781 resultados para Surgery, Plastic


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Curing reactions of the viscous PS prepolymer and PS/AP propellant slurry have been studied. The molecular weight of the binder (separated from the propellant) and the prepolymer was found to increase to a maximum value, remain constant for some time, and then fall off between 50–125°C. The molecular weight of the binder was found to be less than corresponding prepolymer between 100–150°C but at lower temperatures (50–75°C) the reverse was found to be true. The increase in the molecular weight during curing at lower temperatures has been explained on the basis of Trommsdorff effect which gets support from the estimated activation energy (9 kcal mole−1) for the curing process. Curing was recognized as chain extension where the rate of polymerization becomes diffusion controlled below 75° C.

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The proportion of patients over 75 years of age, receiving all different types of healthcare, is constantly increasing. The elderly undergo surgery and anaesthetic procedures more often than middle-aged patients. Poor pain management in the elderly is still an issue. Although the elderly consumes the greatest proportion of prescribed medicines in Western Europe, most clinical pharmacological studies have been performed in healthy volunteers or middle-aged patients. The aim of this study was to investigate pain measurement and management in cognitively impaired patients in long term hospital care and in cognitively normal elderly patients after cardiac surgery. This thesis incorporated 366 patients, including 86 home-dwelling or hospitalized elderly with chronic pain and 280 patients undergoing cardiac surgery with acute pain. The mean age of patients was 77 (SD ± 8) years and approximately 8400 pain measurements were performed with four pain scales: Verbal Rating Scale (VRS), the Visual Analogue Scale (VAS), the Red Wedge Scale (RWS), and the Facial Pain Scale (FPS). Cognitive function, depression, functional ability in daily life, postoperative sedation and postoperative confusion were assessed with MMSE, GDS, Barthel Index, RASS, and CAM-ICU, respectively. The effects and plasma concentrations of fentanyl and oxycodone were measured in elderly (≥ 75 years) and middle-aged patients (≤ 60 years) and the opioid-sparing effect of pregabalin was studied after cardiac surgery. The VRS pain scores after movement correlated with the Barthel Index. The VRS was most successful in the groups of demented patients (MMSE 17-23, 11-16 and ≤ 10) and in elderly patients on the first day after cardiac surgery. The elderly had a higher plasma concentration of fentanyl at the end of surgery than younger patients. The plasma concentrations of oxycodone were comparable between the groups. Pain intensity on the VRS was lower and the sedation scores were higher in the elderly. Total oxycodone consumption during five postoperative days was reduced by 48% and the CAM-ICU scores were higher on the first postoperative day in the pregabalin group. The incidence of postoperative pain during movement was lower in the pregabalin group three months after surgery. This investigation demonstrates that chronic pain did not seem to impair daily activities in home-dwelling Finnish elderly. The VRS appeared to be applicable for elderly patients with clear cognitive dysfunction (MMSE ≤17) and it was the most feasible pain scale for the early postoperative period after cardiac surgery. After cardiac surgery, plasma concentrations of fentanyl in elderly were elevated, although oxycodone concentrations were at similar level compared to middle-aged patients. The elderly had less pain and were more sedated after doses of oxycodone. Therefore, particular attention must be given to individual dosing of the opioids in elderly surgical patients, who often need a smaller amount for adequate analgesia than middle-aged patients. The administration of pregabalin reduced postoperative oxycodone consumption after cardiac surgery. Pregabalin-treated patients had less confusion, and additionally to less postoperative pain on the first postoperative day and during movement at three months post-surgery. Pregabalin might be a new alternative as analgesic for acute postoperative and chronic pain management in the elderly. Its clinical role and safety remains to be verified in large-scale randomized and controlled studies. In the future, many clinical trials in the older category of patients will be needed to facilitate improvements in health care methods.

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The radius of an elastic-plastic boundary was measured by the strain gage method around the cold-worked region in L72-aluminum alloy. The relative radial expansion was varied from 2.5 to 6.5 percent during the cold-working process using mandrel and split sleeve. The existing theoretical studies in this area are reviewed. The experimental results are compared with existing experimental data of various investigators and with various theoretical formulations. A model is developed to predict the radius of elastic-plastic boundary, and the model is assessed by comparing with the present experiments.

