bluuebunny/crossref_metadata_2025 huggingface dataset:
Iteration and numerical computation for runoff regulation of hydropower station
Authors: Yu Guo , Shouyu Chen
Published: September 2005

Runoff regulation of hydropower station is always an important point and difficult issue for researchers and engineers, and different methods have been advanced for obtaining simple and accurate results, but they do not often do good work. In this paper a new approach is presented to regulate runoff of hydropower station that through iterative equation for turbine discharge and construct numerical computation for runoff regulation of hydropower station. A case shows that the solution is simple, accurate and easy to use in practice. Copyright © 2005 John Wiley & Sons, Ltd.
Reorder notifying TCP (RN‐TCP) with explicit packet drop notification (EPDN)
Authors: Sathiaseelan Arjuna , Radzik Tomasz
Published: September 2005

Numerous studies have shown that packet reordering is common, especially in networks where there is high degree of parallelism and different link speeds. Reordering of packets decrease the TCP performance of a network, mainly because it leads to overestimation of the congestion in the network. In this paper, we analyse the performance of networks when reordering of packets occur. We propose a proactive solution that could significantly improve the performance of the network when reordering of packets occurs. We report results of our simulation experiments, which support this claim. Our solution is based on enabling the senders to distinguish between dropped packets and reordered packets. Copyright © 2005 John Wiley & Sons, Ltd.
The role of groundwater in cliff instability: an example at Cape Blanc‐Nez (Pas‐de‐Calais, France)
Authors: Pierre Guillaume , Lahousse Philippe
Published: September 2005

Cliff retreat in northern Boulonnais is described. The distribution of the amount of retreat is related to structural and topographic factors. Both control the runoff–infiltration balance and therefore the mechanical behaviour of the rocks, which determines the modes of failure. The spatial variability of the retreat rate is explained, but predicting the temporal variability of the retreat rate, which is central to risk management, is much more difficult. Rainfall and piezometric surface data enhanced a ‘piston flow’ mechanism during November 2000. The result of its occurrence on the stability of the cliff and conditions of its recurrence are examined with a view to better understanding the rate of recession of coastal cliffs and wiser management of risk. Copyright © 2005 John Wiley & Sons, Ltd.
Palaeomonsoon variability in the southern fringe of the Badain Jaran Desert, China, since 130 ka BP
Authors: Gao Quanzhou , Tao Zhen , Li Baosheng , Jin Heling , Zou Xueyong , Zhang Yechun , Dong Guangrong
Published: September 2005

Taking the Chagelebulu Stratigraphic Profile as a typical example, a comprehensive study has been conducted to elucidate the palaeoclimatic and geomorphic evolution patterns in the southern fringe of the Badain Jaran Desert, which were found to be complex and polycyclic in the past 130 ka. However, the fluctuating magnitude is not as remarkable as that in the eastern China sandy region. The shift in climate from interglacial to glacial and the uplift process of the Qinghai–Xizang Plateau are the two leading forces driving the evolution of the climate and desert landforms in this area. Seventeen cycles of cold, dry and warm, humid climatic stages were recognized in the Upper Pleistocene Series of the profile. The sharp uplift of the Qinghai–Xizang Plateau superimposed a cool and arid climatic trend in this area. As a result of the climatic changes, the desert in this area has undergone multiple stages of expansion and contraction since 130 ka bp. The middle Holocene Epoch and the early stage of the Late Pleistocene Period were the main periods when the sand dunes became stabilized, and the early and late phases of the Holocene Epoch and late phase of the Pleistocene Epoch were the main periods when the previously stabilized sand dunes became mobile. The late phase of the Pleistocene Epoch was the most mobile stage, when the aeolian sand activities formed the essential geomorphic pattern of the Badain Jaran Desert. Copyright © 2005 John Wiley & Sons, Ltd.
A Rb/Sr record of catchment weathering response to Holocene climate change in Inner Mongolia
Authors: Jin Zhangdong , Cao Junji , Wu Jinglu , Wang Sumin
Published: September 2005

Variation in the rubidium to strontium (Rb/Sr) ratio of the loess–palaeosol sequences has been proposed to reflect the degree of pedogenesis and weathering in the northwestern region of China. To characterize the Rb/Sr ratio of the dissolved loads of a single catchment, we analysed a 12·08 m sediment core from Daihai Lake in Inner Mongolia, north China. Dating control was provided by 210Pb, 137Cs and AMS‐14C. Sequential extraction experiments were conducted to investigate the concentrations of Rb and Sr on various chemical fractions in the lake sediments. Down‐core variation in the Rb/Sr ratios provides a record of Holocene weathering history. From 9 to 3·5 ka bp, accelerated chemical weathering was experienced throughout the Daihai catchment under mainly warm and humid conditions, and this reached a maximum at c. 5 ka bp. However, weathering was reduced between c. 8·25 and 7·90 ka bp, which may reflect the global 8·2 ka cooling event. After c. 2·5 ka bp, increased Rb/Sr ratios with higher frequency of fluctuations indicate reduced weathering within the Daihai catchment. The highest Rb/Sr ratios in the Little Ice Age lake sediments indicate the weakest phase of Holocene chemical weathering, resulting from a marked reduction in Sr flux into the basin. The Rb/Sr record also shows an enhancement of chemical weathering under today's climate, but its intensity is less than that of the Medieval Warm Period. Increased Rb/Sr in lake sediment corresponding to reduced catchment weathering is in striking contrast to Rb/Sr decrease in the glacial loess layers in the loess–palaeosol sequence. Copyright © 2005 John Wiley & Sons, Ltd.
Retinoid‐mediated stimulation of steroid sulfatase activity in myeloid leukemic cell lines requires RARα and RXR and involves the phosphoinositide 3‐kinase and ERK‐MAP kinase pathways
Authors: Hughes Philip J. , Zhao Yi , Chandraratna Roshantha A. , Brown Geoffrey
Published: September 2005

