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141.
OBJECTIVE: To evaluate the relationships between patient and physician pretreatment expectations of pain relief and subsequent pain relief reported by chronic pain patients immediately after treatment. DESIGN: Prospective study of consecutive patients undergoing a procedure in a pain clinic for treatment of chronic pain. Patients rated their current pain level and their expectation of pain relief immediately prior to undergoing a procedure (e.g., intravenous drug infusion, nerve block) for the treatment of chronic pain. Simultaneously and independently, the treating physician completed a similar questionnaire. At completion of the procedure, patients rated their current pain level and degree of pain relief. SETTING: University of Washington Multidisciplinary Pain Center procedure suite. PATIENTS: Forty-six consecutive chronic pain patients. INTERVENTION: Intravenous drug infusions and nerve blocks. OUTCOME MEASURES: Current pain and pain relief ratings. RESULTS: Patients' pain relief expectation ratings were not correlated significantly with their postprocedure pain relief ratings or pre-post procedure changes in pain ratings. However, a statistically significant correlation was found between physician expectations of pain relief and patient pain relief ratings and patient pre-post procedure changes in pain. CONCLUSIONS: The results of this study suggest that physicians are better predictors than are patients of patients responses to these procedures and/or that physicians may somehow subtly communicate their expectations to patients during the procedure, and these expectations then influence patient response. Patient pretreatment expectations may not always play a significant role in nonspecific treatment effects.  相似文献   
142.
Phase contrast magnetic resonance imaging (MRI) can provide in vivo myocardial velocity field measurements. These data allow densely spaced material points to be tracked throughout the whole heart cycle using, for example, the Fourier tracking algorithm. To process the tracking results for myocardial deformation and strain quantification, we developed a method that is based on fitting the tracking results to an appropriate local deformation model. We further analyzed the accuracy and precision of the method and provided performance predictions for several local models. In order to validate the method and the theoretical performance analysis, we conducted controlled computer simulations and a phantom study. The results agreed well with expectations. Human heart data were also acquired and analyzed, and provided encouraging results. At the signal-to-noise ratio (SNR) level and spatial resolution expected in clinical settings, the study predicts strain quantification accuracy and precision that may allow the technique to become a practical and powerful noninvasive approach for the study of cardiac function, although clinically acceptable data acquisition strategies for three-dimensional (3-D) data are still a challenge.  相似文献   
143.
This review is written to evaluate the stereoselectivity in cutaneous hydrolysis and transdermal transport of propranolol prodrug. This discussion will be useful in the development of knowledge about stereoselective cutaneous hydrolysis and its influence on stereoselective transdermal transport of many other chiral prodrugs and drugs. Propranolol prodrugs undergo stereoselective hydrolysis in hairless mouse skin homogenate and in excised skin samples during permeation; the stereoselectivity is markedly biased towards hydrolysis of the (R) isomer. Unlike the liver, the esterase activity of the skin is high in its cytosolic fraction. Most of the lipophilic propranolol prodrugs cause stereoselective permeation across hairless mouse skin. A mechanism of stereoselective permeation of propranolol prodrug across the skin has been proposed, which indicates that the stereoselectivity in permeation is resulted from the stereoselective hydrolysis of lipophilic prodrug during permeation.  相似文献   
144.
Nitric oxide (NO) acts as a modulator of neuronal transmission in mature neuronal systems, including the retina. Recently, NO has also been suggested to have a trophic function during development. We examined immunocytochemically the distribution of NO-producing cells in developing and transplanted rabbit retinas. An antibody detecting the neuronal isoform of its biosynthetic enzyme, nitric oxide synthase (NOS), was used on normal developing retinas [starting at embryonic day (E) 15] and on rabbit retinal transplants after various survival times (1-139 days after surgery). Weakly stained cell bodies were first observed in the proximal margin of the neuroblastic layer at E 29. Stained processes projecting towards a developing inner plexiform layer were also visible at this time point. Immunoreactive cells were located at later stages in the innermost part of the inner nuclear layer and in the ganglion cell layer, and are likely to correspond mainly to amacrine cells. NOS-labelled cells were also found in retinal transplants. The first NOS-labelled cells appeared, as in normal developing retinas, in ages corresponding to E 29 and were still detected in transplants corresponding to postnatal day 123. NOS-labelled cells were seen in areas between rosettes, where amacrine cells are located. NOS-labelled processes were at times seen to project for long distances, forming very distinct plexuses. NOS-containing amacrine cells thus appear both in the transplants and in developing retinas in the embryonic stages, long before synaptic function involving these cells can be expected, suggesting a role for NO not only in neuromodulation but also in retinal development.  相似文献   
145.
