Дисертації з теми "Fractures, Open"
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Aird, J. "Human Immunodeficiency Virus and open fractures : is wound or fracture healing affected in surgically stabilised open fractures? : a prospective study." Thesis, University College London (University of London), 2012. http://discovery.ucl.ac.uk/1343913/.
Повний текст джерелаNussbaum, Marcy Lauren. "Meta-Analysis of Open vs Closed Surgery of Mandibular Condyle Fractures." VCU Scholars Compass, 2006. http://scholarscompass.vcu.edu/etd/1397.
Повний текст джерелаWorlock, Peter Harrison. "The prevention of infection in open fractures : an experimental study of the effects of fracture stability and of antibiotic therapy." Thesis, University of Nottingham, 1986. http://eprints.nottingham.ac.uk/13676/.
Повний текст джерелаП`ятикоп, Геннадій Іванович, Геннадий Иванович Пятикоп, Hennadii Ivanovych Piatykop, Дмитро Володимирович Шищук, Дмитрий Владимирович Шищук, Dmytro Volodymyrovych Shyshсhuk та Л. О. Самодахова. "Тактика лікування відкритих переломів кісток". Thesis, Вид-во СумДУ, 2005. http://essuir.sumdu.edu.ua/handle/123456789/7298.
Повний текст джерелаBoriani, Filippo <1977>. "The "Orthoplastic" combined surgical approach to open tibia fractures: a multicentric prospective outcome study." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2015. http://amsdottorato.unibo.it/6754/.
Повний текст джерелаMelin, Hanna. "Controlling parameters for normal and shear behaviour of rock fractures-a study of direct shear test data from SKB." Thesis, KTH, Jord- och bergmekanik, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-93976.
Повний текст джерелаLanka, Gopi Krishna. "Stability of the Mandible–Strut Plate Complex in Isolated Angle Fractures: A Finite Element Study." University of Cincinnati / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1535382405124984.
Повний текст джерелаBarouni, Elyas. "Soft tissue Reconstruction of Gustilo-Anderson Grade IIIB Open Extra-Articular Tibial Fractures at a Tertiary Hospital in Cape Town, South Africa: A Retrospective Case Series." Master's thesis, Faculty of Health Sciences, 2020. http://hdl.handle.net/11427/32588.
Повний текст джерелаNemanja, Gvozdenović. "Rana prognoza kvaliteta života politraumatizovanih bolesnika sa prelomima dugih kostiju." Phd thesis, Univerzitet u Novom Sadu, Medicinski fakultet u Novom Sadu, 2016. http://www.cris.uns.ac.rs/record.jsf?recordId=99961&source=NDLTD&language=en.
Повний текст джерелаThe term of polytrauma means, a patient with multiple severe injuries in at least two regions of the body with anatomical severity of trauma AIS equal or greater than three and the total calculated weight anatomical injuries expressed by ISS score must be greater than 15. The aim of our study is early estimate of quality of life in polytrauma patients with multiple fractures of the long bones and polytrauma patients without fractures of long bones as well as to detect early indicators of poor prognosis of quality of life after treatment, using questionnaires (SF 36, PTSD test and Glasgow Outcome Scale). This was prospective study and included 202 polytrauma patients who were injured during the period 2010-2014 and were treated in the Emergency Center of Clinical Center of Vojvodina. From 202 polytrauma patients, on control examinations responded 72 patients, 37 with fractures of long bones - study group and 35 polytrauma patients without fractures of long bones and they were control group. One year after the end of hospitalization each patient filled out a questionnaire (SF36, PTSD test and Glasgow Outcome Scale), made a clinical examination and standard X-rays of long bone fractures. Our results indicate that the overall quality of life after treatment is not significantly different between the groups, although polytraumatized patients with fractures have a lower quality of life and significantly worse physical functioning and have significantly more mental disorders (post-traumatic stress disorder, depression) compared to the control group. Type of long bone fractures did not affect on the final quality of life, while those patients with two or more fractures had a significantly poorer quality of life. Based on these results we concluded that greater chance for a better quality of life have patients younger than 44 years, unless they had initially ISS score less than 30.5 points, systolic and diastolic blood pressure in the reference values as well as the number of red blood cells and platelets, and if they received less than 4 units of blood transfusions in the first 24 hours.