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According to a large body of evidence, carotid endarterectomy (CEA) can prevent strokes, provided that appropriate inclusion criteria and high-quality perioperative treatment methods are utilised with low complication rates. From the patient s perspective, it is of paramount importance that the operation is as safe and effective as possible. From the community s point of view, it is important that CEA provision prevents as many strokes as possible. In order to define the stroke preventing potential of CEA in different communities, a comparison between eight European countries and Australia was performed including 53 077 carotid interventions. A more detailed evaluation was performed in Finland, the United Kingdom and Egypt. It could be estimated that many potentially preventable strokes occur due to insufficient diagnostics and CEA provision. The number of CEAs should be at least doubled in the Helsinki region. The theoretical power of CEA provision in stroke prevention varied significantly between the countries. Delay from symptom to surgery has been identified as one of the most important factors influencing the effectiveness of CEA. In 2008 only 11% of CEAs in Helsinki university central hospital (HUCH) were performed within the recommended14 days. Registered data of 673 CEAs in HUCH during 2000-2005 was analyzed. There was no systematic error that would have changed the outcome analysis. However it is important that registers are audited regularly and cross matching of different registries is possible. A previously unpublished method of combining medial mandibulotomy, neck incision and carotid artery interposition was carried out as a collaboration of maxillofacial, ear, nose and throat and vascular surgeons. Five patients were operated on with a technique that was feasible and possible to perform with little morbidity, but due to the significant risks involved, this technique should be reserved for carefully selected cases. In stroke prevention, organisational decisions seem far more important than details in interventional procedures when CEA is performed with low complication rates, as was the case in the present study. A TIA clinic approach with close co-operation between the on-call vascular surgeons, neurologists and radiologists should be available at all centres treating these patients. Patients should have a direct and fast admission to the hospital performing CEA.

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Stress relaxation testing is often utilised for determining whether athermal straining contributes to plastic flow; if plastic strain rate is continuous across the transition from tension to relaxation then plastic strain is fully thermally activated. This method was applied to an aged type 316 stainless steel tested in the temperature range 973–1123 K and to a high purity Al in the recrystallised annealed condition tested in the temperature range 274–417 K. The results indicated that plastic strain is thermally activated in these materials at these corresponding test temperatures. For Al, because of its high strain rate sensitivity, it was necessary to adopt a back extrapolation procedure to correct for the finite period that the crosshead requires to decelerate from the constant speed during tension to a dead stop for stress relaxation.

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A block of high-purity copper was indented by a 120-degrees diamond-tipped cone. Strain gauges were placed on the surface to measure the radial strains at different surface locations, during loading as well as unloading. The competence of three stress fields proposed for elastic-plastic indentation is assessed by comparing the predicted surface radial strains with those experimentally observed.

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The paper describes an experimental and analytical study of the normal and scratch hardnesses of a model soft rigid-plastic solid. The material known as ‘Plasticine’, a mixture of dry particles and a mineral oil, has been deformed with a range of rigid conical indentors with included angles of between 30° and 170°. The sliding velocity dependence of the computed scratch hardness and friction has been examined in the velocity range 0.19 mm/s to 7.3 m/s. Data are also described for the time dependence of the normal hardness and also the estimated rate dependence of the intrinsic flow stress. The latter values were estimated from data obtained during the upsetting of right cylinders. Three major conclusions are drawn from these data and the associated analysis. (1) A first-order account of the scratching force may be provided by adopting a model which sums the computed plastic deformation and interfacial sliding contributions to the total sliding work. This is tantamount to the adoption of the two-term non-interacting model of friction. (2) For this system during sliding, at high sliding velocities at least, the interface shear stress which defines the boundary condition is not directly related to the bulk shear stress. The interface rheological characteristics indicate an appreciable dependence on the imposed strain or strain rate. In particular, the relative contributions of the slip and stick boundary conditions appear to be a function of the imposed sliding velocity. (3) The computed normal and scratch hardness values are not simply interrelated primarily because of the evolving boundary conditions which appear to exist in the scratching experiments.

