Gastrointestinal permeability following cardiopulmonary bypass : a randomised study comparing the effects of dopamine and dopexamine
To compare the effects of dopexamine and dopamine on the mucosal permeability of the gastrointestinal tract (GIT). Prospective, randomised clinical trial. Intensive care unit of a postgraduate teaching hospital, London, England. Thirty patients undergoing elective surgery involving cardiopulmonary b...
Gespeichert in:
| Veröffentlicht in: | Intensive care medicine 1997-05, Vol.23 (5), p.510-516 |
|---|---|
| Hauptverfasser: | , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 516 |
|---|---|
| container_issue | 5 |
| container_start_page | 510 |
| container_title | Intensive care medicine |
| container_volume | 23 |
| creator | SINCLAIR, D. G HOULDSWORTH, P. E KEOGH, B PEPPER, J EVANS, T. W |
| description | To compare the effects of dopexamine and dopamine on the mucosal permeability of the gastrointestinal tract (GIT).
Prospective, randomised clinical trial.
Intensive care unit of a postgraduate teaching hospital, London, England.
Thirty patients undergoing elective surgery involving cardiopulmonary bypass, performed by a single surgeon.
Patients were randomly assigned to receive either dopexamine 2.0 micrograms/kg per min or dopamine 2.5 micrograms/kg per min for the duration of the study period.
Hemodynamic parameters and gastric intramucosal pH (pHi) were measured at intervals throughout the study. GIT permeability was measured once, post-operatively, using the ratio of absorbed lactulose to L-rhamnose. The groups were similar with respect to demographics, pre- and post-operative risk factors. The lactulose/rhamnose ratio was (mean +/- SEM) 0.44 +/- 0.10 in the dopexamine group vs 0.65 +/- 0.08 in that receiving dopamine (p < 0.05). The dopexamine group had a significantly higher oxygen delivery preoperatively (479.5 +/- 32.0 ml/min per m2 vs 344.4 +/- 23.9 ml/min per m2 for dopamine, p < 0.01), but no other significant differences emerged between the groups.
Compared to dopamine, dopexamine reduces GIT permeability following surgery involving cardiopulmonary bypass. The mechanism of this effect remains unclear. |
| doi_str_mv | 10.1007/s001340050366 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_79084493</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2656775861</sourcerecordid><originalsourceid>FETCH-LOGICAL-c378t-5a7dad44386f6189bb745fbaebb825f4339b72d8896059340f0418952aac64643</originalsourceid><addsrcrecordid>eNp9kc1rFTEUxYNY6rO6dCkELOJmNF-TybiTorVQcKPr4eZLU2YmYzKDvr1_eO9rHwVduLpc7u-em5xDyAvO3nLGuneVMS4VYy2TWj8iO66kaLiQ5jHZMalEo7QST8jTWm-Q7HTLT8lpLxhvhdiRP5dQ15LTvIa6phlGuoQyBbBpTOuexjyO-Veav1MHxae8bOOUZyh7avcL1ErfU6AFZp-nVIOndd38nro8LVAOW-uPQEOMwa2V5kh9XmBKc6C4cWjC77v2GTmJMNbw_FjPyLdPH79efG6uv1xeXXy4bpzszNq00HnwSkmjo-amt7ZTbbQQrDWijUrK3nbCG9Nr1vboSWQKsVYAOI0uyDPy-l53Kfnnhh8e8NUujCPMIW916HpmlOolgm_-C3I0Eo8o1iP66h_0Jm8FjbyjBMdcBEOquadcybWWEIelpAl9RGg4xDj8FSPyL4-qm52Cf6CPueH8_DiH6mCMGIFL9QET2qgO9W4BHUGlJQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1012105020</pqid></control><display><type>article</type><title>Gastrointestinal permeability following cardiopulmonary bypass : a randomised study comparing the effects of dopamine and dopexamine</title><source>MEDLINE</source><source>SpringerLink</source><creator>SINCLAIR, D. G ; HOULDSWORTH, P. E ; KEOGH, B ; PEPPER, J ; EVANS, T. W</creator><creatorcontrib>SINCLAIR, D. G ; HOULDSWORTH, P. E ; KEOGH, B ; PEPPER, J ; EVANS, T. W</creatorcontrib><description>To compare the effects of dopexamine and dopamine on the mucosal permeability of the gastrointestinal tract (GIT).