All‐trans retinoic acid and 9‐cis‐retinoic acid stimulate the activity of steroid sulfatase in HL60 acute myeloid leukemia cells in a concentration‐ and time‐dependent manner. Neither of these ‘natural retinoids’ augmented steroid sulfatase activity in a HL60 sub‐line that expresses a dominant‐negative retinoic acid receptor α (RARα). Experiments with synthetic RAR and RXR agonists and antagonists suggest that RARα/RXR heterodimers play a role in the retinoid‐stimulated increase in steroid sulfatase activity. The retinoid‐driven increase in steroid sulfatase activity was attenuated by inhibition of phospholipase D (PLD), but not by inhibitors of phospholipase C. Experiments with inhibitors of protein kinase C (PKC) show that PKCα and PKCδ play an important role in modulating the retinoid‐stimulation of steroid sulfatase activity in HL60 cells. Furthermore, we show that pharmacological inhibition of the RAF‐1 and ERK MAP kinases blocked the retinoid‐stimulated increase in steroid sulfatase activity in HL60 cells and, by contrast, inhibition of the p38‐MAP kinase or JNK‐MAP kinase had no effect. Pharmacological inhibitors of the phosphatidylinositol 3‐kinase, Akt, and PDK‐1 also abrogated the retinoid‐stimulated increase in steroid sulfatase activity in HL60 cells. These results show that crosstalk between the retinoid‐stimulated genomic and non‐genomic pathways is necessary to increase steroid sulfatase activity in HL60 cells. © 2005 Wiley‐Liss, Inc.
Structure investigation of Maltacine D1a, D1b and D1c—cyclic peptide lactones of the Maltacine complex from Bacillus subtilis
Authors: Hagelin Gunnar
Published: September 2005

A new complex of cyclic peptide lactone antibiotics from Bacillus subtilis, which we named Maltacines has recently been described. The structure elucidation of three of them is reported in this paper. The amino acid sequences and structures of the peptides were found by MSn of the ring‐opened linear peptides that gave uninterrupted sequences of Bn and Y″n ions. The identities of four unknown residues in the sequences were solved by a combination of derivatisation with phenylisothiocyanate (PITC), high‐resolution mass spectrometry and H/D exchange. The nature and position of the cyclic structure was disclosed by a chemo‐selective ring opening with Na18OH and was found to be a lactone formed between a hydroxyl of residue number 4 and the C‐terminal amino acid number 12. For verification of the structure of the B2+ ion, peptides with different combinations of P/Q and P/K at the N‐terminus were synthesized. The structures of the four peptides is tentatively suggested to be: D1a: cyclo(4,12)‐P‐Q‐Y‐Adip‐A‐E‐T‐Y‐Orn‐HGly‐Y‐I‐OH, D1b: cyclo(4,12)‐P‐Q‐Y‐Adip‐A‐E‐T‐Y‐Orn‐S‐Y‐I‐OH and D1c: cyclo(4,12)‐P‐Q‐Y‐Adip‐A‐E‐T‐Y‐K‐S‐Y‐I‐OH. Adip = aminodihydroxy pentanoic acid and HGly = hydroxyglycine. Copyright © 2005 John Wiley & Sons, Ltd.
Changes in calcium absorption and subsequent tissue distribution induced by Maillard reaction products: in vitro and in vivo assays
Authors: Delgado‐Andrade Cristina , Seiquer Isabel , Navarro M Pilar
Published: September 2005

The effects of Maillard reaction products (MRP) from glucose–lysine and glucose–methionine on calcium bioavailability were studied by in vivo (rats) and in vitro (Caco‐2 cells) assays. Equimolar glucose/lysine and glucose/methionine mixtures (40% moisture) were heated (150 °C, 30 min) to prepare samples (GL30 and GM30, respectively). For 21 days, rats were fed a control diet (control group) or diets containing separately 3% of the heated mixtures (GL30 and GM30 groups, respectively). In the last week a calcium balance was performed, after which the animals were sacrificed and some organs and serum were removed to analyze calcium levels. A second balance was carried out throughout the experimental period to calculate global calcium retention (retained calcium during the entire 21 days). Unheated and heated samples were used for calcium transport experiments in Caco‐2 cells. Food intake and final body weight were lower in the GM30 group. Calcium fecal excretion decreased and digestibility increased in this group. Accordingly, increased calcium transport in Caco‐2 cells was found in the presence of the GM30 sample, when compared with the unheated sample. However, global calcium retention tended to decrease in the GM30 group, mainly owing to the lower food intake. Bone calcium concentrations decreased in the animals fed the MRP diets. The possible long‐term effects of MRP intake on calcium digestibility and bone calcium should be taken into account to avoid related diseases. Copyright © 2005 Society of Chemical Industry
Sacral versus pudendal nerve stimulation for voiding dysfunction: A prospective, single‐blinded, randomized, crossover trial
Authors: Peters Kenneth M. , Feber Kevin M. , Bennett Richard C.
Published: September 2005

Aims

The objective of the study was to compare sacral nerve stimulation (SNS) to pudendal nerve stimulation (PNS) for voiding dysfunction.

Methods

Thirty subjects with voiding dysfunction had a tined lead placed at S3 and a second electrode implanted at the pudendal nerve via a posterior approach. In a blinded, randomized fashion, each lead was tested for 7 days. Voiding diaries and questionnaires were completed and outcomes monitored.

