bluuebunny/crossref_metadata_2025 huggingface dataset:
Thermomechanical analysis of ultra-high molecular weight polyethylene-metal hip prostheses
Authors: Rocchi M , Affatato S , Falasca G , Viceconti M
Published: September 2007

In order to predict the frictional heating and the contact stresses between the polyethylene cup and the metallic ball-head forming the articulation of a hip prosthesis a three-dimensional finite element model was developed and calculated. The non-linear model includes a fully coupled thermomechanical formulation of the mechanical properties of the ultra-high-molecular-weight polyethylene, and a large-sliding Coulomb frictional contact between the two components. The model predicts the temperature of the polyethylene with an accuracy that was tested by comparing the model predictions with the temperature measurements. The temperature measurements were taken by thermocouples placed on the cup surface, the head surface and the inside of the thermostatic bath, during a complete test within a hip joint wear simulator. The model was found to be very accurate, predicting the measured temperatures with an accuracy better than 2 per cent. The temperature peak (51 °C) was predicted at the contact surface. The model results indicate that frictional heat is mostly dissipated through the metallic ball-head. The full coupling between the thermal and the mechanical conditions used in this study appears to be necessary if accurate predictions of the polyethylene deformation are required.
Measurement of laxity in the anterior cruciate ligament-deficient knee: A comparison of three different methods in vitro
Authors: Khan R T , Lie D T , Cashman P M , Thomas R W , Amis A A
Published: September 2007

The aim of this study was to compare in-vitro measurements of anteroposterior laxity in the anterior cruciate ligament (ACL)-deficient knee using three different methods: an Instron materials-testing machine, then a KT-2000 arthrometer, and finally by Roentgen stereophotogrammetric analysis (RSA). Eight ACL-deficient human cadaver knees were used. Total displacement was measured between 90 N anterior and 90 N posterior tibiofemoral drawer forces at both 20° and 90° knee flexion. Laxity ranged from 11.5 to 27.6 mm at 20° and from 8.7 to 23.9 mm at 90°. A statistically significant difference was not found between the mean RSA and KT-2000 measurements. However, the mean Instron measurements of laxity were significantly (3-4 mm) higher than both RSA and KT-2000 measurements. The clinical methods of RSA and the KT-2000 measurements agreed well but appeared to underestimate tibiofemoral anteroposterior laxity compared with the materials-testing machine. These findings may be helpful in the future comparison of different studies.
Measuring multi-dimensional, time-dependent mechanical properties of a human tibial fracture using an automated system
Authors: Ogrodnik P J , Moorcroft C I , Thomas P B
Published: September 2007

This paper presents an element of a long-term research project determining a clinically quantifiable end point for fracture healing in humans. An automated loading and measurement device is presented. It has been developed as a research tool for the assessment of the mechanical properties of a healing human tibial fracture. The device has been specifically designed for use with patients treated with external fixation. The characteristics of the device have been presented together with an assessment of errors. A typical sample of results has been presented to demonstrate the significance of the device; subsequent papers will examine the whole data set in greater depth. The results presented here confirm the non-linear behaviour of callus and reinforce the requirement to measure the load rate when measuring the fracture stiffness. A new material property for the assessment of fracture healing, namely γ, is examined and preliminary results are shown. Polar plots of stiffness demonstrate that, when measuring fracture stiffness, not only should the load rate be considered, but also the orientation of measurement. The results from this work support the view that the fracture stiffness should be measured in at least two planes. Currently a fracture can be considered healed when the fracture stiffness exceeds 15 N m/deg; this paper questions whether this value is now valid and suggests that it should be re-examined.
Generalized robust H∞ fault diagnosis filtering based on conditional stochastic distributions of system outputs
Authors: Guo L , Zhang Y
Published: September 2007

The efficiency of fault detection and diagnosis by using output probability density functions (PDFs) for stochastic time-delayed systems has been shown in practical processes. Neural network modelling has been applied to characterize the output PDFs and to the dynamical weighting system. In this paper, the system perturbations and disturbance are considered and the robust fault diagnosis design is studied for the general stochastic system in the presence of time delays. The main objective is to design linear matrix inequality (LMI)-based fault diagnostic filtering (FDF) to estimate the fault and attenuate the disturbances. The modelling errors and system uncertainties resulting from both B-spline expansion and the weighting system are merged into system disturbance. It can be seen that the resulting weighting system comprises non-linearities, uncertainties, disturbances, and time delays, and includes the non-zero initial condition. The generalized H∞ optimization is presented and applied to the fault diagnosis problem of the weighting system with the non-zero initial condition and truncated norms. Simulations are given to demonstrate the efficiency of the proposed approach.
Design of a fault-tolerant control scheme for two collaborative subsystems
Authors: Yao L , Wang A. P.
Published: September 2007

A fault-tolerant control method is proposed for a class of dynamic systems including two subsystems. These two subsystems work together in order to perform a joint task. The proposed fault-tolerant control aims at obtaining a control strategy that can use the healthy subsystem to compensate the faulty one. When one subsystem is subjected to faults, the other subsystem is used to accommodate faults and compensate the influences onto the total system, leading to a fault-tolerant control of the whole system. Theoretical analysis and computer simulations illustrate the validity of this method.
An interaction predictive approach to fault-tolerant control in network control systems
Authors: Kambhampati C , Perkgoz C , Patton R. J. , Ahamed W
Published: September 2007

