bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ponseti casting
Authors: Brewster M. B. S. , Gupta M. , Pattison G. T. R. , Dunn-van der Ploeg I. D. 
Published: November 2008

We have modified the Ponseti casting technique by using a below-knee Softcast instead of an above-knee plaster of Paris cast. Treatment was initiated as soon as possible after birth and the Pirani score was recorded at each visit. Following the manipulation techniques of Ponseti, a below-knee Softcast was applied directly over a stockinette for a snug fit and particular attention was paid to creating a deep groove above the heel to prevent slippage. If necessary, a percutaneous Achilles tenotomy was performed and casting continued until the child was fitted with Denis Browne abduction boots. Between April 2003 and May 2007 we treated 51 consecutive babies with 80 idiopathic club feet with a mean age at presentation of 4.5 weeks (4 days to 62 weeks). The initial mean Pirani score was 5.5 (3 to 6). It took a mean of 8.5 weeks (4 to 53) of weekly manipulation and casting to reach the stage of percutaneous Achilles tenotomy. A total of 20 feet (25%) did not require a tenotomy and for the 60 that did, the mean Pirani score at time of operation was 2.5 (0.5 to 3). Denis Browne boots were applied at a mean of 10 weeks (4 to 56) after presentation. The mean time from tenotomy to boots was 3.3 weeks (2 to 10). We experienced one case of cast-slippage during a period of non-attendance, which prolonged the casting process. One case of prolonged casting required repeated tenotomy, and three feet required repeated tenotomy and casting after relapsing while in Denis Browne boots. We believe the use of a below-knee Softcast in conjunction with Ponseti manipulation techniques shows promising initial results which are comparable to those using above-knee plaster of Paris casts.
Pre-operative predictors of the length of hospital stay in total knee replacement
Authors: Smith I. D. M. , Elton R. , Ballantyne J. A. , Brenkel I. J. 
Published: November 2008

In Scotland, the number of primary total knee replacements performed annually has been increasing steadily. The price of the implant is fixed but the length of hospital stay is variable. We prospectively investigated all patients who underwent primary unilateral total knee replacement in the Scottish region of Fife, between December 1994 and February 2007 and assessed their recorded pre-operative details. The data were analysed using univariate and multiple linear regression statistical analysis. Data on the length of stay were available from a total of 2106 unilateral total knee replacements. The median length of hospital stay was eight days. The significant pre-operative risk factors for an increased length of stay were the year of admission, details of the consultant looking after the patient, the stair score, the walking-aid score and age. Awareness of the pre-operative factors which increase the length of hospital stay may provide the opportunity to influence them favourably and to reduce the time in hospital and the associated costs of unilateral total knee replacement.
The value of radiographs obtained during forced traction under general anaesthesia in predicting flexibility in idiopathic scoliosis with Cobb angles exceeding 60°
Authors: Ibrahim T. , Gabbar O. A. , El-Abed K. , Hutchinson M. J. , Nelson I. W. 
Published: November 2008

Our aim in this prospective radiological study was to determine whether the flexibility rate calculated from radiographs obtained during forced traction under general anaesthesia, was better than that of fulcrum-bending radiographs before corrective surgery in predicting the extent of the available correction in patients with idiopathic scoliosis. We evaluated 33 patients with a Cobb angle > 60° on a standing posteroanterior radiograph, who had been treated by posterior correction. Pre-operative standing fulcrum-bending radiographs and those with forced-traction under general anaesthesia were obtained. Post-operative standing radiographs were taken after surgical correction. The mean forced-traction flexibility rate was 55% (sd 11.3) which was significantly higher than the mean fulcrum-bending flexibility rate of 32% (sd 16.1) (p < 0.001). We found no correlation between either the forced-traction or fulcrum-bending flexibility rates and the correction rate post-operatively (p = 0.24 and p = 0.44, respectively). Radiographs obtained during forced traction under general anaesthesia were better at predicting the flexibility of the curve than fulcrum-bending radiographs in curves with a Cobb angle > 60° in the standing position and may identify those patients for whom supplementary anterior surgery can be avoided.
Arthroscopic release for painful subtalar stiffness after intra-articular fractures of the calcaneum
Authors: Lee K.-B. , Chung J.-Y. , Song E.-K. , Seon J.-K. , Bai L.-B. 
Published: November 2008