Carvalho, Vladimir Cordeiro de. "Osteomielite por bacilos Gram-negativos: estudo comparativo das características clínico-microbiológicas e fatores de risco com as infecções por Staphylococcus aureus." Universidade de São Paulo, 2013. http://www.teses.usp.br/teses/disponiveis/5/5140/tde-14082013-105434/.
Повний текст джерелаINTRODUCTION: Bone and joint infection remains a serious therapeutic challenge, despite the high success rate observed with antibiotic therapy in most bacterial disease since the end of 1930 decade. Staphylococcus aureus (S. aureus) is the most studied and the most frequently isolated pathogen, but there is insufficient information in medical literature regarding Gram- negative bacilli (GNB) osteomyelitis. OBJECTIVES: Describe clinical and microbiological characteristics of Gram-negative bacilli osteomyelitis. Establish evolving differences and risk factors for the occurrence of GNB osteomyelitis, compared to S. aureus osteomyelitis. METHODS: Retrospective analysis of all patients with GNB osteomyelitis treated at Institute of Orthopedics and Traumatology, Hospital das Clínicas - School of Medicine, Universidade de São Paulo from january 2007 to january 2009. Only bone or bone marrow aspirate samples were included. RESULTS: 89 patients were included in S. aureus group and 101 patients were included in GNB group. Patients in GNB group were mostly male (63%), with median age of 42 years. At presentation, they had chronic osteomyelitis (43%) and acute open-fracture associated osteomyelitis (32%), in the lower limbs (71%), with a discharging sinus as the main clinical sign (69%). When compared to S. aureus group, GNB group was statistically associated with a previous history of open-fracture (35% vs. 18%; p=0.0064), showed a longer length of hospital stay (median 41 vs. 24 days; p=0.0114), a higher number of days to isolate the infective bacteria (median 10 vs. 6,5 days; p=0.0042), a longer use of antibiotics (median 40 vs. 24 days; p=0.0329), a higher number of surgical procedures (mean 3,41 vs. 2,47; p=0.0173) and a higher rate of soft- tissue reconstruction (31% vs. 9%; p=0.0005). S. aureus group was statistically associated with spine osteomyelitis (23,6% vs. 6.9%; p=0.0008). 121 Gram-negative pathogens were isolated from 101 clinical samples and the most frequent agents were Enterobacter spp. (24.7%), Acinetobacter baumannii (21.4%), Pseudomonas aeruginosa (19.8%) and Klebsiella pneumoniae (8.2%). CONCLUSIONS: Patients with GNB osteomyelitis were mainly young, male, with lower limb trauma and developed chronic and open- fracture associated osteomyelitis. Patients in GNB group had a higher number of surgical procedures, a higher rate of soft-tissue reconstruction, a longer length of hospitalization, a longer time to isolate the infective bacteria and a prolonged use of antibiotics, when compared to patients in S. aureus group. A previous history of open-fracture was the main risk factor to development of GNB osteomyelitis, compared to S. aureus group
Bass, Michael Kevin 1975. "Fully-plastic open-bend and back-bend fracture specimens." Thesis, Massachusetts Institute of Technology, 2000. http://hdl.handle.net/1721.1/88831.
Повний текст джерелаClotet, i. Fons Xavier. "Imbibition in a model open fracture. Capillary rise, kinetic roughening, and intermittent avalanche dynamics." Doctoral thesis, Universitat de Barcelona, 2014. http://hdl.handle.net/10803/284588.