This paper illustrates some of the capabilities of previously proposed network control system (NCS) architectures to carry on functioning in the event of faults, without recourse to system reconfiguration. The principle of interaction prediction is used to set up a coordination strategy that encapsulates an ability to withstand or tolerate certain faults, thereby allowing the system to continue functioning. It is also shown that the coordination strategy can be made more effective if a learning agent is allowed to learn the coordination functions. This facilitates the use of different types of agent at the local level, together with recurrent networks and genetic algorithms (GAs) at the coordination level. The experimental test-bed system is a benchmark three-tank system that has some of the main features of an industrial process control system.
An Innovative Conceptual Model of Multi Agent System for Control of Distributed Power System Networks Including Green Power Resources
Authors: Raza Syed M. Alamdar , Akbar Muhammad , Kamran Farrukh , Jafri M. N.
Published: September 2007

The paper proposes an Agent System for multi faceted distributed generation setup with green power generators identifying role and requirements of each agent. The Object Model, treating various agents as Entity/Object is proposed showing their interaction/interfacing. Each entity has been elaborated with its attributes. In addition, the services expected from each agent are highlighted. The Use Case Model is proposed showing assigned role of each agent. Each use case has been elaborated with its purpose, data handling, stimuli and responses. A lay out of the sub-systems of each of the proposed main agents has also been included. Subsequently the State Machine Model is proposed showing behavior of system in real time scenarios. Finally the Event Loop Model is appended along with sensor/actuator control process.
Assessing Risk Preferences in E&P Operational Settings
Authors: Jablonowski Christopher J.
Published: September 2007

Risk preferences influence decision making across the entire oil and gas exploration and production (E&P) enterprise. Previous studies have examined risk preferences within this sector mainly in economic settings, where the decision maker compares dollar payoffs between two or more choices. Understanding risk preferences in the context of operational settings, where the payoffs manifest as injuries, fatalities, or environmental incidents is equally important. This research investigates risk preferences in the operational setting by examining the decision to evacuate offshore drilling rigs under the threat of hurricanes. This research develops econometric models for the evacuation decision, and explicitly incorporates risk preferences through specification of a utility function. The results provide support for the conclusion that location attributes, specifically water depth, increase the propensity to evacuate. There is also support for the conclusion that oil company experience increases the propensity to evacuate, that is, experience leads to caution. Results of a utility-based model suggest a high degree of risk aversion.
Role of Coal in Sustainable Energy Development
Authors: Balat Havva
Published: September 2007

Coal is the one fossil energy source that can play a substantial role as a transitional energy source as one moves from the petroleum and natural gas based economic system to the future economic system based on nondepletable or renewable energy systems. For coal to remain competitive with other sources of energy in the industrialized countries of the world, continuing technological improvements in all aspects of coal extraction have been necessary. Coal has many important uses, but most significantly in electricity generation, steel and cement manufacture, and industrial process heating. Despite the long-term importance of oil and gas use, coal will remain a major pillar of the world's energy supply. Developing countries use about 55% of the world's coal today; this share is expected to grow to 65% over the next 15 years. The main objective of the present study is to investigate the contribution of coal to global energy demand and its share in global energy sources by presenting its historical development. In addition, this paper describes and summarizes environmental impacts of coal consumption and present status of several clean coal technologies.
Rare Earth Elements (REEs) in the Late Carboniferous Coal from the Heidaigou Mine, Inner Mongolia, China
Authors: Chen Huwei
Published: September 2007

This paper discusses the rare earth elements in the No. 6 Coal (Late Carboniferous) in the Heidaigou Mine of Inner Mongolia, northern China. The results show that the vitrinite reflectance (0.57%) is lowest and the proportions of inertinite and liptinite (32.4% and 5.4%, respectively) in the No. 6 Coal of the Heidaigou Mine are highest among all of the Late Paleozoic coals in the Ordos Basin. The No. 6 Coal was significantly enriched in rare earth elements (346 μg/g) as compared with those of Chinese coals, Guizhou coals of China, and US coals. The REEs in the coal are supplied from the sediment-source region, and the REEs leached from the adjacent partings by groundwater.
The Effect of Fluctuations on the Perception of Low Frequency Sound
Authors: Moorhouse A T , Waddington D C , Adams M D
Published: September 2007

Results of laboratory tests are presented in which 18 subjects, including some low frequency noise sufferers, were presented with low frequency sounds with varying degrees of fluctuation. Thresholds of acceptability were obtained for each sound and each subject, using the method of adjustment. These thresholds were then normalised to individual low frequency hearing threshold. It was found that sufferers tend to set thresholds of acceptability closer to their hearing threshold than other subject groups. Also, acceptability thresholds were set on average 5dB lower for fluctuating sounds. It is proposed that a sound should be considered fluctuating when the difference between L10 and L90 exceeds 5dB, and when the rate of change of the ‘Fast’ response sound pressure level exceeds 10dB/s
Modal Analysis for Global Control of Broadband Noise in a Rectangular Enclosure
Authors: Montazeri Allahyar , Poshtan Javad , Kahaei Mohammad Hossein
Published: September 2007

