bluuebunny/crossref_metadata_2025_split huggingface dataset:
A technique for wound closure that minimizes sepsis after stoma closure
Authors: Sutton Christopher Derek , Williams Nigel , Marshall Leslie‐Jayne , Lloyd Geraint , Thomas William Michael 
Published: March 2003

Background:  The aim of the present study was to assess the incidence of wound sepsis following closure of ileostomies and colostomies in our institution.Methods:  Circumferential subcuticular wound approximation was used in 51 patients in our institution. Evidence of wound sepsis (assessed by the presence of cellulitis, induration and or purulent discharge) was documented both in the postoperative period and in outpatient follow‐up.Results:  A wound infection rate of 0% was achieved, both in the immediate postoperative period and upon 6‐week follow‐up.Conclusions:  Circumferential subcuticular wound approximation is, therefore, a safe and efficacious technique for dealing with the skin woundafter stomal closure, virtually abolishing wound sepsis.
Thyroid cancer: The Kuala Lumpur experience
Authors: Abdullah Muhammad 
Published: March 2003

Background:  There have been few detailed studies on thyroid cancer (TC) in Malaysia, a multiethnic country with three major races − Malays, Chinese and Indians.
Methods:  The paper retrospectively audits the records of 107 consecutive cases with histologically proven thyroid cancer between 1995 and 2000 presenting to University Hospital, Kuala Lumpur. The demographic distribution, histological variants, mode of presentation, sensitivity of fine needle aspiration cytology and the modalities of treatment are examined in the present paper.
Results:  Of a total of 107 cases of TC, 74 were papillary, 23 follicular, one Hurthle Cell, seven medullary and two anaplastic. There were 91 women and 16 men; the corresponding median age of presentation being 34.0 and 40.0 years. The median age at presentation of TC was 36 years in the Malay population, 37 in the Chinese population and 33 in the Indian population. Fifty‐six per cent of follicular cancer incidence was in the Malay population alone, the remaining in the other populations. Solitary thyroid nodule was seen in 75 patients, generalized enlargement in 20 and no goiter in 11. Local symptoms were reported in <10% of patients. Preoperative FNAC had a sensitivity of 72.26%. Of 98 patients with well‐differentiated TC (WDTC), total thyroidectomy was employed in 92. Surgery alone was used in 48 cases and combined with radioactive iodine ablation in the remaining 50.
Conclusion:  All histological variants of TC are represented in the study. Well‐differentiated TC forms the bulk with papillary cancer having the largest percentage. Follicular cancer is more common in the Malay population. Total thyroidectomy in WDTC, although controversial, remains the mainstay of surgical treatment in Malaysia.
Fasciotomy for chronic compartment syndrome in the lower limb
Authors: Cook Steven , Bruce Greg 
Published: March 2003

Background:  The aim of this study was to determine the success of fasciotomy of lower limb compartments with elevated intra­compartment pressure.Methods:  The present report is a retrospective cohort study at No. 3 Combat Support Hospital involving a survey and case note review of patients who had undergone fasciotomy for compartment syndrome at least 6 months earlier (December 1997−December2000).Results:  Fourteen patients met the inclusion criteria. Eleven reported success with complete resolution of symptoms and return to military fitness levels. Two reported no change and significant residual symptoms. One reported worse symptoms and one required re‐operation with a successful result.Conclusion:  Surgical decompression is the accepted treatment of compartment syndrome as proven by pressure manometry, after failure of conservative treatment.
Does laparoscopic fenestration provide long‐term alleviation for symptomatic cystic disease of the liver?
Authors: Tan Y. M. , Ooi London Lucien , Soo K. C. , Mack P.O. P. 
Published: March 2003