Prospective, randomised clinical trial.
Intensive care unit of a postgraduate teaching hospital, London, England.
Thirty patients undergoing elective surgery involving cardiopulmonary bypass, performed by a single surgeon.
Patients were randomly assigned to receive either dopexamine 2.0 micrograms/kg per min or dopamine 2.5 micrograms/kg per min for the duration of the study period.
Hemodynamic parameters and gastric intramucosal pH (pHi) were measured at intervals throughout the study. GIT permeability was measured once, post-operatively, using the ratio of absorbed lactulose to L-rhamnose. The groups were similar with respect to demographics, pre- and post-operative risk factors. The lactulose/rhamnose ratio was (mean +/- SEM) 0.44 +/- 0.10 in the dopexamine group vs 0.65 +/- 0.08 in that receiving dopamine (p < 0.05). The dopexamine group had a significantly higher oxygen delivery preoperatively (479.5 +/- 32.0 ml/min per m2 vs 344.4 +/- 23.9 ml/min per m2 for dopamine, p < 0.01), but no other significant differences emerged between the groups.
Compared to dopamine, dopexamine reduces GIT permeability following surgery involving cardiopulmonary bypass. The mechanism of this effect remains unclear.</description><identifier>ISSN: 0342-4642</identifier><identifier>EISSN: 1432-1238</identifier><identifier>DOI: 10.1007/s001340050366</identifier><identifier>PMID: 9201522</identifier><identifier>CODEN: ICMED9</identifier><language>eng</language><publisher>Heidelberg: Springer</publisher><subject>Adult ; Aged ; Analysis of Variance ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; APACHE ; Biological and medical sciences ; Biological Transport - drug effects ; Carbohydrates - pharmacokinetics ; Cardiopulmonary Bypass - adverse effects ; Catheters ; clinical trials ; demography ; Dopamine ; Dopamine - analogs & derivatives ; Dopamine - pharmacology ; Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care ; Female ; Fentanyl ; Gastrointestinal Diseases - drug therapy ; Gastrointestinal Diseases - etiology ; Glucose - pharmacokinetics ; Hemodynamics ; Hemodynamics - drug effects ; Hospitals ; Humans ; Intensive care ; Intensive care medicine ; intervention ; Intestinal Absorption - drug effects ; Intestinal Mucosa - drug effects ; Intestinal Mucosa - metabolism ; Ischemia ; Laboratories ; Lactulose - pharmacokinetics ; Male ; Medical personnel ; Medical sciences ; Middle Aged ; Mortality ; Oxygen ; Permeability ; Permeability - drug effects ; Prospective Studies ; Rhamnose - pharmacokinetics ; Risk factors ; Surgery ; Treatment Outcome ; Urine ; Ventilators ; Xylose - pharmacokinetics</subject><ispartof>Intensive care medicine, 1997-05, Vol.23 (5), p.510-516</ispartof><rights>1997 INIST-CNRS</rights><rights>Springer-Verlag Berlin Heidelberg 1997</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c378t-5a7dad44386f6189bb745fbaebb825f4339b72d8896059340f0418952aac64643</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2684701$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9201522$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>SINCLAIR, D. G</creatorcontrib><creatorcontrib>HOULDSWORTH, P. E</creatorcontrib><creatorcontrib>KEOGH, B</creatorcontrib><creatorcontrib>PEPPER, J</creatorcontrib><creatorcontrib>EVANS, T. W</creatorcontrib><title>Gastrointestinal permeability following cardiopulmonary bypass : a randomised study comparing the effects of dopamine and dopexamine</title><title>Intensive care medicine</title><addtitle>Intensive Care Med</addtitle><description>To compare the effects of dopexamine and dopamine on the mucosal permeability of the gastrointestinal tract (GIT).
