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Fujii T, Misumi S, Shibasaki T, Tamura M, Kunimine H, Hayakawa K, Niibe H, Miyazaki M, Miyagi O. [Treatment of delayed brain injury after pituitary irradiation]. NO SHINKEI GEKA. NEUROLOGICAL SURGERY 1988; 16:241-7. [PMID: 2453809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Treatment for delayed brain injury after pituitary irradiation is discussed. Six cases with delayed brain injury were treated with a combination of dexamethasone or betamethasone, with heparin, glycerol, dextran 40 and some vasodilators. Two cases with temporal lobe syndrome were treated in the early stages of brain injury for a period of over 12 months were almost completely cured, another two cases with chiasma syndrome were treated in the relatively late stages, showed a partial improvement. One case which was irradiated 120 GY during 13 years did not improve. The final case treated with steroids for a short period also resulted in failure and the patient underwent an operation for the removal of the necrotic mass three years after the radiotherapy. Steroid therapy started in the early stages of brain injury after irradiation for over the 12 months is thought to be effective. Heparin therapy was also effective in one out of three cases, but in one of the cases subarachnoid hemorrhage from a traumatic aneurysm occurred during the therapy. In an acute phase, showing edematous change of the injured brain, the administration of glycerol is also thought to be useful. But the effectiveness of the other medicines containing some vasodilators was obscure or doubtful. We propose the following: (1) A meticulous observation is essential for the patients who received high doses of irradiation to diagnose brain injury in the early reversible stage. (2) Steroids should be given immediately in this reversible stage of brain injury before the irreversible "necrosis" occurs. (3) Steroids should be maintained for a long period over 12 months.(ABSTRACT TRUNCATED AT 250 WORDS)
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Fujii T, Misumi S, Onoda K, Fukuda H, Ibuki Y. Pituitary enlargement with target organ deficiency: hypothyroidism and hypogonadism. SURGICAL NEUROLOGY 1987; 28:390-4. [PMID: 3660210 DOI: 10.1016/0090-3019(87)90064-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Three women with pituitary enlargements associated with preexisting target organ failures are reported. Two pituitary enlargements owing to primary hypothyroidism and one to primary hypogonadism were shown to be regressed on computed tomography after the replacement therapy. Clinically and pathologically, the differentiation of a pituitary hyperplasia from a pituitary adenoma is often very difficult. Moreover, the treatments for these conditions are quite different. Adequate medication can diminish a pituitary enlargement because of the feedback mechanism. Existence of the target organ deficiency should always be checked before the management of pituitary tumor.
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28
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Naganuma H, Fukamachi A, Kawakami M, Misumi S, Nakajima H, Wakao T. Spontaneous resolution of chronic subdural hematomas. Neurosurgery 1986; 19:794-8. [PMID: 3785628 DOI: 10.1227/00006123-198611000-00013] [Citation(s) in RCA: 47] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Four patients with chronic subdural hematomas, all of which resolved spontaneously, were followed from the time of injury to resolution of the chronic subdural hematoma. Periodic computed tomographic (CT) scans showed spontaneous resolution 78, 174, 231, and 326 days after the development of the chronic subdural hematoma, respectively. Features of the CT scans and a possible mechanism of spontaneous resolution are discussed.