Results

The time to place a sacral lead was 25.85 min, pudendal lead 23.71 min (P = 0.57). Twenty‐four of 30 (80%) subjects responded and had a permanent implant placed. PNS was chosen as a superior lead in 79.2%, SNS was superior in 20.8%. The order in which the lead was simulated had no impact on the final lead implanted and no carry over effect was seen. Overall reduction in symptoms was 63% for PNS and 46% for SNS (P = 0.02). On a 7‐point scale from markedly worse to markedly better, the pudendal lead was superior to sacral for pelvic pain (P = 0.024), urgency (P = 0.005), frequency (P = 0.007), and bowel function (P = 0.049). Complications were minimal.

Conclusions

This is the first blinded study of sacral versus pudendal stimulation for voiding dysfunction. Successful implantation of a pudendal lead was achieved in all subjects. The majority of subjects chose PNS to be superior to SNS. More patients and longer term data is needed to confirm these promising results. © 2005 Wiley‐Liss, Inc.
Monolithic modelling of electro‐mechanical coupling in micro‐structures
Authors: Rochus V. , Rixen D. J. , Golinval J.‐C.
Published: September 2005

The purpose of the present work is to model and to simulate the coupling between the electric and mechanical fields. A new finite element approach is proposed to model strong electro‐mechanical coupling in micro‐structures with capacitive effect. The proposed approach is based on a monolithic formulation: the electric and the mechanical fields are solved simultaneously in the same formulation. This method provides a tangent stiffness matrix for the total coupled problem which allows to determine accurately the pull‐in voltage and the natural frequency of electro‐mechanical systems such as MEMs. To illustrate the methodology results are shown for the analysis of a micro‐bridge. Copyright © 2005 John Wiley & Sons, Ltd.
Metropolitan restructuring (and more restructuring) in South Africa
Authors: Cameron Robert
Published: September 2005

This article analyses the evolution of metropolitan government in South Africa. During the past ten years South Africa has progressed from having no metropolitan government, to a two‐tier metropolitan system and now to a single‐tier metropolitan system. The ruling African National Congress (ANC) prefers single‐tier metropolitan authorities as a means to, inter alia, promote redistribution of resources and services, promote strategic land‐use planning and facilitate economic and social development. A single‐tier system was accordingly introduced in 2000. The major thrust of this article is an examination of the process that led to the introduction of six metropolitan governments, and the theoretical debates that underpinned this decision. It also analyses new types of executive systems, forms of public participation, development and service delivery. Finally, it provides a preliminary analysis of the performance of the new metropolitan governments. The article argues that structural reform, territorial changes, development in local government and new forms of service delivery have seriously overburdened local government in the short term and have detracted from service delivery. These unitary metros have, however, been operating for less than four years and must be given time to prove themselves before an informed evaluation can be made. Copyright © 2005 John Wiley & Sons, Ltd.
The governance of metropolitan areas in Canada
Authors: Sancton Andrew
Published: September 2005

This article briefly examines five significant Canadian developments with respect to the governance of metropolitan areas: annexations and mergers such that there is one main municipal government for the metropolitan area, two‐tier metropolitan government, the amalgamation of two‐tier metropolitan systems into a single municipality, demergers in Quebec, and the creation of flexible and innovative entities for metropolitan governance. Special attention is paid to the Greater Toronto Area, a continuous built‐up urban area that transcends at least three metropolitan areas as defined by Statistics Canada. In the absence of any authority covering the entire metropolitan area, it now appears that the Ontario provincial government is becoming the key policy maker. As an example of a flexible and innovative form of metropolitan governance, the Greater Vancouver Regional District merits attention elsewhere in the world. Canada's experiences with so many different institutional arrangements in recent years means that there is much to be learnt from their obvious failures and occasional successes. Copyright © 2005 John Wiley & Sons, Ltd.
Molecular‐microscopic characterization of 10 binary solvent mixtures based on solvatochromic reference solutes: a comparison of multiparametric empirical solvent scales
Authors: Mancini P. M. , Vottero L. R.
Published: September 2005

The main objective of this work was the comparison of molecular‐microscopic solvent descriptors measured from different solvatochromic reference probes. The π*, β and α (Kamlet, Abboud and Taft) and SPP, SB and SA (Catalán and co‐workers) multiparametric approaches were selected for this analysis. Attention was focused on the comparison of paired measurements corresponding to different types of binary solvent mixtures in which the pure solvents are able to form molecular associates by specific intermolecular interactions. The linear correlation between paired parameters measured using both scales was analyzed in order to investigate the strength of the relationship between them. Taking into account that the correlation coefficient says nothing about the magnitude of the differences between paired solvent descriptors, the Bland and Altman method was applied in order to establish the degree of agreement between different scales which measure the same solvent molecular‐microscopic property. Although both multiparametric approaches are fairly powerful tools to quantify the molecular‐microscopic solvent properties of pure and mixed solvents, the unequivocally correct measurements remain unknown. It can be considered that the mean of paired values is the best estimate available. Copyright © 2005 John Wiley & Sons, Ltd.
Fractionation process in TREF systems: Validation of thermodynamic model and calculation procedure by Raman LAM studies
Authors: Tomba J. Pablo , Carella José M. , Pastor Jośe M.
Published: September 2005