Background:  The use of laparoscopic technique for management of symptomatic liver cysts is documented to be a feasible and safe procedure with good short‐term symptomatic relief. However, it cannot be recommended as the standard of care as long‐term results are scarce. The present study was initiated to review the long‐term results of this approach in the management of symptomatic liver cysts.Methods:  A retrospective review of all patients with symptomatic liver cysts that were treated by laparoscopic fenestration in our department over an 8‐year period from 1993 to 2001. The clinical and radiographical data were analysed at follow‐up to assess the ­outcome.Results:  Eleven patients were treated using a laparoscopic approach;10 patients with solitary cysts and one with adult polycystic liver disease. All patients achieved short‐term alleviation of symptoms and an uneventful postoperative course. The mean hospital stay was 3 days. Long‐term follow up was available for 9 patients with a mean of 44 months. Histologically, one of the patients was diagnosed with a biliary cystadenoma and she had a symptomatic recurrence and a liver resection at 20 months. In the other seven patients, there was no clinical recurrence but a radiographical recurrence of 28.5%. The patient with adult polycystic liver disease had two symptomatic recurrences: at 26 months where he underwent a repeat laparoscopic fenestration and at 43 monthswhere he underwent an open fenestration.Conclusion:  The present study confirms that with adequate patient selection, long‐term alleviation of symptoms can be achieved with the laparoscopic approach for solitary simple liver cysts but not for polycystic liver disease or cystic tumours of the liver.
Recurrent laryngeal nerve in thyroid surgery: A critical appraisal
Authors: Hisham Abdullah N. , Lukman Mohd R. 
Published: March 2003

Background:  Identification and preservation of the recurrent laryngeal nerve (RLN) is of major concern in surgery of the thyroid gland. The purpose of this study was to review the surgical anatomy of the nerve and to describe its relationship to other important structures.Methods:  A total of 325 patients were accrued in this prospective non‐randomized study from January 1999 to December 2000. All patients who had total, subtotal and hemithyroidectomies were included in this study. Each side of the thyroid gland was considered as a separate unit in the analysis of the results.Results:  Two hundred and seventy‐six patients had thyroidectomies as their primary operation, while 49 patients had them as a reoperative procedure. There were 276 women and 46 men (6:1 female to male ratio) with a mean age of 43.1 years (range: 10−84 years). The total number of dissections was 502. The RLN was clearly identified in 491 (97.8%) dissections: single trunk in 323 dissections (65.8%), two extralaryngeal branches in 164 dissections (33.4%), and three extralaryngeal branches in three dissections (0.6%). One non‐recurrent laryngeal nerve was encountered (0.2%) in the series. The proximity of the RLN to the inferior thyroid artery (ITA) was noted in 444 (90.4%) dissections: 372 (83.8%) nerves were described to be posterior and intertwined between the branches of the ITA, and in 72 (16.2%) RLNs, they were observed to be anterior to the ITA. The close association of RLN to an enlarged tubercle of Zuckerkandl was documented in 381 dissections (73.7%). A total of 231 RLNs (60.8%) was seen in the tracheoesophageal groove, 18 (4.9%) nerves were observed to be lateral to the trachea, and in 109 (28.3%), they were posterior in location. Of concern in 23 (6.0%) dissections the RLN was on the anterior surface of the thyroid gland, which is at highest risk of injury before curving down to pass behind the tubercle of Zuckerkandl. It appears that the anterior course of the RLN was seen more often in the reoperative procedures to the thyroid gland (20%).Conclusions:  Although various methods of localizing the RLN have been described, surgeons should be aware of the variations and have a thorough knowledge of normal anatomy in order to achieve a high standard of care. This will ensure the integrity and safety of the RLN in thyroid surgery. The anatomical variation may be minor in degree, but is of great importance as it may affect the outcome of the surgery and the patient's quality of life.
Vascular closure staples reduce intimal hyperplasia in prosthesis implantation
Authors: Hawthorne Wayne J. , Ao Peng Y. , Fletcher John P. 
Published: March 2003