Prospective, randomised clinical trial.
Intensive care unit of a postgraduate teaching hospital, London, England.
Thirty patients undergoing elective surgery involving cardiopulmonary bypass, performed by a single surgeon.
Patients were randomly assigned to receive either dopexamine 2.0 micrograms/kg per min or dopamine 2.5 micrograms/kg per min for the duration of the study period.
Hemodynamic parameters and gastric intramucosal pH (pHi) were measured at intervals throughout the study. GIT permeability was measured once, post-operatively, using the ratio of absorbed lactulose to L-rhamnose. The groups were similar with respect to demographics, pre- and post-operative risk factors. The lactulose/rhamnose ratio was (mean +/- SEM) 0.44 +/- 0.10 in the dopexamine group vs 0.65 +/- 0.08 in that receiving dopamine (p < 0.05). The dopexamine group had a significantly higher oxygen delivery preoperatively (479.5 +/- 32.0 ml/min per m2 vs 344.4 +/- 23.9 ml/min per m2 for dopamine, p < 0.01), but no other significant differences emerged between the groups.
Compared to dopamine, dopexamine reduces GIT permeability following surgery involving cardiopulmonary bypass. The mechanism of this effect remains unclear.</description><subject>Adult</subject><subject>Aged</subject><subject>Analysis of Variance</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>APACHE</subject><subject>Biological and medical sciences</subject><subject>Biological Transport - drug effects</subject><subject>Carbohydrates - pharmacokinetics</subject><subject>Cardiopulmonary Bypass - adverse effects</subject><subject>Catheters</subject><subject>clinical trials</subject><subject>demography</subject><subject>Dopamine</subject><subject>Dopamine - analogs & derivatives</subject><subject>Dopamine - pharmacology</subject><subject>Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care</subject><subject>Female</subject><subject>Fentanyl</subject><subject>Gastrointestinal Diseases - drug therapy</subject><subject>Gastrointestinal Diseases - etiology</subject><subject>Glucose - pharmacokinetics</subject><subject>Hemodynamics</subject><subject>Hemodynamics - drug effects</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Intensive care</subject><subject>Intensive care medicine</subject><subject>intervention</subject><subject>Intestinal Absorption - drug effects</subject><subject>Intestinal Mucosa - drug effects</subject><subject>Intestinal Mucosa - metabolism</subject><subject>Ischemia</subject><subject>Laboratories</subject><subject>Lactulose - pharmacokinetics</subject><subject>Male</subject><subject>Medical personnel</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Oxygen</subject><subject>Permeability</subject><subject>Permeability - drug effects</subject><subject>Prospective Studies</subject><subject>Rhamnose - pharmacokinetics</subject><subject>Risk factors</subject><subject>Surgery</subject><subject>Treatment Outcome</subject><subject>Urine</subject><subject>Ventilators</subject><subject>Xylose - pharmacokinetics</subject><issn>0342-4642</issn><issn>1432-1238</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1997</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kc1rFTEUxYNY6rO6dCkELOJmNF-TybiTorVQcKPr4eZLU2YmYzKDvr1_eO9rHwVduLpc7u-em5xDyAvO3nLGuneVMS4VYy2TWj8iO66kaLiQ5jHZMalEo7QST8jTWm-Q7HTLT8lpLxhvhdiRP5dQ15LTvIa6phlGuoQyBbBpTOuexjyO-Veav1MHxae8bOOUZyh7avcL1ErfU6AFZp-nVIOndd38nro8LVAOW-uPQEOMwa2V5kh9XmBKc6C4cWjC77v2GTmJMNbw_FjPyLdPH79efG6uv1xeXXy4bpzszNq00HnwSkmjo-amt7ZTbbQQrDWijUrK3nbCG9Nr1vboSWQKsVYAOI0uyDPy-l53Kfnnhh8e8NUujCPMIW916HpmlOolgm_-C3I0Eo8o1iP66h_0Jm8FjbyjBMdcBEOquadcybWWEIelpAl9RGg4xDj8FSPyL4-qm52Cf6CPueH8_DiH6mCMGIFL9QET2qgO9W4BHUGlJQ</recordid><startdate>19970501</startdate><enddate>19970501</enddate><creator>SINCLAIR, D. G</creator><creator>HOULDSWORTH, P. E</creator><creator>KEOGH, B</creator><creator>PEPPER, J</creator><creator>EVANS, T. W</creator><general>Springer</general><general>Springer