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Kakegawa T, Fujii T, Misumi S, Tamura M. [Growth hormone-producing pituitary adenoma in an 8-year-old girl: case report]. NO SHINKEI GEKA. NEUROLOGICAL SURGERY 1986; 14:1505-10. [PMID: 3808214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
A rare case of pituitary adenoma in childhood presenting as giantism is reported. A 6-year-old girl came to our attention in 1982 because of excessive growth noted since the age of 3 yr. Her appearance revealed giantism. She also had a 4 year history of genital bleeding, but no development of external genitalia nor mammary gland. Endocrinological studies revealed markedly elevated serum basal levels of both growth hormone (GH) and prolactin (PRL). She had a bromocriptine therapy for 1 year and 8 months, but it was difficult to suppress her excessive growth rate. So she was admitted at the age of 8 years to undergo the operation. Visual fields were intact. X-ray examination of the skull demonstrated a slightly enlarged sella turcica. Computerized tomography revealed an isodense mass at the pituitary fossa without extrasellar extention. Repeated endocrinological studies were carried out. Basal levels of GH and PRL were 43.8 ng/ml and 67 ng/ml. All other pituitary function were normal, except for puberal responses of luteinizing hormone (LH) and follicle stimulating hormone in LH-RH loading test. 50 g oral glucose tolerance test was normal. Transsphenoidal microsurgery was performed in August 1984. The tumor filled up the pituitary fossa with fibrous element. Histological examination disclosed a mixed adenoma, predominantly chromophobe, with a few granulated eosinophils. Immunoperoxidase staining was also performed on the adenoma. Most of the tumor cells stained for GH, and a few of them stained for PRL. Postoperatively hypopituitalism was not complicated. Surgery produced a decrease in serum PRL level under 20 ng/ml, but serum GH level was not enough reduced under 10 ng/ml.(ABSTRACT TRUNCATED AT 250 WORDS)
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Fujii T, Misumi S, Onoda K, Takeda F. Simple management of cerebrospinal fluid rhinorrhea after pituitary surgery. SURGICAL NEUROLOGY 1986; 26:345-8. [PMID: 2428122 DOI: 10.1016/0090-3019(86)90134-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
A simple procedure for managing postoperative cerebrospinal fluid rhinorrhea after pituitary surgery is described. Under local anesthesia, a needle is introduced manually through a nostril toward the sella turcica and EDH adhesive or fibrin glue is injected into the sellar cavity or sphenoid sinus, or both. This procedure is simple and safe to perform, acceptable to the patient, and can be done in a short hospital stay.
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31
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Ono N, Inoue HK, Naganuma H, Misumi S, Tamura M. Germ cell tumor in the basal ganglia: immunohistochemical demonstration of alpha-fetoprotein, human chorionic gonadotropin, and carcinoembryonic antigen. SURGICAL NEUROLOGY 1986; 25:495-500. [PMID: 2421426 DOI: 10.1016/0090-3019(86)90090-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
A case of germ cell tumor in the basal ganglia and its vicinity was successfully treated surgically and by radiation. alpha-Fetoprotein, human chorionic gonadotropin, and carcinoembryonic antigen were found in the tumor tissue, using the immunoperoxidase method. The presence of three immunohistochemically demonstrated tumor markers in a single germ cell tumor is extremely unusual. These results strongly suggest a cell differentiation or transformation in germ cell tumors.
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32
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Nakashima K, Nakatsuji S, Akiyama S, Kaneda T, Misumi S. The complexation of "crowned" 4-(2,4-dinitrophenylazo)phenol with alkali and alkaline earth metal ions, and its application to the determination of Li(I) in a pharmaceutical preparation. Chem Pharm Bull (Tokyo) 1986; 34:168-73. [PMID: 3754492 DOI: 10.1248/cpb.34.168] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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33
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Fukamachi A, Kohno K, Nagaseki Y, Misumi S, Kunimine H, Wakao T. The incidence of delayed traumatic intracerebral hematoma with extradural hemorrhages. THE JOURNAL OF TRAUMA 1985; 25:145-9. [PMID: 3973942 DOI: 10.1097/00005373-198502000-00010] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
After introduction of computerized tomography (CT), we experienced 22 patients with traumatic extradural and intracerebral combined hematomas, of whom 15 underwent sequential CT scans. In 14 of the 22 patients or 13 of the 15 patients whose initial CT scans were performed early, within 6 hours after injury, intracerebral hematomas developed more slowly than extradural hematomas. In ten of the 13 patients, development of intracerebral hematomas was demonstrated only after removal of extradural hematomas, and in four patients acute brain swelling was observed during surgery. Therefore it is emphasized that the incidence of post-surgical intracerebral hematoma with extradural hemorrhages is high and that acute brain swelling during surgery for extradural hematomas is largely caused by the delayed intracerebral hematomas.
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Fujii T, Misumi S, Takeda F. Management of polyuria subsequent to pituitary surgery based on the diurnal pattern of urinary excretion. SURGICAL NEUROLOGY 1985; 23:49-55. [PMID: 3964977 DOI: 10.1016/0090-3019(85)90159-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Polyuria subsequent to pituitary surgery was studied in 64 cases. Most cases of postoperative polyuria were due to diabetes insipidus. These cases showed a triphasic pattern in daily urinary volume. Observation of hourly urinary volume in polyuria revealed four diurnal patterns of urinary excretion: rhythmic, continuous, transient, and unspecific. Clinical observation of diurnal patterns has an advantage, in terms of simplicity of procedure, in immediately determining the nature of the polyuria, prognosticating diabetes insipidus, and eliminating inappropriate procedures in treatment. Indomethacin suppository is considered to be a favorable agent in reducing polyuria without disturbing the diurnal pattern in diabetes insipidus.