We describe the surgical technique and results of arthroscopic subtalar release in 17 patients (17 feet) with painful subtalar stiffness following an intra-articular calcaneal fracture of Sanders’ type II or III. The mean duration from injury to arthroscopic release was 11.3 months (6.4 to 36) and the mean follow-up after release was 16.8 months (12 to 25). The patient was positioned laterally and three arthroscopic portals were placed anterolaterally, centrally and posterolaterally. The sinus tarsi and lateral gutter were debrided of fibrous tissue and the posterior talocalcaneal facet was released. In all, six patients were very satisfied, eight were satisfied and three were dissatisfied with their results. The mean American Orthopaedic Foot and Ankle Society ankle-hindfoot score improved from a mean of 49.4 points (35 to 66) pre-operatively to a mean of 79.6 points (51 to 95). All patients reported improvement in movement of the subtalar joint. No complications occurred following operation, but two patients subsequently required subtalar arthrodesis for continuing pain. In the majority of patients a functional improvement in hindfoot function was obtained following arthroscopic release of the subtalar joint for stiffness and pain secondary to Sanders type II and III fractures of the calcaneum.
Histopathological and biochemical changes following fat embolism with administration of corn oil micelles
Authors: Liu D. D. , Hsieh N.-K. , Chen H. I. 
Published: November 2008

Several experimental models have been used to produce intravascular fat embolism. We have developed a simple technique to induce fat embolism using corn oil emulsified with distilled water to form fatty micelles. Fat embolism was produced by intravenous administration of these fatty micelles in anaesthetised rats, causing alveolar oedema, haemorrhage and increased lung weight. Histopathological examination revealed fatty droplets and fibrin thrombi in the lung, kidney and brain. The arteriolar lumen was filled with fatty deposits. Following fat embolism, hypoxia and hypercapnia occurred. The plasma phospholipase A2, nitrate/nitrite, methylguidanidine and proinflammatory cytokines were significantly increased. Mass spectrometry showed that the main ingredient of corn oil was oleic acid. This simple technique may be applied as a new animal model for the investigation of the mechanisms involved in the fat embolism syndrome.
The Harris-Galante porous-coated, hemispherical, polyethylene-lined acetabular component in patients under 50 years of age
Authors: Utting M. R. , Raghuvanshi M. , Amirfeyz R. , Blom A. W. , Learmonth I. D. , Bannister G. C. 
Published: November 2008

We have reviewed 70 Harris-Galante uncemented acetabular components implanted as hybrid hip replacements with cemented stems between 1991 and 1995 in 53 patients whose mean age was 40 years (19 to 49). The mean follow-up was for 13.6 years (12 to 16) with no loss to follow-up. We assessed the patients both clinically and radiologically. The mean Oxford hip score was 20 (12 to 46) and the mean Harris hip score 81 (37 to 100) at the final review. Radiologically, 27 hips (39%) had femoral osteolysis, 13 (19%) acetabular osteolysis, and 31 (44%) radiolucent lines around the acetabular component. Kaplan-Meier survival curves were constructed for the outcomes of revision of the acetabular component, revision of the component and polyethylene liner, and impending revision for progressive osteolysis. The cumulative survival for revision of the acetabular component was 94% (95% confidence interval 88.4 to 99.7), for the component and liner 84% (95% confidence interval 74.5 to 93.5) and for impending revision 55.3% (95% confidence interval 40.6 to 70) at 16 years. Uncemented acetabular components with polyethylene liners undergo silent lysis and merit regular long-term radiological review.
Simultaneous anterior decompression and posterior instrumentation of the tuberculous spine using an anterolateral extrapleural approach
Authors: Jain A. K. , Dhammi I. K. , Prashad B. , Sinha S. , Mishra P. 
Published: November 2008

