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Elfström, Anna, and Anna Grunditz. "Evaluation of Sternum Closure Techniques Using Finite Element Analysis." Thesis, KTH, Skolan för teknik och hälsa (STH), 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-123957.
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In an open thoracic surgery the surgeon dissociate the sternum, the breastbone, into two halves to be able to perform the operation. At the end of the surgery a standard technique is used which to close the sternum. The technique is based on steel wires that are wrapped around the halves of the sternum to close it. This technique is the most cost effective technique available on the market today but is still not optimal because it can cause infection, wound rupture and pain for the patient. The goal with this master thesis was to, with the help of finite element method, to find out which closure technique is the best one to close the sternum and to provide suggestions for improvement. This was done with respect to the aspects of how large the displacement between the sternum halves is and how much the stresses generated by the implants affect the sternum. Using literature studies and interviews three techniques were chosen to be simulated; the standard technique, Zipfix and Sternal Talon. Their implants consisted of stainless steel, PEEK and titanium respectively and the materials were simulated with every technique. In the lower part of the sternum it is a greater displacement between the two halves after simulation than in the rest of the sternum. An improvement was hence to simulate Zipfix and Sternal Talon with an extra steel wire in the lower part. Zipfix with the implants of titanium and the standard technique with the implants of stainless steel provided the best results with respect to the two aspects. The two improvements produced smaller displacement but the stresses were higher.Vid öppen thoraxkirurgi öppnar kirurgen sternum, bröstbenet, i två halvor för att kunna utföra operationen. När operationen är genomförd används en standardteknik som bygger på att använda ståltrådar för att försluta de två sternumhalvorna. Denna teknik är den mest kostnadseffektiva som finns på marknaden idag, men är trots detta inte optimal då den kan ge upphov till infektioner, sårrupturer och smärta för patienten. Målet med detta examensarbete var att, med hjälp av finita elementmetoder, ta reda på vilken förslutningsmetod som är bäst samt att ge förbättringsförslag. Detta skedde utifrån aspekterna hur stor förskjutning som uppstår mellan sternumhalvorna samt hur stor spänning implantaten påverkar sternum med. Med hjälp av litteraturstudier och intervjuer valdes tre metoder ut för att simuleras; standardtekniken, Zipfix och Sternal Talon. Dessa implantat bestod av rostfritt stål, PEEK respektive titan och varje teknik simulerades med varje material. I sternums nedre del uppstod efter simulering större förskjutning av sternumhalvorna än i resterande av sternum. Ett förbättringsförslag var därför att simulera Zipfix och Sternal Talon med en extra ståltråd i nedre delen av sternum. Zipfix med implantat av titan och standardtekniken med implantat av rostfritt stål gav bäst resultat utifrån de två nämnda aspekterna. De två förbättringsförslagen gav mindre förskjutning men spänningen blev dock högre.
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Baril, Yannick-Vincent. "Conception et modélisation d'un système de fermeture du sternum." Mémoire, École de technologie supérieure, 2004. http://espace.etsmtl.ca/723/1/BARIL_Yannick%2DVincent.pdf.
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Le présent mémoire a pour objectif de concevoir un système de fermeture (SDF) en alliage à mémoire de forme (AMF) réduisant le taux de rupture du sternum. Le système développé est une tresse tubulaire en AMF utilisant la superplasticité. La géométrie de ce système permet de diminuer de façon considérable la rigidité en flexion du SDF, ce qui facilite les manipulations. Cette géométrie permet aussi d'augmenter la surface de contact entre le SDF et le sternum diminuant du même coup les contraintes de surface.
Les études de validation du système faites selon un modèle par éléments finis ainsi que par un modèle en laboratoire montrent respectivement qu'un SDF utilisant les AMF réapplique une charge 30% supérieure à celle d'un fil d'acier standard n o 5 et que le SDF en AMF conserve une charge résiduelle 25% plus importante que celle des fils d'acier, peu importe le type de passage, la densité de l'os ou le type de chargement.
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Baril, Yannick-Vincent. "Conception et modélisation d'un système de fermeture du sternum /." Thèse, Montréal : École de technologie supérieure, 2004. http://proquest.umi.com/pqdweb?did=1407513351&sid=10&Fmt=2&clientId=46962&RQT=309&VName=PQD.
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Thèse (M. Ing.)--École de technologie supérieure, Montréal, 2004."Mémoire présenté à l'École de technologie supérieure comme exigence partielle à l'obtention de la maîtrise en génie mécanique". CaQMUQET Bibliogr.: f. [187]-192. Également disponible en version électronique. CaQMUQET
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Kuriki, Mao. "Transient and lineage-restricted requirement of Ebf3 for sternum ossification." Doctoral thesis, Kyoto University, 2020. http://hdl.handle.net/2433/253491.
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京都大学0048
新制・課程博士
博士(医学)
甲第22646号
医博第4629号
新制||医||1044(附属図書館)
京都大学大学院医学研究科医学専攻
(主査)教授 篠原 隆司, 教授 松田 秀一, 教授 安達 泰治
学位規則第4条第1項該当
Doctor of Medical Science
Kyoto University
DFAM
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Litjuschkin, Alexej [Verfasser]. "Eigenschaften von mesenchymalen Stammzellen aus dem Sternum herzchirurgischer Patienten / Alexej Litjuschkin." Ulm : Universität Ulm, 2019. http://d-nb.info/119282587X/34.
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Hedberg, David, and Jessica Edqvist. "Sjuksköterskors erfarenheter av att vårda patienter som bär Post-thorax väst : - En intervjustudie." Thesis, Umeå universitet, Institutionen för omvårdnad, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-133297.
