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191.
Morgagni hernias are the least common form of diaphragmatic hernias. Although they are congenital, most of them are not diagnosed until later in life. The indication for surgery is based on the patient's symptoms or on the radiological evidence of incarcerated tissue, and until quite recently involved a laparotomy or thoracotomy. Laparoscopy not only permits the suspected diagnosis to be confirmed--which is otherwise often difficult--but also makes it possible to close the hernia site by suturing. For improved security, the hernia site is augmented by fixing in place a non-absorbable mesh. The operative technique employed is described.  相似文献   
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The influence of ionic strength and composition on the binding and inhibition of human leukocyte elastase by glycosaminoglycans with variable degree and position of sulfation was investigated. The kinetic mechanism of inhibition had a hyperbolic, mixed-type character with a competitive component that was promoted by low ionic strength, reduced by phosphate ions, and which also depended on the substrate and glycosaminoglycan structure. Enzyme binding was a cooperative phenomenon that varied with ionic strength and composition. The inhibition patterns correlated with the cationic character of elastase and with the distribution of arginines on its molecular surface, most notably with residues located in the vicinity of the substrate binding region. The order of affinity for elastase binding was chondroitin 4-sulfate < chondroitin 6-sulfate < dermatan sulfate, iduronate-containing derivatives being superior with respect to the glucuronate-containing counterparts. Additional sulfation at both the 4- and 6- positions or at the N- and 4-positions of the N-acetylgalactosamine moiety decidedly improved the inhibitory efficiency. The results highlight a fundamental physiological role of enzyme-glycosaminoglycan interactions. In the azurophil granule of the human polymorphonuclear neutrophil, elastase and other enzymes are bound to a matrix of chondroitin 4-sulfate because this is the only glycosaminoglycan that simultaneously offers good binding for enzyme compartmentalization together with prompt release from the bound state at the onset of phagocytosis.  相似文献   
194.
The physical widths of reference features incorporated into electrical linewidth test structures patterned in films of monocrystalline silicon have been determined from Kelvin voltage measurements. The films in which the test structures are patterned are electrically insulated from the bulk-silicon substrate by a layer of silicon dioxide provided by SIMOX (Separation by the IMplantation of OXygen) processing. The motivation is to facilitate the development of linewidth reference materials for critical-dimension (CD) metrology-instrument calibration. The selection of the (110) orientation of the starting silicon and the orientation of the structures' features relative to the crystal lattice enable a lattice-plane-selective etch to generate reference-feature properties of rectangular cross section and atomically planar sidewalls. These properties are highly desirable for CD applications in which feature widths are certified with nanometer-level uncertainty for use by a diverse range of CD instruments. End applications include the development and calibration of new generations of CD instruments directed at controlling processes for manufacturing devices having sub-quarter-micrometer features  相似文献   
195.
The value of flexible videoendoscopy as a biofeedback tool in conservative swallowing rehabilitation of patients suffering from aspiration after head and neck surgery was examined. For this purpose, the outcomes of conventional swallowing therapy and of swallowing therapy with support of videoendoscopic biofeedback were compared. In the first 40 days of swallowing therapy, videoendoscopic biofeedback significantly increased the chance of therapeutic success, shortening the period of functional rehabilitation in comparison to conventional swallowing therapy. Limitations of this visual biofeedback procedure are poor cognitive skills of the patient, rejection of the procedure by the patient and local factors that make the positioning of the endoscope difficult.  相似文献   
196.
197.
For part I see, ibid., p. 134, 1998. The basic approach outlined in the previous article is applied to the difficult problem of computing the optical modes of a vertical-cavity surface-emitting laser. The formulation utilizes a finite difference equation based upon the lowest order term of an infinite series solution of the scalar Helmholtz equation in a local region. This difference equation becomes exact in the one-dimensional (1-D) limit, and is thus ideally suited for nearly 1-D devices such as vertical-cavity lasers. The performance of the resulting code is tested on both a simple cylindrical cavity with known solutions and an oxide-confined vertical-cavity laser structure, and the results compared against second-order-accurate code based upon Crank-Nicolson differencing  相似文献   
198.
In order to build models that relate thematic mapper (TM) imagery to field forest variables, several regression techniques, such as the ones based on the Mallows' Cp and the adjusted R2 statistics, were applied. Nevertheless, although the best created models had good fittings (R2>0.65) apparently supported by a clear statistical significance (p<0.0001), later trials tested with additional plots showed that these models were, in fact, nonrobust models (models with very low-predictive capabilities). Two factors were pointed out as causes of these inconsistencies between predicted and observed values: a relatively small number of available field plots and a relatively high number of possible independent variables. Actually, different trials suggested much lower fittings for the expected “really” predictive models. Some restrictions of TM satellite data, such as its radiometric, spectral, and spatial limitations, together with restrictions arising from gathering and processing of field data, might have led to these poor relations. This study shows the need for guarantees stronger than the usual ones before concluding that there is a clear possibility of using satellite information to estimate forest parameters by means of regression techniques  相似文献   
199.
We study run-time issues, such as site allocation and query scheduling policies, in executing read-only queries in a hierarchical, distributed memory, multicomputer system. The particular architecture considered is based on the hypercube interconnection. The data are stored in a base cube, which is controlled by a control cube and host node hierarchy. Input query trees are transformed into operation sequence trees, and the operation sequences become the units of scheduling. These sequences are scheduled dynamically at run-time. Algorithms for dynamic site allocation are provided. Several query scheduling policies that support interquery concurrency are also studied. Average query completion times and initiation delays are obtained for the various policies using simulations  相似文献   
200.
It is well known that the effectiveness of relational database systems is greatly dependent on the efficiency of the data access strategies. For this reason, much work has been devoted to the development of new access techniques, supported by adequate access structures such as the B+trees. The effectiveness of the B +tree also depends on the data distribution characteristics; in particular, poor performance results when the data show strong key value distribution unbalancing. The aim of this paper is to present the partial index: a new access structure that is useful in such cases of unbalancing, as an alternative to the B+tree unclustered indexes. The access structures are built in the physical design phase, and at execution (or compilation) time, the optimizer chooses the most efficient access path. Thus, integration of the partial indexing technique in the design and in the optimization process are also described  相似文献   
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