In this paper, possible sources for the unexpected distributions of crystalline sequence lengths calculated from temperature rising elution fractionation (TREF) calibration experiments, as reported in a previous work, are investigated. With this aim, chain folding and cocrystalization phenomena were explored in the conditions of crystallization as used for TREF or crystallization analysis fractionation (CRYSTAF). Slow crystallizations were performed from xylene solutions of model low molecular weight ethylene homopolymers with narrow molecular weight distributions. The same experiments were performed with homopolymers having narrow molecular weight distributions and with blends having wide molecular weight distributions. The resulting distributions of the lengths of crystalline methylene sequences were directly studied by Raman in the so‐called longitudinal acoustic mode (LAM) and by DSC. For ethylene homopolymers with molecular weights below 2000 g/mol, the results from Raman LAM indicate that slow crystallization in TREF or CRYSTAF systems occurs in the extended‐chain mode. For higher molecular weights, evidence of chain folding was found. In the case of blends, independent crystallization was observed for each molecular weight when the molecular weight ranges used for the blends are relatively narrow. Cocrystallization was observed when this range was increased. Overall, these results strongly support the inverse technique calculation procedure developed by our group for the calculation of distributions of lengths of crystallizable sequences from TREF spectra. In this context, the results confirm that the unexpected crystallizable sequence lengths found in our previous work really exist and can be associated to chain folding or cocrystallization phenomena. © 2005 Wiley Periodicals, Inc. J Polym Sci Part B: Polym Phys 43: 3083–3092, 2005
Additional antiprotozoal constituents from Cuphea pinetorum, a plant used in Mayan traditional medicine to treat diarrhoea
Authors: Calzada Fernando
Published: September 2005

In addition to kaempferol and quercetin already found in the roots from Cuphea pinetorum, bioassay‐guided fractionation of the crude extract of the aerial part of this species gave four flavonoid glycosides, quercetin‐3‐O‐α‐rhamnopyranoside, luteolin‐7‐O‐β‐d‐glucopyranoside, apigenin‐7‐O‐α‐l‐rhamnopyranoside and apigenin‐7‐O‐β‐d‐glucopyranoside, as well as squalen and β‐sitosterol. In vitro antiamoebic and antigiardial activities of isolated compounds indicated that kaempferol is the principal antiprotozoal agent in C. pinetorum. Based on finding this antiprotozoal inhibitor, flavonoids were studied in order to elucidate structure‐activity relationships. These data suggest that kaempferol may play an important role in antidiarrhoeal activity of C. pinetorum. Copyright © 2005 John Wiley & Sons, Ltd.
Hypoglycemic effect and chlorogenic acid content in two Cecropia species
Authors: Nicasio Pilar , Aguilar‐Santamaría Lucía , Aranda Eduardo , Ortiz Sharon , González Manasés
Published: September 2005

The hypoglycemic effect of methanol leaf extracts from Cecropia obtusifolia and C. peltata was evaluated in healthy mice. A significant decrease (p < 0.05) in plasma glucose levels was recorded 2 and 4 h after a single oral administration of methanol extracts (1 g/kg). This effect was correlated with the chlorogenic acid contents in both species; C. peltata, containing 19.84 ± 1.64 mg of chlorogenic acid/g of dried leaves produced the highest decrease (Dα 2,60 = 20.18, p < 0.05) of plasma glucose levels (52.8%). The extracts of C. obtusifolia from Tabasco and Veracruz, showed similar hypoglycemic effects (33.3% and 35.7%, respectively) and chlorogenic acid contents (Tukey0.05 = 1.8859) (13.3 ± 3.2 mg/g and 13.1 ± 1.6 mg/g, respectively). The hypoglycemic effect produced by different doses (0.1, 0.25, 0.50, 0.75 and 1 g/kg body wt, p.o.) of C. peltata showed a lineal relationship with chlorogenic acid content, reaching an ED50 = 0.540 g/kg body wt for extract, and an ED50 = 10.8 mg/kg body wt for chlorogenic acid. These results suggest that C. peltata is a better hypoglycemic agent than C. obtusifolia, and it could be considered for developing a phytomedicinal product to carry out clinical trials. Copyright © 2005 John Wiley & Sons, Ltd.
The effects of a Chinese medicinal suppository (Vitalliver) on insulin‐like growth factor 1 and homocysteine in patients with hepatitis B infection
Authors: Chui S. H. , Chan K. , Chui A. K. K. , Shek L. S. L. , Wong R. N. S.
Published: September 2005

The liver is the major organ for the metabolism of homocysteine (Hcy) and production of insulin‐like growth factor 1 (IGF‐1). Hcy metabolism and IGF‐1 synthesis may be impaired in chronic liver diseases. The study investigated the regulatory effect of a Chinese herbal suppository, Vitalliver, on Hcy and IGF‐1, as well as their relationship in patients with hepatitis B infection. Forty patients with chronic hepatitis B virus (HBV) infection without cirrhosis, 25 males and 15 females, were observed for changes in Hcy and IGF‐1 after the administration of Vitalliver (one nightly) for a period of 3 months. Serum levels of Hcy, IGF‐1 and IGFBP‐3 were measured at baseline, and at 1 month and 3 months after treatment. Vitalliver reduced Hcy levels significantly (p = 0.001) from 9.7 ± 2.8 to 9.0 ± 2.1 µmol/L after treatment of 3 months. Furthermore, the IGF‐1 levels increased significantly (p < 0.001) from 170.2 ± 81.8 to 212.8 ± 80.9 ng/mL at 1 month and 187.5 ± 72.3 ng/mL at 3 months (p = 0.001) after treatment. In conclusion, it is speculated Vitalliver may have a self‐regulatory effect on the release of IGF‐1 in HBV patients without liver cirrhosis. Copyright © 2005 John Wiley & Sons, Ltd.
Effect of water on zinc (II), cadmium (II) complexes with pyridylimidazole: Theoretical study of stability and electronic spectrum
Authors: Liao Yi , Su Zhong‐Min , Kan Yu‐He , Yue Shu‐Mei , Ma Jian‐Fang , Yang Ji‐Hua
Published: September 2005

