ABSTRACT
Electron-transfer(ET) from organic sulfides to excited state rhenium(I)-based heteroleptic tricarbonyl complexes [Re(bpy)(CO)(3)(py)](+) (I) and [Re(bpy)(CO)(3)(ind))](+) (II) in acetonitrile solution is facile and luminescence quenching constants, k(q), are in the range 10(5)-10(8) M(-1)s(-1). The detection of the sulfide radical cation in this system using time-resolved absorption spectroscopy is a direct evidence for the ET nature of the reaction. The k(q) values for the quenching of Re(I)-complexes with organic sulfides are analyzed with a scheme involving rate controlling electron transfer process. The measured rate constants for the electron transfer (ET) reaction are close to the values calculated from Marcus theory.
Subject(s)
Luminescence , Organometallic Compounds/chemistry , Rhenium/chemistry , Sulfides/chemistry , Electron Transport , Luminescent Measurements , Molecular Structure , Organometallic Compounds/chemical synthesis , StereoisomerismABSTRACT
BACKGROUND: The management of an appendix mass in children is controversial. An experience of conservative management of appendix masses in a paediatric population over the last 19 years is reviewed. METHODS: The medical records of all children who presented with an appendix mass to one of three children's hospitals between 1982 and 2000 were reviewed. In that interval 427 children with a mean age of 7.3 years (range from 2 months to 18 years) presented with an appendix mass. Sixteen children had an immediate appendicectomy. The remaining 411 children were treated conservatively by close observation and antibiotics, with intravenous fluids and nasogastric suction if required. Once the child was well enough for discharge home, elective appendicectomy was booked for 4-6 weeks later. RESULTS: Three hundred and forty-six (84.2 per cent) of the children responded to initial conservative management and were discharged after a median stay of 6 (range 3-24) days. The children returned 4-6 weeks later for elective appendicectomy. The complication rate for elective appendicectomy was 2.3 per cent (eight patients). Those who had an uncomplicated elective appendicectomy had a median hospital stay of 3 (range 1-6) days. Histological examination demonstrated acute or subacute inflammation in 50.8 per cent of appendices removed at elective appendicectomy. CONCLUSION: Non-operative management of an appendix mass followed by elective appendicectomy is a safe and effective method of management.
Subject(s)
Appendix , Cecal Diseases/therapy , Adolescent , Anti-Bacterial Agents/therapeutic use , Appendectomy/methods , Appendix/surgery , Cecal Diseases/drug therapy , Cecal Diseases/surgery , Child , Child, Preschool , Elective Surgical Procedures/methods , Female , Humans , Infant , Length of Stay , Male , Treatment OutcomeABSTRACT
PURPOSE: We compared the incidence of renal scarring in infants with high grade vesicoureteral reflux in those presenting with and without urinary tract infection. METHODS AND METHODS: We reviewed the medical records of 81 male and 46 female infants (194 renal refluxing units) with a mean age of 4 months who had grade IV or V primary vesicoureteral reflux and underwent an anti-reflux procedure between 1984 and 1997. Dimercapto-succinic acid (DMSA) scans and voiding cystourethrography were performed in all cases. Patients were followed for 2 to 16 years, including 90% for greater than 3 years. Renal ultrasound and DMSA scan were done at followup. RESULTS: A total of 97 patients (76%) (148 refluxing renal units) presented clinically with urinary tract infection. The initial DMSA scan demonstrated renal scarring in 40 of the 106 grade IV (38%) and 28 of the 42 grade V (67%) refluxing renal units. There was no scarring on followup in previously normal refluxing renal units. Of the patients 30 (24%) (46 refluxing renal units) were diagnosed before a urinary tract infection developed, 16 underwent screening due to vesicoureteral reflux in a sibling and in 10 reflux was initially suspected due to hydronephrosis on prenatal ultrasound. In the remaining 4 patients vesicoureteral reflux was suspected during abdominal ultrasound to investigate abdominal pain, jaundice, associated hypospadias and fetal alcohol syndrome, respectively. DMSA scan showed evidence of scarring in 6 of 21 grade IV (29%) and 9 of 25 grade V (36%) refluxing renal units in this group. Followup revealed scarring in only 1 previously normal refluxing renal unit. CONCLUSIONS: The incidence of reflux nephropathy in primary grade V vesicoureteral reflux is lower in cases detected by screening and with treatment it remained lower than in cases of urinary tract infection that presented clinically. Early treatment of grade V vesicoureteral reflux made possible by screening may prevent renal damage.