Modal analysis for examination of the possibility of the global reduction of broadband noise in a rectangular enclosure has been studied in this paper. By developing a modal model of the acoustic environment of the enclosure the shape modes and their frequencies are obtained and on suitable bandwidth for the controller design is calculated. In order to simplify the analysis the noise sources are assumed localized and internal in one corner of the kiosk. The analysis results show that due to the existence of some degenerate modes in this application, the control action is complicated. Simulation results demonstrate how positions and number of loudspeakers and microphones will change the performance of the controller and its corresponding control effort. Based on these results and analysis a reasonable size for the controller and proper locations for sensors and actuators are proposed. Simulation results also confirm the effectiveness of the proposed system in reduction of the acoustic potential energy in the kiosk.
A Simple Force Analysis for the Raising and Lowering of a Small Wind Turbine and Tower
Authors: Wood D.H.
Published: September 2007

This paper considers the tension in the cable used to raise or lower a small wind turbine and tower without a crane. The tower is hinged at its base and has a gin pole. It is assumed that the movement is slow enough to ignore inertial effects. Most results are obtained for the situation where the gin pole is very close to the tower hinge. Two cases are analysed. In the first, a fixed-length cable from the far end of the gin pole is attached directly to a vehicle. In the second, either a pulley anchored to the ground passes the cable horizontally to the vehicle, or a winch is fixed at the same location. Equations are derived for the maximum tension in the cable in both cases, the maximum vertical force in the first case, and the total length of cable used with second, which may well determine the efficacy of using a winch.
Noise Generation in Ventilation Systems by the Interaction of Airflow with Duct Discontinuities: Part 1 Bends
Authors: Waddington D. C. , Oldham D. J.
Published: September 2007

Discontinuities in air duct systems give rise to turbulence and some of this turbulence results in airflow generated noise. One potential source of flow generated noise in ducts is the presence of a bend. Various strategies are employed to reduce turbulence by smoothing the flow around a bend, such as the use of turning vanes, large radius of curvature and the associated use of splitters, and these will also affect the noise generated. Recent work on the prediction of airflow generated noise in ducts based upon pressure loss characteristics is applied to a range of bends including mitred bends, with and without turning vanes, and radiussed bends, with and without splitters. The effect of bends with different aspect ratios is also examined. An excellent collapse of measured data onto a single characteristic curve is reported for each configuration based upon standard values of pressure loss coefficients. It is suggested that these characteristic curves might form the basis for a practical prediction method.
The three-dimensional structure of the Moorella thermoacetica selenocysteine insertion sequence RNA hairpin and its interaction with the elongation factor SelB
Authors: Beribisky Alexander V. , Tavares Tony J. , Amborski Andrew N. , Motamed Mina , Johnson Anne E. , Mark Tobi L. , Johnson Philip E.
Published: September 2007

Incorporation of the amino acid selenocysteine into a growing protein chain involves the interaction between a hairpin in the mRNA termed the selenocysteine insertion sequence (SECIS) and the special elongation factor SelB. Here we present the structure of the SECIS from the thermophilic organism Moorella thermoacetica (SECIS-MT) determined using nuclear magnetic resonance (NMR) spectroscopy. The SECIS-MT hairpin structure contains a pentaloop with the first and fourth nucleotides of the loop forming a noncanonical GC base pair; the fifth loop nucleotide is bulged out and unstructured. The G and U in positions two and three are on opposite sides of the loop and solvent exposed. The backbone resonances of the SECIS-binding domain from the M. thermoacetica SelB protein were assigned, and the degree of chemical shift perturbations that occur upon SECIS binding were mapped onto the structure of the complex. We demonstrate that a region in the third winged-helix domain of SelB, not previously implicated in binding, is affected by SECIS binding.
The responses of extrinsic fibroblasts infiltrating the devitalised patellar tendon to IL-1β are different from those of normal tendon fibroblasts
Authors: Tohyama H. , Yasuda K. , Uchida H. , Nishihira J.
Published: September 2007

In order to clarify the role of cytokines in the remodelling of the grafted tendon for ligament reconstruction we compared the responses to interleukin (IL)-1β, platelet-derived growth factor (PDGF)-BB and transforming growth factor (TGF)-β1 of extrinsic fibroblasts infiltrating the frozen-thawed patellar tendon in rats with that of the normal tendon fibroblasts, in regard to the gene expression of matrix metalloproteinase (MMP)-13, using Northern blot analysis. We also examined, immunohistologically, the local expression of IL-1β, PDGF-BB, and TGF-β1 in fibroblasts infiltrating the frozen-thawed patellar tendon.