The geometry structures of complexes such as [Zn(PIm)2(H2O)] and [Cd(PIm)2(H2O)2] [PIm = (2‐(2′‐pyridyl) imidazole)] are optimized by density functional theory (DFT) B3LYP methods. On the basis of their stable structures, the stability of the coordinated water existing in the complexes is analyzed quantitatively in terms of the interaction between the central metal and the coordinated water. The interaction energy of the Zn pyridylimidazole complex increased obviously by considering the intermolecular hydrogen bond (OH…N). The theoretical calculation well explained penta‐ and hexa‐coordinated conformation, respectively, in Zn and Cd pyridylimidazole complexes. The spectral properties of the Zn Cd complexes have been studied by time‐dependent density functional theory (TD‐DFT). The calculation results show that the coordinated waters in Cd complexes have little effect on their spectral properties. While the axially coordinated waters in Zn pyridylimidazole cause a red shift in the absorption wavelength and change the pattern of charge transfer as a result of the effect of polarization from intermolecular hydrogen bond. © 2005 Wiley Periodicals, Inc. Int J Quantum Chem, 2006
Re: Comment on “New methods for old Coulomb few‐body problems”
Authors: Harris Frank E. , Frolov Alexei M. , Smith Vedene H.
Published: September 2005

The scope and purpose of the subject paper by the present authors Int J Quantum Chem 2004, 100, 1086 are clarified. © 2005 Wiley Periodicals, Inc. Int J Quantum Chem, 2006
The Drosophila homologue of the dystrophin gene – Introns containing promoters are the major contributors to the large size of the gene
Authors: Neuman Sara , Kovalio Moran , Yaffe David , Nudel Uri
Published: September 2005

We show that the drosophila gene encoding the dystrophin‐like protein (DLP) is as complex as the mammalian dystrophin gene. Three 5′ promoters and three internal promoters regulate the expression of three full‐length and three truncated products, respectively. The existence of this complex gene structure in such evolutionary remote organisms suggests that both types of products have diverse important functions. The promoters of both the DLP gene and the mammalian dystrophin gene are located in very large introns. These introns contribute significantly to the large size of the genes. The possible relevance of the conservation of the large size of introns containing promoters to the regulation of promoter activity is discussed.
Aneurysmal Bone Cyst Involving the Lunate
Authors: MANKIN K. P. , BISCHOFF R. J. , GELBERMAN R. H. , ROSENBERG A. E.
Published: September 2005

Aneurysmal bone cysts are rare lesions which even more rarely involve the bones of the hand. We report a case of a cyst involving the lunate which was initially mistaken for interosseous ganglion. Due to delay in diagnosis, marked destruction of the lunate occurred, necessitating excision and scapho-capitate arthrodesis. Although rare, aneurysmal bone cysts should be included in the differential diagnosis and ruled out prior to embarking on a course of treatment.
Klumpke’s Birth Palsy
Authors: AL-QATTAN M. M. , CLARKE H. M. , CURTIS C. G.
Published: September 2005

Erb’s palsy is the most common obstetric brachial plexus injury followed by total plexus palsy. The distribution of Klumpke’s birth palsy with modern obstetric practice is unknown. In this paper, we studied the distribution of Klumpke’s birth palsy in our series of 235 consecutive cases of obstetrical brachial plexus injury and determined the incidence of this type of palsy to be 0.6% as cited in the English literature over the last decade.
The Relationships between Skin Hardness, Pressure Perception and two-Point Discrimination in the Fingertip
Authors: DELLON E. S. , KELLER K. , MORATZ V. , DELLON A. L.
Published: September 2005

With the recent introduction of computer-assisted sensibility testing devices, it is possible to investigate the hypothesis that the neurological mechanisms responsible for perception of pressure and two-point discrimination are influenced by skin hardness. This study examined the relationships between the skin hardness of the human index and little finger pulp and the perception of pressure in 25 adults. Skin hardness was measured using the Derma-Durometer. Pressure perception was measured with the Pressure-Specified Sensory Device®* for both static and moving touch stimuli and for two-point discrimination. The mean hardness of the fingertip pulp was 12.5 ± 0.6 gm/mm2. There was no statistically significant difference in hardness between the dominant and non-dominant, right and left, index and little, or male and female fingertips. Skin hardness was independent of age for this population. The highest correlation, which was r = 0.46, was found between the cutaneous pressure threshold for one-point static touch and skin hardness. While this degree of correlation is significant at the P < 0.02 level, the r2 = 21%, demonstrating that this degree of correlation leaves 79% of the variability unexplained. These results suggest a physical interaction between mechanoreceptors and dermis that is only partially explained by the hardness of the skin.
A Complex Free Toe Transfer after a Reverse Radial Forearm Flap
Authors: CULP R. W. , LINEAWEAVER W. C. , PARTINGTON M. , TARAS J.
Published: September 2005

A case is reported of the difficulties associated with late free toe transfer for thumb reconstruction after an initial reverse radial forearm flap.
A Simple and Efficient Treatment for Fingertip Injuries
Authors: LEE L. P. , LAU P. Y. , CHAN C. W.
Published: September 2005