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Sasaki R, Misumi S, Fujii T, Takeda F, Yamamoto K. Quantitative measurement of the ability of human chromophobe adenomas to synthesize and release human growth hormone. AJNR Am J Neuroradiol 1985; 15 pt 1:7-11. [PMID: 60723 PMCID: PMC8367697 DOI: 10.2176/nmc.15pt1.7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
A retrospective review of 120 patients undergoing transsphenoidal surgery for pituitary adenomas revealed that computed tomography (CT) was less sensitive and less specific than hormonal methods in identifying residual functioning adenomas, However, CT was the only useful method of evaluating nonfunctioning tumors, including pseudoprolactinomas, Enlargement of the pituitary stalk, when seen on preoperative CT, was 100% predictive of “cure” if the enlargement returned to normal size on a remote follow-up scan (n = 8) and was 100% predictive of residual tumor if the enlargement persisted or evolved (n = 8), Resolution of stalk displacement was the next most reliable predictor of cure (91%, n = 11), but persistent displacement was less reliable than abnormal intrasellar enhancement in predicting the presence of residual tumor (71%, n = 28, vs. 81%, n = 26). Enhancement in the postoperative sella by other than normal pituitary gland was presumed to be due to inflammation in 19% of patients. Inflammatory enhancement was observed in the presence of autograft and homograft muscle plugs and, unlike enhancement due to untreated tumors, was observed to decrease in size and intensity with time. Intrasellar enhancement was an unreliable criterion of success or failure in cases of microadenoma. All 14 patients with functioning adenomas and preoperative parasellar tumor extension had persistent tumor at postoperative evaluation. Of the 47 patients with resected functioning adenomas who had CT scans showing empty or partly empty sellas after operation, 22 (47%) had hormonally detectable residual tumor.
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36
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Naganuma H, Inoue H, Misumi S, Nakamura M, Tamura M. Intracranial germ-cell tumors. Immunohistochemical study of three autopsy cases. J Neurosurg 1984; 61:931-7. [PMID: 6208344 DOI: 10.3171/jns.1984.61.5.0931] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Histological and immunohistochemical findings in three cases with primary intracranial germ-cell tumors are reported. Based on histological examination, they were diagnosed, respectively, as an endodermal sinus tumor with immature teratoid differentiation, teratoma and embryonal carcinoma, and choriocarcinoma and germinoma. The first case was presumed to be a combination of endodermal sinus tumor and germinoma. An immunohistochemical examination showed positive reactions to alpha-fetoprotein (AFP) and carcinoembryonic antigen (CEA) in the endodermal sinus tumor, and to human chorionic gonadotropin (HCG) in the choriocarcinoma, but showed no reaction in the embryonal carcinoma. Human chorionic gonadotropin was demonstrated in syncytiotrophoblastic cells and CEA in a gland-like structure. The value of measuring CEA in cases of germ-cell tumors, in addition to AFP and HCG assays, is stressed, and the characteristics of CEA-positive tissue are discussed.
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Fukamachi A, Misumi S, Kaneko M, Wakao T. Traumatic extradural hematomas with delayed development. COMPUTERIZED RADIOLOGY : OFFICIAL JOURNAL OF THE COMPUTERIZED TOMOGRAPHY SOCIETY 1984; 8:197-201. [PMID: 6478808 DOI: 10.1016/0730-4862(84)90123-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
After introduction of computerized tomography (CT), we experienced 74 patients with 78 traumatic extradural hematomas. Among these, 16 hematomas were subjected to sequential CT examinations in the early stage after injury. Four hematomas of four patients became enlarged, and another five hematomas of four patients were delayed. Accordingly the delayed extradural hematomas are thought to be less uncommon than previously believed. Three patients with four delayed extradural hematomas of surgical significance are reported, and pathogenesis of the delayed extradural hematoma is discussed.