Northern blot analysis showed that fibroblasts derived from the patellar tendon six weeks after the freeze-thaw procedure in situ showed less response to IL-1β than normal tendon fibroblasts with respect to MMP-13 mRNA gene expression. The immunohistological findings revealed that IL-1β was over-expressed in extrinsic fibroblasts which infiltrated the patellar tendon two and six weeks after the freeze-thaw procedure in situ, but neither PDGF-BB nor TGF-β1 was over-expressed in these extrinsic fibroblasts. Our findings indicated that IL-1β had a close relationship to matrix remodelling of the grafted tendon for ligament reconstruction, in addition to the commencement of inflammation during the tissue-healing process.
Symptomatic nonunion after fracture of the calcaneum
Authors: Molloy A. P. , Myerson M. S. , Yoon P.
Published: September 2007

We have treated 14 patients (15 fractures) with nonunion of an intra-articular fracture of the body of the calcaneum. The mean follow-up was six years (2 to 8.5). A total of 14 fractures (93%) had initially been treated operatively with 12 (86%) having non-anatomical reductions. Four feet (27%) had concomitant osteomyelitis. Of the nonunions, 14 (93%) went on to eventual union after an average of two reconstructive procedures. All underwent bone grafting of the nonunion. The eventual outcome was a subtalar arthrodesis in ten (67%) cases, a triple arthrodesis in four (27%) and a nonunion in one (6%). Three patients had a wound dehiscence; all required a local rotation flap. The mean American Orthopaedic Foot and Ankle Society score at latest follow-up was 69, and the mean Visual analogue scale was 3. Of those who were initially employed, 82% (9 of 11) eventually returned to work. We present an algorithm for the treatment of calcaneal nonunion, and conclude that despite a relatively high rate of complication, this complex surgery has a high union rate and a good functional outcome.
Arthrodesis after failed total ankle replacement
Authors: Culpan P. , Le Strat V. , Piriou P. , Judet T.
Published: September 2007

We present a series of 16 patients treated between 1993 and 2006 who had a failed total ankle replacement converted to an arthrodesis using bone grafting with internal fixation. We used tricortical autograft from the iliac crest to preserve the height of the ankle, the malleoli and the subtalar joint. A successful arthrodesis was achieved at a mean of three months (1.5 to 4.5) in all patients except one, with rheumatoid arthritis and severe bone loss, who developed a nonunion and required further fixation with an intramedullary nail at one year after surgery, before obtaining satisfactory fusion. The post-operative American Orthopaedic Foot and Ankle Society score improved to a mean of 70 (41 to 87) with good patient satisfaction. From this series and an extensive review of the literature we have found that rates of fusion after failed total ankle replacement in patients with degenerative arthritis are high. We recommend our method of arthrodesis in this group of patients. A higher rate of nonunion is associated with rheumatoid arthritis which should be treated differently.
Orientation and wear of the acetabular component in third generation alumina-on-alumina ceramic bearings
Authors: Lusty P. J. , Watson A. , Tuke M. A. , Walter W. L. , Walter W. K. , Zicat B.
Published: September 2007

We studied 33 third generation, alumina ceramic-on-ceramic bearings retrieved from cementless total hip replacements after more than six months in situ. Wear volume was measured with a Roundtest machine, and acetabular orientation from the anteroposterior pelvic radiograph. The overall median early wear rate was 0.1 mm3/yr for the femoral heads, and 0.04 mm3/yr for the acetabular liners. We then excluded hips where the components had migrated. In this stable subgroup of 22 bearings, those with an acetabular anteversion of < 15° (seven femoral heads) had a median femoral head wear rate of 1.2 mm3/yr, compared with 0 mm3/yr for those with an anteversion of ≥15° (15 femoral heads, p < 0.001). Even under edge loading, wear volumes with ceramic-on-ceramic bearings are small in comparison to other bearing materials. Low acetabular anteversion is associated with greater wear.
Pain relief and functional results after resection arthroplasty of the shoulder
Authors: Rispoli D. M. , Sperling J. W. , Athwal G. S. , Schleck C. D. , Cofield R. H.
Published: September 2007

We have examined the relief from pain and the functional outcome in 18 patients who underwent resection arthroplasty of the shoulder as a salvage operation between 1988 and 2002. The indications included failed shoulder replacement in 17, with infection in 13, and chronic septic arthritis in one. The mean follow-up was 8.3 years (2.5 to 16.6). Two intra-operative fractures of the humerus occurred, both of which healed.

The level of pain was significantly decreased (t-test, p < 0.001) but five patients continued to have moderate to severe pain. The mean active elevation was 70° (0° to 150°) postoperatively and represented an improvement from 39° (0° to 140°) (t-test, p = 0.003), but internal and external rotation were hardly changed. The mean number of positive answers on the 12-question Simple Shoulder Test was 3.1 (0 to 12) but the shoulder was generally comfortable when the arm was positioned at rest by the side. The mean post-operative American Shoulder and Elbow Surgeon’s score was 36 (8 to 73).