Nature B.V</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M7Z</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7U1</scope><scope>7U2</scope><scope>C1K</scope><scope>7X8</scope></search><sort><creationdate>19970501</creationdate><title>Gastrointestinal permeability following cardiopulmonary bypass : a randomised study comparing the effects of dopamine and dopexamine</title><author>SINCLAIR, D. G ; HOULDSWORTH, P. E ; KEOGH, B ; PEPPER, J ; EVANS, T. W</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c378t-5a7dad44386f6189bb745fbaebb825f4339b72d8896059340f0418952aac64643</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1997</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Analysis of Variance</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>APACHE</topic><topic>Biological and medical sciences</topic><topic>Biological Transport - drug effects</topic><topic>Carbohydrates - pharmacokinetics</topic><topic>Cardiopulmonary Bypass - adverse effects</topic><topic>Catheters</topic><topic>clinical trials</topic><topic>demography</topic><topic>Dopamine</topic><topic>Dopamine - analogs & derivatives</topic><topic>Dopamine - pharmacology</topic><topic>Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care</topic><topic>Female</topic><topic>Fentanyl</topic><topic>Gastrointestinal Diseases - drug therapy</topic><topic>Gastrointestinal Diseases - etiology</topic><topic>Glucose - pharmacokinetics</topic><topic>Hemodynamics</topic><topic>Hemodynamics - drug effects</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Intensive care</topic><topic>Intensive care medicine</topic><topic>intervention</topic><topic>Intestinal Absorption - drug effects</topic><topic>Intestinal Mucosa - drug effects</topic><topic>Intestinal Mucosa - metabolism</topic><topic>Ischemia</topic><topic>Laboratories</topic><topic>Lactulose - pharmacokinetics</topic><topic>Male</topic><topic>Medical personnel</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Oxygen</topic><topic>Permeability</topic><topic>Permeability - drug effects</topic><topic>Prospective Studies</topic><topic>Rhamnose - pharmacokinetics</topic><topic>Risk factors</topic><topic>Surgery</topic><topic>Treatment Outcome</topic><topic>Urine</topic><topic>Ventilators</topic><topic>Xylose - pharmacokinetics</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>SINCLAIR, D. G</creatorcontrib><creatorcontrib>HOULDSWORTH, P. E</creatorcontrib><creatorcontrib>KEOGH, B</creatorcontrib><creatorcontrib>PEPPER, J</creatorcontrib><creatorcontrib>EVANS, T. W</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Nursing & Allied Health Database</collection><collection>ProQuest Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Biochemistry Abstracts 1</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>Risk Abstracts</collection><collection>Safety Science and Risk</collection><collection>Environmental Sciences and Pollution Management</collection><collection>MEDLINE - Academic</collection><jtitle>Intensive care medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>SINCLAIR, D. G</au><au>HOULDSWORTH, P. E</au><au>KEOGH, B</au><au>PEPPER, J</au><au>EVANS, T. W</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Gastrointestinal permeability following cardiopulmonary bypass : a randomised study comparing the effects of dopamine and dopexamine</atitle><jtitle>Intensive care medicine</jtitle><addtitle>Intensive Care Med</addtitle><date>1997-05-01</date><risdate>1997</risdate><volume>23</volume><issue>5</issue><spage>510</spage><epage>516</epage><pages>510-516</pages><issn>0342-4642</issn><eissn>1432-1238</eissn><coden>ICMED9</coden><abstract>To compare the effects of dopexamine and dopamine on the mucosal permeability of the gastrointestinal tract (GIT).
