Search results for: neck femur fracture

Authors: Guoyang Fu, Wei Yang, Chun-Qing Li

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The most common type of cracks that appear on metal pipes is longitudinal cracks. For ductile metal pipes, the existence of plasticity eases the stress intensity at the crack front and consequently increases the fracture resistance. It should be noted that linear elastic fracture mechanics (LEFM) has been widely accepted by engineers. In order to make the LEFM applicable to ductile metal materials, the increase of fracture toughness due to plasticity should be excluded from the total fracture toughness of the ductile metal. This paper aims to develop a model of elastic fracture toughness for ductile metal pipes with external longitudinal cracks. The derived elastic fracture toughness is a function of crack geometry and material properties of the cracked pipe. The significance of the derived model is that the well-established LEFM can be used for ductile metal material in predicting the fracture failure.

Keywords: Ductile metal pipes, elastic fracture toughness, longitudinal crack, plasticity

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Authors: Rajendra Kumar Kanojia

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Treatment of fracture both bones of leg following trauma is done intially at nearby primary health care center.primary management for shock,pain,control of bleeding,plaster application. These are treated for primay fixation of fracture, debridment of wound. Then, they were refered to tertiary care where they were again and planned for further treatment. This leads to loss of lot of time, money, job, etc.

Keywords: fracture both bones leg, non-union, ilizarov, cost

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Authors: Pitchaporn Purngpiputtrakul, Suttasinee Petsakul, Sunisa Chatmongkolchart

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Nasogastric tube (NGT) insertion in anaesthetized and intubated patients can be challenging even for experienced anesthesiologists. Various techniques have been proposed to facilitate NGT insertion in these patients. This study aimed to compare the success rate and time required for NGT insertion between the GlideScope visualization and neck flexion with lateral neck pressure techniques. This randomized clinical trial was performed at a teaching hospital on 86 adult patients undergoing abdominal surgery under relaxant general anaesthesia who required intraoperative NGT insertion. The patients were randomized into two groups, the GlideScope group (group G) and the neck flexion with lateral neck pressure group (group F). The success rate of first and second attempts, duration of insertion, and complications were recorded. The total success rate was 79.1% in Group G compared with 76.7% in Group F (P=1) The median time required for NGT insertion was significantly longer in Group G, for both first and second attempts (97 vs 42 seconds P<0.001) and (70 vs 48.5 seconds P=0.015), respectively. Complications were reported in 23 patients (53.5%) in group G and 13 patients (30.2%) in group F. Bleeding and kinking were the most common complications in both techniques. Using GlideScope visualization to facilitate NGT insertion was comparable to neck flexion with lateral neck pressure technique in degree of success rate of insertion, while neck flexion with lateral neck pressure technique had fewer complications and was less time-consuming.

Keywords: anaesthesia, nasogastric tube, GlideScope, intubation

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Authors: Reda Abdel Azim, Tariq Shehab

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The main objective of this study is to develop a subsurface fracture map of naturally fractured reservoirs by overcoming the limitations associated with different data sources in characterising fracture properties. Some of these limitations are overcome by employing a nested neuro-stochastic technique to establish inter-relationship between different data, as conventional well logs, borehole images (FMI), core description, seismic attributes, and etc. and then characterise fracture properties in terms of fracture density and fractal dimension for each data source. Fracture density is an important property of a system of fracture network as it is a measure of the cumulative area of all the fractures in a unit volume of a fracture network system and Fractal dimension is also used to characterize self-similar objects such as fractures. At the wellbore locations, fracture density and fractal dimension can only be estimated for limited sections where FMI data are available. Therefore, artificial intelligence technique is applied to approximate the quantities at locations along the wellbore, where the hard data is not available. It should be noted that Artificial intelligence techniques have proven their effectiveness in this domain of applications.

Keywords: naturally fractured reservoirs, artificial intelligence, fracture intensity, fractal dimension

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Authors: Shu-Ching Chen, Li-Yun Lee

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The purpose of the study was to identify the factors associated with head and neck cancer-related lymphoedema (HNCRL)-related symptoms, body image, and HNCRL-related functional outcomes among patients with resected advanced head and neck cancer. A cross-sectional correlational design was conducted to examine the predictors of HNCRL-related functional outcomes in patients with resected advanced head and neck cancer. Eligible patients were recruited from a single medical center in northern Taiwan. Consecutive patients were approached and recruited from the Radiation Head and Neck Outpatient Department of this medical center. Eligible subjects were assessed for the Symptom Distress Scale–Modified for Head and Neck Cancer (SDS-mhnc), Brief International Classification of Functioning, Disability and Health (ICF) Core Set for Head and Neck Cancer (BCSQ-H&N), Body Image Scale–Modified (BIS-m), The MD Anderson Head and Neck Lymphedema Rating Scale (MDAHNLRS), The Foldi’s Stages of Lymphedema (Foldi’s Scale), Patterson’s Scale, UCLA Shoulder Rating Scale (UCLA SRS), and Karnofsky’s Performance Status Index (KPS). The results showed that the worst problems with body HNCRL functional outcomes. Patients’ HNCRL symptom distress and performance status are robust predictors across over for overall HNCRL functional outcomes, problems with body HNCRL functional outcomes, and activity and social functioning HNCRL functional outcomes. Based on the results of this period research program, we will develop a Cancer Rehabilitation and Lymphedema Care Program (CRLCP) to use in the care of patients with resected advanced head and neck cancer.