Despite applying this procedure principally to failed shoulder replacements, the results were similar to those reported in the literature for patients after severe fracture-dislocation. Reduction of pain is possible in one half to two-thirds of patients. The outcome of this operation in providing relief from pain cannot be guaranteed, but the shoulder is usually comfortable at rest, albeit with profound functional limitations.
An unusual cause of locking after total knee replacement
Authors: Auyeung J. , Doorgakant A. , Shand J. E. G. , Orr M. M.
Published: September 2007

Locking after total knee replacement is uncommon and is generally caused by the formation of fibrous tissue around the patella. We report an unusual cause of locking resulting from intermittent occlusion of the popliteal artery, which was tethered to cement at the posterior aspect of the tibial component.
Implementing Strategy: the politics of healthcare commissioning
Authors: North Nancy
Published: September 2007

English

The purchaser-provider division in the National Health Service was intended to enable informed purchasers – general practitioner (GP) fundholders and district health authorities (DHAs) – to improve the cost-efficiency and quality of healthcare provision. Competition, or the threat of it, would encourage compliance from hospital and community trusts which previously had been protected by routinely provided resources. Although much attention has been given to the performance of GP fund holders, rather less interest has been paid to the activities of DHAs, whose task is qualitatively and quantitatively different from that of our GP purchasers. Drawing on research undertaken over a 15-month period, this article analyses a DHA’s attempts to implement a purchasing strategy. It uncovers several factors contributing to the strategy’s slow progress and concludes that factors constrained the DHA’s ability to achieve strategic changes in an important service area.
Evaluating Quality in Mental Health Services: contexts and issues
Authors: Shaw Ian
Published: September 2007

English

Quality in healthcare services is neither a simple nor an apolitical issue. Quality is a complex concept and how it is defined and measured has important consequences for services. This article explores some of the issues which arise when the notions of ‘quality’ and ‘mental health’ are discussed together. Mental health services contribute to the regulation and maintenance of social order. The article particularly focuses upon the changing role of service users in quality assurance methods and argues for a new approach.
Mental Health Policy: making gender and ethnicity visible
Authors: Busfied Joan
Published: September 2007

English

The implications of two major twentieth century changes in mental health policy are explored in relation to gender and ethnicity. The most visible change has been a shift in the dominant focus of service provision away from the asylum towards a diverse range of services loosely defined as community care. This shift has been associated with a second change: the expansion of services dealing with less severe forms of mental disorder such as depression and anxiety – a terrain where women tend to be more heavily represented both as patients and as service providers. At the same time inpatient care is increasingly focused on those with severe problems, especially persons considered dangerous – a population where men and those from certain ethnic groups tend to be over-represented.
United States Mental Health Policy in the 1990s: an era of cost-effectiveness, research and consumerism
Authors: Salzer Mark S.
Published: September 2007

English

This article reviews three forces that currently influence US mental health policy: cost-effectiveness, mental health services research and consumerism. Rising mental health care costs, managed care cost-containment strategies, and concerns about the quality of services all influence the emphasis on cost-effectiveness by mental health service policy makers. The emphasis on cost-effectiveness co-occurs within the larger zeitgeist of data-driven policy making. Appropriations for mental health services research are a major funding priority. Finally, the concerns and perspectives of mental health consumers are more frequently voiced and heard, and are influencing service delivery concepts and how services are evaluated.
Therapeutic Communities in Prisons
Authors: Rawlings Barbara
Published: September 2007

English

This review of research into prison therapeutic communities (TCs) covers democratic TCs, which treat personality disorders, and hierachical TCs, which treat drug abusers. The article outlines the history and establishment of TCs in Britain, USA, Canada and Europe and also describes typical TC treatment regimes and examines research into treatment outcome. It highlights the fact that outcome research rests mainly on reconviction and recidivism figures, despite criticisms of these as measures. Research shows that TCs can reduce offending and a relationship between length of time in therapy and positive outcome as been a consistent finding. However, TCs are established sparingly in prisons and historically have been relatively short-lived.
Whose lives and whose learning? Whose narratives and whose writing? Taking the next research and literature steps with experts by experience
Authors: Preston-Shoot Michael
Published: September 2007

English

This article reviews the barriers that impact on the involvement of ‘experts by experience’ in research and in publishing. It charts how their views are generally reported through others and how their roles are often limited to particular aspects of the research process. Drawing on work within several research and social work education projects, and journal editorship, the article also explores practices that contribute to further change in the relationships surrounding knowledge production and dissemination, extending the involvement of experts by experience and embedding it more securely in research practice and in academic and professional publishing.
Beérkezett könyvek
Authors: Pléh Csaba
Published: September 2007

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Prevalência de queixas supra-esofágicas em pacientes com doenças do refluxo erosiva e não-erosiva
Authors: Aguero Gustavo Cálcena , Lemme Eponina M. O. , Alvariz Ângela , Carvalho Beatriz Biccas , Schechter Rosana B. , Abrahão Jr. Luiz
Published: September 2007