Background:  Vascular surgery, like the various other surgical specialities, has seen an increasing demand toward faster and more minimally invasive procedures. One such need is to create a reliable vascular anastomosis that is faster, easier and less damaging to the tissue. The vascular closure staples (VCS*) device provides such characteristics but, to date, no studies have investigated its effectiveness in reducing intimal hyperplasia when used for vascular prosthesis implantation. The present study evaluated its effectiveness compared with suturing of a graft in vascular prosthesis implantation.Methods:  Twelve female Merino sheep underwent gelatin sealed Dacron patch graft implantation into the left and right common carotid artery. Grafts were randomly allocated so that one carotid artery and graft was anastomosed using sutures and the other with VCS*. The two techniques were compared for operation time, clip/suture numbers and blood loss during the implantation procedure. After a 4‐week period, the sheep were killed and the grafts were harvested for intimal hyperplasia (IH) assessment.Results:  There was a significant reduction in the amount of IH seen in the VCS* group (mean ± SD: 0.278 ± 0.079 mm2/mm) when compared with the sutured group (0.575 ± 0.331 mm2/mm) (P < 0.05). There was also significant reduction in anastomosis time (mean ± SD: 14 ± 4.4 min) and fewer points of contact (23 ± 1.4) using the VCS* compared with suturing (22 ± 3.2 min, P < 0.01; 27 ± 3.3, P < 0.05, respectively).Conclusions:  In this model, the VCS* shows several distinct advantages over suturing with significant time saving at operation and, most importantly, the reduction of IH seen at 1 month.
Cutaneous innervation in man before and after lumbar sympathectomy: evidence for interruption of both sensory and vasomotor nerve fibres
Authors: Coventry Brendon J. , Walsh John A. 
Published: March 2003

Background:  Rest pain and severe ischaemia in patients who are unable to be offered (further) surgery to revascularize the lower limb is still problematic. Lumbar sympathectomy has been used for many years but the mechanisms by which this works are not absolutely clear. Both sensory and vasomotor fibres travel in the lumbar sympathetic chain and the effects of lumbar sympathectomy on these nerve types have been investigated in the present paper.Methods:  Immunohistochemical methods were used to detect neuropeptides contained in sensory and vasomotor nerves in the lower limb skin of (i) patients having amputations for peripheral vascular disease (PVD) after previous (chemical or surgical) sympathectomy; (ii) patients having amputations for PVD without previous (chemical or surgical) sympathectomy; and in control normal skin. The three groups are compared and the results are discussed.Results:  Normal and PVD controls had intact sensory and vasomotor nerves around dermal cutaneous blood vessels, but these were completely or virtually completely lost after lumbar sympathectomy, by either chemical or surgical means.Conclusions:  Lumbar sympathectomy severs both vasomotor and sensory fibres, suggesting that relief of rest pain may be explained not only by increased cutaneous and muscle blood flow, but also by nociceptive sensory denervation.
INTERACTIONS BETWEEN TIME AND CYCLIC DEFORMATION PROCESSES IN A NIMONIC ALLOY
Authors: Rees DWA 
Published: March 2003

Interactive creep–fatigue behaviour of a nickel‐base superalloy (IN 597) has been examined at 850 °C under various strain‐limited, cyclic torsional loading conditions. In one test, forward creep deformation was reversed by creep under equal magnitude stress levels and strain limits. In other tests, forward creep strain was reversed by fast monotonic plasticity with and without a subsequent period of relaxation. These cycles were repeated within each test until fracture. This paper examines empirically the influence of a number of test variables upon cyclic creep curves, and demonstrates the usefulness of predictions based upon continuous low cycle fatigue and simple creep data when used in conjunction with a mechanical equation of state. A cyclic equilibrium condition was not achieved from these tests. Instead, a progressive softening occurred giving reductions to the amount of creep strain, creep time interval and reversed peak stress with each new cycle. Such reductions are expressed from derived formulae that embrace the range of inelastic strain, cycle number, creep dwell stress, reversed peak stress, and times expended in creep and relaxation.Observations made on accumulated creep strain reveal the contribution to a creep–fatigue fracture from cyclic creep. This has led to a modified form of the linear damage rule which can provide conservative life predictions for components operating in service under similar cyclic conditions.
Acoustic emission from surface fatigue cracks in SS41 steel
Authors: Nam  
Published: March 2003