We have developed a simple, cheap and efficient method of management of fingertip injuries using an occlusive dressing – the fingertip cap (Hyphecan). The results of 156 fingertip injuries treated with this method demonstrate recovery to a near normal fingertip.
Effect of Suture Knots on Tensile Strength of Repaired Canine Flexor Tendons
Authors: AOKI M. , PRUITT D. L. , KUBOTA H. , MANSKE P. R.
Published: September 2005

59 dog cadaver flexor digitorum profundus tendons were repaired with one or two knots inside or outside the tendon, using two, four and six suture strands. The ultimate tensile strength and gap strengths were compared. Locating the knots outside rather than within the tendon repair site showed significantly higher ultimate tensile strength for two, four, and six strand sutures. The strength was greater in one knot than in two knot sutures; the value of the six-strand suture using the one knot outside technique was the greatest. Similarly, increased gap strength was also obtained from the one-knot-outside technique. We concluded that the knots should be located away from the tendon repair site and there should be as few as possible.
Buttress Pinning in the Unstable Distal Radial Fracture
Authors: BENOIST L. A. , FREELAND A. E.
Published: September 2005

Between 1989 and 1993, 20 patients with distal radial fractures were treated with a buttressing technique felt to be safe, effective and simple. Out of the initial 20 patients, 16 have been followed-up and are reported. The technique uses an intramedullary styloid pin and a combined extramedullary–intramedullary dorsal buttress pin. The insertion technique and the use of a medial corner pin are illustrated. Results are evaluated from both final X-ray appearance as well as return of function using the five X-ray parameters of Abbasazadegan et al (1989) and the Mayo modification of the Green and O’Brien wrist score (Cooney et al, 1987). The average score on return of function was 78 (two excellent, eight good, six fair). Final axial shortening averaged –1.4mm (+5 mm– –4 mm), radial displacement averaged 0.68 mm (0 mm–5 mm), radial angle averaged 24.75° (18°–34°), dorsal angle averaged +8.25° (–5°–25°) and dorsal displacement averaged +1.31 (0 mm–+12 mm). From this study we recognize the need for a posterior medial pin, and that routine stress views after pinning can yield information concerning carpal instability, palmar instability and the need for bone grafting.
The Distally-Based Dorsal Hand Flap for Resurfacing Skin Defects in Dupuytren’s Contracture
Authors: EKEROT L.
Published: September 2005

Surgery for recurrence of Dupuytren’s disease often results in a volar skin defect. The use of the distally-based dorsal hand flap for resurfacing is reported. 17 flaps were used to cover 16 fingers after radical digital fasciectomy. All flaps survived with minor areas of partial necrosis in four of them. The raising of the flap was a simple procedure and good quality skin cover was achieved. There were no complaints about the donor site or the flap pedicle passing between the digits. The short post-operative immobilization time might result in less stiffness and a better functional result. It is concluded that the flap is a useful technique in treating skin defects in this condition resulting from surgical excision of the disease and involved skin.
Congenital Varicella of the Upper Limb
Authors: AL-QATTAN M. M. , THOMSON H. G.
Published: September 2005

Two patients with a rare form of congenital varicella involving the upper limb are described. The spectrum of disease, pathophysiology, principles of management and prevention are discussed.
Open Dislocation of the Trapezoid
Authors: CUÉNOD P. , DELLA SANTA D. R.
Published: September 2005

Isolated dislocation of trapezoid is rare. We report here a new case of open dorsal dislocation of the trapezoid following a high energy crush injury of the left hand in a factory worker. It was associated with multidigital mutUation and metacarpal fractures.
Analysis of Proximal Fragment Sclerosis and Surgical Outcome of Scaphoid Non-Union by Magnetic Resonance Imaging
Authors: SAKUMA M. , NAKAMURA R. , IMAEDA T.
Published: September 2005

32 patients with scaphoid non-union were examined to clarify the relationship between pre-operative radiographic sclerosis in the proximal fragment and signal intensity on magnetic resonance imaging (MRI). In addition, the correlation between changes in signal intensity in the proximal fragment and surgical outcome after bone grafting and internal fixation was investigated. Proximal fragment sclerosis was observed in seven patients. Comparison of the T1 and T2-weighted images with those of the 25 patients without proximal fragment sclerosis revealed no differences. Therefore, there was no relationship between sclerotic changes on plain radiography and the degree of avascularity of the proximal fragment assessed by MRI. None of the patients who had low signal intensity on both T1 and T2-weighted images achieved union within 5 months after surgery. Thus the detection of signal intensity on both T1 and T2-weighted images can be useful to predict the prognosis after the surgery.
Occult Injury of the Median Nerve
Authors: FAITHFULL D. K. , PETCHELL J. F.
Published: September 2005

A case of median nerve injury caused by an unsuspected foreign body is described. The mechanism was not recognized at the time of injury. The suspicion of a penetrating missile injury was raised only with the aid of radiographs. At operation the foreign body was found in the substance of the median nerve.
Low Velocity Gun Shot Wounds of the Brachial Plexus
Authors: VRETTOS B.C. , ROCHKIND S. , BOOME R.S.
Published: September 2005

28 patients with low velocity gunshot wounds of the brachial plexus were treated at Groote Schuur Hospital from 1980 to 1991. Delayed exploration of the brachial plexus (up to 7 months after injury) was performed in nine (30%) of the patients. The other 19 patients did not have exploration of the plexus; most of these patients showed signs of recovery within 2 to 4 weeks of injury. Injury to the subclavian or axillary artery occurred in nine (30%) of the cases.