Keywords: head and neck cancer, resected, lymphedema, symptom, body image, functional outcome

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Authors: Magdy Abouzeid

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Introduction: Physical activity has been shown to have a positive effect on bone mineral density (BMD) and bone mineral content (BMC) among children, adolescents, and adults. Sports characterized by little or moderate weight bearing or impact have a low osteogenic effect. However, the action of such sports on bone turnover remains unclear. Swimming, as a non-weight-bearing sport, has been considered to be insignificant in the maintenance of bone mass. Purpose: To examine this issue we measured (BMD) and(BMC) of the lumbar spine, proximal femur via dual energy x-ray absorptiometry in the group of elite male swimmers, and determine the effect of swimming training on bone health and compared the results with matched controls group in age, body weight and height. Materials and Methods: Twenty-five male swimmers (age 20.7+/-0.8 years) training for 12-15 hours/week; and the controls group consisted of 25 non-active male (age 21.3 +/-1.3 years) were studied BMD and BMC of lumbar spine, femur were assessed via (DXA) absorptiometry. Results: There was significant difference between swimmers and control group in BMD and BMC, BMD of Swimmers was significantly greater than controls at all sites. The lumbar spine (1, 08 +/-0.202 vs., 0717+0.57 gxcm (-2), right proximal femur (1, 02 +/-, 044 vs., 771+/-, 027 gxcm (-2), and left proximal femur (1.374+/-0.212 vs. 1.01 +/-0.141 gxcm (-2). Swimmers were significantly taller, and had greater BMC and BMD compared to the controls group (P<0.001). Conclusions: These results suggest that swimming training may be beneficial in the prevention or therapy of OSTEOPENIA, and may lead to increased (BMD) and (BMC) for male swimmers. Swimming may be an effective non-pharmacological intervention for the adults and adolescent. Further research with younger athletes of another type of aquatics sport is warranted to better identify the periods of BMD development during which Aquatics sport has the greatest impact on bone health.

Keywords: bone mineral density, lumbar spine, femur, swimming, DXA absorptiometry

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Authors: Ennouri Triki, Toan Vu-Khanh

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Resistance to combined puncture/cutting by pointed blades is an important property of gloves materials. The purpose of this study is to propose an approach derived from the fracture mechanics theory to calculate the fracture energy associated to the puncture/cutting of nitrile rubber. The proposed approach is also based on the application of a sample pre-strained during the puncture/cutting test in order to remove the contribution of friction. It was validated with two different pointed blade angles of 22.5° and 35°. Results show that the applied total fracture energy corresponding to puncture/cutting is controlled by three energies, one is the fracture energy or the intrinsic strength of the material, the other reflects the friction energy between a pointed blade and the material. For an applied pre-strain energy (or tearing energy) of high value, the friction energy is completely removed. Without friction, the total fracture energy is constant. In that case, the fracture contribution of the tearing energy is marginal. Growth of the crack is thus completely caused by the puncture/cutting by a pointed blade. Finally, results suggest that the value of the fracture energy corresponding to puncture/cutting by pointed blades is obtained at a frictional contribution of zero.

Keywords: elastomer, energy, fracture, friction, pointed blades

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Authors: Amany Mohamed, Alaa Balbaa, Magdoline Mishel

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Background: Pain in the neck or scapular region is one of the most frequent symptoms in cervical radiculopathy, which is commonly caused by degenerative process in the spine. Purpose: To determine the effect of scapular stabilization exercises in the treatment of chronic neck pain regarding pain and disability and limitation in the range of motion. Patients and Methods: Thirty male and female patients with chronic neck pain were involved. Aged between 30-50 years old. They were randomly assigned into two groups. In group (A), patients received physical therapy program in the form of infrared, transcutaneous electrical nerve stimulation (TENS), Stretching and cervical stabilization exercises. In group (B), patients received scapular stabilization exercises in addition to the same physical therapy program. Treatment was given 3 times a week for 4 weeks. Range of motion of the cervical spine, range of motion of the scapula, neck pain and disability were assessed before and after treatment. Results: There was significant improvement in both groups (A and B) in cervical range of motion, pain and disability. Group (B) showed more significant improvement than group (A) in cervical range of motion and pain and disability. There was no significant improvement in both groups in scapular range of motion. Conclusion: Scapular stabilization exercises should be used as an integral part in the rehabilitation program