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ABSTRAKT Bakgrund: Mediastinit är en allvarlig komplikation efter öppen hjärtkirurgi. Syftet med post- thorax västen är att förebygga och förhindra mediastinit genom att stötta upp instabilitet och minska friktion i sternum efter operation. Uttalade osäkerheter och brister i erfarenheter av att jobba med västen väckte författarnas intresse för att intervjua intensivvårdssjuksköterskor och sjuksköterskor om deras erfarenheter med att arbeta med post-thorax västen. Syfte: Syftet med studien var att belysa sjuksköterskors erfarenheter av att vårda patienter som bar Post-thorax väst. Design: En kvalitativ intervjustudie Metod: Semistrukturerade intervjuer av 14 stycken grundutbildade och intensivvårdsutbildade sjuksköterskor som arbetade vid två enheter på ett sjukhus i Norra Sverige och hade mer än 6 månaders erfarenhet av att arbeta med västen. Intervjuerna analyserades genom en kvalitativ innehållsanalys. Resultat: Sjuksköterskors erfarenheter av att vårda patienter som burit Post-thorax väst resulterade i 4 kategorier och 13 subkategorier. Följande kategorier finns representerade: Ambivanlens, Säkerhet, Svårigheter, Motivation. Konklusion: Resultatet i studien visade att deltagarna hade varierande erfarenheter av att arbeta med patienter som bär väst. Deltagare utryckte svårigheter och fördelar med västen samt sin egen osäkerhet kring den. Deltagare ville ha utbildning och en utvärdering av västen och de beskrev motivationsarbetet och varför det är viktigt. Deltagarnas erfarenheter av patienternas upplevelser var något som genomsyrade alla kategorier. Resultatet kan tala för att implementeringen av västen på berörda enheter inte genomförts på ett optimalt sätt.ABSTRACT Background: Mediastinitis is an infection in the mediastinum which can be a serious complication after open heart surgery. The purpose of the Post-thorax vest is to prevent mediastinitis by providing the required support to and minimize any friction within the sternum after heart surgery. There are outspoken uncertainties and gaps in the experience of working with the vest which aroused the interest of the authors to interview nurses and intensive care nurses about their experiences of working with the Post-thorax vest. Aim: The aim of this study was to investigate nurses’ experiences of working with patients who wear a Post-thorax vest. Design: A qualitative interview study Method: Semi-structured qualitative interview study of 14 nurses and intensive care nurses who worked at two units in the north of Sweden who had at least 6 months of experience working with the vest. The interviews were analyzed using content analysis. Results: Nurses’ experiences of working with patients who wore Post-thorax vests resulted in 4 categories and 13 sub-categories. The following categories are represented: Ambivalence, Security, Difficulties, Motivation. Conclusion: The result of the study showed that the participants had various experiences of working with patients wearing the vest. Participants expressed difficulties and benefits of the vest, and their own uncertainty about it. Participants wanted education and an evaluation of the vest and they described why motivational work was important. The participants described patients' experiences of the vest in almost every category. The result may indicate that the implementation of the vest at the units in question where not completed in an optimal way.
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Pai, Shruti. "In vivo characterization of respiratory forces on the sternal midline following median sternotomy." Digital WPI, 2005. https://digitalcommons.wpi.edu/etd-theses/1001.
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"The development and clinical adoption of more effective fixation devices for re-approximating and immobilizing the sternum after open-heart surgery to enable bony healing has been limited, in part, by the lack of in vitro test methods used to evaluate these devices which precisely emulate in vivo loading of the sternum. The present study is an initial effort to determine the loading parameters necessary to improve current in vitro and numerical test methods by characterizing the direction, magnitude, and distribution of loading along the sternotomy midline in vivo using a porcine model. Changes in forces incurred by death and embalming were also investigated to estimate the applicability of cadavers as chest models for sternal fixation. Two instrumented plating systems were used to measure the magnitude, direction, and distribution of forces across the bisected sternum in four pigs during spontaneous breathing, ventilated breathing, and coughing for four treatments; live, dead, embalmed, and refrigerated. Forces were highest in the lateral direction and highest at the xiphoid. An important finding was that the magnitude of the respiratory forces in all directions was smaller than anticipated from previous estimations, ranging from 0.37 N to 43.8 N. No significant differences in force were found between the four treatments, most likely due to the very small magnitude of the forces and high variability between animals. These results provide a first approximation of in vivo sternal forces and indicate that small cyclic fatigue loads should be applied for long periods of time, rather than large quasistatic loads, to best evaluate the next generation of sternal fixation devices. "
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Dieselman, John Conrad. "Comparison of Alternative Rigid Sternal Fixation Techniques." Digital WPI, 2012. https://digitalcommons.wpi.edu/etd-theses/73.
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Sternal malunion is a complication resulting in displacement of the sternal halves following open heart surgery. Currently, little is known about the effectiveness of alternative fixation systems under physiologically relevant loading scenarios. The goal of this study was to mechanically test several currently marketed sternal fixation devices and compare them to a prototype device in different loading conditions to simulate sitting up or breathing. Each system showed unique differences in cost, failure mode and efficiency; however, no statistical difference in failure load or displacement was observed between the testing groups.
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GESTA, JEAN-MICHEL. "Facteurs influencant l'evolution des fractures multiples de cotes et/ou du sternum : etude epidemiologique a propos de 104 cas pris en charge au service d'urgence du c.h.r. de roanne de mai 1991 a mai 1992." Lyon 1, 1993. http://www.theses.fr/1993LYO1M311.
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NIJAD, LEILA. "Interet de l'utilisation des agrafes de cotrel pour la fixation du sternum en chirurgie cardiaque." Toulouse 3, 1990. http://www.theses.fr/1990TOU31230.
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Nooh, Ehab [Verfasser], Michael [Akademischer Betreuer] Weyand, and Frank [Gutachter] Harig. "Entwicklung eines Risiko-Scoring-Systems zur Prädiktion und Vermeidung postoperativer Komplikationen nach Sternum-Osteosynthese bei offenen Herzoperationen MUST (MalUnion of STernum) Score / Ehab Nooh ; Gutachter: Frank Harig ; Betreuer: Michael Weyand." Erlangen : Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 2019. http://d-nb.info/1198486481/34.
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Chartrand, Maxime. "Banc d'esssai et la méthodologie pour essais comparatifs sur systèmes de fermeture du sternum." Mémoire, École de technologie supérieure, 2008. http://espace.etsmtl.ca/121/1/CHARTRAND_Maxime.pdf.
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Le système de fermeture (SDF) du sternum est utilisé pour refermer le sternum, coupé en
deux à la suite de la sternotomie. On observe chez environ 5% des patients des complications
postopératoires associées à de haut taux de mortalité telles que l'instabilité, la non-union et la
déhiscence du sternum. Afin de réduire ce risque de complications, plusieurs méthodes et
alternatives au fil en acier ino.xydables - le SDF le plus utilisé - sont proposées. Parmi ces
solutions, le SmartCable. un nouveau type de SDF fabriqué à partir de filaments en alliage à
mémoire de forme (AMF). montre de belles promesses. Cependant, les propriétés
mécaniques des AMF introduisent de nouveaux défis au niveau de l'installation du SDF ainsi
que de la méthodologie employée pour comparer ce SDF vis-à-vis le fil en acier inoxydable
standard.