Injury to the spinal cord and kyphosis are the two most feared complications of tuberculosis of the spine. Since tuberculosis affects principally the vertebral bodies, anterior decompression is usually recommended. Concomitant posterior instrumentation is indicated to neutralise gross instability from panvertebral disease, to protect the anterior bone graft, to prevent graft-related complications after anterior decompression in long-segment disease and to correct a kyphosis. Two-stage surgery is usually performed in these cases. We present 38 consecutive patients with tuberculosis of the spine for whom anterior decompression, posterior instrumentation, with or without correction of the kyphus, and anterior and posterior fusion was performed in a single stage through an anterolateral extrapleural approach. Their mean age was 20.4 years (2.0 to 57.0). The indications for surgery were panvertebral disease, neurological deficit and severe kyphosis. The patients were operated on in the left lateral position using a ‘T’-shaped incision sited at the apex of kyphosis or lesion. Three ribs were removed in 34 patients and two in four and anterior decompression of the spinal cord was carried out. The posterior vertebral column was shortened to correct the kyphus, if necessary, and was stabilised by a Hartshill rectangle and sublaminar wires. Anterior and posterior bone grafting was performed. The mean number of vertebral bodies affected was 3.24 (2.0 to 9.0). The mean pre-operative kyphosis in patients operated on for correction of the kyphus was 49.08° (30° to 72°) and there was a mean correction of 25° (6° to 42°). All except one patient with a neural deficit recovered complete motor and sensory function. The mean intra-operative blood loss was 1175 ml (800 to 2600), and the mean duration of surgery 3.5 hours (2.7 to 5.0). Wound healing was uneventful in 33 of 38 patients. The mean follow-up was 33 months (11 to 74). None of the patients required intensive care. The extrapleural anterolateral approach provides simultaneous exposure of the anterior and posterior aspects of the spine, thereby allowing decompression of the spinal cord, posterior stabilisation and anterior and posterior bone grafting. This approach has much less morbidity than the two-stage approaches which have been previously described.
The cytotoxic effect of phenol and ethanol on the chondrosarcoma-derived cell line OUMS-27
Authors: Verdegaal S. H. M. , Corver W. E. , Hogendoorn P. C. W. , Taminiau A. H. M. 
Published: November 2008

Surgery is considered to be the most effective treatment for cartilaginous tumours. In recent years, a trend has emerged for patients with low-grade tumours to be treated less invasively using curettage followed by various forms of adjuvant therapy. We investigated the potential for phenol to be used as an adjuvant. Using a human chondrosarcoma-derived cartilage-producing cell line OUMS-27 as an in vitro model we studied the cytotoxic effect of phenol and ethanol. Since ethanol is the standard substance used to rinse phenol out of a bone cavity, we included an assessment of ethanol to see whether this was an important secondary factor with respect to cell death. The latter was assessed by flow cytometry. A cytotoxic effect was found for concentrations of phenol of 1.5% and of ethanol of 42.5%. These results may provide a clinical rationale for the use of both phenol and ethanol as adjuvant therapy after intralesional curettage in low-grade central chondrosarcoma and justify further investigation.
Early management of proximal humeral fractures with hemiarthroplasty
Authors: Kontakis G. , Koutras C. , Tosounidis T. , Giannoudis P. 
Published: November 2008

We performed a comprehensive systematic review of the literature to examine the role of hemiarthroplasty in the early management of fractures of the proximal humerus. In all, 16 studies dealing with 810 hemiarthroplasties in 808 patients with a mean age of 67.7 years (22 to 91) and a mean follow-up of 3.7 years (0.66 to 14) met the inclusion criteria. Most of the fractures were four-part fractures or fracture-dislocations. Several types of prosthesis were used. Early passive movement on the day after surgery and active movement after union of the tuberosities at about six weeks was described in most cases. The mean active anterior elevation was to 105.7° (10° to 180°) and the mean abduction to 92.4° (15° to 170°). The incidence of superficial and deep infection was 1.55% and 0.64%, respectively. Complications related to the fixation and healing of the tuberosities were observed in 86 of 771 cases (11.15%). The estimated incidence of heterotopic ossification was 8.8% and that of proximal migration of the humeral head 6.8%. The mean Constant score was 56.63 (11 to 98). At the final follow-up, no pain or only mild pain was experienced by most patients, but marked limitation of function persisted.
A three-dimensional reconstruction plate for displaced midshaft fractures of the clavicle
Authors: Shen J.-W. , Tong P.-J. , Qu H.-B. 
Published: November 2008