Keywords: Neck pain, neck stabilization exercise, scapular stabilization exercise, chronic neck pain

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Authors: Iqbal Pramukti, Mamat Lukman, Hasniatisari Harun, Kusman Ibrahim

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Introduction: People living with HIV had a higher risk of osteoporotic fracture than the general population. The purpose of this study was to predict the 10-year risk of fracture among people living with HIV (PLWH) using FRAX™ and to identify characteristics related to the fracture risk. Methodology: This study consisted of 75 subjects. The ten-year probability of major osteoporotic fractures (MOF) and hip fractures was assessed using the FRAX™ algorithm. A cross-tabulation was used to identify the participant’s characteristics related to fracture risk. Results: The overall mean 10-year probability of fracture was 2.4% (1.7) for MOF and 0.4% (0.3) for hip fractures. For MOF score, participants with parents’ hip fracture history, smoking behavior and glucocorticoid use showed a higher MOF score than those who were not (3.1 vs. 2.5; 4.6 vs 2.5; and 3.4 vs 2.5, respectively). For HF score, participants with parents’ hip fracture history, smoking behavior and glucocorticoid use also showed a higher HF score than those who were not (0.5 vs. 0.3; 0.8 vs. 0.3; and 0.5 vs. 0.3, respectively). Conclusions: The 10-year risk of fracture was higher among PLWH with several factors, including the parent’s hip. Fracture history, smoking behavior and glucocorticoid used. Further analysis on determining factors using multivariate regression analysis with a larger sample size is required to confirm the factors associated with the high fracture risk.

Keywords: HIV, PLWH, osteoporotic fractures, hip fractures, 10-year risk of fracture, FRAX

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Authors: Mamatha Hosapatna, Anne D. Souza, Vrinda Hari Ankolekar, Antony Sylvan D. Souza

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Introduction: The lower extremity of the femur is characterized by an anterior groove in which patella is held during motion. This groove separates the two lips of the trochlea (medial and lateral), prolongation of the two condyles. In humans, the lateral trochlear lip is more developed than the medial one, creating an asymmetric groove that is also specific to the human body. Because of femoral obliquity, contraction of quadriceps leads to a lateral dislocation stress on the patella, and the more elevated lateral side of the patellar groove helps the patella stays in its correct place, acting as a wall against lateral dislocation. This specific shape fits an oblique femur. It is known that femoral obliquity is not genetically determined but comes with orthostatism and biped walking. Material and Methodology: To measure the various dimensions of the Femoropatellar groove (FPG) and femoral condyle using digital image analyser. 37 dried adult femora (22 right,15 left) were used for the study. End on images of the lower end of the femur was taken. Various dimensions of the Femoropatellar groove and FP angle were measured using image J software. Results were analyzed statistically. Results: Maximum of the altitude of medial condyle of the right femur is 4.98± 0.35 cm and of the left femur is 5.20±.16 cm. Maximum altitude of lateral condyle is 5.44±0.4 and 5.50±0.14 on the right and left side respectively. Medial length of the groove is 1.30±0.38 cm on the right side and on the left side is 1.88±0.16 cm. The lateral length of the groove on the right side is 1.900±.16 cm and left side is 1.88±0.16 cm. Femoropatellar angle is 136.38◦±2.59 on the right side and on the left side it is 142.38◦±7.0 Angle and dimensions of the femoropatellar groove on the medial and lateral sides were measured. Asymmetry in the patellar groove was observed. The lateral lip was found to be wider and bigger which correlated with the previous studies. An asymmetrical patellar groove with a protruding lateral side associated with an oblique femur is a specific mark of bipedal locomotion. Conclusion: Dimensions of FPG are important in maintaining the stability of patella and also in knee replacement surgeries. The implants used in to replace the patellofemoral compartment consist of a metal groove to fit on the femoral end and a plastic disc that attaches to the undersurface of the patella. The location and configuration of the patellofemoral groove of the distal femur are clinically significant in the mechanics and pathomechanics of the patellofemoral articulation.

Keywords: femoral patellar groove, femoro patellar angle, lateral condyle, medial condyle

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Authors: M. Wigwe, M. Y Soloman, E. Pirayesh, R. Eghorieta, N. Stegent

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The moving reference point (MRP) technique has been used in the analyses of the first three stages of two fracturing jobs. The results obtained verify the proposition that a hydraulic fracture in shale grows in spurts rather than in a continuous pattern as originally interpreted by Nolte-Smith technique. Rather than a continuous Mode I fracture that is followed by Mode II, III or IV fractures, these fracture modes could alternate throughout the pumping period. It is also shown that the Nolte-Smith time parameter plot can be very helpful in identifying the presence of natural fractures that have been intersected by the hydraulic fracture. In addition, with the aid of a fracture length-time plot generated from any fracture simulation that matches the data, the distance from the wellbore to the natural fractures, which also translates to the actual fracture length for the stage, can be determined. An algorithm for this technique is developed. This procedure was used for the first 9 minutes of the simulated frac job data. It was observed that after 7mins, the actual fracture length is about 150ft, instead of 250ft predicted by the simulator output. This difference gets larger as the analysis proceeds.