Le présent mémoire a donc comme objectifs la conception d'un outil d'installation spécialisé
pour le SmartCable ainsi que le développement d'un banc d'essai et d'une méthodologie
pour essais comparatifs du SmartCable vis-à-vis le fil en acier inoxydable.
L'outil développé permet la pose du SDF en AMF mais une nouvelle itération du concept est
nécessaire afin de mieux maîtriser le processus de sertissage, utilisé pour retenir de façon
permanente une boucle de SmartCable. Le banc d'essai développé permet l'acquisition d'un
nouveau critère de performance, soit la force en compression entre les moitiés de sternum.
Mais quelques améliorations techniques sont nécessaires afin de compléter une évaluation
plus approfondie du SmartCable. Les résultats suivants ont été obtenus à la suite des essais
comparatifs entre le SmartCable et le fil en acier inoxydable :
• Le SmartCable et le fil en acier offre une rigidité semblable, le fil en acier ayant un léger
avantage sur le SmartCable pour les forces en traction au-dessus de 1200 N.
• Le SmartCable réapplique une plus grande force en compression entre les moitiés de
sternum à la suite de l'application et du retrait répété d'une force disruptive
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Bickley, S. R. B. "The gene Tbx5 links development, evolution and adaptation of the sternum in terrestrial vertebrates." Thesis, University College London (University of London), 2013. http://discovery.ucl.ac.uk/1415674/.
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The transition from fins to limbs during the colonisation of land was a key innovation in vertebrate evolution. Changes in the limb and shoulder girdle during this event have been investigated extensively, but little attention has been given to the acquisition of the sternum, a feature considered characteristic of virtually all terrestrial vertebrates, and which is mandatory for tetrapod locomotion. The sternum is a thin flat bone lying at the ventral midline of the thorax that provides a crucial attachment site for the pectoral muscles, allowing the forelimbs to raise the body up from the ground. I demonstrate that a sternum completely fails to form in conditional Tbx5 mutant mouse embryos. Consistent with this, sternum defects are a characteristic feature of Holt-Oram syndrome, which is caused by mutations in TBX5. While the role of Tbx5 in the development of the heart and forelimbs has been studied extensively, Tbx5 function in sternum formation is not understood. Using chick and mouse models systems, I set out to investigate the developmental origin of the sternum, and why it fails to form in the absence of Tbx5. Since the function of the sternum is to facilitate forelimb movement, I explored the correlation between forelimb use and sternum morphology by comparing sternum size across different avian species. I then investigated the genetic adaptations that could explain sternum and forelimb reduction in flightless birds, using the emu as a model. I suggest that Tbx5 represents a common node in the molecular pathways regulating forelimb and sternum development.
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Chartrand, Maxime. "Banc d'esssai et la méthodologie pour essais comparatifs sur systèmes de fermeture du sternum /." Thèse, Montréal : École de technologie supérieure, 2008. http://proquest.umi.com/pqdweb?did=1562930271&sid=3&Fmt=2&clientId=46962&RQT=309&VName=PQD.
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Thèse (M. Ing.) -- École de technologie supérieure, Montréal, 2008."Mémoire présenté à l'École de technologie supérieure comme exigence partielle à l'obtention de la maîtrise en génie mécanique". "par Chartrand, Maxime" -- p. de t. CaQMUQET CaQMUQET Bibliogr : f. [73]-77. Également disponible en version électronique. CaQMUQET
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Beyer, Benoit. "Contribution à la modélisation 3D du thorax humain durant le mouvement respiratoire : analyse in vivo de la cinématique des articulations du thorax." Thesis, Lyon, 2016. http://www.theses.fr/2016LYSE1309/document.
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La respiration est un phénomène vital qui implique une synergie entre diverses structures anatomiques qui constituent le thorax. La physiologie articulaire reste un parent pauvre de la physiologie et la littérature concernant la quantification de la cinématique 3D des articulations du thorax durant le mouvement respiratoire est rare. Ce travail se concentre sur le développement et l'application d'une méthodologie permettant de répondre à cet objectif. La méthode développée combine le traitement de données tomodensitométriques réalisées à trois volumes pulmonaires différents et des techniques d'infographies. Les amplitudes (ROMs) et axes de mouvements (axe hélicoïdaux moyen, AHMs) ont été obtenus au niveau des articulations costo-vertébrales de 12 sujets asymptomatiques. En résumé, les amplitudes diminuent graduellement dans les étages inférieurs ; le volume pulmonaire et l'étage costal influencent significativement les amplitudes costales ; l'orientation des AHMs ne diffère pas entre les étages costaux. En complément, la méthode a été appliquée pour un échantillon de 10 patients atteints de mucoviscidose. La condition pathologique influençait significativement les amplitudes de mouvements mais pas l'orientation des AHMs. Enfin, le déplacement sternal, les variations de l'angle sternal et la cinématique des articulations sternocostales a été analysée. Les déplacements angulaires des côtes par rapport au sternum diminuaient dans les étages inférieurs comme au niveau des articulations costo-vertébrales. L'orientation des AHMs des articulations sternocostales ne différait pas entre les étages. Une corrélation linéaire a été mise en évidence entre les déplacements verticaux du sternum et les amplitudes de mouvement costales au niveau costo-vertébral et sternocostal. Ce travail contribue de façon substantielle à la modélisation 3D du thorax humain durant le mouvement respiratoire d'un point de vue qualitatif et quantitatifBreathing is a vital phenomenon that implies synergy of various anatomical structures that constitute the thorax. Joint physiology remains a relatively poorly-known component of the overall thorax physiology. Quantitative literature related to in vivo thorax kinematics during breathing is scarce. The present work focuses specifically on developing and applying a methodology to reach this goal. The developed method combined processing of CT data obtained at different lung volumes and infographic techniques. Detailed ranges of motion (ROMs) and axes of movement (mean helical axes, MHAs) were obtained at costovertebral joints in 12 asymptomatic subjects; rib ROMs gradually decrease with increasing rib number; lung volume and rib level have a significant influence on rib ROM; MHAs did not differ between rib levels. In addition, the method was applied on a sample of 10 patients with cystic fibrosis. The pathological condition significantly influenced CVJ ROMs while the orientation of the MHAs did not differ. Finally, the sternal displacement, sternal angle variations and sternocostal joints (SCJ at rib1 to 7) kinematics during breathing motion were analyzed. Rib ranges of motion relative to sternum decreased with increasing rib number similarly to CVJ. Orientation of the MHAs did not differ between SCJ levels. A significant linear correlation was demonstrated between sternum vertical displacement and rib ranges of motion at both CVJ and SCJ. The present work substantially contributes to 3D modelling of human thorax in breathing at a joint level both qualitatively and quantitatively
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Fallot, Jean-Pierre. "Traitement des volets thoraciques antérieurs par traction présternale transcutanée." Montpellier 1, 1989. http://www.theses.fr/1989MON11301.
