Congenital abnormalities of the aortic arch may lead to signs and symptoms of tracheal and esophageal obstruction secondary to a restrictive vascular ring. There are many case reports and monographs concerning the surgical management of dysphagia lusoria. This case provides the first example of long-term follow-up of surgical intervention for relief of dysphagia lusoria. A 45-year-old laborer presented with a several year history of episodic bilateral blindness and a more recent onset of "drop attacks." Notably this patient had presented at the age of 18 months with difficulty breathing and eating since birth. The patient also had frequent upper respiratory infections and episodes of pneumonia. Workup revealed a right-sided aortic arch with a left ligamentum arteriosum. When he was first seen in our clinic, history and physical examination revealed claudication and diminished pulses in the left upper extremity. Arteriography and duplex studies confirmed reversal of flow in the patient's left vertebral artery. The arteriogram demonstrated the presence of a right-sided aortic arch and descending aorta along with the proximal stump of the previously ligated left subclavian artery. He underwent left carotid to left axillary artery bypass for the treatment of symptomatic subclavian steal syndrome. His symptoms have resolved with return of antegrade vertebral flow and the presence of normal pulses in the left arm. Congenital aortic abnormalities that lead to tracheal and esophageal compromise are numerous and varied. Surgical management requires a thorough understanding of the person's anatomy and preoperative planning. The life expectancy of patients with dysphagia lusoria necessitates consideration of the long-term consequences of surgical intervention. 相似文献
In this study, we report the results of an investigation into the sintering temperature dependence of magnetic and transport properties for GdBaCo2O5 + δ synthesized through a sol-gel method. The lowering of sintering temperature leads to the increase of oxygen content and the reduction of grain size. The increase of oxygen content results in the enhancement of magnetic interactions and the weakening of Coulomb repulsion effect, while the reduction of grain size improves the magnetoresistance effect. Metal-insulator transition accompanied with spin-state transition is observed in all samples. 相似文献
The homogeneous incorporation of heteroatoms into two-dimensional C nanostructures, which leads to an increased chemical reactivity and electrical conductivity as well as enhanced synergistic catalysis as a conductive matrix to disperse and encapsulate active nanocatalysts, is highly attractive and quite challenging. In this study, by using the natural and cheap hydrotropic amino acid proline—which has remarkably high solubility in water and a desirable N content of ~12.2 wt.%—as a C precursor pyrolyzed in the presence of a cubic KCl template, we developed a facile protocol for the large-scale production of N-doped C nanosheets with a hierarchically porous structure in a homogeneous dispersion. With concomitantly encapsulated and evenly spread Fe2O3 nanoparticles surrounded by two protective ultrathin layers of inner Fe3C and outer onion-like C, the resulting N-doped graphitic C nanosheet hybrids (Fe2O3@Fe3C-NGCNs) exhibited a very high Li-storage capacity and excellent rate capability with a reliable and prolonged cycle life. A reversible capacity as high as 857 mAh•g–1 at a current density of 100 mA•g–1 was observed even after 100 cycles. The capacity retention at a current density 10 times higher—1,000 mA•g–1—reached 680 mAh•g–1, which is 79% of that at 100 mA•g–1, indicating that the hybrids are promising as anodes for advanced Li-ion batteries. The results highlight the importance of the heteroatomic dopant modification of the NGCNs host with tailored electronic and crystalline structures for competitive Li-storage features.
"Holistic therapy" can be just a slogan, a catchword. Two examples--the combination of behaviour therapy and pharmacotherapy on one side, the use of biofeedback in psychiatry on the other--shall present the possible integration of different therapeutic strategies into a holistic concept. The quality of different therapeutic concepts may be influenced by their possible combination. No more any therapeutic method (except some eclectic ones) can see itself as the one and only cure for everything. Of course this view has a consequence on psychopathology and diagnosis, which have to be more exact under these premisses. A holistic treatment requires more knowledge about details in psychopathology and diagnosis as well as about therapeutic methods. 相似文献
We consider the problem of revenue maximization on multi‐unit auctions where items are distinguished by their relative values; any pair of items has the same ratio of values to all buyers. As is common in the study of revenue maximizing problems, we assume that buyers' valuations are drawn from public known distributions and they have additive valuations for multiple items. Our problem is well motivated by sponsored search auctions, which made money for Google and Yahoo! in practice. In this auction, each advertiser bids an amount bi to compete for ad slots on a web page. The value of each ad slot corresponds to its click‐through‐rate, and each buyer has her own per‐click valuations, which is her private information. Obviously, a strategic bidder may bid an amount that is different with her true valuation to improve her utility. Our goal is to design truthful mechanisms avoiding this misreporting. We develop the optimal (with maximum revenue) truthful auction for a relaxed demand model (where each buyer i wants at most di items) and a sharp demand model (where buyer i wants exactly di items). We also find an auction that always guarantees at least half of the revenue of the optimal auction when the buyers are budget constrained. Moreover, all of the auctions we design can be computed efficiently, that is, in polynomial time. 相似文献
Multimedia Tools and Applications - In recent years there has been significant interest in reversible data hiding, and also in particular, reversible data hiding in encrypted images (RDH-EI). This... 相似文献