bluuebunny/crossref_metadata_2025_split huggingface dataset:
Experimental Study of Two New Flexor Tendon Suture Techniques for Postoperative Early Active Flexion Exercises
Authors: KUSANO N. , YOSHIZU T. , MAKI Y. 
Published: September 2002

We used a rabbit model to test the postoperative mechanical strengths of two new tendon suture techniques. These were compared with the conventional modified Kessler and double looped suture techniques. For each technique, maximum load until 3 mm gap, load at 1 mm gap and ultimate load were measured at the time of operation and at weeks 1 and 3 after operation. Maximum load until 3 mm gap and load at 1 mm gap were significantly higher in the new techniques than in the conventional techniques at the time of operation and at 1 week; there was no statistical difference between the four techniques at 3 weeks. No technique resulted in a decrease in maximum load until 3 mm gap, load at 1 mm gap and ultimate load at 1 week. The new techniques reported here have the potential to withstand early active flexion exercises.
Dynamic Changes in the Shape of the Triangular Fibrocartilage Complex During Rotation Demonstrated with High Resolution Magnetic Resonance Imaging
Authors: NAKAMURA T. , YABE Y. , HORIUCHI Y. 
Published: September 2002

We studied in vivo dynamic changes in the triangular fibrocartilage complex (TFCC) in ten healthy volunteers using high-resolution magnetic resonance imaging (MRI). A custom made surface coil, which was specially designed to allow movements of the wrist in all directions, was used in this study. MR images in the axial and coronal planes were acquired at maximum pronation, in the neutral position and at maximum supination. During pronation and supination, little deformity of the disc proper was seen on axial sections. In contrast, the ulnar side of the TFCC around the ulnar styloid process showed obvious dynamic changes. The ulnar head translated palmarly to the radius in supination and dorsally in pronation, while there was little change in the position of the fovea of the ulna in relation to the radius. Considering the three-dimensional structure of the TFCC, these findings suggest that the disc proper is strong enough to support the ulnar carpus with little deformity during rotation and that the triangular ligament twists at its origin. During rotation there is friction between the proximal side of the disc proper and the ulnar head. On coronal sections, the disc proper became thinner in pronation due to increased ulnar variance.
Outcome Measures Following Metacarpophalangeal Joint Replacement
Authors: SYNNOTT K. , MULLETT H. , FAULL H. , KELLY E. P. 
Published: September 2002

We used the Jebsen–Taylor hand function assessment system to prospectively study the effect of metacarpophalangeal joint replacement on overall hand function in 29 hands. In addition pain relief, subjective improvement in hand function, appearance and overall patient satisfaction were assessed. There was modest improvement in the number of Jebsen–Taylor tasks performed (1.8 to 3.1), and pain relief was good or excellent in 18 of 24 patients. Eleven patients felt their hand function had improved by more than 50%, and the majority of patients (22 of 24) were very satisfied with the procedure. This study demonstrates that despite limited improvements in objective outcome measures, this procedure is reliable in producing a very high rate of patient satisfaction.
A Modification of the Technique for Intravenous Regional Blockade for Hand Surgery
Authors: THAM C. H. J. , LIM B. H. 
Published: September 2002

A prospective study was conducted to assess a modification to Bier’s intravenous regional anaesthesia which introduced a third temporary distal forearm tourniquet. This confines the injected lignocaine to the hand, resulting in a higher local lignocaine concentration. Subsequent exsanguination of the limb then channels the remaining intravascular lignocaine under the distal cuff of a double tourniquet. Of the 18 patients, none experienced pain during operation and all tolerated the tourniquet without significant discomfort. Mild postoperative giddiness was noted in one patient. No other anaesthetic complications were encountered. In a subjective assessment of the bloodlessness of the operating field, two were ranked satisfactory, ten good and six excellent. None of the patients required re-exsanguination when using this technique.
A Conservative Approach for Proximal Interphalangeal Joint Arthroplasty
Authors: FAHMY N. R. , LAVENDER A. , BREW C. 
Published: September 2002