Повний текст джерелаL'objectiu de la tesi és l'estudi de la dinàmica espacio-temporal de la interfície entre aire desplaçat i oli invasor, en desplaçaments d'imbibició a través d'un model de fractura oberta. La recerca presentada combina un extens i exhaustiu treball experimental amb una anàlisi de dades acurada, basada en mètodes utilitzats en física estadística de no-equilibri. El procés d'imbibició, en que el fluid invasor mulla preferentment el medi envaït, és rellevant en diverses situacions d'interès, des de fluxos fisiològics a la irrigació del sòl i l'extracció de petroli. També és un sistema model interessant per a l'estudi de problemes de física fonamental degut a les correlacions de llarg abast que es desenvolupen al front, que indueixen una dinàmica complexa. Primer s'estudia l'avançament de la posició mitjana del front de fluid en condicions d'imbibició espontània (ascens capil•lar). Hem proposat una nova solució analítica que reprodueix els resultats experimentals tant amb presència de gravetat efectiva oposant-se a l'avançament del fluid com sense. En experiments d'imbibició forçada s'ha caracteritzat el procés d'arrugament dinàmic (kineticroughening) del front oli-aire a baixa viscositat. L'escenari d'escalament observat és super-rugós. Finalment s'ha estudiat la dinàmica del sistema en el règim estadísticament estacionari. S'han analitzat les correlacions temporals i espacials de les velocitats des de l'escala local, per sota la mida de les heterogeneïtats del desordre, fins a la mida del sistema. El front mostra una dinàmica a batzegades caracteritzada en termes d'allaus. Les mides i durades d'aquestes allaus estan distribuïdes estadísticament en llei de potències, amb exponents independents de les condicions experimentals, amb un truncament exponencial, que divergeix en reduir el nombre de capil•laritat. La intermitència del senyal s'ha quantificat i se n'ha extret els dos paràmetres que la controlen. El conjunt de resultats presentats en aquesta tesi dóna suport a una descripció molt general de la dinàmica de propagació lenta de fronts d'imbibició fora de l'equilibri en fractura oberta. La conservació local de massa controla la correlació lateral de les fluctuacions de la interfície. La longitud característica de les illes de desordre i la velocitat mitjana del front, per la seva banda, controlen l'avançament del front en la direcció de propagació.
Clotet-Fons, Xavier. "Imbibition in a model open fracture - Capillary rise, kinetic roughening and intermittent avalanche dynamics." Phd thesis, Ecole normale supérieure de lyon - ENS LYON, 2014. http://tel.archives-ouvertes.fr/tel-01068638.
Повний текст джерелаRaymond, Miriam Shirley. "Practical assessment of fractured rock hydrogeology in the open cut area at Northparkes Mines, NSW." Thesis, University of Canterbury. Geological Science, 2002. http://hdl.handle.net/10092/6426.
Повний текст джерелаZeno, Mohamed Saaed [Verfasser]. "Long-term results after open reduction of the subcondylar fracture via - modified Risdon approach / Mohamed Saaed Zeno." Berlin : Medizinische Fakultät Charité - Universitätsmedizin Berlin, 2015. http://d-nb.info/1079525084/34.
Повний текст джерелаWullschleger, Martin Eduard. "Effect of surgical approach on bone vascularisation, fracture and soft tissue healing : comparison of less invasive to open approach." Thesis, Queensland University of Technology, 2010. https://eprints.qut.edu.au/38523/1/Martin_Wullschleger_Thesis.pdf.
Повний текст джерелаLin, Y. "Optimum design for sustainable 'green' overlays : controlling flexural failure." Thesis, Coventry University, 2014. http://curve.coventry.ac.uk/open/items/b5ba73e5-9cb8-4a0b-ac99-c53b3c3e54ed/1.
Повний текст джерелаFischer, Miriam. "Evolution of the fossil hydrothermal system at Long Valley Exploratory Well, Mammoth Lakes, California, USA the record of open fracture mineralization at 2600 m depth and numerical simulations /." [S.l. : s.n.], 2003. http://deposit.ddb.de/cgi-bin/dokserv?idn=970060289.
Повний текст джерелаSeon, Guillaume. "Finite element-based failure models for carbon/epoxy tape composites." Thesis, Atlanta, Ga. : Georgia Institute of Technology, 2009. http://hdl.handle.net/1853/28117.