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ABE, TOSHIO, AKIHIKO USUI, TAKASHI WATANABE, MINORU TANAKA, MITSUYA MURASE, and EIJI TAKEUCHI. "New Approach to the Aneurysm Originating in the Ascending Aorta, Eroding the Sternum and Extending to the Cervix." Nagoya University School of Medicine, 1988. http://hdl.handle.net/2237/17503.
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Sugino, Rafael Lindi. "Estudo morfométrico da coluna vertebral torácica: relação da transição cervicotorácica com o esterno." Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/17/17142/tde-08062017-095810/.
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A transição cervicotorácica compreende a região anatômica que envolve as vértebras cervicais distais e as torácicas proximais. Durante a realização de abordagens cirúrgicas anteriores para tratamento de afecções que acometem as vértebras desta região, o esterno pode representar uma barreira mecânica. Assim, diversos métodos de programação pré-operatório foram propostos para avaliar a necessidade de osteotomias do esterno. Até a presente data, não existem trabalhos correlacionando as medidas com as variáveis sexo e idade. Nosso estudo envolveu a avaliação retrospectiva de 300 exames de tomografia computadorizada. Os pacientes foram separados de acordo com o sexo em dois grupos e de acordo com a faixa etária em 3 subgrupos. Os parâmetros estudados foram: nível horizontal em relação ao esterno (NHE), angulação do corpo (AC), nível discal (ND) e angulação do nível discal (AND). O NHE variou de C7 a T4, sendo mais frequente o nível T2 (34,3%). Os NHE menos frequentes foram T4 (0,3%) e C7 (1%). A AC e AND evidenciaram uma média de 18,51o e 19,63o, respectivamente. O AC variou de 1,29o a 54,32o, enquanto o AND variou de 0o a 49o. O ND variou de C5-C6 a T2-T3, sendo C7-T1 o ND mais frequente com 46%. O ND menos frequente foi encontrado nos níveis T2-T3 (1,7%) e C5-C6 (3%). Comparado o AND entre os grupos masculino e feminino, encontramos diferença estatística (p=0,003), sendo maior no grupo masculino. Houve diferença estatisticamente significante quando comparado os valores da AND entre os grupos etários (p=0,01). Com relação a AC, encontramos diferença estatística entre os grupos dos sexos masculino e feminino (p=0,02), sendo maior no grupo masculino. A comparação do AC entre os grupos de diferentes faixas etárias demonstrou uma diferença estatística (p=0,001). Não houve diferença quando comparados os resultados do NHE entre os grupos masculino e feminino (p=0,3), nem comparando valores de NHE entre as diferentes faixas etárias (p=0,79). O ND e NHE de nossa amostra da população brasileira apresenta valores menores quando comparados à outras amostras populacionais. O ND apresentou diferenças entre os grupos etários, sendo que quanto mais velho o grupo, menor eram os valores. Os nossos resultados evidenciaram que o nível discal mais distal acessível com a realização de abordagem anterior à região cervicotorácica da coluna vertebral, sem a teórica necessidade de uma osteotomia do esterno, apresenta valores menores quando comparados aos dados previamente relatados atribuídos a outras populações. Em outras palavras, este achado pode ser traduzido como se os pacientes envolvidos no estudo apresentassem um menor número de vértebras passíveis de serem abordadas por meio de procedimento cirúrgico anterior sem a realização de osteotomia do esterno. Desta forma, o mesmo raciocínio pode ser aplicado para o nível horizontal em relação ao esterno, pois nossos resultados apresentaram valores mais craniais, comparados aos resultados de estudos prévios. Além disso, o nível discal apresentou diferença quando comparamos os pacientes de diferentes faixas etárias, sendo que, quanto maior a faixa etária, menor foram os valores encontrados. Este achado representa uma migração para cranial do nível discal mais distal, conforme aumentamos a faixa etária dos pacientes estudadosThe cervicothoracic transition comprises the anatomical region including the distal cervical and proximal thoracic vertebrae. While conducting anterior surgical approaches for treatment of conditions that affect the vertebrae in this region, the sternum may represent a mechanical barrier. Thus, various methods of preoperative programming have been proposed to assess the need for osteotomies of the sternum. To date, there are no studies correlating the measures with gender and age. Our study involved a retrospective review of 300 CT examinations. Patients were separated according to gender into two groups and according to age into 3 subgroups. The studied parameters were: horizontal level in relation to the sternum (LHS), vertebral body angle (VA), disc level (DL) and angulation of the disc level (ADL). The LHS ranged from C7 to T4, and T2 was the most frequent (34.3%). The less frequent LHS were T4 (0.3%) and C7 (1%). The AC and ADL showed an average of 18,51o and 19,63o respectively. The VA varied 1,29o the 54,32o, while the ADL varied from 0o to 49o. DL ranged from C5-C6 to T2-T3, being C7-T1 the most frequent (46%). The less frequent DL found were T2-T3 (1.7%) and C5-C6 (3%). Compared the ADL between male and female groups, we found statistically significant difference (p = 0.003), being higher in the male group. There was a statistically significant difference when compared the values of ADL between the groups (p = 0.01). Regarding VA, we found statistically significant differences between male and female groups (p = 0.02), being higher in the male group. Comparison of VA between groups of different age showed a statistically significant difference (p = 0.001). There was no difference when comparing the results of the LHS between male and female groups (p = 0.3), or comparing LHS values between the different age groups (p = 0.79). The DL and LHS in our sample of the population has lower values compared to other population samples. DL differ between age groups, and the older the group, the lower were the figures. Our results show that the most distal disc level accessible from an anterior approach to the cervicothoracic region of the spine, with no theoretical need for a sternal osteotomy, present lower values when compared to previously reported data assigned to other populations. In other words, this finding can be translated as if the enrolled patients presented fewer vertebrae that can be addressed through anterior surgical procedure without performing sternal osteotomy. Thus, the same thought can be applied to the horizontal level in relation to the sternum, since our results showed more cranial values compared to results of previous studies. In addition, the disc level was different when comparing patients of different age groups, and the higher the age, the lower were the values found. This finding represents a migration to the more distal cranial disc level, as we increase the age of the patients
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Hammer, Dominique. "Contribution a l'etude des atteintes neoplasiques primitives et secondaires du sternum et/ou de la clavicule : a propos de 75 cas." Université Louis Pasteur (Strasbourg) (1971-2008), 1986. http://www.theses.fr/1986STR1M158.