Access to the proximal interphalangeal joint of the finger for arthroplasty is difficult without detaching its stabilizers or dividing the tendons that cross it, which then require repair and slow rehabilitation. We describe a method that conserves both, so facilitating post-operative rehabilitation. A C-shaped incision is made on the dorsum of the finger. The lateral bands of the extensor expansion are separated from the central slip proximally to the extensor hood. They are then retracted to expose the condyles of the proximal phalanx, which are excised. The PIP joint is then dislocated between the central slip and a lateral band allowing the remainder of the head to be excised. The middle and proximal phalanges are then prepared to accept the prosthesis. The prosthesis is then inserted and the joint is reduced. The lateral bands of the extensor mechanism are sutured back to the central slip before the skin is closed.
A new approach to depth determination from magnetic anomalies
Authors: Abdelrahman El‐Sayed M. , El‐Araby Hesham M. , El‐Araby Tarek M. , Essa Khalid S. 
Published: September 2002

We have developed a semiautomatic method to determine the depth to shallow and deep‐seated structures from a magnetic anomaly profile. It involves using a relationship between the depths to two coaxial sources obtained by combining observations at symmetric points with respect to the coordinate of the sources center. For five established, fixed data points, the depth to the shallow structure is determined for each preassigned depth of the deep‐seated structure. The computed depths to the shallow structure are plotted against the computed depths to the deep‐seated structure, yielding a continuous, monotonically increasing depth curve. The spacing between the observations is then modified, producing several curves. The accepted estimates for the depths to both structures are read at the common intersection of these curves. The effective intensity and the angle of magnetization of both structures are also estimated. The proposed method was tested both on noisy synthetic and real magnetic data. In the case of synthetic data, the depth curves method determined the correct depths of both coaxial and laterally offset sources. In the case of practical data (vertical component anomaly over a chromite body in the Guleman concession, Turkey), the method suggested the shape of the buried shallow structure resembles a horizontal cylinder model buried at a depth of 31 m and the shape of the buried deep seated structure resembles a dike model buried at a depth of 62 m. The estimated shape and depth of the shallow structure are in very good agreement with the results obtained from drilling and surface geology. The area appears to still hold promise for chromite exploration from the deeper structure.
Finite‐difference modeling of SH‐wave propagation in nonwelded contact media
Authors: Slawinski Raphael A. , Krebes Edward S. 
Published: September 2002

Many geological structures of interest are known to exhibit fracturing. Fracturing directly affects seismic wave propagation because, depending on its scale, fracturing may give rise to scattering and/or anisotropy. A fracture may be described mathematically as an interface in nonwelded contact (i.e., as a displacement discontinuity). This poses a difficulty for finite‐difference modeling of seismic wave propagation in fractured media, because the standard heterogeneous approach assumes welded contact. In the past, this difficulty has been circumvented by incorporating nonwelded contact into the medium parameters using equivalent medium theory. We present an alternate method based on the homogeneous approach to finite differencing, whereby nonwelded contact boundary conditions are imposed explicitly. For simplicity, we develop the method in the SH‐wave case.In the homogeneous approach, nonwelded contact boundary conditions are discretized by introducing auxiliary, so‐called fictitious, grid points. Wavefield values at fictitious grid points are then used in the discrete equation of motion, so that the time‐evolved wavefield satisfies the correct boundary conditions. Although not as general as the heterogeneous approach, the homogeneous approach has the advantage of being relatively simple and manifestly satisfying nonwelded contact boundary conditions. For fractures aligned with the numerical grid, the homogeneous and heterogeneous approaches yield identical results. In particular, in both approaches nonwelded contact results in a larger maximum stable time step size than in the welded contact case.
Escherichia coli O157[ratio ]H7 infection in cows and calves in a beef cattle herd in Alberta, Canada
Authors: GANNON V. P. J. , GRAHAM T. A. , KING R. , MICHEL P. , READ S. , ZIEBELL K. , JOHNSON R. P. 
Published: September 2002

