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To determine the influence of early pain relief for patients with suspected appendicitis on the diagnostic performance of surgical residents.
Methods
A prospective randomized, double-blind, placebo-controlled trial was conducted for patients with suspected appendicitis. The patients were randomized to receive placebo (normal saline intravenous [IV]) infusions over 5 minutes or the study drug (morphine 5 mg IV). All of the clinical evaluations by surgical residents were performed 30 minutes after administration of the study drug or placebo. After obtaining the clinical probability of appendicitis, as determined by the surgical residents, abdominal computed tomography was performed. The primary objective was to compare the influence of IV morphine on the ability of surgical residents to diagnose appendicitis.
Results
A total of 213 patients with suspected appendicitis were enrolled. Of these patients, 107 patients received morphine, and 106 patients received placebo saline. The negative appendectomy percentages in each group were similar (3.8% in the placebo group and 3.2% in the pain control group, p=0.62). The perforation rates in each group were also similar (18.9% in the placebo group and 14.3% in the pain control group, p=0.75). Receiver operating characteristic analysis revealed that the overall diagnostic accuracy in each group was similar (the area under the curve of the placebo group and the pain control group was 0.63 v. 0.61, respectively, p=0.81).
Conclusions
Early pain control in patients with suspected appendicitis does not affect the diagnostic performance of surgical residents.
Whether an association exists between cerebral microbleeds (CMBs) and functional recovery after ischemic stroke is unclear. We aimed to evaluate the association between CMBs and functional outcome after acute ischemic stroke.
Methods
Consecutive patients with acute stroke were enrolled, and all patients were stratified into good and poor functional outcome groups at discharge and 6 months after ischemic stroke by using a modified Rankin Scale score. Cardiovascular risk factors, CMBs, and white matter hyperintensities were compared between these two outcome groups. Logistic regression analysis was used to estimate the risk of poor functional outcomes.
Results
A total of 225 patients were enrolled, 121 of whom were classified as having a good functional outcome at discharge and 142 as having a good 6-month functional outcome. The presence of CMBs was associated with a poor functional outcome at discharge [CMBs (+) patients in poor vs. good functional group; 48.1% vs. 30.6%; p=0.007] and 6 months [53.0% vs. 30.3%; p=0.001]. After adjustment for confounding factors, only the presence of infratentorial CMBs was associated with a poor functional outcome at discharge and 6 months. The poor functional outcome group had more CMBs than the good outcome group at 6 months.
Conclusions
Infratentorial cerebral microbleeds were significantly associated with worse functional outcomes not only in the early phase of ischemic stroke but also in the chronic phase. These findings suggest that the presence of infratentorial CMBs can predict poor functional outcome after acute ischemic stroke.
The objective of the present study was to determine whether angiotensinogen G(–6)A polymorphism is associated with the elevation of blood pressure (BP) in the hypertensive disorders of pregnancy in Korean population. The subjects included 201 cases with the hypertensive disorders of pregnancy and 160 healthy controls. The medical records of subjects were reviewed. Cases were classified into the four subtypes (transient hypertension, preeclampsia, chronic hypertension, and preeclampsia superimposed on chronic hypertension) by the diagnostic criteria suggested by the National High Blood Pressure Education Program Working Group. Cases were also divided into the high and low BP group by the elevation of BP (diastolic BP greater than or equal to 110 mmHg). Maternal angiotensinogen G(–6)A polymorphism was determined by restriction fragment length polymorphism. Frequencies of AA genotype were significantly higher in the high than in the low BP group in the preeclampsia, superimposed preeclampsia, and the combined group (N = 201), suggesting that the angiotensinogen G(–6)A allele was significantly associated with the elevation of BP in the hypertensive disorders of pregnancy among South Korean women. The present findings imply that the elevation of BP can serve as an endophenotype for a spectrum of hypertensive conditions in pregnancy.
Non-steroidal anti-inflammatory drugs cause gastric ulceration through a number of mechanisms including inhibition of PG synthesis, generation of reactive oxygen species (ROS) and induction of apoptosis. Recently, matrix metalloproteinases (MMP) have been suggested to play a crucial role in these mechanisms. The present study investigated the protective effect of anthocyanins isolated from black rice bran (Heugjinjubyeo) against naproxen-induced gastric mucosal injury in rats. The oral administration of anthocyanins (5, 25 or 50 mg/kg body weight) showed significant protection against naproxen (80 mg/kg body weight)-induced gastric ulcer and inhibited lipid peroxidation in the gastric mucosa. In addition, pretreatment with anthocyanins resulted in a significant increase in the activities of radical-scavenging enzymes such as superoxide dismutase, catalase and glutathione peroxidase. Also biochemical and zymographic analyses suggested that the administration of anthocyanins gives a significant protection against naproxen-induced gastric antral ulcer through scavenging ROS and regulation of matrix metalloproteinase-2 (MMP-2) activity. The results of intracellular radical activation show that anthocyanins suppress the generation of intracellular ROS and attenuate the suppression of MMP-2 activity by naproxen. These results suggest that anthocyanins extracted from black rice may offer potential remedy of gastric antral ulceration.