Повний текст джерелаOliveira, Priscila Rosalba Domingos de. "Incidência e fatores associados à ocorrência de infecção de sítio cirúrgico nas fraturas diafisárias do fêmur e da tíbia tratadas com haste intramedular: estudo prospectivo." Universidade de São Paulo, 2018. http://www.teses.usp.br/teses/disponiveis/5/5140/tde-23102018-092906/.
Повний текст джерелаBACKGROUND: Diaphyseal fractures of femur and tibia are prominent due to its high incidence and high economic and social impact. Intramedullary nailing (IN) is the surgical procedure of choice. Surgical site infection (SSI) related to this procedure is considered a difficult to treat complication. OBJECTIVES: Determine the incidence of SSI after IM in femoral and tibial diaphyseal fractures and evaluate possible risk factors. METHODS: Prospective observational cohort study. SSI was defined according to CDC-NHSN criteria. Incidence of SSI was calculated as the ratio between the number of patients with SSI and total number of patients. Analysis of potential risk factors included patients-related factors (age, gender, body mass index, active foci of infection, immunosuppressive conditions, ASA score, alcohol or illicit drug abuse, smoking, polytrauma, etiology of fracture, type of fracture if closed or open, classification of fracture according to Müller AO, Tcherne classification for closed fractures, to Gustilo-Anderson classification for open fractures, previous surgical manipulation, use of blood products); environmental and surgical-related factors (surgical wound classification, duration of surgery, hair removal, intraoperative contamination, antimicrobial use, presence of drains, hypothermia or hypoxia in the perioperative period, type of IN used, reaming, need for muscle or skin flap repair, use of negative pressure therapy) and microbiotarelated factors (S. aureus and A. baumannii colonization). RESULTS: 221 patients were included and completed the 12-month follow-up period. Incidence of SSI was 11.8%. In the initial analysis by unadjusted logistic regression, following factors were associated SSI: trauma etiology related to car and bicycle accidents, Müller AO classification of the fracture morphology groups 2 or 3, previous use of external fixator, surgeries with larger length of time, presence of drains, use of negative pressure therapy and need for muscle or skin flap repair. In the multiple logistic regression-adjusted analysis, previous use of external fixator and need for muscle or skin flap repair remained associated with SSI. CONCLUSIONS: Incidence of SSI associated with IN for femoral and tibial diaphyseal fractures was 11.8%. Previous use of external fixators and need for muscle or skin flap repair were factors associated with occurrence of infection
Treasurer, Paul James. "Characterization and Analysis of Damage Progression in Non-Traditional Composite Laminates With Circular Holes." Thesis, Georgia Institute of Technology, 2006. http://hdl.handle.net/1853/13989.
Повний текст джерелаFontes, Raphael Siqueira. "Comp?sito Polim?rico H?brido: Comportamento Mec?nico, Descotinuidade Geom?trica e Resist?ncia Residual." Universidade Federal do Rio Grande do Norte, 2013. http://repositorio.ufrn.br:8080/jspui/handle/123456789/15693.