This randomised study compared outcomes in patients with displaced fractures of the clavicle treated by open reduction and fixation by a reconstruction plate which was placed either superiorly or three-dimensionally. Between 2003 and 2006, 133 consecutive patients with a mean age of 44.2 years (18 to 60) with displaced midshaft fractures of the clavicle were allocated randomly to a three-dimensional (3D) (67 patients) or superior group (66). Outcome measures included the peri-operative outcome index, delayed union, revision surgery and symptoms beyond 16 weeks. CT was used to reconstruct an image of each affected clavicle and Photoshop 7.0 software employed to calculate the percentage of the clavicular cortical area in the sagittal plane. The patients were reviewed clinically and radiographically at four and 12 months after the operation. The superior plate group had a higher rate of delayed union and had more symptomatic patients than the 3D group (p < 0.05). The percentage comparisons of cortical bone area showed that cortical bone in the superior distal segment is thicker than in the inferior segment, it is also thicker in the anterior mid-section than in the posterior (p < 0.05). If fixation of midshaft fractures of the clavicle with a plate is indicated, a 3D reconstruction plate is better than one placed superiorly, because it is consistent with the stress distribution and shape of the clavicle.
Consenting Practice for Open Inguinal Hernia Repairs – Are We Failing to Warn Patients of Serious Complications?
Authors: Hoosein Moinuddin M , Towse Hilary , Conn Gemma , Stoker David L 
Published: November 2008

INTRODUCTION Open inguinal hernia repairs are one of the most commonly performed procedures in the UK. The procedure can sometimes result in considerable morbidity. It is imperative that the consenting process for this procedure is meticulous. This allows the patient to make a fully informed decision as they are aware of potential complications. In turn, this reduces the risk of future litigation. The aim of this study was to examine the adequacy of consenting for open inguinal hernia repairs, in particular, focusing on serious risks associated with the procedure. PATIENTS AND METHODS The notes of male patients who had undergone open inguinal hernia repair over a 6-month period were identified by the IT department. Inclusion and exclusion criteria were defined, giving a total of 97 male patients. Their consent forms were examined, focusing on: (i) the complications mentioned; and (ii) the grade of the consentor. A proforma was filled in for each of these patients and the data collated. RESULTS Of the 97 patients in the study, 25.7% of patients were consented by a consultant, 54.6% by a specialist registrar, and 19.6% by a senior house officer/FY2. The most commonly recorded risks included infection (100%) and bleeding (100%). Serious complications such as chronic pain (consented for at an average of 14%), testicular complications (45.3%) and visceral injury (52.1%) were poorly accounted for at all levels. CONCLUSIONS Consultants and juniors alike are not adequately consenting patients for inguinal hernia repairs, omitting serious complications such as chronic pain, recurrence and testicular complications. This leaves surgical teams vulnerable to claims for negligence. Good consenting practice may ultimately benefit both patient and surgeon.
Survival of Dogs Following Surgical Excision of Histologically Well-differentiated Melanocytic Neoplasms of the Mucous Membranes of the Lips and Oral Cavity
Authors: Esplin D. G. 
Published: November 2008

Postsurgical follow-up information was obtained on 64 dogs with 69 histologically well-differentiated melanocytic neoplasms that involved the mucous membranes of the lips and oral cavity. The patients received no adjunct therapy. Sixty one of 64 dogs (95%) were alive at the end of the study or had died of causes unrelated to the tumor, with a mean survival of 23.4 months and a median survival of 34 months after surgery. Twenty-eight dogs alive at the end of the study had a mean survival of 31.3 months after surgery. There were 2 dogs, which had recurrent tumors, that were still alive at the end of the study. All dogs that died of tumor-related causes (3) and all dogs with recurrent tumors (2) had tumors in the oral cavity. Results of this study indicate that a favorable clinical course and prolonged survival can be expected in most dogs with histologically well-differentiated melanocytic neoplasms of the mucous membranes of the lips and oral cavity, with only local excision of the lesions and no adjunct therapy.
Computer Simulation of Quenched Steel Working Stress
Authors: Smoljan B. , Smokvina Hanza S. , Iljkić D. 
Published: November 2008