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Korn, Andreas. "Schwerebeschleunigungen Kühler Sterne." Diss., lmu, 2002. http://nbn-resolving.de/urn:nbn:de:bvb:19-3525.
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Morris, Laura Claire. "Breeding ecology of Artic tern (Sterna paradisaea) and common tern (Sterna hirundo)." Thesis, University of Newcastle upon Tyne, 2013. http://hdl.handle.net/10443/1882.
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Seabird breeding populations have been experiencing change over the last 40 years with low reproductive success being associated with poor foraging conditions. A comparison of the breeding ecology of Arctic and Common Terns showed significant differences in reproductive strategy and output associated with differences in their sensitivities to changing conditions. Both clutch size and productivity were consistently lower in Arctic Terns than Common Terns. Chicks of both species hatched asynchronously with mortality increasing down the brood hierarchy. Younger sibling survival was impacted both by seasonal conditions and by elder sibling survival, although to varying degrees depending on species and hatching order. Arctic Terns foraged at a higher rate but on less energy rich prey and on a less varied diet. Both species increased provisioning and decreased parental attendance at the nest as chicks grew older, corresponding with the changes in chicks’ thermoregulatory abilities and energy requirements. Provisioning of chicks was primarily increased by selection of higher energy prey rather than through increased provisioning rate. Diurnal rhythms in either provisioning rate or diet were seen in both species, primarily associated with changing behaviour of prey fish. Temperature and precipitation affected provisioning, but adults maintained energy delivery to chicks. Increase in wind speed negatively impacted chick provisioning despite increased foraging effort. Chick mortality was linked to weather and feeding conditions, with high mortality linked to windy conditions and low provisioning. Yearly differences in productivity and chick mortality were associated with provisioning, and low parental attendance indicated poor foraging conditions. The reproductive output of both species is sensitive to declining foraging conditions and increased severity of weather conditions. The data implies that the sensitivity of Arctic Terns is greater than that of Common Terns, and that conditions around Coquet Island are sub-optimal for Arctic Tern breeding.
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Lasne, Sandra. "Modèles et sujet : Laurence Sterne, 1713-1768, lecture épistémocritique /." Montpellier : Presses universitaires de la Méditerranée, 2008. http://catalogue.bnf.fr/ark:/12148/cb41340885c.
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Texte remanié de: Thèse de doctorat--Études anglo-américaines--Montpellier 3, 2000. Titre de soutenance : Modèles du sujet dans l'oeuvre romanesque de Laurence Sterne : illustrations et perversions.Bibliogr. p. 307-356. Index.
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Klingner, Annett. "Die Macht der Sterne." Doctoral thesis, Humboldt-Universität zu Berlin, 2018. http://dx.doi.org/10.18452/19206.
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Darstellungen der Planeten und ihrer Kinder gehörten zu den ersten paganen Bildern, die im Spätmittelalter produziert und rezipiert wurden. Während der rund 200 Jahre ihres hauptsächlichen Auftretens, bis zum Ende des 16. Jahrhunderts, erreichten sie eine enorme Popularität. Im Weltbild des Mittelalters und der frühen Neuzeit war jeder Mensch von dem Gestirn geprägt, unter dessen Einfluss er geboren wurde. Dieser Planet bestimmte, wie man körperlich und charakterlich beschaffen war, welchen Beruf man ausübte und welche gesellschaftliche Stellung man erwarten durfte. Der Geburtsmoment sorgte für eine lebenslange, familiäre Verbindung zum Gestirn, man wurde quasi zu dessen Kind.
Die Macht der Sterne zeichnet die Entwicklung von der ersten Erwähnung der Planetenkinder in Schriftquellen, über die Herausbildung eines relativ stabilen ikonografischen Kanons in verschiedenen Medien, funktionsgebundene Variationen bis zum Aufgehen in anderen Bildgattungen nach. Die zumeist siebenteiligen Zyklen stellen sich als Teil eines weit ausgebauten Beziehungsgefüges und Verweissystems dar, in dem sich das jeweilige gesellschaftliche Bild der Zeit spiegelt. Die Darstellungen dokumentieren zudem zentrale Entwicklungen des individuellen Denkens bis zum Ende des 16. Jahrhunderts. Sie zeigen, wie das jeweils aktuelle kosmologische Verständnis und Wissen einem breiten Publikum durch Bilder vermittelt werden konnte, wie dies mit dem religiösen Leben vereinbar war oder sich im Alltag niederschlug.
Planetenkinder-Darstellungen hatten im Verlauf ihrer Geschichte vielfältige Funktionen. In ihnen manifestierte sich die Vorstellung einer Einheit der Dinge in zahlreichen Analogien. Gezielt eingesetzt wurden die Bilder zur Markierung sozialer Aufstiege, politischer Interessen und der Reklamation von Machtansprüchen sowie der Repräsentation von Einfluss bzw. Verherrlichung von Auftraggebern. Die Bilder zeigen philosophische Diskurse auf, verweisen auf konkrete historische Ereignisse und bewerten diese.Representations of the planets and their children were among the first pagan images to be produced and adopted in the late Middle Ages. During the circa 200 years in which they mainly appeared, up until the end of the sixteenth century, they became enormously popular. In the worldview of the Middle Ages and early modern era, every person was believed to be influenced by the celestial body under whose influence they were born. This planet determined one’s physical appearance and character, one’s profession, and the social standing one could expect. The moment of birth ensured the continuation of a life-long, familiar connection to this celestial body, and a person was effectively considered its “child”. Die Macht der Sterne traces these developments from the first written references to the children of the planets, through to the emergence of a relatively stable iconographical canon in various media, variations in terms of function, as well as their appearance in other pictorial genres. These cycles, usually consisting of seven parts, presented themselves as part of a highly elaborate relational structure and system of references which reflected the current social worldview. The images also document key developments in individual thought up until the end of the sixteenth century. They show how the prevailing understanding of the cosmos and knowledge could be communicated to a wide audience by means of imagery, how this was reconciled with religious life, and how it was reflected in everyday life. Over the course of their history, images of the children of the planets served a variety of functions. By means of a number of analogies they illustrated the notion of the unity of all things. These images were also consciously employed to underscore social advancement, political interests, and the reassertion of claims to power as well as representations of influence or the glorification of patrons. These depictions also highlight philosophical discourses and refer to concrete historical events while offering evaluations of these phenomena.