Escherichia coli O157[ratio ]H7 infection of cows and calves in a naturally-infected beef cattle herd in Alberta, Canada, was investigated over 2 years, encompassing two calf production cycles. In both years of the study, E. coli O157[ratio ]H7 was isolated from the faeces of cows shortly after but not before parturition in late winter: 6/38 (16%) in 1996 and 13/50 (26%) in 1997. At <1 week post-partum, 13/52 (25%) calves born in 1997 were shedding the organism. Faecal shedding of E. coli O157[ratio ]H7 by cows and calves continued over the 7 weeks that they were in the calving pens, with the organism being isolated from the faeces of 2–18% of cows and 23–26% of calves during this period. Five weeks after they were moved onto a native grass pasture, all the calves and all but one cow in 1997 had ceased shedding the organism. When the calves were weaned in the fall, E. coli O157[ratio ]H7 was isolated from the faeces of 0–1.5% of the calves 1 week prior to weaning and from 6–14% of the calves within 2 weeks after weaning. Parturition, calving pens and weaning appear to be important factors in maintaining E. coli O157[ratio ]H7 infections in this beef cattle herd. Isolates from cows and calves during the immediate post-partum period were mostly of the same pulsed-field gel electrophoresis (PFGE) type of E. coli O157[ratio ]H7. Similarly, at weaning a common PFGE type of E. coli O157[ratio ]H7, which differed slightly from the post-partum PFGE type, was isolated from the calves. These typing data suggest a common source of infection for the animals as well as demonstrate clonal turnover of resident populations of this pathogen.
Microvascular Dysfunction in Sepsis
Authors: Lush Cameron W. , Kvietys Peter R. 
Published: September 2002

ABSTRACTThe microvascular dysfunction which occurs in sepsis involves all three elements of the microcirculation: arterioles, capillaries, and venules. In sepsis, the arterioles are hyporesponsive to vasoconstrictors and vasodilators. Sepsis also reduces the number of perfused capillaries, thereby impacting on oxygen diffusion to mitochondria. In the venules of some tissues (e.g., mesentery) there is an inflammatory response characterized by neutrophil infiltration and protein leakage. In addition, PMN‐endothelial adhesive interactions occur in precapillary microvessels and capillaries in organs, such as, the lung and heart. Thus, all these elements of the microcirculation are involved in the sepsis‐induced inflammation. In this review we address emerging views on the mechanisms involved in the microvascular dysfunction induced by sepsis within the framework of these three basic elements of the microcirculatory unit.
Activation of Adenosine A2a Receptors Inhibits Mast Cell Degranulation and Mast Cell‐Dependent Vasoconstriction
Authors: Fenster M.S. , Shepherd R.K. , Linden J. , Duling B.R. 
Published: September 2002