We fabricated PMOS SPC-Si TFTs which show better current uniformity than ELA poly-Si TFTs and superior stability compare to a-Si:H TFT on a glass substrate employing alternating magnetic field crystallization. However the leakage current of SPC-Si TFT was rather high for circuit element of AMOLED display due to many grain boundaries which could be electron hole generation centers. We applied off-state bias annealing of VGS=5V, VDS=−20V in order to suppress the leakage current of SPC-Si TFT. When the off-state bias annealing was applied on the SPC-Si TFT, the electron carriers were trapped in the gate insulator by high gate-drain voltage (25V). The trapped electron carriers could reduce the gate-drain field, so that the leakage current of SPC-Si TFT was reduced after off-state bias annealing. We applied AC-bias stress on the gate node of SPC-Si TFT for 20,000 seconds in order to verify that the leakage current of SPC-Si TFT could be remained low at actual AMOLED display circuit after off-state bias annealing. The suppressed leakage current was not altered after AC-bias stress. The off-state bias annealed SPC-Si TFT could be used as pixel element of high quality AMOLED display.
An asymmetric dual gate poly-Si thin film transistors (TFTs), which is consist a long-gate TFT and a short-gate TFT, were fabricated in order to suppress the kink current and increase the reliability. The long-gate TFT operates in a linear regime and limits the total current flow by its current operation region. The asymmetric dual-gate does not exhibit from the kink current in a high drain bias due to the distribution of lateral electric field. The asymmetric dual-gate structure improves kink-free characteristics compared with conventional single and dual-gate TFTs. The hot-carrier stress reliability is successfully improved due to kink current suppression.
The nc-Si films where the troublesome incubation layer was almost eliminated were deposited by inductively coupled plasma chemical vapor deposition (ICP-CVD) under various dilution conditions. The nc-Si films were analyzed with cross-sectional high resolution transmission electron microscopy (HR-TEM) images. It was verified that the Si crystalline components formed and grew from the surface of buffer layer. The grain size of 20~50nm was measured. The absence of incubation layer in nc-Si film may be attributed mainly to ICP-CVD which generates remote plasma of high density, the role of hydrogen, and the dilution effect on the growth of crystalline. Our experimental results show that incubation-free nc-Si film deposited by ICP-CVD may be suitable for the active layer of bottom gate nc-Si TFTs as well as top gate nc-Si TFTs.
We have proposed low hydrogen concentration (CH) silicon nitride (SiNX) as a dielectric for flexible display application. The fabrication temperature on plastic substrate is limited below Tg (glass transition temperature, typically 130˜180 °C) and it was reported that CH in thin film is strongly depends on fabrication temperature. As the fabrication temperature is decreasing, hydrogen concentration is increasing. SiNX deposited in ultra low temperature (< 150 °C) has high CH which is porous, low density. Our experimental results using SiH4, He, N2 gas mixture shows that in the SiNX CH is less than 15 at.%. Breakdown voltage of proposed SiNX dielectric is 5 MV/cm. In the wet etch rate test using a nitride etching solution, He dilution is more dense than NH3 dilution. This process approach is useful for flexible display application.
A new post annealing method employing excimer laser pulses is proposed to improve the transfer characteristics and the breakdown voltage of the unpassivated AlGaN/GaN heterostructure field-effect transistor (HFET) and the passivated one. The XeCl excimer laser pulses with wavelength of 308 nm anneal the AlGaN/GaN HFET after the Schottky gate metallization. The interface defects between the Schottky gate metal and a GaN layer is decreased by the lateral heat diffusion of the laser pulses. Our experimental results show that the drain current and the maximum transconductance of the unpassivated AlGaN/GaN HFET after laser pulses annealing are 496 mA/mm and 134 mS/mm while a virgin device shows 434 mA/mm and 113 mS/mm, respectively. The proposed method anneals effectively the SiO2 passivated AlGaN/GaN HFET and the leakage current of the passivated device is decreased from 483 nA to 29 nA.
Nanocrystalline silicon (nc-Si) films were deposited by inductively coupled plasma chemical vapor deposition (ICP-CVD) at 150°C. ICP power was 400W. The process gas was SiH4 diluted with He as well as H2. The flow rate of He, H2 and He/H2 mixture was varied from 20sccm to 60sccm and that of SiH4 was 3sccm. X-ray diffraction (XRD) patterns of the nc-Si films were measured. From the XRD results of nc-Si films deposited by ICP-CVD, the properties of Si film deposited under each condition were studied. As the dilution ratio increases and He/H2 mixture was used as a dilution gas, intensities of <111>and<220> peaks were increased and the incubation layer was thin. These results were explained in the point of role of H2 plasma and He plasma in the nc-Si deposition process. Our experimental results show that nc-Si film deposited by ICP-CVD may be suitable for an active layer of nc-Si TFTs.
Cu/C films were prepared at room temperature under Cu(hfac)2-Ar-H2 atmosphere in order to obtain metallized polymer by using ECR-MOCVD (Electron Cyclotron Resonance Metal Organic Chemical Vapor Deposition) coupled with periodic DC bias system. Room temperature MOCVD was possible when periodic negative voltage was applied on the polymer substrate. The periodic negative voltage induces ions and radicals to have nucleation reaction on the surface of the substrate. Formation of Cu/C films strongly depends on the periodic negative pattern of DC bias and the electric sheet resistance of the films was controlled from 108 to 100ohm/sq ranges by process parameters such as microwave power and magnet current. The increase in microwave power and magnet current brought on copper-rich film formation with low electric resistance. On the other hand carbon-rich films with high sheet electric resistance were prepared with decreased values for process parameters aforementioned.
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