Keywords: shale, fracturing, reservoir, simulation, frac-length, moving-reference-point

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Authors: Ahmad Nazrun Shuid, Isa Naina Mohamed, Nurul Izzah Ibrahim, Norazlina Mohamed

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Studies have shown that oral tocotrienol, a potent vitamin E, promoted fracture healing of osteoporotic bone. In this study, tocotrienol was combined with a polymer carrier (PLGA), and injected to the fracture site. The slow and constant release of tocotrienol particles would promote fracture healing of post-menopausal osteoporosis rat model. Fracture healing was assessed using micro-CT. Twenty-four Sprague-Dawley rats were ovariectomised or sham-operated and the left tibiae were fractured and fixed with plate and screws. The fractures were created at the upper third of the left tibiae. The rats were divided into 3 groups: sham-operated (SO), ovariectomised-control (OVxC) and PLGA-incorporated tocotrienol treatment (OVx + TT) groups. After 4 weeks, the OVx + TT group showed significantly better callus fracture healing than the OVxC group. In conclusion, tocotrienol-incorporated PLGA was able to promote fracture healing of osteoporotic bone.

Keywords: osteoporosis, micro-CT, tocotrienol, PLGA, fracture

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Authors: Mahdi Fakoor, Seyed Mohammad Navid Ghoreishi

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Investigation of fracture of wood components can prevent from catastrophic failures. Created fracture process zone (FPZ) in crack tip vicinity has important effect on failure of cracked composite materials. In this paper, a failure criterion for fracture investigation of cracked wood specimens under mixed mode I/II loading is presented. This criterion is based on maximum strain energy release rate and material nonlinearity in the vicinity of crack tip due to presence of microcracks. Verification of results with available experimental data proves the coincidence of the proposed criterion with the nature of fracture of wood. To simplify the estimation of nonlinear properties of FPZ, a damage factor is also introduced for engineering and application purposes.

Keywords: fracture criterion, mixed mode loading, damage zone, micro cracks

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Authors: Ghorbanali Mohammadi

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Background: The objectives of this study were the association between physical and psychological risk factors for occupational lower back and neck pain among industrial workers. Methods: We conducted a cross-sectional study among 400 male workers of an industrial company over the previous 7days and 12 months. Data were collected using Nordic and third version of COPSOO questionnaires and QEC method for assessment of postures during the work. Results: The prevalence of LB and NP in the last 12 months is 58% and 52% respectively. The relationship between risk factors and low back/ neck pain in the last 12 months were cognitive demands (OR 995% CI 1.65) and (OR 995% CI 1.75); Influence at work (OR 995% CI 2.21) and (OR 995% CI 1.85); quality of leadership (OR 995% CI 2.42) and (OR 995% CI 2.09) was strongly correlated with complaints of low back and neck pains. Conclusion: Data of this study showed a higher prevalence of LBP and NP in the subjects. The results revealed that workers with work experience of more than 12 yrs. and who work more than 8 hrs. days with smoking habits had more probability to develop both LBP and NP.

Keywords: low back pain, neck pain, physical risk factors, psychological risk factors, QEC, COPSOQ III

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Authors: Tao Yang, Yongli Zhao

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Low-temperature cracking is one of the major challenges for asphalt pavement in the cold region. Fracture energy could determine from various test methods, which is a commonly used parameter to evaluate the low-temperature cracking resistance of asphalt mixture. However, the feasibility of evaluating the low-temperature cracking performance of asphalt mixture using fracture energy is not investigated comprehensively. This paper aims to verify whether fracture energy is an appropriate parameter to evaluate the low-temperature cracking performance. To achieve this goal, this paper compared the test results of thermal stress restrained specimen test (TSRST) and semi-circular bending test (SCB) of asphalt mixture with different types of aggregate, TSRST and indirect tensile test (IDT) of asphalt mixture with different additives, and single-edge notched beam test (SENB) and TSRST of asphalt mixture with different asphalt. Finally, the correlation between in-suit cracking performance and fracture energy was surveyed. The experimental results showed the evaluation result of critical cracking temperature and fracture energy are not always consistent; the in-suit cracking performance is also not correlated well with fracture energy. These results indicated that it is not feasible to evaluate low-temperature performance by fracture energy. Then, the composition of fracture energy of TSRST, SCB, disk-shaped compact tension test (DCT), three-point bending test (3PB) and IDT was analyzed. The result showed: the area of thermal stress versus temperature curve is the multiple of fracture energy and could be used to represent fracture energy of TSRST, as the multiple is nearly equal among different asphalt mixtures for a specific specimen; the fracture energy, determined from TSRST, SCB, DCT, 3PB, SENB and IDT, is mainly the surface energy that forms the fracture face; fracture energy is inappropriate to evaluate the low-temperature cracking performance of asphalt mixture, as the relaxation/viscous performance is not considered; if the fracture energy was used, it is recommended to combine this parameter with an index characterizing the relaxation or creep performance of asphalt mixture.

