a, which have fac geometry. The latter is best suited for concurrent Re-N and Re-P back-bonding. Variable-temperature rate data of the reaction 4a-->5 are consistent with an intramolecular strongly associative transition state (delta S++, -22.6 eu) in which the dangling phosphine function lies close to the metal. Two-atom transfer to P1P is believed to proceed via a transient binuclear intermediate which undergoes cleavage at one end due to steric crowding, affording 11 and 12. Crystal data for the complexes are as follows: 5.1.5 C6H6, empirical formula C45H39Cl4N3OP2Re, crystal system triclinic, space group P1, a = 10.034(2) A, b = 10.737(2) A, c = 20.357(4) A, alpha = 89.38(3) degrees, beta = 87.79(3) degrees, gamma = 80.22(3) degrees, V = 2159.7(7) A3, Z = 2; 7a.CH2Cl2, empirical formula C30H25Cl6N3PRe, crystal system monoclinic, space group P2(1)/n, a = 11.695(6) A, b = 17.745(7) A, c = 15.459(9) A, beta = 100.94(5) degrees, V = 3150(3) A3, Z = 4; 9a, empirical formula C52H48Cl6N4O2P2Re2, crystal system monoclinic, space group C2/c, a = 19.769(12) A, b = 12.864(6) A, c = 22.20(2) A, beta = 101.76(6) degrees, V = 5530(6) A3, Z = 4; 11, empirical formula C36H30Cl4N3O2P2Re, crystal system monoclinic, space group I2/a, a = 16.866(6) A, b = 12.583(6) A, c = 34.78(2) A, beta = 99.22(4) degrees, V = 7285(7) A3, Z = 8.

Journal Article↗