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Important issues of water and thermal history affecting ion transport in a representative plastic crystalline lithium salt electrolyte: succinonitrile (SN)-lithium perchlorate (LiClO4) are discussed here. Ionic conductivity of electrolytes with high lithium salt amounts (similar to 1 M) in SN at a particular temperature is known to be influenced both by the trans-gauche isomerism and ion association (solvation), the two most important intrinsic parameters of the plastic solvent. In the present study both water and thermal history influence SN and result in enhancement of ionic conductivity of 1 M LiClO4-SN electrolyte. Systematic observations reveal that the presence of water in varying amounts promote ion-pair dissociation in the electrolyte. While trace amounts (approximate to 1-15 ppm) do not affect the trans-gauche isomerism of SN, the presence of water in large amounts (approximate to 5500 ppm) submerges the plasticity of SN. Subjugating the electrolyte to different thermal protocol resulted in enhancement of trans concentration only. This is an interesting observation as it demonstrates a simple and effective procedure involving utilization of an optimized set of external parameters to decouple solvation from trans-gauche isomerism. Observations from the ionic conductivity of various samples were accounted by changes in signature isomer and ion-association bands in the mid-IR regime and also from plastic to normal crystal transition temperature peak obtained from thermal studies. (C) 2010 Elsevier B.V. All rights reserved.

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A cross-linked polymer-gel soft matter electrolyte with superior electrochemical, thermal and mechanical properties obtained from free radical polymerization of vinyl monomers in a semi-solid organic nonionic plastic crystalline electrolyte for application in rechargeable lithium-ion batteries is discussed here.

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Recycling plastic waste from water bottles has become one of the major challenges worldwide. The present study provides an approach for the use plastic waste as reinforcement material in soil. The experimental results in the form of stress-strain-pore water pressure response are presented. Based on experimental test results, it is observed that the strength of soil is improved and compressibility reduced significantly with addition of a small percentage of plastic waste to the soil. The use of the improvement in strength and compressibility response due to inclusion of plastic waste can be advantageously used in bearing capacity improvement and settlement reduction in the design of shallow foundations. (C) 2010 Elsevier Ltd. All rights reserved.

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We address the long-standing problem of the origin of acoustic emission commonly observed during plastic deformation. We propose a framework to deal with the widely separated time scales of collective dislocation dynamics and elastic degrees of freedom to explain the nature of acoustic emission observed during the Portevin-Le Chatelier effect. The Ananthakrishna model is used as it explains most generic features of the phenomenon. Our results show that while acoustic emission bursts correlated with stress drops are well separated for the type C serrations, these bursts merge to form nearly continuous acoustic signals with overriding bursts for the propagating type A bands.

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Influence of succinonitrile (SN) dynamics on ion transport in SN-lithium perchlorate (LiClO4) electrolytes is discussed here via dielectric relaxation spectroscopy. Dielectric relaxation spectroscopy (similar to 2 x 10(-3) Hz to 3 MHz) of SN and SN-LiClO4 was studied as a function of salt content (up to 7 mol % or 1 M) and temperature (-20 to +60 degrees C). Analyses of real and imaginary parts of permittivity convincingly reveal the influence Of trans gauche isomerism and solvent-salt association (solvation) effects on ion transport. The relaxation processes are highly dependent on the salt concentration and temperature. While pristine SN display only intrinsic dynamics (i.e., trans-gauche isomerism) which enhances with an increase in temperature, SN-LiClO4 electrolytes especially at high salt concentrations (similar to 0.04-1 M) show salt-induced relaxation processes. In the concentrated electrolytes, the intrinsic dynamics was observed to be a function of salt content, becoming faster with an increase in salt concentration. Deconvolution of the imaginary part of the permittivity spectra using Havriliak-Negami (HN) function show a relaxation process corresponding to the above phenomena. The permittivity data analyzed using HN and Kohlrausch-Williams-Watta (KWW) functions show non-Debye relaxation processes and enhancement in the trans phase (enhanced solvent dynamics) as a function of salt concentration and temperature.