RACIONAL: Na doença do refluxo gastroesofágico pode-se encontrar, como parte do quadro clínico da doença, queixas respiratórias, otorrinolaringológicas, dor torácica ou disfagia. As duas primeiras são intituladas de manifestações supra-esofágicas da doença. É discutível a prevalência destas alterações em pacientes com doença do refluxo gastroesofágico nas formas erosiva e não-erosiva. OBJETIVOS: Avaliar a prevalência de manifestações supra-esofágicas em pacientes com doenças do refluxo erosiva e não-erosiva. MÉTODOS: Foram revistas as fichas de pacientes que realizaram endoscopia digestiva alta, esofagomanometria e pHmetria prolongada nos últimos 5 anos, na investigação de doença do refluxo gastroesofágico (pirose como queixa principal), em que havia informações a respeito de queixas respiratórias e otorrinolaringológicas. Foram selecionados pacientes com doença do refluxo erosiva (graus I a III, pela classificação de Savary-Miller) e com doença do refluxo não-erosiva (endoscopia negativa, com pHmetria prolongada anormal). A análise estatística utilizou o teste de qui-quadrado. RESULTADOS: Duzentos e oitenta pacientes preencheram os critérios de inclusão, sendo 162 com doença do refluxo erosiva (70% com esofagite grau I) e 118 com doença do refluxo não-erosiva. No grupo total, 88 apresentavam queixas otorrinolaringológicas (31%), com predomínio de rouquidão e pigarro e 42, queixas respiratórias (15%), predominando a tosse crônica. Dos pacientes com queixas otorrinolaringológicas, 45 pertenciam ao grupo doença do refluxo erosiva (28%) e 43 ao grupo doença do refluxo não-erosiva (36,4%). Em relação aos com queixas respiratórias, 21 pacientes (13%) pertenciam ao grupo doença do refluxo erosiva e 21 (18%) ao grupo doença do refluxo não-erosiva. CONCLUSÃO: Não houve diferença entre a prevalência das queixas supra-esofágicas em pacientes com doenças do refluxo erosiva e não-erosiva.
Neurônios NADH-diaforase positivos do jejuno de ratos adultos (Rattus norvegicus) desnutridos: aspectos quantitativos
Authors: Zanin Sônia Trannin de Mello , Molinari Sonia Lucy , Sant'Ana Débora de Mello Gonçales , Miranda Neto Marcílio Hubner de
Published: September 2007

Temos por objetivo contribuir com informações sobre os aspectos quantitativos dos neurônios mioentéricos NADH-diaforase positivos do jejuno de ratos submetidos a desnutrição protéica. Foram utilizados 10 ratos (90 dias de idade), divididos em grupos: controle (n=5, ±278g) e desnutrido (n=5, ±280g). Nos 120 dias seguintes, os ratos do grupo controle receberam ração com teor protéico de 22%, os do grupo desnutrido, 8%. Ao final deste período, os ratos do grupo controle pesaram ±394,4g e os desnutrido ±273,5g.O jejuno foi submetido à técnica histoquímica da NADH-diaforase para evidenciação de células nervosas em preparado de membranas. Foram contados os neurônios presentes em 80 campos microscópicos em ambos os grupos. Verificaram-se no controle ±674,6 neurônios e no desnutrido ±1326,8 neurônios; A dieta não alterou a organização dos neurônios entretanto, levou a um menor desenvolvimento corporal nos animais desnutridos, contribuindo para que os neurônios destes sofressem menor dispersão e apresentassem maior densidade por mm².
Meningioma of the internal auditory vanal: case report
Authors: Amato Marcelo Campos Moraes , Colli Benedicto Oscar , Carlotti Junior Carlos Gilberto , Santos Antonio Carlos dos , Féres Maria Cristina Lancia Cury , Neder Luciano
Published: September 2007

Meningiomas limited to the internal auditory canal (IAC) are rare. Acoustic neuroma is usually the diagnosis made when a tumor is found in this location because of its higher frequency. We report on a 58 year-old woman with a meningioma arising from the IAC and the difficulty to establish the pre-surgical diagnosis, based on clinical and radiological features. The perioperative suspicion and confirmation are very important to deal with the dura and bone infiltration in order to reduce tumor recurrence.
Epidemiologia de 118 casos de esclerose múltipla com seguimento de 15 anos no centro de referência do Hospital da Restauração de Pernambuco
Authors: Ferreira Maria Lúcia Brito , Machado Maria Íris Moraes , Vilela Maria Lúcia , Guedes Maria José , Ataíde Jr Luis , Santos Silvana , Laurentino Sílvia Gomes
Published: September 2007

A prevalência de esclerose múltipla (EM) varia consideravelmente no mundo. De acordo com Kurtzke, a América do Sul é considerada região de baixa prevalência (menor que 5 casos:100000 habitantes). OBJETIVO: Descrever a epidemiologia da EM em centro de referência, comparando-a aos achados de oito serviços nacionais. MÉTODO: Através de estudo de incidência, descritivo, prospectivo, longitudinal, foram analisados dados de 118 pacientes, atendidos no Centro de Referência para Atenção ao Paciente Portador de Doença Desmielinizante do Hospital da Restauração - Recife - PE - Brasil (CRAPPDD-HR), entre janeiro de 1987 e março de 2002, com diagnóstico de EM, segundo critérios de Poser. RESULTADOS: Os pacientes foram acompanhados por um a 15 anos. Noventa e cinco (80,5%) pacientes estavam em tratamento específico com imunomoduladores. A prevalência foi igual a 1,36:100000 habitantes. Identificaram-se: predomínio da etnia parda (110 casos, 93,2%); 82 (82,2%) casos clinicamente definidos, 15 (12,7%) laboratorialmente definidos e 6 (5,1%) clinicamente prováveis; número máximo de surtos igual a 46; maior número de casos com EDSS leve, assim como um a 10 anos de doença na forma surto/remissão (SR). A razão de gênero dos 83 casos da forma SR se equivaleu à geral (4,1:1), contudo na forma SR com progressão secundária houve predomínio duas vezes maior para o sexo feminino e na forma primariamente progressiva, 5,5 vezes maior para o sexo masculino. CONCLUSÃO: Apesar da presente pesquisa ter se assemelhado aos oito estudos utilizados para comparação, as diferenças constatadas irão requerer novas pesquisas e novas abordagens.
Extensa falha cutânea e craniana em paciente com aplasia cutis congenita
Authors: Henriques José Gilberto de Brito , Pianetti Filho Geraldo , Giannetti Alexandre Varella , Henriques Karina Santos Wandeck
Published: September 2007