Повний текст джерелаConselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico
The growing demand in the use of hybrid composite materials makes it essential a better understanding of their behavior face of various design conditions, such as the presence of geometric discontinuities in the cross section of structural elements. This way, the purpose of this dissertation is a study of the mechanical response (strength and stiffness), modes (characteristics) of fracture and Residual Strength of an hybrid polymeric composite with and without a geometric discontinuity in its longitudinal section (with a reduction in the cross section) loaded by uniaxial tension. This geometric discontinuity is characterized by central holes of different diameters. The hybrid composite was fabricated as laminate (plate) and consisting of ortho-tereftalic polyester matrix reinforced by 04 outer layers of Jute fibers bidirectional fabrics and 01 central layer of E-glass bidirectional fabric. The laminate was industrially manufactured (Tecniplas Nordeste Ind?stria e Com?rcio Ltda.), obtained by the hand lay-up technique. Initially, a study of the volumetric density of the laminate was made in order to verify its use in lightweight structures. Also were performed comparative studies on the mechanical properties and fracture modes under the conditions of the specimens without the central hole and with the different holes. For evaluating the possible influence of the holes in the structural stability of the laminate, the Residual Strength of the composite was determined for each case of variation in hole diameter. As a complementary study, analyses of the macroscopic final fracture characteristic of the laminates were developed. The presence of the central hole of any sizes, negatively changed the ultimate tensile strength. Regarding the elastic modulus, moreover, the difference found between the specimens was within the range of tests displacement, showing the laminate stability related to the stiffness
A crescente demanda na utiliza??o dos materiais comp?sitos h?bridos torna imprescind?vel uma melhor compreens?o do seu comportamento frente ?s mais diversas condi??es de projeto, como a presen?a de descontinuidades geom?tricas nos elementos estruturais. Nesse sentido, a proposta desta disserta??o ? um estudo envolvendo a resposta mec?nica (resist?ncia e rigidez), os modos (caracter?sticas) da fratura e Resist?ncia Residual de um laminado comp?sito h?brido de matriz polim?rica com e sem presen?a de descontinuidade geom?trica em sua se??o longitudinal (com redu??o da se??o transversal), sob a a??o de tra??o uniaxial. Essa descontinuidade geom?trica ? caracterizada por furos centrais de diferentes di?metros. O laminado comp?sito h?brido foi confeccionado na forma de placa e composto por matriz poli?ster orto-tereft?lica refor?ada por 04 camadas externas de tecidos bidirecionais de fibras de juta e 01 camada central de tecidos bidirecionais de fibras de vidro-E. O laminado foi fabricado industrialmente (Tecniplas Nordeste Ind?stria e Com?rcio Ltda.), obtido atrav?s do processo de lamina??o manual (hand lay-up). Inicialmente, foi feito um estudo da densidade volum?trica do laminado, de modo a comprovar sua aplica??o em estruturas leves. Foram realizados estudos comparativos entre as propriedades mec?nicas nas condi??es dos corpos de prova sem o furo e com os diferentes di?metros do furo. Para a avalia??o de poss?vel influ?ncia da presen?a dos furos centrais na estabilidade estrutural do laminado, a Resist?ncia Residual foi determinada para cada caso de varia??o do di?metro do furo. Como estudo complementar, an?lises macrosc?picas da caracter?stica de fratura final dos laminados foram desenvolvidas. A presen?a do furo central, independente do di?metro, influiu de forma danosa, principalmente na resist?ncia ?ltima ? tra??o. Quanto ao m?dulo de elasticidade, por outro lado, a diferen?a encontrada entre os corpos de prova apresentou-se dentro da faixa da dispers?o dos ensaios, mostrando estabilidade com rela??o ? rigidez do laminado
Nguyen, Anh Tuan. "Influence des incertitudes géométriques et de la méthode de modélisation dans l'analyse de stabilité des talus rocheux : application aux mines à ciel ouvert." Thesis, Université de Lorraine, 2015. http://www.theses.fr/2015LORR0296/document.