Abstract
The possibility of the application of a modified Jominy-test in the computer simulation of quenching of steels for tools and dies has been investigated. The performance of an investigated modified Jominy-test in the simulation of quenching of tools and dies was estimated by a comparison of the cooling curves of a modified Jominy-specimen (JM®-specimen) and a cylindrical specimen. The hardness distribution in a quenched specimen was estimated based on a relevant cooling time from 800 to 500°C, as well as on the results of a modified Jominy-test. The characteristic cooling time, relevant for the results of quenching, was predicted by the computer simulation of quenching of both the JM®-specimen and cylindrical specimen. Mechanical properties of quenched steel directly depend on the degree of quenched steel hardening. The algorithm of the estimation of yield strength and fracture toughness on the base of steel hardness is established in this paper. Using the established algorithm, the mechanical properties of quenched and tempered die steel were estimated by computer simulation. It was found that the modified Jominy-test can be applied in the simulation of quenching of high hardenability steel more successfully than by the original Jominy-test.
Warnings and Instructions: One of Three Legs on Ice Hockey’s Safety Stool
Authors: Granger Mark S. , Miosek Ryan W. 
Published: November 2008

Abstract
Ice hockey is a fast-moving, action-packed contact sport. With any high-action sport there is a risk of serious personal injury and possibly even death. The combination of fast play, substantial contact, and high speed with good-size force, hard ice, and unyielding boards creates potential for injury. The sport has responded to these factors by controlling and setting rules for play, designing protective equipment to reduce the risk of serious personal injury or death, and providing warnings and instructions both on protective gear and through the amateur leagues and school coaching. This paper will primarily deal with this third leg of the safety stool with a primary emphasis on the warnings and instructions provided on the actual equipment and with accompany materials.
Discrepancies in thorium oxide solubility values: a new experimental approach to improve understanding of oxide surface at solid/solution interface
Authors: Vandenborre Johan , Abdelouas A. , Grambow Bernd 
Published: November 2008

AbstractThe solubility of ThO2(cr) was studied since many years but a large discrepancy in solubility values is noticed in the literature. The present work suggests that this discrepancy is related to differences in the surface properties of thorium oxide.To understand the role of surface properties on solubility values, we conducted experiments with ThO2(cr) spheres with reproducable surface properties. Batch dissolution experiments were conducted in 0.01 M NaCl solution at pH=3.0 and 4.0 for periods of time up to 270 days. The solutions were spiked with229Th to determine precipitation (sorption) rates of thorium, while dissolution rates were determined by measuring232Th released from ThO2(cr) spheres. We assume that229Th atoms are exchanged only with active sites involved in Th-dissolution. Using229Th as local sensor of attachement and detachment processes at the ThO2(cr) surface under close-to-equilibrium conditions, allows to assess surface reactivity of the solid during solubility experiments.
Modeling plutonium solubility for Yucca Mountain performance assessment
Authors: Chen Y. , Pearson F. J. 
Published: November 2008

AbstractThe Yucca Mountain performance assessment requires a Pu solubility model over a broad range of environmental conditions. Several Pu solubility models have been developed and evaluated for the Yucca Mountain Project. These models are 1) the theoreticalfO2model; 2) the empiricalEhupper limit model; and 3) the adjustedEhupper limit model. It is found that over the expected environmental conditions, Pu solubility is very sensitive to redox conditions and properly selecting the redox conditions to be modeled is the key to developing a realistic and defensible Pu solubility model. Analyzing the modeling results carefully and using experimental results as benchmarks suggest that the adjustedEhupper limit model is a realistic and yet defensible model to be used by the PA.
Uranium/technetium separation for the UREX process – synthesis and characterization of solid reprocessing forms
Authors: Poineau Frédéric , Du Mazaubrun Julie , Ford Doris , Fortner Jeffrey , Kropf Jeremy , Silva G.W. Chinthaka , Smith Nicholas , Long Kristy , Jarvinen Gordon , Czerwinski Kenneth R. 
Published: November 2008

AbstractIn the context of the demonstration of the UREX (uranium extraction) process, a separation of uranium and technetium using an anion exchange resin was performed on a simulant solution containing 98.95 g/L of238U and 130.2 mg/L of99Tc. After sorption on the resin, TcO4−was eluted with NH4OH, the eluting stream was treated, and the technetium converted to Tc metal (yield=52.5%). The purity of the compound was analyzed: it contains less than 23.8 μg of238U per gram of99Tc. Tc metal was characterized by X-ray diffraction (XRD) and X-ray absorption fine structure (XAFS) spectroscopy; EXAFS analysis clearly confirms the hexagonal structure of the metal obtained after treatment. Uranium was converted to ammonium diuranate and to U3O8in a yield of 88.2%, analysis indicates that the compound contains less than 0.16 μg of99Tc per gram of ammonium diuaranate.