Aplasia cutis congenita (ACC) é doença rara, caracterizada pela ausência de formação completa da pele. Geralmente ocorre no couro cabeludo, na linha mediana, e apresenta-se ao nascimento como uma ferida ulcerada que pode atingir diferentes profundidades e envolver o periósteo, crânio e dura-máter. Descrevemos o caso de menina recem-nascida que apresentava fácies dismórfica com defeito no couro cabeludo que abrangia a quase totalidade da abóbada craniana e apresentava falha óssea desde a base dos ossos frontais até os occipitais e mastóides. A dura-máter estava em sua maior parte exposta, sem sinais de fissuras. Devido à raridade da ACC e ao pequeno número de pacientes nas séries publicadas na literatura a padronização do tratamento ainda é incipiente. O que existem são recomendações. Ainda são necessários estudos que abordem desde a etiologia da doença até a avaliação dos métodos de tratamento e evolução de grupos maiores de pacientes.
The clinical spectrum of malformations of cortical development
Authors: Montenegro Maria Augusta , Cendes Fernando , Lopes-Cendes Iscia , Guerreiro Carlos A.M. , Li Li M. , Guerreiro Marilisa M.
Published: September 2007

BACKGROUND: Malformations of cortical development (MCD) usually manifest in childhood with epilepsy, developmental delay and focal neurological abnormalities. OBJECTIVE: To evaluate the presentation and severity of epilepsy in the different types of MCD. METHOD: We evaluated the first 100 consecutive patients with a neuroimaging diagnosis of MCD. They were identified among all the high resolution magnetic resonance imaging exams performed at our service between 1997 and 2001. The causes of referral were diverse, according to the routine of the neurology outpatient clinic. After magnetic resonance imaging diagnosis of the subtype of MCD a detailed clinical assessment was performed. RESULTS: There were 55 females and 45 males, with ages ranging from five months to 71 years old (mean=15.2 years). Seventy-seven patients presented with epilepsy. Sixty-one had partial epileptic syndromes, 13 secondary generalized syndromes, and in three, the type of epileptic syndrome could not be established. Epilepsy was less frequent in patients with the MCD subtypes of polymicrogyria and schizencephaly (p<0.001). Patients with schizencephaly and polymicrogyria had their seizures more easily controlled by antiepileptic drugs (p<0.001). CONCLUSION: That the frequency of epilepsy is lower and seizures are more easily controlled in the setting of polymicrogyria and schizencephaly. Patients with MCD frequently present with secondary generalized epilepsy early in childhood.
Using clinical data to predict sleep hypoxemia in patients with acromegaly
Authors: Rodrigues Marcelo Palmeira , Naves Luciana Ansanelli , Casulari Luiz Augusto , Silva César Augusto Melo e , Araújo Renata Rodrigues de , Viegas Carlos Alberto de Assis
Published: September 2007

Hypoxemia secondary to sleep apnea is commonly seen in patients with acromegaly, and this alteration apparently leads to considerable morbidity and mortality among such patients. With the objective of identifying hypoxemia based on clinical data, we conducted a cross-sectional study of 34 patients with acromegaly, all of whom were submitted to nocturnal oximetry and evaluation of snoring, as well as to the determination of body mass index (BMI) and neck circumference. In addition, daytime sleepiness was evaluated using the Epworth sleepiness scale (ESS). In this study, sleep hypoxemia was defined as five or more episodes of desaturation per hour. The sensitivity and specificity of the various parameters in predicting such hypoxemia were, respectively, as follows: snoring (92.9% and 35%); BMI >28.5 kg/m² (71.4% and 60%); neck circumference >44 cm (28.6% and 95%); ESS score >10 (42.9% and 70%). For patients with a neck circumference of more than 44 cm, the probability of sleep hypoxemia was found to increase from 41% (pre-test) to 80% (post-test). For patients with a neck circumference of less than 44 cm, positivity for two or three of the other parameters (snoring, ESS score >10 and BMI >28.5 kg/m²) increased the post-test probability to 62%, whereas positivity for only one (or none) reduced post-test probability to 8%. We can conclude that the clinical parameters evaluated allowed us to predict, with considerable accuracy, whether or not sleep hypoxemia would occur in patients with acromegaly.
Espectroscopia multivoxel com tempo de eco curto: a razão colina/N-acetil-aspartato e a graduação dos astrocitomas cerebrais
Authors: Aragão Maria de Fátima Vasco , Otaduy Maria Concepción García , Melo Roberto Vieira de , Azevedo Filho Hildo Rocha Cirne de , Victor Edgar Guimarães , Silva José Laércio , Araújo Nelson , Leite Claudia da Costa , Valença Marcelo Moraes
Published: September 2007