The ITER magnet system consists of structurally linked sets of toroidal (TF) and poloidal (PF) field coils, central solenoid (CS), and various support structures. The coils are superconducting, force flow Helium cooled with a Kapton-Glass-Epoxy multilayer insulation system. The stored magnetic energy is about 100GJ in the TF system and 20GJ in the PF-CS. Coils and structure are maintained at 4 K by enclosing them in a vacuum cryostat. The cryostat, comprising an outer envelope to the magnets, forms most of the second radioactivity confinement barrier. The inner primary barrier is formed by the vacuum vessel, its ports and their extensions. To keep the machine size within acceptable bounds, it is essential that the magnets are in close proximity to both of the nuclear confinement barriers. The objective of the magnet design is that, although local damage to one of the barriers may occur in very exceptional circumstances, large scale magnet structural or thermal failure leading to simultaneous breaching of both barriers is not credible. Magnet accidents fall into three categories: thermal (which includes arcing arising from insulation failure and local overheating due to discharge failure in the event of a superconductor quench), structural (which includes component mechanical failure arising from material inadequacies, design errors and exceptional force patterns arising from coil shorts or control failures), and fluid (Helium release due to cooling line failure). After a preliminary survey to select initial faults conceivable within the present design, these faults are systematically analyzed to provide an assessment of the damage potential. The results of this damage assessment together with an assessment of the reliability of the monitoring and protective systems, shows that the magnets can operate with the required safety condition.  相似文献   
146.
This paper presents a new self-routing packet network called the plane interconnected parallel network (PIPN). In the proposed design, the traffic arriving at the network is shaped and routed through two banyan network based interconnected planes. The interconnections between the planes distribute the incoming load more homogeneously over the network. The throughput of the network under uniform and heterogeneous traffic requirements is studied analytically and by simulation. The results are compared with the results of the baseline network and another banyan network based parallel interconnection network. It is shown that, for the proposed design, a higher degree of heterogeneity results in better performance  相似文献   
147.
Reliable multicast protocols suffer from the problem of feedback implosion. To avoid this problem, the number of receivers sending feedback in case of loss must be small. However, losses experienced by different receivers are strongly correlated, since receivers share common resources in the multicast tree. One approach to feedback implosion avoidance relies on delaying feedback at the receivers. We present deterministic timeouts for reliable multicast (DTRM), a distributed algorithm to compute optimal deterministic timeouts for each receiver in a multicast tree as a function of the tree topology and the sender-to-receiver round-trip delays. DTRM has several desirable properties. First, feedback implosion is provably avoided for a single loss anywhere in the tree, provided delay jitter is bounded. Second, the computation of the timeouts can be entirely distributed; receivers and intermediate nodes only rely on local topology information. Third, the timeouts computed by DTRM are optimal with respect to the maximum response time  相似文献   
148.
A beam propagation method (BPM) based on the finite element method (FEM) is described for longitudinally varying three-dimensional (3-D) optical waveguides. In order to avoid nonphysical reflections from the computational window edges, the transparent boundary condition is introduced. The present algorithm using the Pade approximation is, to our knowledge, the first wide-angle finite element beam propagation method for 3-D waveguide structures. To show the validity and usefulness of this approach, numerical results are shown for Gaussian-beam excitation of a straight rib waveguide and guided-mode propagation in a Y-branching rib waveguide  相似文献   
149.
Impact ionization is a major limiting factor to the maximum operating voltage of InGaAs-based, high-speed transistors. In this work, data on the positive temperature dependence of the electron impact ionization coefficient αn in In0.53Ga0.47As at medium-low electric fields are reported for the first time. The increase of αn with temperature is opposite to the behavior normally observed in most semiconductors. This anomalous behavior implies the onset of a positive feedback between power dissipation and avalanche generation which may adversely affect the power handling capability of In0.53Ga 0.47As-based devices, and which should be taken into account in device thermal modeling. In the experimental procedure, based on the measurement of the multiplication factor M-1 in npn In0.53Ga 0.47As/InP Heterojunction Bipolar Transistors (HBT), particular care has been taken in order to rule out possible spurious, temperature-dependent contributions to the measured multiplication current  相似文献   
150.
A comprehensive survey of photosensitivity in silica glasses and optical fiber is reviewed. Recent work on understanding the mechanisms contributing to germanium or aluminum doped fiber photosensitivity is discussed within the framework of photoelastic densification models  相似文献   
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