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Flaskamp, Martin. "Nichtlokale und zeitabhängige Konvektion in Sternen." [S.l. : s.n.], 2003. http://deposit.ddb.de/cgi-bin/dokserv?idn=969863632.
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Stewart, Neil. ""Glimmerings of wit" : Laurence Sterne und die russische Literatur von 1790 bis 1840." Heidelberg Winter, 2005. http://deposit.ddb.de/cgi-bin/dokserv?id=2643518&prov=M&dokv̲ar=1&doke̲xt=htm.
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VALLEE, VERONIQUE. "La luxation sterno-claviculaire posterieure." Toulouse 3, 1989. http://www.theses.fr/1989TOU31159.
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Sassenberg, Marina. "Selma Stern (1890 - 1981) : das Eigene in der Geschichte." Tübingen Mohr Siebeck, 2004. http://bvbm1.bib-bvb.de/webclient/DeliveryManager?pid=213628&customa̲tt2̲=simplev̲iewer.
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Bernkopf, Jan. "Untersuchungen zur Altersbestimmung von hauptreihenahen kühlen Sternen." [S.l.] : [s.n.], 2001. http://deposit.ddb.de/cgi-bin/dokserv?idn=964618990.
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Bernkopf, Jan. "Untersuchungen zur Altersbestimmung von hauptreihenahen kuehlen Sternen." Diss., lmu, 2002. http://nbn-resolving.de/urn:nbn:de:bvb:19-2061.
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Horn, Wylie. "Prey selection, foraging effort and breeding performance of Arctic (Sterna paradisaea) and Common (Sterna hirundo) terns." Thesis, University of Glasgow, 1995. http://theses.gla.ac.uk/5540/.
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Madurasinghe, M. A. D. "Splashless ship bows and waveless sterns /." Title page, summary, contents and general introduction only, 1986. http://web4.library.adelaide.edu.au/theses/09PH/09phm183.pdf.
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Knaack, Reto. "Helligkeitsänderungen der Sonne im Vergleich zu sonnenähnlichen Sternen /." Zürich : ETH Zürich, Institut für Astronomie, 1999. http://e-collection.ethbib.ethz.ch/show?type=dipl&nr=19.
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Kim, Chunghee. "Laurence Sterne and an ethics of pleasure." Thesis, Birkbeck (University of London), 1997. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.267532.
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This thesis proposes that an ethics of pleasure informs the destabilising elements of Sterne's texts, delineated through the peculiar energies and vitality in his jesting narrative voice. I demonstrate the Sternean synthesis of two problematic principles, ethics and pleasure, incompatible for the modem mind but complementary for Eighteenth century moralists. Sterne's configuration of ethical pleasure can be differentiated from those of major moral discourses of the seventeenth and eighteenth century: 1) by his distinctive ethical position which enfranchises laughter, gaiety, and mirth which his contemporaries underplay; 2) through a Rabelaisian humour which Bakhtin sees as exemplifying signs of Renaissance folk and peasant culture, so creating a distance from the progressivistic zeal of the Enlightenment; 3) in his conjunction of Fideistic scepticism with Rabelaisian grotesque, which absorbs and transfigures a sense of the plenitude and the inexplicability of nature. The first chapter examines Sterne's incorporation of a "heteroclite" perspective into orthodox latitudinarian theism in his sermons, in the specific forms of his selectiveness in adaptations or borrowings from various divine homilies. The second chapter compares his ethics of pleasure with major contemporaneous moral discourses, focusing on the production of different moral frameworks through differing perceptions of man's place in nature. The third chapter locates Sterne's formulation of text and narrative in a material presence of communion and fellow-feeling among disparate sUbjectivities. The fourth chapter investigates the ethical significance of Sterne's particular use of laughter, in which he tries to re-enact the laughing spirit of Rabelaisian grotesque with partial success, thus suggesting his comic spirit be identified as Romantic grotesque. A fmal chapter concludes with Sterne's attempt to test his ethics through interlocution and engagement with strangers in A Sentimental Journey, charting the pragmatic obstacles to a praxis of love for the concretised being.
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Scattareggia, Marchese Sandro. "Sterno-clavicular kinematics : a new measurement system." Thesis, University of Newcastle Upon Tyne, 2000. http://hdl.handle.net/10443/864.
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The study of the human motion as a discipline is ancient almost like the man. Early theories and observations on these topics can be found in Hyppocrates' and Galeno's work. More recently Duchenne de Boulogne (1867), Marey (1885), Braune and Fisher (1888), Sherrington (1933), Luria and finally Haken (1996) applied new techniques to the study of movement trying to understand and localise also the main areas of the brain involved during motion. Despite the richness of the literature produced, "man in motion" still represents a fascinating and partially unknown theme to deal with, particularly in the dynamic behaviour of the arms during the execution of specific tasks. Such movement, indeed individual expression of the complex interaction of biological subsystems (brain, muscles, skeleton, etc. ) against the surrounding environment, hides nowadays its features and very few data are available on its kinematic and dynamic response. This gap is largely due to the lack of knowledge on the dynamic movement of the "shoulder complex" and of the related muscles involved during motion. In fact, the large number of degrees of freedom to be measured and the high deformability of skin and soft tissues prevent the direct measurement of skeletal movements and contribute to increment the above described indetermination. Against this complex background, the rehabilitationist faces the pragmatic difficulties to decide which joints require attention as a priority or, in the case of biological damage, to assess the degree of impairment and subsequent recovery. As a result, clinical assessmentis performed by the use of relatively elementary test tasks, which can be monitored either by timing or by some indirect measurement of the success of the execution. The aim of the present research is then to provide new means of measurements to be used for gaining objective information on the motion particularly of "non visible" joints like the shoulder complex in order to characterise properly their motion and, in turn, the workspace of the arm.
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Gama, Vítor Castelões. "Laurence Sterne e Luiz Ruffato : convergências/divergências." reponame:Repositório Institucional da UnB, 2017. http://repositorio.unb.br/handle/10482/31387.
