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981.
BACKGROUND: Recently, investigators have reported the use of endoscopic myotomy in the treatment of esophageal achalasia. As with the open operation, considerable disagreement exists regarding the appropriate length of the myotomy and the need for a concomitant antireflux procedure. METHODS: Patients presenting with symptomatic achalasia between 1993 and 1997 were included in this prospective study. Preoperative studies included barium upper gastrointestinal study, endoscopy, and esophageal manometry. Laparoscopic myotomy was completed in all 20 patients; 18 had concomitant Toupet fundoplication. RESULTS: Operative times ranged from 95 to 345 minutes (mean 216). Blood loss ranged from 50 to 300 cc (mean 100 cc). There were 7 minor complications (5 mucosal injuries repaired laparoscopically, 1 bile leak and 1 splenic capsular tear). Nine patients began a liquid diet on the first day postoperatively; 19 were tolerating liquids by postoperative day 3. Hospital stay ranged from 2 to 20 days (mean 5). Eighteen patients had complete relief of dysphagia, with less than one reflux episode per month. One individual continues to have mild persistent solid food dysphagia. Another patient initially did well but subsequently developed mild recurrent dysphagia and reflux. One patient required laparoscopic take-down of the wrap because of recurrent dysphagia and now has no problems swallowing, but does complain of mild reflux. Two other patients also have mild reflux, 1 of whom did not undergo fundoplication. CONCLUSIONS: Laparoscopic Heller myotomy can be performed safely with excellent results in patients with achalasia. Adding a partial fundoplication appears to help control postoperative symptoms of reflux. This procedure should be considered the procedure of choice in patients with symptomatic esophageal achalasia. 相似文献
982.
Hemiballism is a rare hyperkinetic disorder which is characterized by irregular vigorous rotatory movements of the limbs of one side of the body. The disabling and exhausting movements with their high risk of severe injuries require an acute drug treatment. However, there are no common guidelines for the treatment of this disorder. Therefore we reviewed the available literature to establish a concept for a rational symptomatic drug treatment. Furthermore, own observations in 6 patients with hemiballism of different origins are reported. 相似文献
983.
The effect of thickness of magnetic conductor and number of electrically insulating layers on the magnetic properties in an alternating field of a layered powder-metallurgy soft-magnetic material based on iron was investigated. It was determined that increasing the thickness of the magnetic conductor and frequency of the alternating current deteriorated the magnetic properties of the material. Creation of a layered structure in which ferromagnetic layers alternate with electrically insulating layers decreased specific magnetic losses. 相似文献
984.
985.
Storozhuk V. N. Romashchenko V. A. Lepikhin P. P. Zhurakhovskii S. V. 《Strength of Materials》2002,34(3):300-304
Large deflections of pulse-loaded elliptic and round plates made of hardenable elastoplastic materials are investigated analytically using an energy-based approach. Formulas that are convenient for engineering design have been derived. 相似文献
986.
Measuring knowledge transfer between fields of science 总被引:4,自引:2,他引:2
Rinia Ed J. van Leeuwen Thed N. Bruins Eppo E. W. van Vuren Hendrik G. van Raan Anthony F. J. 《Scientometrics》2002,54(3):347-362
In this paper we report on the results of an exploratory study of knowledge exchange between disciplines and subfields of
science, based on bibliometric methods. The goal of this analysis is twofold. Firstly, we consider knowledge exchange between
disciplines at a global level, by analysing cross-disciplinary citations in journal articles, based on the world publication
output in 1999. Among others a central position of the Basic Life Sciences within the Life Sciences and of Physics within
the Exact Sciences is shown. Limitations of analyses of interdisciplinary impact at the journal level are discussed. A second
topic is a discussion of measures which may be used to quantify the rate of knowledge transfer between fields and the importance
of work in a given field or for other disciplines. Two measures are applied, which appear to be proper indicators of impact
of research on other fields. These indicators of interdisciplinary impact may be applied at other institutional levels as
well.
This revised version was published online in August 2006 with corrections to the Cover Date. 相似文献
987.
988.
Michael Anthony Puso Tod A. Laursen 《International journal for numerical methods in engineering》2002,54(8):1161-1194
In this work, a method is developed for smoothing three‐dimensional contact surfaces. The method can be applied to both regular and irregular meshes. The algorithm employs Gregory patches to interpolate finite element nodes and provide tangent plane continuity between adjacent patches. The resulting surface interpolation is used to calculate gaps and contact forces, in a variationally consistent way, such that contact forces due to normal and frictional contact vary smoothly as slave nodes transition from one patch to the next. This eliminates the ‘chatter’ which typically occurs in a standard contact algorithm when a slave node is situated near a master facet edge. The elimination of this chatter provides a significant improvement in convergence behaviour, which is illustrated by a number of numerical examples. Furthermore, smoothed surfaces also provide a more accurate representation of the actual surface, such that resulting stresses and forces can be more accurately computed with coarse meshes in many problems. This fact is also demonstrated by the numerical examples. Published in 2002 by John Wiley & Sons, Ltd. 相似文献
989.
990.
P. A. Hausladen D. C. Weisser N. R. Lobanov L. K. Fifield H. J. Wallace 《Nuclear instruments & methods in physics research. Section B, Beam interactions with materials and atoms》2002,190(1-4):402-404
We report on improvements in the overall intensity of a sputter ion source that evolved originally from an NEC MCSNICS. Beam output increases benefit both AMS measurements and nuclear physics experiments using low natural abundance beams. In particular, minor changes in source geometry suggested by a combination of electrostatic calculations and simple design principles have yielded increases in extracted negative ion intensity of nearly a factor of 4. 相似文献