Avaliou-se a relação colina/N-acetil-aspartato (Co/NAA), obtida pela espectroscopia multivoxel com tempo de eco (TE) curto, na graduação histológica dos astrocitomas encefálicos (graus I, II e III-IV), comparando com o parênquima cerebral normal. Observou-se aumento significativo (p<0,05) das relações médias de Co/NAA nos três grupos de astrocitomas estudados em relação ao tecido normal, havendo tendência de elevação com o aumento da graduação, sem significância estatística, que correspondeu a: 0,53±0,24 no grupo controle, 1,19±0,49 no grau I, 1,58±0,65 no grau II e 5,13±8,12 no grupo de alto grau (graus III-IV). Houve aumento da relação Co/NAA em 4/5 (80%) dos pacientes com grau I, 5/6 (83%) com grau II e 10/20 (50%) com graus III e IV. Concluiu-se que a espectroscopia multivoxel com TE curto pode ser usada na discriminação entre o parênquima normal e o tecido neoplásico. Entretanto, nem todo tecido neoplásico estudado apresentou aumento da relação Co/NAA, principalmente o grupo com maior malignidade.
Study of interhemispheric coherence on healthy adults
Authors: Jorge Mario Silva , Botelho Ricardo Vieira , Melo Antonio Carlos de Paiva
Published: September 2007

The interhemispheric coherence of electroencephalogram was studied in a group of healthy individuals in the age range of 20-50 years. The results showed higher coherence for all bands in parietal regions (P3-P4). It was observed that individuals with high values of coherence for a certain frequency band in a pair of electrodes also showed high values of coherence for other bands across other pairs of electrodes. No significant influence on interhemispheric coherence was found for age, gender or hand dominance.
Clinical, laboratory and neuroimage findings in juvenile systemic lupus erythematosus presenting involvement of the nervous system
Authors: Spinosa Mônica Jaques , Bandeira Márcia , Liberalesso Paulo Breno Noronha , Vieira Simone Carreiro , Janz Jr Loris Lady , Sá Eliane Gomes de , Löhr Jr Alfredo
Published: September 2007

OBJECTIVE: To characterize neurological involvement in juvenile systemic lupus erythe-matosus. METHOD: The charts of all patients with the diagnosis of systemic lupus erythematosus before the age of 16 years, followed at the Rheumatology Unit of Pequeno Príncipe Hospital, from January 1992 to January 2006, were retrospectively reviewed, highlighting neuropsychiatric aspects. RESULTS: Forty-seven patients were included. Neuropsychiatric syndromes were found 29 (61.7%): seizures (17 / 36.2%), intractable headache (7 / 14.9%), mood disorders (5 / 10.6%), cerebrovascular disease (4 / 8.5%), acute confusional state (3 / 6.4%), aseptic meningitis (3 / 6.4%), psychosis (3 / 6.4%), chorea (3 / 6.4%), Guillain-Barré syndrome (2 / 4.3%) and cranial neuropathy (1 / 2.1%). Morbidity indexes (SLEDAI and SLICC) were higher among patients with neuropsychiatric manifestations (p<0.05). CONCLUSION: Neuropsychiatric syndromes are frequent, and add significant morbidity to juvenile systemic lupus erythematosus.
Memória de procedimentos e SPECT cerebral: avaliação de fluxo sanguíneo cerebelar e em córtex pré-frontal durante uma tarefa visuo-motora
Authors: Silva Márcia Thereza , Piedade Roberto , Ribeiro Pedro , Fonseca Léa Mirian B. da , Pellini Marcos Pinto , Cagy Maurício
Published: September 2007

O objetivo deste estudo foi avaliar o fluxo sanguíneo cerebral no córtex cerebelar (4 sub-regiões) e no córtex pré-frontal, em repouso e durante uma tarefa motora. A amostra foi composta por 8 sujeitos saudáveis, ambos os sexos, entre 23 e 36 anos. O grupo foi submetido a tarefa visuo-motora (memória implícita) que consistia na ação de desviar um submarino de supostas minas que percorriam a tela do monitor. Para avaliar a perfusão, foi utilizado o método de análise semi-quantitativa para imagens de SPECT cerebral - 99mTc-ECD. Os resultados evidenciaram aumento de atividade nas áreas de interesse durante a realização da tarefa. Em conclusão, quatro sub-regiões do córtex cerebelar e ambos os hemisférios do córtex pré-frontal apontaram uma ativação simultânea durante a tarefa. Ainda, e conforme estudos prévios, nossos resultados sugerem um modo de operação em paralelo do sistema nervoso central, no intuito de integrar uma informação sensorial e motora.