Keywords: asphalt pavement, cold region, critical cracking temperature, fracture energy, low-temperature cracking

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Authors: Karthikeyan M., Paul M. J.

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This case report discusses a 54-year-old woman from Salem, Tamilnadu, who presented with a rare case of papillary thyroid carcinoma (PTC), manifesting as a hypervascular mass in the left carotid sheath. The patient had a two-and-a-half-month history of non-progressive neck swelling, with symptoms including dysphagia and a choking sensation. Clinical examination and investigations such as FNAC and CECT revealed a large vascular mass in the left neck region, initially perplexing the diagnosis. The patient underwent total thyroidectomy and excision of the left carotid sheath mass. Histopathology confirmed PTC. Postoperatively, the patient received Iodine-131 ablation and showed good recovery with no recurrence. This case highlights the diagnostic challenge and atypical presentation of PTC as a vascular neck mass, emphasizing the importance of a comprehensive approach in evaluating thyroid and neck lesions.

Keywords: lateral neck vascular mass, lateral aberrant thyroid, thyroid vascular swelling, smooth post op recovery

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Authors: Xi Yang, Bulent Chavdar, Alan Vonseggern, Taylan Altan

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Fracture in hot precision forging of engine valves was investigated in this paper. The entire valve forging procedure was described and the possible cause of the fracture was proposed. Finite Element simulation was conducted for the forging process, with commercial Finite Element code DEFORMTM. The effects of material properties, the effect of strain rate and temperature were considered in the FE simulation. Two fracture criteria were discussed and compared, based on the accuracy and reliability of the FE simulation results. The selected criterion predicted the fracture location and shows the trend of damage increasing with good accuracy, which matches the experimental observation. Additional modification of the punch shapes was proposed to further reduce the tendency of fracture in forging. Finite Element comparison shows a great potential of such application in the mass production.

Keywords: hotforging, engine valve, fracture, tooling

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Authors: S. Salah, S. A. El-Masry, H. F. Sheba, R. A. El-Banna, W. Saad

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Background: Familial Mediterranean fever (FMF) has episodic or subclinical inflammation that may lead to a decrease in bone mineral density (BMD). Objective: To assess BMD in Egyptian children with FMF on genetic basis. Subjects and Methods: A cross sectional study included 45 FMF patients and 25 control children of both sexes, with age range between 3-16 years old. The patients were reclassified into 2 groups: Group I (A) 23 cases used colchicines for 1 month or less, and Group I (B) 22 cases used colchicines for more than 6 months. For both patients and control, MEFV mutations were defined using molecular genetics technique and BMD was measured by DXA at 2 sites: proximal femur and the lumber spines. Results: four frequent gene mutations were found in the patient group: E148Q (35.6%), V726A (33.3%), M680I (28.9.0%) and M694V (2.2%). There were also 4 heterozygous gene mutations in 40% of control children. Patients received colchicines treatment for less than 1 month had highly significant lower values of BMD at femur and lumber spines than control children (p<0.05). Patients received colchicines treatment for more than 6 months had improved values of BMD at femur compared to control, but there were still significant differences between them at lumbar spine (p>0.05). There are insignificant effect of type of gene mutation on BMD and the risk of osteopenia among the patients. Conclusion: FMF had significant effect on BMD. However, regular use of colchicines treatment improves this effect mainly at femur.

Keywords: familial mediterranean fever, bone mineral density, genes, children

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Authors: Chun-Liang Wu, Kai-Ping Shaw, Cheng-Ping Yu, Wu-Chien Chien, Hsiao-Ting Chen, Shao-Huang Wu