Повний текст джерелаThe stability of open-cast operations (mines or quarries), excavated in rock mass depends on their geometry, the geometrical characteristics of the rock mass fractures (orientation and spacing) and the mechanical characteristics of the rock mass and the discontinuities. The assessment of the rock instability risk depends on the quantity and quality of the available information on the rock mass and the analysis methods used for the evaluation of the mechanical behavior of the rock block collection. Different sites of natural rock slopes, of road cuts, and of open-cast mines and quarries, described in the present document, show that the known information can vary a lot from one site to the other. The steps of data gathering and analysis, then the modelling step used to analyze the stability of the rock slope, lead to uncertainties. The present work deals in particular with the influence of the geometrical uncertainties, and the different clustering methods, to define families of fractures, are examined. The combination of works suggested by several authors leads to a new method called PSMY. This method, together with the spectral method, was coded in the Mathematica platform, and the obtained results are compared with "hand-made" clusters, done with the DIPS software. The clustering methods are presented according to the ratio of classified orientations. The orientation and spacing of fracture families are fitted by statistical law. The statistical parameters are compared according to the clustering method used. These parameters have an influence on the construction of the rock mass geometrical model, called DFN (Discrete Fracture Network). The influence of the clusters on the stability analysis is studied from the stochastic models based on the limit equilibrium analysis, in the SWEDGE and RESOBLOK software. These programs do not take into account the same uncertainties, and as a result, they give different stability indicators. A sensitivity analysis of these indicators (number of unstable blocks, average volume of unstable blocks, and total volume of unstable blocks) versus the clustering methods used, and the orientation of the slopes, is carried out. A variance analysis allows an evaluation of the influence of these factors. The assessment of the global stability condition of the rock mass, depending on the cohesion and the friction angle, is proposed. The influence of the modeling method is analyzed by comparing 3D calculations using the limit equilibrium calculations, and 2D and 3D models using discrete rigid and deformable blocks. A coupling between RESOBLOK (limit equilibrium) and LMGC90 (discrete elements) allows the comparison of results on the same original geometry. For the case of Ax-les-Thermes road-cut, and for various unstable geometries, the influence of the model parameters is tested. Several cases are compared. The 3D simulation of an excavation, at different steps, is performed, and the mobilization index is studied, in order to compare several types of contacts, within the LMGC model, in relation to the possible sliding of blocks, at those different steps
Pinheiro, João Francisco Durão da Costa Rosa. "Indication and Benefit of Early Debridement in Open Fractures of Lower Extremity Bones - A Systematic Review." Master's thesis, 2021. https://hdl.handle.net/10216/136123.
Повний текст джерелаPinheiro, João Francisco Durão da Costa Rosa. "Indication and Benefit of Early Debridement in Open Fractures of Lower Extremity Bones - A Systematic Review." Master's thesis, 2021. https://hdl.handle.net/10216/139161.
Повний текст джерелаНосівець, Д. С. "Порівняльні характеристики способів лікування переломів дистального метаепіфізу плечової кістки : автореф. дис. на здобуття наук. ступеня канд. мед. наук / Д. С. Носівець. - Донецьк, 2012. - 22 с". Thesis, 2012. http://repo.dma.dp.ua/197/1/aref_%D0%9D%D0%BE%D1%81%D0%B8%D0%B2%D0%B5%D1%86_%D1%83%D0%BA%D1%80.pdf.
Повний текст джерелаAmeli, Aboutaleb. "Hygrothemal Degradation of Toughened Adhesive Joints: The Characterization and Prediction of Fracture Properties." Thesis, 2011. http://hdl.handle.net/1807/29659.
Повний текст джерелаLIN, MENG-YI, and 林孟宜. "A Study of Patient Experience about Open Reduction and Internal Fixation surgery Of Fracture and Dislocation." Thesis, 2016. http://ndltd.ncl.edu.tw/handle/82983928297312555812.
Повний текст джерела國立雲林科技大學
工業工程與管理系
104
In recent years, It is often to here that healthcare institutions prepared fake file for Hospital accreditation. To encourage healthcare institutions implement the daily manage and reduce pressure of hospital colleagues, Ministry of Health and Welfare is reforming the mode of Hospital accreditation, such as: Streamlining provisions, Patient Focus Methodology(PFM) instead of Investigating paperwork. PFM case is chosen by the high-volume or high-risk disease of the healthcare institutions, and visited with the patient care process each patient care team, checked medical records, access to care personnel or even visit the patient in order to understand healthcare institutions meet the criteria. Therefore, it is an important issue to implement disease management for hospital supervision and management team. In addition, Taiwan hospital accreditation also refer CAHPS of the United States, require hospital must have patient experience investigation in 2014. Therefore, this study combined patient experience and disease management to explore the patient experience about “Open Reduction and Internal Fixation surgery Of Fracture and Dislocation”. The results of this study are: patient experienced average is 4.36, most of the patient living in Yunlin County and Chiayi County. Independent samples T test showed that patient experience average scores are lower when the patient self-assessment of the severity of the disease is a serious and critical condition, or when the self-assessment during the hospitalization is too short, or the ward room belongs to double or single rooms. In the correlation analysis we found that the patient experience of emergency medical treatment overall experience score correlation is not significant. The nurses in the hospital performance, overall performance of patient experience scores were highly correlated. . Keywords:Patient experience, Open Reduction and Internal Fixation surgery Of Fracture and Dislocation
Huang, Sheng-Hsiung, and 黃勝雄. "The Impact of Case Payment System on Health Resources Utilization- A Case Study of Open Reduction of Close Fracture in a Regional Hospital." Thesis, 2000. http://ndltd.ncl.edu.tw/handle/76983072264227495513.