ABSTRACTCrack penetration behaviour by fatigue crack propagation and the measurements of acoustic emission (AE) before and after crack penetration were examined using SS41 steel plate. The experimental crack shape of the SU type which has an out‐of‐plane degree of freedom was in good agreement with the calculated shape. But this was not so for the S type which has a restriction to out‐of‐plane freedom. The crack propagation behaviour on the front surface appears not to change markedly after penetration. However, crack growth on the back surface appears to accelerate. As a crack propagates, substantial acoustic emission occurred just prior to penetration. Then it decreased and the crack penetrated. Intense AE emanation has been attributed to a transition from a plane strain condition to a plane stress condition.
Fracture control assessment in the base metal and welded joint of a pipeline steel
Authors: Costa  , Bastian  
Published: March 2003

ABSTRACTThe present study evaluates the fracture behaviour of a pipe steel and compares the real scale pipeline assessment methodology (pipeline methodology) with the Guidance on Methods for Assessing the Acceptability of Flaws in Welded Structures (PD 6493). It is shown that the base metal is the toughest region and that the heat‐affected zone is the least tough zone, that both assessment methods do not give the same result for the base metal, and that plasticity at the crack tip can toughen the welded joint.
Thermal failure under conditions of restrained deformation
Authors: Shesterikov  , Yumasheva  , Yumashev  , Lebedev  
Published: March 2003

ABSTRACTThe time behaviour of solids during unsteady temperature conditions is considered. The conditions for the initiation of failure of a solid are formulated in the form of conditions for the attainment of the threshold values of stress and strain fields. The evolution of a cracked region through the body is considered. It is shown that the destruction process is divided into two stages in some cases. At the first stage, when a threshold value is achieved at some point or region of the body, a jump‐like extension of the region occurs until a state of equilibrium within the region is attained. This jump‐like destruction can be considered as an instability process. Various examples are presented relating to the destruction of brittle solids. The influences of plasticity and time‐dependent characteristics is considered.
A crack tip blunting analysis in the ductile‐to‐brittle transition of a structural steel
Authors: Tosal  , Rodríguez  , Belzunce  , Betegón  
Published: March 2003

The J‐integral versus crack growth resistance curves ( J–R curves) of an AE‐460 structural steel were evaluated at different temperatures in the ductile‐to‐brittle transition region. This curve as well as the critical JI value at the initiation of crack growth was found to be independent of temperature, being dependent only on the stress triaxiality state of the specimen.The blunting expressions described in the ASTM and ESIS standards were evaluated using fractographic techniques. The ESIS blunting line fits the linear regression of the experimental results very well, while the blunting line predicted by the ASTM standard is clearly located below the experimental points.
An experimental and theoretical approach for an estimation of ΔKth
Authors: Herold H. , Streitenberger M. , Zinke M. , Orazi L. , Cammarota G. P. 
Published: March 2003

The existence of a fatigue threshold value may affect the design process when a damage‐tolerant design is considered that uses non‐destructive techniques for evaluating the shape and dimensions of the defects inside materials. Obviously it should be possible to estimate the stress field surrounding these defects and this is not generally a problem with modern numerical methods.Many factors are involved in determining the growth rate of a fatigue crack. Some of these are highly significant and it is possible to obtain the coefficients of a correlation function. Some others are not well defined and the only effect is to expand the scatter of experimental data.Consider the sigmoidal curve we obtain when plotting the crack growth rate versus the applied ΔKI . A very difficult parameter to measure but very useful for fatigue design is the ΔKIthvalue, because below this value a crack may be forming, hence, here ΔKIthis defined by the transition between a normal (e.g. 10−10 m/cycle) and a very low range of crack growth rate (<10−10 m/cycle).The ΔKIthvalue is very difficult to obtain by experimental methods because the growth rate is of the order or less than the atomic lattice span (3 × 10−10 m/cycle), but we can correlate the transition value with the cyclic crack tip plastic zone size and other structural parameters of metallic materials.The aim of this work is to offer a contribution about the parameters which influence ΔKIthin stainless steels and welded joints based on the crack tip plastic zone radius.
The Equivalent Strain Energy Density approach re‐formulated and applied to sharp V‐shaped notches under localized and generalized plasticity
Authors: LAZZARIN P. , ZAMBARDI R. 
Published: March 2003