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Dissertação (mestrado)—Universidade de Brasília, Instituto de Letras, Departamento de Teoria Literária e Literaturas, Programa de Pós-Graduação em Literatura, 2017.Submitted by Raquel Almeida (raquel.df13@gmail.com) on 2018-03-05T16:13:00Z No. of bitstreams: 1 2017_VítorCastelõesGama.pdf: 1983901 bytes, checksum: 8543235d8096a137fd0576ef7f3bb90e (MD5)
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Considerando o apreço que Luiz Ruffato demonstrou por Laurence Sterne, objetiva-se entender as convergências entre as obras dos autores. Para tanto, procede-se à análise bibliográfica dos romances “A vida e as opiniões do cavalheiro Tristram Shandy” e “Eles eram muitos cavalos” em relação ao gênero da sátira menipeia e às outras artes como o cinema, a poesia, a música e o teatro. Observa-se o percurso da menipeia nas obras dos autores com o aporte de teóricos como Mikhail Bakhtin, Northrop Frye, José Guilherme Merquior e Enylton José de Sá Rego para apontar as similaridades e dessemelhanças em suas construções. É necessário ressaltar que este gênero agrega um questionamento social aos autores por discutir também a relação entre literatura e realidade. Questão aprofundada pelos autores também pelo amplo uso de técnicas provenientes de outras artes, por esse motivo as obras são consideradas como híbridas. Para trabalhar esse conceito seguimos com base no antropólogo Néstor Garcia Canclíni. É de importância na análise o conceito de performance, pois na tessitura das obras há um trabalho de mediação com os leitores realizado pela materialidade do livro e por um estilo tipográfico. Este conceito é balizado pelo entendimento de Paul Zumthor, e outros pensadores como Renato Cohen e Regina Melim. Por fim, conclui-se que apesar do distanciamento de séculos entre os autores há um intenso diálogo entre as obras que se iluminam mutuamente e demonstram a utilidade da tradição na vanguarda da literatura contemporânea brasileira.
Considering the appreciation Luiz Ruffato showed for Laurence Sterne. We intend to understand the similitaries between the authors works. Therefore, we proceed to a bibliographical analysis of the novels “The life and opinions of Tristram Shandy, gentleman” and “They were many horses” in comparison to the menippean satire and the cinema, poetry, music and drama. With the theoretical groundwork of Mikhail Bakhtin, Northrop Frye, José Guilherme Merquior and Enylton José de Sá Rego we take notice of the mennipean satire influence in the analysed novels to discover correlations and dissimilarities between them. It is necessary to point out that this literary gender brings a taste for social criticism by discussing also the relation between literature and reality. Which is further questioned by the intense use of techniques derived from other arts. Because of this usage “Tristram Shandy” and “They were many horse” are considered hybrid novels. To work with hybridization we approach the thought of Néstor Garcia Canclini. It is also important the concept of performance, because in the making of the novels there are a personalized form of mediation with the reader and a typographical style. This concept is based in Paul Zumthor’s theory and other authors like Renato Cohen and Regina Melim. In the end, we conclude that in spite of the centuries apart there is an intense dialogue between the authors and their works that demonstrate the usefulness of tradition in contemporary brazilian literature vanguard.
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Montandon, Alain. "La Réception de Laurence Sterne en Allemagne /." Clermont-Ferrand : Association des publications de la Faculté des lettres et sciences humaines, 1986. http://catalogue.bnf.fr/ark:/12148/cb34843471g.
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Salvador, Villà Marta. "[r,s,t]-Färbung von Wegen, Kreisen und Sternen." [S.l.] : [s.n.], 2004. http://deposit.ddb.de/cgi-bin/dokserv?idn=974286435.
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Salvador, Villà Marta. "[r,s,t]-Färbung von Wegen, Kreisen und Sternen." Doctoral thesis, Technische Universitaet Bergakademie Freiberg Universitaetsbibliothek "Georgius Agricola", 2009. http://nbn-resolving.de/urn:nbn:de:swb:105-9254662.
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Im Jahre 2002 führten A. Hackmann, A. Kemnitz und M. Marangio das Konzept der [r, s, t]-Färbungen als eine Verallgemeinerung der Knoten-, Kanten- und Totalfärbungen von Graphen ein. Für gegebene nicht negative Zahlen r, s und t ist eine [r, s, t]-Färbung von einem Graphen G eine Abbildung c, von V(G) und E(G) auf die Menge {1, 2,…, k}, wobei c(v) und c(w) sich um mindestens r unterscheiden, für je zwei adjazente Konten v, w ; c(e) und c(f) unterscheiden sich um mindestens s für je zwei adjazente Kanten e, f ; und c(v) und c(e) unterscheiden sich um mindestens t für je zwei inzidente Knoten v und Kanten e . Die [r, s, t]-chromatische Zahl von G ist die kleinste Zahl k, für die eine solche Färbung für G existiert. In dieser Dissertation wird die [r, s, t]-chromatische Zahl für Wege, Kreise und Sterne mit drei Blättern vollständig bestimmt. Darüber hinaus werden Schranken für Sterne mit mehr als drei Blättern und weitere Ergebnisse für bipartite und vollständige Graphen vorgestellt.
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Friberg, Örjan. "Local Collagen-Gentamicin for Prevention of Sternal Wound Infections." Doctoral thesis, Linköpings universitet, Thoraxkirurgi, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-7125.
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In cardiac surgery, sternal wound infection (SWI) continues to be one of the most serious postoperative complications. Coagulase-negative staphylococci (CoNS) have become the most common causative agents of SWI. Prophylaxis with intravenous beta-lactam antibiotics (cephalosporins or in Sweden most commonly isoxazolyl penicillins) is routinely practised. However, many CoNS species are resistant to beta-lactam antibiotics. Vancomycin is often the only effective antibiotic available for treatment of these infections, but its use for routine prophylaxis is strongly discouraged because of the risk of increasing the selection of resistant bacteria. The aim of this work was to develop and evaluate a new technique for antibiotic prophylaxis in cardiac surgery consisting of application of drug eluting collagen-gentamicin sponges in the sternal wound in addition to conventional intravenous antibiotics. The antibiotic concentrations in the wound and serum achieved by routine intravenous dicloxacillin prophylaxis and those after application of local collagen-gentamicin in the sternal wound were investigated. These studies showed dicloxacillin levels adequate for prevention of infections by methicillin-susceptible staphylococci, and extremely high gentamicin levels in the wound fluid, during the first 8-12 hours postoperatively with the local application. Two thousand cardiac surgery patients were then randomised to routine prophylaxis with intravenous isoxazolyl penicillin alone (control group) or to this prophylaxis combined with application of collagen-gentamicin (260 mg gentamicin) sponges within the sternotomy before wound closure. The primary end-point was any sternal wound infection within two months postoperatively. Evaluation was possible in 983 and 967 patients in the treatment and control groups, respectively. The incidence of any sternal wound infection was 4.3% in the treatment group and 9.0 % in the control group (relative risk = 0.47, (95% confidence interval 0.33 to 0.68); P<0.001). The most common microbiological agents were CoNS, followed by Staphylococcus aureus. Local gentamicin reduced the incidence of SWIs caused by all major, clinically important microbiological agents except Propionibacterium acnes. Assignment to the control group, high body mass index, diabetes mellitus, younger age, single or double internal mammary artery, left ventricular ejection fraction less than 35% and longer operation time were independent risk factors for SWI in a multivariable risk factor analysis. In patients with additional sternal fixation wires (> six wires) the collagen-gentamicin prophylaxis was associated with an approximately 70 % reduction in the incidence of SWI at all depths and the application of collagen sponges between sternal halves may require particular attention regarding the stability of fixation. A cost effectiveness analysis showed that the application of local collagen-gentamicin as prophylaxis was dominant, i.e. resulted in both lower costs and fewer wound infections. Routine use of the described prophylaxis in all adult cardiac surgery patients could be recommended.