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Objective: This study analyzed three criminal judicial cases. We applied the patterned injuries of the rider to demonstrate the facts of each accident, reconstruct the scenes, and pursue the truth. Methods: Case analysis, a method that collects evidence and reasons the results in judicial procedures, then the importance of the pattern of injury as evidence will be compared and evaluated. The patterned injuries analysis method is to compare the collision situation between an object and human body injuries to determine whether the characteristics can reproduce the unique pattern of injury. Result: Case 1: Two motorcycles, A and B, head-on collided; rider A dead, and rider B was accused. During the prosecutor’s investigation, the defendant learned that rider A had an 80 mm open wound on his neck. During the court trial, the defendant requested copies of the case file and found out that rider A had a large contusion on his chest wall, and the cause of death was traumatic hemothorax and abdominal wall contusion. The defendant compared all the evidence at the scene and determined that the injury was obviously not caused by the collision of the body or the motorcycle of rider B but that rider was out of control and injured himself when he crossed the double yellow line. In this case, the defendant was innocent in the High Court judgment in April 2022. Case 2: Motorcycles C and D head-on crashed, and rider C died of massive abdominal bleeding. The prosecutor decided that rider C was driving under the influence (DUI), but rider D was negligent and sued rider D. The defendant requested the copies’ file and found the special phenomenon that the front wheel of motorcycle C was turned left. The defendant’s injuries were a left facial bone fracture, a left femur fracture, and other injuries on the left side. The injuries were of human-vehicle separation and human-vehicle collision, which proved that rider C suddenly turned left when the two motorcycles approached, knocked down motorcycle D, and the defendant flew forward. Case 3: Motorcycle E and F’s rear end collided, the front rider E was sentenced to 3 months, and the rear rider F sued rider E for more than 7 million N.T. The defendant found in the copies’ file that the injury of rider F was the left tibial platform fracture, etc., and then proved that rider F made the collision with his left knee, causing motorcycle E to fall out of control. This evidence was accepted by the court and is still on trial. Conclusion: The application of patterned injuries in the reconstruction of a motorcycle accident could discover the truth and provide the basis for judicial justice. The cases and methods could be the reference for the policy of preventing traffic accident casualties.

Keywords: judicial evidence, patterned injuries analysis, accident reconstruction, fatal motorcycle injuries

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Authors: Marzieh Yassin, Azizeh Parandnia, Javad Sarrafzadeh, Reza Salehi

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Background: Myofascial trigger points (MTrPs) are one of the main causes of musculoskeletal pain syndromes and are associated with pain, tenderness, and limited range of motion (ROM). This study compared the effectiveness of high-intensity laser therapy (HILT) and dry needling (DN) on pain intensity, pain pressure threshold, cervical range of motion and disability in people with chronic neck pain. Method and Material: 30 patients with chronic neck pain were randomly divided into two groups: a HILT group (n=15) and a DN group (n=15). Treatment sessions were performed for three weeks, and all participants received related intervention twice a week (5 sessions). The pain level was measured using a Visual Analog Scale (VAS); the pain pressure threshold (PPT) was measured using a digital algometer; perceived disability was measured using the neck disability index (NDI); and cervical range of movements (CROMs) were measured using an iPhone app (lateral flexion) and a goniometer (Rotation). Results: In both the dry needling and high-intensity laser therapy groups, the pain and neck disability were significantly decreased (P < 0.05). Also, the pain pressure threshold and cervical range of motions were significantly increased in both groups. However, there was no significant difference between the two groups (P > 0.05). Conclusion: Both high-intensity laser therapy and dry needling can be used to treat chronic neck pain.

Keywords: chronic neck pain, dry needling, high intensity laser therapy (HILT), pain, pain pressure threshold

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Authors: R. Bensaada, M. Almansba, M. Ould Ouali, R. Ferhoum, N. E. Hannachi

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The aim of this work is to simulate the ductile fracture of SEN specimens in aluminium alloy. The assessment of fracture toughness is performed with the calculation of Jc (the critical value of J-Integral) through the resistance curves. The study is done using finite element code calculation ABAQUSTM including an elastic plastic with damage model of material’s behaviour. The procedure involves specimens of four different thicknesses and four ligament sizes for every thickness. The material of study is an aluminium alloy 6061-T6 for which the necessary parameters to complete the study are given. We found the same results for the same specimen’s thickness and for different ligament sizes when the fracture criterion is evaluated.

Keywords: j-integral, critical-j, damage, fracture toughness

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Authors: Mahdi Fakoor, Hannaneh Manafi Farid

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In order to predict the fracture behavior of cracked orthotropic materials under mixed-mode loading, well-known minimum strain energy density (SED) criterion is extended. The crack is subjected along the fibers at plane strain conditions. Despite the complicities to solve the nonlinear equations which are requirements of SED criterion, SED criterion for anisotropic materials is derived. In the present research, fracture limit curve of SED criterion is depicted by a numerical solution, hence the direction of crack growth is figured out by derived criterion, MSED. The validated MSED demonstrates the improvement in prediction of fracture behavior of the materials. Also, damaged factor that plays a crucial role in the fracture behavior of quasi-brittle materials is derived from this criterion and proved its dependency on mechanical properties and direction of crack growth.