The average length of follow-up of the patients was 19 months (range 2–90 months). Of the 19 patients treated non-operatively, 15 (79%) had an excellent or good result and four (21%) a fair result. The indications for surgery were the absence of improvement within 3 months of injury or persistent pain. Surgery was indicated for significant pain in five of the nine patients; post-operatively two had complete relief of pain, two improvement in the pain and one no improvement. Of the nine surgically treated patients, three (33%) had a good result, two (22%) a fair result and four (45%) a poor result. The potential for recovery was not dependent on the severity of the injury at presentation or the presence of vascular injury but on the appearance of signs of recovery within 4 weeks of injury.
The Provision of Innervated Skin Cover for the Injured Thumb Using Dorsal Metacarpal Artery Island Flaps
Authors: WILLIAMS R. L. , NANCHAHAL J. , SYKES P. J. , O’SHAUGHNESSY M.
Published: September 2005

Provision of stable sensate skin is of great importance in reconstruction of the injured thumb. Island flaps based on the dorsal metacarpal arteries were used to resurface ten injured thumbs, and the degree of retained sensibility was assessed using static and moving two-point discrimination and the pick-up test. Results show that these flaps are capable of providing stable full-thickness skin cover in a single procedure and functional sensibility is retained in most cases.

The second dorsal metacarpal artery island flap, previously advocated for use in small thumb defects only, has been successfully used as a large wraparound flap in two cases. In one of these it was used with free bone graft to increase the length of the thumb and an excellent functional result was achieved.
Cold-Induced Vasospasm after Digital Replantation does not Improve with Time
Authors: POVLSEN B. , NYLANDER G. , NYLANDER E.
Published: September 2005

The incidence of cold-induced vasospasm after hand injuries has been reported to be as high as 100%, following replanted digital amputations. The exact cause of this problem is obscure, no specific treatment is available and little is known about the long-term prognosis. Further knowledge is therefore needed in order to advise patients concerning future job potential at an early stage. In a previous paper we evaluated the incidence and severity of cold intolerance 2 years after digital replantation. The incidence of cold-induced vasospasm then was high as well as the discomfort experienced by the patients. We carried out a follow-up of patients previously examined 10 years ago. Our results show that cold induced vasospasm in replanted digits does not improve with time. Patients with moderate symptoms may perceive improvement, probably due to a change of habits. Patients with severe problems did not experience improvement and should be given early advice to seek work in warm surroundings to reduce the discomfort.
Bone Suture Anchors in Hand Surgery
Authors: SKOFF H. D. , HECKER A. T. , HAYES W. C. , SEBELL-SKLAR R. , STRAUGHN N.
Published: September 2005

The recent development of small bone suture anchors has created potential applications in reconstructive surgery of the hand and wrist. A combined laboratory and clinical study was devised to evaluate their use. 16 paired fingers (32 in all) from eight cadaveric hands were disarticulated at the MP joint with a 10 cm tail of FDP tendon. The FDP insertion was released in all specimens. In 16 fingers reinsertion was performed with the classic Bunnell technique; in the paired 16 fingers, the repair utilized Acufex 2 mm anchors.

There was no significant difference between the two groups regarding load-to-failure at approximately 40 Newtons. The mean stiffness of the anchor repairs was significantly greater than the Bunnell repairs.

19 consecutive patients were prospectively enrolled with a tendon or ligament repair of the hand or wrist using bone anchors. The average age was 41 years and the average length of follow-up was 24 months. All repairs were stable at the time of follow-up. Bone anchors were simple to insert, required less dissection and surgical time than the Bunnell technique and appeared to be reliable in both laboratory and clinical settings.
Combined Fourth and Fifth Metacarpal Fracture and Fifth Carpometacarpal Joint Dislocation
Authors: LIAW Y. , KALNINS G. , KIRSH G. , MEAKIN I.
Published: September 2005

Three cases of hamato-metacarpal fracture-dislocation with fracture of the shaft or base of the fourth metacarpal and dorsal dislocation of the fifth metacarpal are described. In one case this was associated with coronal fracture of the hamate. An oblique radiograph of the hand with the forearm pronated 15° and 45° provided a good view of the extent of the fourth and fifth carpometacarpal injury. Treatment with open reduction and internal fixation achieves good clinical results.
Swan-Neck Deformity as a Complication of the Agee Technique
Authors: RAWES M. L. , ONI O. O. A.
Published: September 2005

Unstable dorsal fracture dislocations of the PIP joint of a finger commonly result in joint stiffness following immobilization or open reduction and internal fixation (Green and Rowland, 1984). The Agee dynamic external fixator, or force couple splint (Agee, 1978Agee, 1987), was introduced in an attempt to avoid this complication and maintains a concentric reduction whilst allowing a full range of joint movement. The splint is constructed from three Kirschner wires and is activated by a single rubber band. A force couple is created across the proximal interphalangeal joint levering the base of the middle phalanx towards the palm whilst simultaneously lifting the distal end of the proximal phalanx dorsally to restore joint reduction. However, this technique is not without complications (Agee, 1987). We report a swan-neck deformity resulting from this treatment.
Clinical Application of a Biological Membrane to Prevent Adhesions of Flexor Tendon Repair
Authors: Shao X-S. , Lin T. , Zhang Y. , Zhang K-L. , Zhang J-J.
Published: September 2005