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Friberg, Örjan. "Local collagen-gentamicin for prevention of sternal wound infections /." Linköping : Univ, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-7125.
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Iwakura, Atsushi. "Basic fibroblast growth factor may improve devascularized sternal healing." Kyoto University, 2001. http://hdl.handle.net/2433/150532.
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Hopmann, Erika Sophie. "Die Organisation der Sinne : Wahrnehmungstheorie und Ästhetik in Laurence Sternes Tristram Shandy /." Würzburg : Königshausen und Neumann, 2008. http://catalogue.bnf.fr/ark:/12148/cb412762848.
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Böger, Roger. "Stochastische Geschwindigkeitsfelder in der expandierenden Hülle entwickelter Sterne." [S.l. : s.n.], 2004. http://deposit.ddb.de/cgi-bin/dokserv?idn=972505911.
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Wood, Gareth. "Javier Marías's debt to translation : Sterne, Browne, Nabokov." Thesis, University of Oxford, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.670143.
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Javier Marías has explained many times that working as a translator of literary works from English into Spanish helped shape him as a writer. This study explores those claims by analysing two things: firstly, his translations themselves; and secondly, seeing how those translations have left discernible traces in his own fiction.
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Reetz, Johannes Krischna. "Sauerstoff in kühlen Sternen und die chemische Entwicklung der Galaxis." Diss., lmu, 1999. http://nbn-resolving.de/urn:nbn:de:bvb:19-4174.
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Casha, Aaron. "A biomechanical study of median sternotomy closure techniques." Thesis, University of Sheffield, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.370056.
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Schmitz, Norbert. "Alfred Stern (1846-1936) : ein europäischer Historiker gegen den Strom der nationalen Geschichtsschreibung /." Hannover : Wehrhahn, 2009. http://d-nb.info/997512504/04.
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Preo, Simone Marino <1995>. "Strutture artificiali per favorire la nidificazione di sterna comune (Sterna hirundo) in una valle da pesca della Laguna di Venezia: valutazione dell'efficacia." Master's Degree Thesis, Università Ca' Foscari Venezia, 2020. http://hdl.handle.net/10579/18262.
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Nello scenario climatico-ambientale che sta interessando l'Alto Adriatico in questi ultimi anni, molte specie di uccelli acquatici, risultano minacciate dalle sempre maggiori perdita e frammentazione dei loro habitat riproduttivi naturali, oltre che dall'aumento dei livelli idrici, tali talvolta da azzerare completamente le nidificazioni. Le valli da pesca della Laguna di Venezia si configurano tuttavia come ecosistemi ideali per la conservazione di queste specie ornitiche, soprattutto per via della gestione antropica che attenua l'impatto delle sopracitate pressioni ambientali. Purtroppo, spesso in queste aree vengono comunque a mancare gli habitat di nidificazione elettivi, persi durante l'utilizzo antropico dell'area. Questo è il caso di Valle Averto, valle da pesca della Laguna sud oggi abbandonata ed in parte divenuta Oasi WWF, all'interno della quale è in corso il progetto LIFE ForestAll, progetto di restauro ambientale che, tra gli altri obiettivi, ambisce ad aumentare la conservazione dell'avifauna acquatica fornendo siti artificiali di nidificazione. Tra le specie target, quella a cui si rivolgono soprattutto questi interventi è la sterna comune (Sterna hirundo), per la quale sono già note frequentazioni su superfici artificiali. Il presente elaborato di tesi mira a valutare e a discutere l'efficacia di tali interventi di conservazione rivolti ad una specie peraltro inserita nell'Allegato I della Direttiva 09/147/CE Uccelli.
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Wolkenhauer, Markus. "Durchdringungs- und Adsorptionsverhalten von Stern-Polymeren." [S.l.] : [s.n.], 2002. http://archimed.uni-mainz.de/pub/2002/0137/diss.pdf.
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Gourdon, G. L. "Time and space in 'Tristram Shandy' and other eighteenth century novels : the issues of progression and continuity." Thesis, University of Sheffield, 2003. http://etheses.whiterose.ac.uk/14724/.
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The thesis argues that the narratives of the eighteenth-century novels selected for this study demonstrate a conscious manipulation of time and space, and that the consequence of this manipulation is to provide the reader with a unique literary journey through the text. The thesis, in its analysis and comparison of these distinctive journeys, chooses to focus on the narrative techniques which facilitate or hamper progression and continuity within the texts. It particularly concentrates on the impact of these narrative techniques on the reading experience. The first chapter studies and compares texts resorting mainly to the present tense with those predominantly written in the past tense. It examines the effects of the tense used in the narration on the reader's engrossment in the fiction. The second chapter concentrates on the repercussions of the author's choice of a beginning and an ending for his story on the nature of the progression of the narrative. The third chapter is devoted to the destabilising reading journey offered by Tristram Shandy. It examines the numerous techniques which react against continuity and progression in time and in space, and the narrator's motivation behind their use. It shows how the narrative choices of Tristram Shandy place the reader face to face with his own act of reading. The fourth and final chapter is concerned with the role and the status of fictional footnotes in some eighteenth-century prose fictions. It demonstrates the fictional nature of the footnotes in Tom Jones. It argues that fictional footnotes affect the reader's progression across the text in time and in space as well as his understanding of the work of fiction, and this in a fundamental way.