Keywords: mixed-mode fracture, minimum strain energy density criterion, orthotropic materials, fracture limit curve, mode II critical stress intensity factor

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Authors: Jaegu Choi, Jae-Mean Koo, Chang-Sung Seok, Byungwoo Moon

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Since massive earthquakes in the world have been reported recently, the safety of nuclear power plants for seismic loading has become a significant issue. Seismic loading is the reverse cyclic loading, consisting of repeated tensile and compression by longitudinal and transverse wave. Up to this time, the study on characteristics of fracture toughness under reverse cyclic loading has been unsatisfactory. Therefore, it is necessary to obtain the fracture toughness under reverse cyclic load for the integrity estimation of nuclear power plants under seismic load. Fracture resistance (J-R) curves, which are used for determination of fracture toughness or integrity estimation in terms of elastic-plastic fracture mechanics, can be derived by the fracture resistance test using single specimen technique. The objective of this paper is to study the effects of reverse cyclic loading on a fracture resistance curve of ESG specimen, having a similar stress gradient compared to the crack surface of the real pipe. For this, we carried out the fracture toughness test under the reverse cyclic loading, while changing incremental plastic displacement. Test results showed that the J-R curves were decreased with a decrease of the incremental plastic displacement.

Keywords: reverse cyclic loading, j-r curve, ESG specimen, incremental plastic displacement

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Authors: Von Jerick Tenorio, Jonald Lucero, Marivic Vestal, Edwin Tiempo

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In patients with hostile aortic neck anatomy, the risks of proximal seal complications and stent migration remain with EVAR despite improved endograft technology. This case report discusses how the technical challenges of the hostile neck anatomy, proximal penetrating atherosclerotic ulcer (PAU) and tortuous femoral access were addressed. The CT aortogram of a 63-year-old hypertensive and diabetic man with recurring abdominal discomfort revealed a fusiform infra-renal aneurysm measuring 8.8 cm in length and 5.7 cm in diameter. The proximal landing zone only has a 3 mm healthy neck with a conicity of > 10% and a thrombus of 4 mm thick. Proximal to the aneurysm is a PAU with a circumferential mural thrombus. The right femoral artery is tortuous with > 90o angulation. A 20% oversized Endurant II endograft and Aptus Heli-FX EndoAnchors were deployed as prophylaxis for type I endoleaks and endograft migration consequent to the conical neck and proximal aneurysm extension consequent to the PAU. A stiff Backup Meier guide wire facilitated the deployment of the endograft. Coil embolization of the right internal iliac artery was performed as prophylaxis for type II endoleaks. EndoAnchors can be used as an adjunct to EVAR as prophylaxis for proximal seal complications and stent migration in patients with hostile aortic aneurysm neck anatomy and concomitant proximal PAU.

Keywords: endoAnchors, endoleaks, EVAR, hostile neck

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Authors: Sait Ozsoy, Asude Gokmen, Mehtap Yondem, Hanife A. Alkan, Gulnaz T. Javan

Abstract:

Deep neck infection often develops due to upper respiratory tract and odontogenic infections. Gastrointestinal System perforation can occur for many reasons and is in need of the early diagnosis and prompt surgical treatment. In both cases late or incorrect diagnosis may lead to increase morbidity and high mortality. A patient with a diagnosis of deep neck abscess died while under treatment due to sepsis and multiple organ failure. Autopsy finding showed duodenal ulcer and this is reported in the literature.

Keywords: peptic ulcer perforation, peritonitis, retropharyngeal abscess, sepsis

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Authors: Abhishek Sharma, Amit Gupta, Manish Singhal

Abstract:

Background: The management of patients with penetrating neck injuries in the prehospital setting and in the emergency department has evolved with regard to the use of multidetector computed tomographic (MDCT) imaging. Hence, there is a shift in the management of neck injuries from mandatory exploration in certain anatomic areas to more conservative approach using imaging and so-called “no zone approach”. Objective: To study the no zone approach in the management of penetrating neck injury using routine imaging in all stable patients. Methods: 137 patients with penetrating neck injury attending emergency department of level 1 trauma centre at AIIMS between 2008–2014 were retrospectively analysed. All hemodynamically stable patients were evaluated using CT scanning. Results: Stab injury is most common (55.91%) mode of pni in civilian population followed by gunshot(18.33%). The majority of patients could be managed with imaging and close observation. 39 patients (28.46%) required operative intervention. The most common indication for operative intervention was vascular followed by airway injury manifesting as hemodynamic destabilisation.There was no statistical difference between the zonal distribution of injuries in patients managed conservatively and those taken to OR. Conclusions: Study shows that patients with penetrating neck trauma who are haemodynamically stable and exhibit no “hard signs” of vascular injury or airway injury may be evaluated initially by MDCT imaging even when platysma violation is present. “No Zone” policy may be superior to traditional zone wise management.