ABSTRACTAdenosine and inosine accumulate in tissue during periods of ischemia and both molecules have been shown to degranulate mast cells in the hamster cheek pouch via activation of an A3 receptor. An A2‐mediated inhibitory action of adenosine on mast cell degranulation has also been reported (16), and the objective of this research was to investigate the role of adenosine A2 receptors in modulating inosine‐induced mast cell degranulation and subsequent vasoconstriction of microvessels. Methods: Cheek pouches of the Golden hamster were prepared for in vivo microscopy. Adenosine, inosine, and other agents were applied either globally in the superfusion solution or to selected regions of the tissue by pipette. Results: Micropipette application of 10−4 M inosine to periarteriolar mast cells caused a vasoconstriction and an associated mast cell degranulation in 71% of the arterioles tested. The average diameter reduction was 29 ± 5%. To establish a modulatory role for the A2 receptor, low doses of adenosine (100 nM and 10 nM) were applied globally via the superfusion prior to inosine stimulation. This adenosine pretreatment resulted in a decrease in the incidence of the inosineinduced vasoconstriction (17% and 31%), as well as smaller constrictions (0.5 ± 1% and 7 ± 3%). Mast cell degranulation was also reduced by pretreatment with adenosine, as evidenced by a decreased number of mast cells exhibiting ruthenium red dye uptake. The inhibitory effect of adenosine could be eliminated by pretreatment with the nonselective A1/A2 antagonist 8‐(p‐sulfophenyl) theophylline, which restored the inosine‐induced responses to control values. To demonstrate that the effect was A2α‐mediated, vessels were pretreated with the selective A2α agonist 2‐[4‐(2‐carboxyethyl) phenethylamino]‐5′‐N‐ethylcarboxamidoadenosine (CGS21680). Following this treatment, constriction in response to microapplication of inosine (10−4 M) occurred in only 11% of the vessels tested; the average constriction was reduced to 2 ± 2% and no mast cell degranulation was observed. Conclusions: We conclude that mast cell degranulation can be inhibited via activation of an adenosine A2α receptor; which activation occurs at a lower concentration of adenosine than stimulatory A3 receptor activation. This finding may have implications for the pathology of ischemia.
Prevalence and characteristics of headache in Dutch schoolchildren
Authors: Bandell‐Hoekstra Inez E.N.G. , Abu‐Saad Huda Huijer , Passchier Jan , Frederiks Carla M.A. , Feron Frans J.M. , Knipschild Paul 
Published: September 2002

The aim of this study was to determine whether there has been an increase in headache prevalence in Dutch children and to compare headache characteristics of children with low, medium and high headache severity.A sample of 2358 schoolchildren between the ages of 10 and 17 years filled out Waters'; Headache Questionnaire and the Paediatric Pain Assessment Tool. Results showed that 21% of the boys and 26% of the girls at elementary school, and 14% of the boys and 28% of the girls at high school reported weekly headaches. When compared to figures from a previous study in the Netherlands published in 1985, the prevalence of weekly headaches in 10–17‐year‐olds has increased by 6%. In boys at elementary school, the prevalence of headaches with a frequency of a few times a week has doubled.Children with low, medium and high headache severity differed with respect to all headache characteristics, i.e. pain quality, accompanying symptoms, warning signals, location, onset, impact of headache, family occurrence, perceived cause, medical consultation, and school absence.
Nalbuphine by PCA‐pump for analgesia following hysterectomy: bolus application versus continuous infusion with bolus application
Authors: Krenn Herbert , Oczenski Wolfgang , Jellinek Helmuth , Krumpl‐Ströher Martha , Schweitzer Ekkehard , Fitzgerald Robert D. 
Published: September 2002

The analgesic properties of the partial agonist–antagonist nalbuphine in the postoperative period are well known. When used for patient‐controlled analgesia (PCA) the effectiveness of this substance is comparable to that of morphine or tramadol. However, the optimal programme for administration of nalbuphine in PCA‐pumps has not been investigated. In particular, the combination of bolus administration vs bolus administration plus continuous basal administration is disputable.We hypothesized that the administration of an extra basal rate of nalbuphine in addition to the patient‐ triggered bolus administration and supplemental doses of diclofenac when required, would lead to a significant improvement in analgesia, without affecting the differences in vital signs and side effects.After approvement by the institutional ethics committee, 50 female patients (ASA I or II) scheduled for elective hysterectomy were included in a prospective, single‐blinded study and randomized either into bolus‐continous (BC‐)group (3 mg base rate/h, 1 mg bolus, 20 min lock out) or bolus (B‐)group (no base rate, 1 mg bolus, 10 min lock out). During the observation period (up to 24 h postoperative) vital parameters, extent of analgesia (10‐step VAS), and vigilance (5‐step scale) were registered. Groups were compared by using unpaired Student t‐test. Ap <0.05 was considered to be significant.No differences were found in demographic data or vital parameters (MAP, PaO2, PaCO2, respiratory rate, heart rate, peripheral SaO2) during the observation period. Vital parameters showed no pathological changes in any group. With an identical rate of requirement for diclofenac (32 and 36%), analgesia in BC‐group showed a decrease in VAS from 4.28±2.11 to 2.04±1.21 and from 3.64±2.20 to 2.08±0.96 in B‐group. Vigilance was only marginally diminished in both groups. No serious side effects were found in either group. The consumption of nalbuphine (mg) was significantly higher in BC‐group (70.28±13.85 vs. 47.44±22.99;p =0.0002) when compared to B‐group. Subjective rating of effectiveness by the patients was similar in both groups.The two administration settings of nalbuphine by PCA pump have shown to be equally effective in the treatment of postoperative pain following hysterectomy. However, as the total amount of nalbuphine was significantly lower in B‐group, the use of this administration schedule should be encouraged. Copyright 2001 European Federation of Chapters of the International Association for the Study of Pain
The Level of Expressed Need—a measure of help‐seeking behaviour for chronic pain in the community
Authors: Smith Blair H. , Penny Kay I. , Elliott Alison M. , Chambers W.Alastair , Smith W.Cairns 
Published: September 2002