Повний текст джерела中國醫藥學院
醫務管理研究所
88
The case payment system of orthopedic close fracture has been implemented in July 1999. The Bureau of National Healthcare Insurance (NHI) introduces All Patients Diagnosis Related Groups (AP-DRGs) and creates the classification of diseases based on the case payment system. So far for service belonging to case payment, they are practiced by hospitals according to different level and codes respectively. Except in medical center, case payment service of orthopedic close fracture merely reimbursed in regional hospital. This research was based on patients who received open reduction of close fracture is femoral shaft, neck and radius or ulna at a regional hospital from October 1, 1998 to March 31, 2000. Relative issues are studied and analyzed by gathering the medical expenditure bills and descriptions of orders that the regional hospital applied to the Bureau of NHI for reimbursement. The objectives of this study are to inquire the impacts with the implementation of case payment service brought to the health resources utilization. The results provide some important application to the concerns about the establishment of case payment method for policy-maker, and about the adaptation of strategic response to case payment method for hospital administrators. The length of stay (LOS) of open reduction of close fracture with femoral shaft or neck increased 0.07 days and total medical fee (TMF) increased NT$177 after the implementation of case payment method, but there are not statistically significant difference. After controlling characteristics of complication and comorbidity, the LOS of open reduction for close fracture in femoral shaft or femoral neck (AP-DRG 211) are reduced 1.67 day and the TMF also decreased NT$ 15541 after the implementation of case payment method. But there are not statistically significant different between before and after implementation of the case payment method. Besides, the operation and injection fee was decreased significantly. On the other hand, the radiology fee increased markedly . The LOS of open reduction for close fracture in radius or ulna was statistically significantly reduced 1.18 days and its TMF also decreased NT$ 5786(P<0.05). Control characteristics of complication or comorbidity, the LOS of AP-DRG 224 was reduced 0.62 day (P>0.05) and TMF was decreased NT$ 2615(P<0.05) after the implementation of case payment method. Besides, operation fee, medications fee, and injection fee were decreased significantly. On the other hand, the orders inspection fee and radiology fee were increased markedly in AP-DRG 224 without complication or comorbidity . Briefly, there are some suggestions to the Bureau of NHI that AP-DRG also considered the effective factors of the health care resource utilization are included age, complication / comorbidity of patient. But the reimbursement system strongly, deeply effects the health care resource utilization. Before enlarge the case payment system of AP-DRG, the practically case-mix should be clearly readjusted weighting value and reconstructed the payment standard systematically.
"Healing of the patellar tendon donor site after the removal of the central one-third for anterior cruciate ligament reconstruction: a comparison between 'close' and 'open' procedure." Chinese University of Hong Kong, 1995. http://library.cuhk.edu.hk/record=b5888382.
Повний текст джерелаThesis (M.Phil.)--Chinese University of Hong Kong,1995.
Includes bibliogrpahical references (leaves 54-68).