Prospective, randomised clinical trial.
Intensive care unit of a postgraduate teaching hospital, London, England.
Thirty patients undergoing elective surgery involving cardiopulmonary bypass, performed by a single surgeon.
Patients were randomly assigned to receive either dopexamine 2.0 micrograms/kg per min or dopamine 2.5 micrograms/kg per min for the duration of the study period.
Hemodynamic parameters and gastric intramucosal pH (pHi) were measured at intervals throughout the study. GIT permeability was measured once, post-operatively, using the ratio of absorbed lactulose to L-rhamnose. The groups were similar with respect to demographics, pre- and post-operative risk factors. The lactulose/rhamnose ratio was (mean +/- SEM) 0.44 +/- 0.10 in the dopexamine group vs 0.65 +/- 0.08 in that receiving dopamine (p < 0.05). The dopexamine group had a significantly higher oxygen delivery preoperatively (479.5 +/- 32.0 ml/min per m2 vs 344.4 +/- 23.9 ml/min per m2 for dopamine, p < 0.01), but no other significant differences emerged between the groups.
Compared to dopamine, dopexamine reduces GIT permeability following surgery involving cardiopulmonary bypass. The mechanism of this effect remains unclear.</abstract><cop>Heidelberg</cop><cop>Berlin</cop><pub>Springer</pub><pmid>9201522</pmid><doi>10.1007/s001340050366</doi><tpages>7</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0342-4642 |
| ispartof | Intensive care medicine, 1997-05, Vol.23 (5), p.510-516 |
| issn | 0342-4642 1432-1238 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_79084493 |
| source | MEDLINE; SpringerLink |
| subjects | Adult Aged Analysis of Variance Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy APACHE Biological and medical sciences Biological Transport - drug effects Carbohydrates - pharmacokinetics Cardiopulmonary Bypass - adverse effects Catheters clinical trials demography Dopamine Dopamine - analogs & derivatives Dopamine - pharmacology Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care Female Fentanyl Gastrointestinal Diseases - drug therapy Gastrointestinal Diseases - etiology Glucose - pharmacokinetics Hemodynamics Hemodynamics - drug effects Hospitals Humans Intensive care Intensive care medicine intervention Intestinal Absorption - drug effects Intestinal Mucosa - drug effects Intestinal Mucosa - metabolism Ischemia Laboratories Lactulose - pharmacokinetics Male Medical personnel Medical sciences Middle Aged Mortality Oxygen Permeability Permeability - drug effects Prospective Studies Rhamnose - pharmacokinetics Risk factors Surgery Treatment Outcome Urine Ventilators Xylose - pharmacokinetics |
| title | Gastrointestinal permeability following cardiopulmonary bypass : a randomised study comparing the effects of dopamine and dopexamine |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-01T12%3A20%3A47IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Gastrointestinal%20permeability%20following%20cardiopulmonary%20bypass%20:%20a%20randomised%20study%20comparing%20the%20effects%20of%20dopamine%20and%20dopexamine&rft.jtitle=Intensive%20care%20medicine&rft.au=SINCLAIR,%20D.%20G&rft.date=1997-05-01&rft.volume=23&rft.issue=5&rft.spage=510&rft.epage=516&rft.pages=510-516&rft.issn=0342-4642&rft.eissn=1432-1238&rft.coden=ICMED9&rft_id=info:doi/10.1007/s001340050366&rft_dat=%3Cproquest_cross%3E2656775861%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1012105020&rft_id=info:pmid/9201522&rfr_iscdi=true |