Chronic pain is a common and disabling condition, with a high impact on health and the health services in the community. The extent of help‐seeking behaviour and factors that influence this are complex, but poorly understood. A simple, valid measure of help‐seeking behaviour would be useful for community‐based research, with a view to developing and evaluating interventions.The aims of the study were to test a hierarchical scale designed to measure help‐seeking behaviour in chronic pain in postal surveys of the community, and to explore factors associated with responses.As part of a community survey of chronic pain, we developed the Level of Expressed Need (LEN) scale, based on questions about the use of treatment and professional advice for chronic pain. We compared this scale with two measures of chronic pain severity—the Chronic Pain Grade (CPG), and the Glasgow Pain Questionnaire (GPQ)—and analyzed associations with the SF36 general health questionnaire and demographic variables.Of 3605 respondents (corrected response rate 82%), 1817 reported chronic pain. Of these, 17% were at the mildest and 28% at the severest LEN. There were strong correlations with both the CPG (r=0.48) and the GPQ (r=0.55). There were, however, many important disparities in responses to these measures. Several other factors were independently associated with a high LEN in chronic pain: female gender, lower educational level, and physical, mental, pain and general health dimensions of the SF36 questionnaire.The LEN is a useful tool for measuring the help‐seeking response to chronic pain in the general population. The findings confirm that this response is influenced by clinical and demographic factors in addition to the severity of the pain. Further development work will strengthen the instrument to explore these.
Current status of pain management in China: an overview
Authors: Huang Yuguang 
Published: September 2002

China is a large country with a huge population.It is estimated that 1.8 million patients suffer initially from cancer and 1.4 million patients die from it each year in Mainland China. Cancer ranks as the primary reason for death among the common diseases in cities and the second in rural areas.The management of pain is still a critical issue in the care of patients both with cancer and non‐cancer pain. A national survey suggested that the fear of addicting patients was still a major barrier for medical professionals in prescribing opioid analgesics. The major reasons for poor management or negative factors of pain relief came from patients' own reasons including their over‐concern about addiction to opioid analgesics, their reluctance to report pain and their resistance to use opioid analgesics. Oral long‐acting opioids are the most commonly used drugs for third ladder pain management. With policy support from the government, the consumption of morphine for medical purposes has increased significantly for the first time in recent Chinese history as this new cancer pain relief policy has been developed in the country. As a result, the three‐step analgesic ladder of the World Health Organization (WHO) has been gradually accepted by medical personnel and patients.Although pain management has been improved since the WHO's strategy of the three‐step approach was implemented in China, variations still exist in different regions of the Mainland. Currently the three main aspects of work on pain measurement are going to be undertaken including (1) continuous support from government policy; (2) consistent education and training; and (3) better availability of drugs for medical use throughout the whole country.