Abstract --- p.1
Acknowledgments --- p.4
Lists of Figures --- p.5
List of Tables --- p.8
Chapter Chapter 1 --- Introduction --- p.9
Chapter 1.1 --- Ligamental Injury --- p.9
Chapter 1.2 --- ACL Injury --- p.10
Chapter 1.3 --- Patellar Tendon and Anterior Cruciate Ligament --- p.11
Chapter 1.4 --- Patellar Tendon Bone Graft --- p.13
Chapter 1.41 --- Strength of the Patellar Tendon Bone Graft --- p.13
Chapter 1.42 --- Use of the Patellar Tendon Bone Graft --- p.14
Chapter 1.5 --- Patellar Tendon Bone Graft in Anterior Cruciate Ligament Reconstruction --- p.14
Chapter 1.6 --- Complications of Anterior Cruciate Ligament Reconstruction after the Use of Patellar Tendon Bone Graft --- p.16
Chapter 1.7 --- Healing of the Patellar Tendon Donor Site --- p.17
Chapter 1.8 --- Objective of the Study --- p.22
Chapter 1.9 --- Significance of the Study --- p.22
Chapter Chapter 2 --- Material & Method --- p.24
Chapter 2.1 --- Animal Model --- p.24
Chapter 2.2 --- Grouping --- p.24
Chapter 2.3 --- Operative Procedure --- p.24
Chapter 2.4 --- Method of Assessment --- p.26
Chapter 2.41 --- Gross Morphology --- p.26
Chapter 2.42 --- Biomechanical Testing --- p.27
Chapter 2.43 --- Biochemical Assay --- p.28
Chapter 2.43.1 --- Water Content --- p.29
Chapter 2.43.2 --- Collagen Content --- p.29
Chapter 2.44 --- Histology --- p.30
Chapter 2.45 --- Immunohistochemistry --- p.31
Chapter 2.5 --- Statistics --- p.32
Chapter Chapter 3 --- Results --- p.33
Chapter 3.1 --- Operation Complications --- p.33
Chapter 3.2 --- Gross Morphology --- p.33
Chapter 3.21 --- Dimension of the Patellar Tendon --- p.33
Chapter 3.22 --- Dimension of the Patellar Tendon Bone Graft --- p.33
Chapter 3.23 --- Dimension of the Remain Patellar Tendon --- p.34
Chapter 3.24 --- Gross Appearance of the Patellar Tendon Donor Site --- p.35
Chapter 3.3 --- Biomechanical Testing --- p.36
Chapter 3.31 --- Failure Load --- p.36
Chapter 3.32 --- Ultimate Stress --- p.37
Chapter 3.33 --- Stiffness --- p.37
Chapter 3.34 --- Energy Absorbed before Failure --- p.38
Chapter 3.4 --- Biochemical Assay --- p.38
Chapter 3.41 --- Water Content --- p.38
Chapter 3.42 --- Collagen Content --- p.39
Chapter 3 .5 --- Histology & Immunohistochemistry --- p.39
Chapter 3.51 --- Morphology of Control Tendon --- p.40
Chapter 3.52 --- Morphology of Experimental Tendon with 'Open' Procedure --- p.40
Chapter 3.53 --- Morphology of Experimental Tendon with 'Close' Procedure --- p.41
Chapter 3.54 --- Healing at the Patellar and Tibial Insertion Site --- p.41
Chapter 3.55 --- Morphology of the Cartilage Surface --- p.42
Chapter Chapter 4 --- Discussion & Conclusion --- p.43
Chapter 4.1 --- Gross Morphology --- p.43
Chapter 4.2 --- Biomechanical Testing --- p.45
Chapter 4.3 --- Biochemical Assay --- p.47
Chapter 4.4 --- Histology & Immunohistochemistry --- p.49
Chapter 4.5 --- Conclusion --- p.51
References --- p.54
Figures
Tables
Appendix
Fischer, Miriam [Verfasser]. "Evolution of the fossil hydrothermal system at Long Valley Exploratory Well, Mammoth Lakes, California, USA : the record of open fracture mineralization at 2600 m depth and numerical simulations / von Miriam Fischer." 2003. http://d-nb.info/970060289/34.
Повний текст джерела