This paper reports the clinical results of reconstructing flexor tendon sheath by a chemically treated absorbable semi-permeable polylactic membrane. This membrane was shown in previous experimental studies to be absorbed 24 weeks after operation and created a good pseudosynovial sheath for tendon gliding. Since January 1989, 80 cases (110 fingers) with flexor tendon lacerations in zone 2 were treated by this technique. These included 52 fingers with primary tendon repair and 58 fingers with free tendon grafts at secondary surgery. The biological membrane was used to repair the defect of the sheath in primary surgery, and in secondary tendon grafting the membrane was wrapped as a tube around the graft and fixed to the graft by suture at its distal end and to the A1 pulley in its proximal end. Controlled passive finger flexion using Kleinert rubber band fraction was commenced 3 days after surgery and active motion after 3 weeks. The cases were followed for 1 to 4 years. The results of repair were excellent in 29 fingers, good in 54, fair in 15, and poor in 3 by the TAM system. The rate of excellent and good results was 82.0%. One case of primary repair developed rupture of the repair due to wound infection.
Management of Vascular Defects in Digital Replantation
Authors: Ren Z-Y. , Wang C-Q. , Fan Q-S. , Shen G-F. , Yan H. , Wang Z-T.
Published: September 2005

207 cases of digital amputation (261 digits) with vascular defects were replantated during the past two decades. The vascular defect was managed with various methods. 240 digits (92%) survived with good post-operative circulation and recovery of function. The methods of management of arterial defects were as follows: 1) Digital artery transfer from adjacent digits in 25 thumbs and three index fingers. All had survived. 2) Arterial transplantation: in 12 digits, arteries from the contralateral side or from the digits that were unsuitable for replantation were grafted to fill the arterial defects. All of these fingers survived. 3) Vein graft: superficial veins were taken to reconstruct the defects of the digital arteries in 59 digits, with 55 digits surviving and four failing. 4) Ulnar digital arterial flap of the ring finger. This technique was used in four digits with composite artery and soft tissue loss. All the cases survived. 5) Implantation of the arteries into the distal amputation parts. This was done in two digits with no arteries for anastomosis in the distal parts. The management of venous defects was as follows: 1) Transfer of veins from the adjacent digits. Five digits treated with this technique survived well. 2) Vein graft. Six digits survived but one failed. 3) A venous flap was done in six digits and all the digits survived after this procedure. 4) Arterio-venous anastomosis: this was used in 20 digits without suitable veins for anastomosis in replantation of the digit distal to the DIP joint level. 5) Replantation without venous return: a fish-mouth incision and heparin irrigation was used for venous drainage in 19 digits, with survival of 14. 6) The palmar venous system was anastomosed in 84 digits without dorsal veins for suture. 77 digits survived. 7) Venous fascial flap transfer: A composite venous fascial flap was harvested from the adjacent fingers. The flap was turned over on the side close to the injured finger to make an anastomosis of the veins with those in the distal amputated part. A skin graft was placed over the flap without a tie-over dressing. The pedicle was divided 3 weeks later. All the 16 digits with this technique survived well.
Biochemical Analysis of the Proteins Secreted by Schwann Cells and Schwann Cell-Derived Neurotrophic Substances
Authors: Gu Li-quang , Zhu Jia-kai
Published: September 2005

The dissociated Schwann cells (SCs) taken from the adult rat sciatic nerve undergoing Wallerian degeneration were cultured in serum-free medium. The SCs serum-free conditioned medium (SC-SF-CM) was collected, ultrafiltrated and concentrated. The proteins secreted by SCs in SC-SF-CM ultrafiltrated-concentrated solution were analyzed by SDS-PAGE. It was found that there were 14 protein bands, which molecular weight were from more than 94 KDa to less than 43 KDa, with their main band at 65 KDa. By immunoblotting (Western Blot) for anti-2.5S NGF antibody, NGF was identified to exist in the proteins secreted by SCs. SC-SF-CM ultrafiltrated-concentrated solution was also separated by Disc-PAGE at 4°C, then electroluted, concentrated and collected. By biological activity examination for motor neuro-trophic substances, one protein zone (B+) of these was identified to have motor NTF activity, which contain five protein bands from 65 KDa to 34 KDa.
Early Active Mobilization of Tendon Grafts Using Mesh Reinforced Suture Techniques
Authors: SILFVERSKIÖLD K. L. , MAY E. J.
Published: September 2005

The flexor digitorum profundus tendon in 11 digits with division of both flexor tendons in zone 2 was reconstructed with a palmaris longus tendon graft in a two-stage procedure. The distal and proximal fixation of the graft was reinforced with a polyester mesh sleeve placed around the ends of the graft during stage 1. All digits were mobilized with a combination of active extension and active and passive flexion within 3 days of the second stage. There were three ruptures, one due to faulty technique and two due to falls on outstretched hands during alcohol intoxication and football. Excluding the ruptures, the mean active composite distal and proximal interphalangeal joint range of motion 6 weeks and 6 months post-operatively was 141° and 136° respectively. The results indicate that palmaris longus tendon grafts can survive and heal during early active mobilization, with few or no adhesions of functional significance. The techniques described here represent one possible approach to the safe implementation of early active mobilization after tendon grafting procedures.
Tissue Expansion for Apert’s Syndactyly
Authors: ASHMEAD D. , SMITH P. J.
Published: September 2005

Tissue expansion is useful in post-traumatic reconstruction in the upper extremity. Its use has also been proposed in congenital syndactyly. Expanded local skin flaps would in theory provide locally appropriate cover, obviating the need for skin grafts. We report a retrospective assessment of tissue expansion in the management of Apert’s syndactyly. Despite theoretical benefits, tissue expansion significantly increased the required number of operations. The technique was associated with an unacceptable rate of complications, and generated inadequate skin flaps, and web spaces requiring a higher rate of revision than traditional techniques. Despite expectations, tissue expansion for Apert’s syndactyly proved disappointing and is not advocated.