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38
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Sakata Y, Akahori K, Hama F, Misumi S. Synthesis and Structure of Purinophanes with Fully Overlapped Conformation. HETEROCYCLES 1984. [DOI: 10.3987/s-1984-02-0574] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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39
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Hama F, Sakata Y, Misumi S. Synthesis, structure, and hypochromism of (2,9)(6,9)purinophane. NUCLEIC ACIDS SYMPOSIUM SERIES 1984:17-20. [PMID: 6549210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
Abstract
The title compound 1 was synthesized via 8 steps from phthalimide derivative 2. The molecular structure of 1 was determined by X-ray analysis and the relationship between the hypochromism and the stacking mode of two purine rings was discussed.
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40
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Tanigawa I, Kaneda T, Misumi S. Synthesis and Property of Fluorescent Polyether Dye Containing a Benzorhioazole Unit. HETEROCYCLES 1984. [DOI: 10.3987/s-1984-02-0763] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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41
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Fujii T, Misumi S, Onoda K, Kimura R, Naganuma H, Kawafuchi J, Fukuda H. [Pituitary enlargement due to primary hypothyroidism: diminution of tumor after replacement therapy for hypothyroidism: case report]. Neurol Med Chir (Tokyo) 1982; 22:677-81. [PMID: 6183611 DOI: 10.2176/nmc.22.677] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
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42
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Fujii T, Misumi S, Takeda F. [Diurnal patterns of urinary excretion during polyuria after pituitary surgery and its management (author's transl)]. Neurol Med Chir (Tokyo) 1981; 21:1105-12. [PMID: 6174882 DOI: 10.2176/nmc.21.1105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
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43
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Murata M, Inoue H, Misumi S, Shimizu T, Tamura M, Kawafuchi JI. [Diagnosis of tumors of the pituitary region by two-plane CT scans--with special reference to operative indication for the transsphenoidal approach (author's transl)]. Neurol Med Chir (Tokyo) 1981; 21:863-71. [PMID: 6172735 DOI: 10.2176/nmc.21.863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
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44
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Ono N, Misumi S, Nukui H, Kawafuchi JI. [Vasospasm following removal of a large pituitary adenoma by the subfrontal approach --report of a case and review of the literature (author's transl)]. Neurol Med Chir (Tokyo) 1981; 21:609-14. [PMID: 6167884 DOI: 10.2176/nmc.21.609] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
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45
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Misumi S, Shimizu T, Shibasaki T, Onoda K, Fujii T, Takeda F. [Transsphenoidal selective removal of the functioning pituitary microadenomas--operative results (author's transl)]. Neurol Med Chir (Tokyo) 1979; 19:817-26. [PMID: 91136 DOI: 10.2176/nmc.19.817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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46
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Inoue H, Ishikawa M, Misumi S, Uki J, Kawafuchi J, Takahashi K. [Skull base examination by computed tomography--model study and clinical value (author's transl)]. Neurol Med Chir (Tokyo) 1979; 19:439-47. [PMID: 89637 DOI: 10.2176/nmc.19.439] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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47
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Mizuno H, Nishiguchi K, Toyoda T, Otsubo T, Misumi S, Morimoto N. The crystal and molecular structure of centrosymmetric tetramethyl quadruple-layered cyclophane. ACTA ACUST UNITED AC 1977. [DOI: 10.1107/s0567740877003628] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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48
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Ohno H, Horita H, Otsubo T, Sakata Y, Misumi S. Layered compounds. XLI. Tricarbonylchromium complexes of multilayered [2.2]paracyclophanes. Tetrahedron Lett 1977. [DOI: 10.1016/s0040-4039(01)92609-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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49
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Okada T, Fujita T, Kubota M, Masaki S, Mataga N, Ide R, Sakata Y, Misumi S. Intramolecular electron donor-acceptor interactions in the excited state of (anthracene)-(CH2)n-(N,N-dimethylaniline) systems. Chem Phys Lett 1972. [DOI: 10.1016/0009-2614(72)87208-7] [Citation(s) in RCA: 129] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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50
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Misumi S. Polarographic studies of cadmium, zinc and manganese(II) iodide complexes in acetonitrile. Talanta 1972; 19:549-57. [DOI: 10.1016/0039-9140(72)80116-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/1971] [Accepted: 09/01/1971] [Indexed: 11/27/2022]
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