ABSTRACTIn the case of a rounded notch, the stress and strain at the notch tip can be determined by the traditional Neuber rule or by the Equivalent Strain Energy Density (ESED) approach, as formulated by Glinka and Molski. In the latter case the elastoplastic strain energy density at the notch tip is thought of as coincident with that determined under purely elastic conditions. For sharply V‐shaped notches this approach is not directly applicable, since the strain energy density at the notch tip tends toward infinity both for a material obeying an elastic law and a material obeying a power hardening law. By using the notch stress intensity factors, the present paper suggests a re‐formulation of the ESED approach which is applied no longer at the notch tip but to a finite size circular sector surrounding the notch tip. In particular we have adopted the hypothesis that, under plane strain conditions, the value of the energy concentration due to the notch is constant and independent of the two constitutive laws. When small scale yielding conditions are present, such a hypothesis immediately results in the constancy of the strain energy averaged over the process volume. As a consequence, plastic notch stress intensity factors valid for sharp V‐shaped notches can be predicted on the basis of the linear elastic stress distributions alone.
Measurement and analysis of wheel loads for design and fatigue evaluation of vehicle chassis components
Authors: DECKER M. , SAVAIDIS G. 
Published: March 2003

ABSTRACTUsing a multiaxial‐randomly loaded air‐suspension rear‐axle for commercial vehicles as an example, this paper gives an insight in the mechanics and interactions of wheel forces and moments, forces acting in the suspension components and the stress response of the axle casing. Taking load‐time and stress‐time data measured on a prototype vehicle on a test track as a basis, fatigue, frequency and correlation analyses for all relevant manoeuvres and straight‐ahead driving situations are performed. Special focus is given to the study and determination of appropriate correlations between the mentioned properties for manoeuvres and straight ahead driving on rough roads. The results point out all decisive load situations which may affect the fatigue behaviour of the axle under operational conditions and were taken into account for the derivation of optimized design solutions, as well as for the experimental verification of the final solution in the test rig.
Determination of load spectra for durability approval of car drive lines
Authors: OELMANN B. 
Published: March 2003

ABSTRACTKnowledge of the significan and representative load spectra is one important requirement for a high‐quality, quick durability life approval of vehicle components on a test rig or by calculation. The way that such load spectra can be derived from measurements is demonstrated in this paper by the example of a passenger car drive line. The paper includes a brief introduction followed by an outline of the objectives. The proposed approach will then be illustrated and the results will be presented. Examples of applications will be shown and an outlook for further activities presented.
Plant‐mediated indirect effects and the persistence of parasitoid–herbivore communities
Authors: Vos M. , Berrocal S.M. , Karamaouna F. , Hemerik L. , Vet L.E.M. 
Published: March 2003

We have examined the effects of herbivore diversity on parasitoid community persistence and stability, mediated by nonspecific information from herbivore‐infested plants.First, we investigated host location and patch time allocation in the parasitoid Cotesia glomerata in environments where host and/or nonhost herbivores were present on Brassica oleracea leaves. Parasitoids were attracted by infochemicals from leaves containing nonhost herbivores. They spent considerable amounts of time on such leaves. Thus, when information from the plant is indistinct, herbivore diversity is likely to weaken interaction strengths between parasitoids and hosts. In four B. oleracea fields, all plants contained herbivores, often two or more species. We modelled parasitoid–herbivore communities increasing in complexity, based on our experiments and field data. Increasing herbivore diversity promoted the persistence of parasitoid communities. However, at a higher threshold of herbivore diversity, parasitoids became extinct due to insufficient parasitism rates. Thus, diversity can potentially drive both persistence and extinctions.