Keywords: penetrating neck injury, zone approach, CT scanning, multidetector computed tomographic (MDCT)

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Authors: B. Kenny

Abstract:

The complications associated with transfusions are well documented, with the serious hazards of transfusion (SHOT) reporting system continuing to report deaths and serious morbidity due to the transfusion of allogenic blood. Many different sources including the TRICC trial, NHMRC and Cochrane recommending similar transfusion triggers/guidelines. Recent studies found the rate of infection (deep infection, wound infection, chest infection, urinary tract infection, and others) were purely a dose response relationship, increasing the Relative Risk by 3.44. It was also noted that each transfused patient stayed in hospital for one additional day. We hypothesise that providing an approved/standardised, guideline with a graphical summary of decision pathways for anaemic patients will reduce unnecessary transfusions. We retrospectively assessed patients undergoing primary knee or hip arthroplasties over a 4 year period, 1459 patients. Of these, 339 (23.24%) patients received allogenic blood transfusions and 858 units of blood were transfused, 9.14% of patients transfused had haemoglobin levels above 100 g/L, 7.67% of patients were transfused without knowing the haemoglobin level, 24 hours prior to transfusion initiation and 4.5% had possible transfusion reactions. Overall, 17% of allogenic transfusions topatients admitted to the Orthopaedic department within a 4 year period were outside NHMRC and Cochrane guidelines/recommendations. If our transfusion frequency is compared with that of other authors/hospitals, transfusion rates are consistently being high. We subsequently implemented a simple guideline for transfusion initiation. This guideline was then assessed. We found the transfusion rate post transfusion implementation to be significantly lower, without increase in patient morbidity or mortalitiy, p <0.001). Transfusion rates and patient outcome can be optimized by a simple graphical aid for decision making.

Keywords: transfusion, morbidity, mortality, neck of femur, fracture, arthroplasty, rehabilitation

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Authors: I-Ling Chang, Jer-An Chen

Abstract:

The elastic properties and fracture of two-dimensional graphene were calculated purely from the atomic bonding (stretching and bending) based on molecular mechanics method. Considering the representative unit cell of graphene under various loading conditions, the deformations of carbon bonds and the variations of the interlayer distance could be realized numerically under the geometry constraints and minimum energy assumption. In elastic region, it was found that graphene was in-plane isotropic. Meanwhile, the in-plane deformation of the representative unit cell is not uniform along armchair direction due to the discrete and non-uniform distributions of the atoms. The fracture of graphene could be predicted using fracture criteria based on the critical bond length, over which the bond would break. It was noticed that the fracture behavior were directional dependent, which was consistent with molecular dynamics simulation results.

Keywords: energy minimization, fracture, graphene, molecular mechanics

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Authors: Anup Kumar Keshri, Arvind Agarwal

Abstract:

Carbon nanotube (CNT) reinforced aluminum oxide (Al2O3) composite coating was synthesized on the steel substrate using plasma spraying technique. Three different compositions of coating such as Al2O3, Al2O¬3-4 wt. % CNT and Al2O3-8 wt. % CNT were synthesized and the fracture strength was determined using the four point bend test. Uniform dispersion of CNTs over Al2O3 powder particle was successfully achieved. With increasing CNT content, porosity in the coating showed decreasing trend and hence contributed towards enhanced mechanical properties such as hardness (~12% increased) and elastic modulus (~34 % increased). Fracture strength of the coating was found to be increasing with the CNT additions. By reinforcement of 8 wt. % of CNT, fracture strength increased by ~2.5 times. The improvement in fracture strength of Al2O3-CNT coating was attributed to three competitive phenomena viz. (i) lower porosity (ii) higher hardness and elastic modulus (iii) CNT bridging between splats.

Keywords: aluminum oxide, carbon nanotube, fracture strength, plasma spraying

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Authors: František Šebek, Petr Kubík, Jindřich Petruška, Jiří Hůlka

Abstract:

Present study is aimed on the cutting process of circular cross-section rods where the fracture is used to separate one rod into two pieces. Incorporating the phenomenological ductile fracture model into the explicit formulation of finite element method, the process can be analyzed without the necessity of realizing too many real experiments which could be expensive in case of repetitive testing in different conditions. In the present paper, the steel AISI 1045 was examined and the tensile tests of smooth and notched cylindrical bars were conducted together with biaxial testing of the notched tube specimens to calibrate material constants of selected phenomenological ductile fracture models. These were implemented into the Abaqus/Explicit through user subroutine VUMAT and used for cutting process simulation. As the calibration process is based on variables which cannot be obtained directly from experiments, numerical simulations of fracture tests are inevitable part of the calibration. Finally, experiments regarding the cutting process were carried out and predictive capability of selected fracture models is discussed. Concluding remarks then make the summary of gained experience both with the calibration and application of particular ductile fracture criteria.

Keywords: ductile fracture, phenomenological criteria, cutting process, explicit formulation, AISI 1045 steel

Procedia PDF Downloads 457