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1.
J Am Chem Soc ; 141(48): 19130-19137, 2019 Dec 04.
Artigo em Inglês | MEDLINE | ID: mdl-31697089

RESUMO

Dirac and Weyl semimetals host exotic quasiparticles with unconventional transport properties, such as high magnetoresistance and carrier mobility. Recent years have witnessed a huge number of newly predicted topological semimetals from existing databases; however, experimental verification often lags behind such predictions. Common reasons are synthetic difficulties or the stability of predicted phases. Here, we report the synthesis of the type-II Dirac semimetal Ir2In8S, an air-stable compound with a new structure type. This material has two Dirac crossings in its electronic structure along the Γ-Z direction of the Brillouin zone. We further show that Ir2In8S has a high electron carrier mobility of ∼10 000 cm2/(V s) at 1.8 K and a large, nonsaturating transverse magnetoresistance of ∼6000% at 3.34 K in a 14 T applied field. Shubnikov de-Haas oscillations reveal several small Fermi pockets and the possibility of a nontrivial Berry phase. With its facile crystal growth, novel structure type, and striking electronic structure, Ir2In8S introduces a new material system to study topological semimetals and enable advances in the field of topological materials.

2.
Phys Rev Lett ; 110(17): 177001, 2013 Apr 26.
Artigo em Inglês | MEDLINE | ID: mdl-23679759

RESUMO

Magnetization noncollinearity in ferromagnet-superconductor (F/S) heterostructures is expected to enhance the superconducting transition temperature (T(c)) according to the domain-wall superconductivity theory, or to suppress T(c) when spin-triplet Cooper pairs are explicitly considered. We study the proximity effect in F/S structures where the F layer is a Sm-Co/Py exchange-spring bilayer and the S layer is Nb. The exchange-spring contains a single, controllable and quantifiable domain wall in the Py layer. We observe an enhancement of superconductivity that is nonmonotonic as the Py domain wall is increasingly twisted via rotating a magnetic field, different from theoretical predictions. We have excluded magnetic fields and vortex motion as the source of the nonmonotonic behavior. This unanticipated proximity behavior suggests that new physics is yet to be captured in the theoretical treatments of F/S systems containing noncollinear magnetization.

3.
Eur Rev Med Pharmacol Sci ; 26(16): 5786-5792, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-36066153

RESUMO

OBJECTIVE: Rehabilitation of disabled children with autism has become a challenge for current rehabilitation centres. This study conducted psychological investigations on disabled children and analysed the symptoms and characteristics of autism in these children to develop more reasonable rehabilitation treatment plans that would help the children receive psychological counselling and effective rehabilitation. SUBJECTS AND METHODS: This study investigated 107 disabled children from the Disabled Rehabilitation Research Centre of the South China Minority Autonomous Region. Using the PEP-3 scale as a research tool, a questionnaire was developed to investigate and collect data on the mental health of disabled children. The survey was conducted from 2017 to 2021, and 107 children's mental health data were collected in the form of questionnaires based on PEP-3 evaluation indicators. After cleaning the data, the questionnaire data were screened and processed. Descriptive statistical and correlation analysis tools were used for model analysis to understand the overall data distribution and the potential relationships among various data variables. RESULTS: The results of correlation analysis showed that cognition, language expression, language understanding, emotion, and social interaction in the subtest of developmental behaviour were the main indicators of the degree of autism in children. These indicators had a strong and significant correlation with the comprehensive score. Moreover, these indicators had a significant correlation with the individual self-care and adaptive behaviours reported by the children's caregivers. Small muscles, big muscles, and imitation (vision and movement) indicators had a significant correlation with problematic behaviours and physical fitness, and language and cognitive indicators also had a strong correlation with emotion and social interaction. CONCLUSIONS: Emphasis should be placed on the improvement of the language and cognitive abilities of disabled children with autism, and corresponding rehabilitation plans, and training can be formulated according to children with different degrees of illness to get a better rehabilitation outcome. Further, identification of key indicators of autism will be of help in aiding the development of rehabilitation treatment for disabled children with autism and formulation of long-term rehabilitation plans.


Assuntos
Transtorno Autístico , Crianças com Deficiência , Adaptação Psicológica , Cuidadores , Criança , Humanos , Inquéritos e Questionários
4.
Phys Rev Lett ; 106(15): 156807, 2011 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-21568598

RESUMO

Using ballistic-electron-emission spectroscopy (BEES), we directly determined the energy barrier for electron injection at clean interfaces of Alq(3) with Al and Fe to be 2.1 and 2.2 eV, respectively. We quantitatively modeled the sub-barrier BEES spectra with an accumulated space charge layer, and found that the transport of nonballistic electrons is consistent with random hopping over the injection barrier.

5.
Sci Adv ; 6(51)2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33355145

RESUMO

Identification, understanding, and manipulation of novel magnetic textures are essential for the discovery of new quantum materials for future spin-based electronic devices. In particular, materials that manifest a large response to external stimuli such as a magnetic field are subject to intense investigation. Here, we study the kagome-net magnet YMn6Sn6 by magnetometry, transport, and neutron diffraction measurements combined with first-principles calculations. We identify a number of nontrivial magnetic phases, explain their microscopic nature, and demonstrate that one of them hosts a large topological Hall effect (THE). We propose a previously unidentified fluctuation-driven mechanism, which leads to the THE at elevated temperatures. This interesting physics comes from parametrically frustrated interplanar exchange interactions that trigger strong magnetic fluctuations. Our results pave a path to chiral spin textures, promising for novel spintronics.

6.
Science ; 261(5126): 1316-9, 1993 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-17731862

RESUMO

Arrays of ferromagnetic nickel and cobalt nanowires have been fabricated by electrochemical deposition of the metals into templates with nanometer-sized pores prepared by nuclear track etching. These systems display distinctive characteristics because of their one-dimensional microstructure. The preferred magnetization direction is perpendicular to the film plane. Enhanced coercivities as high as 680 oersteds and remnant magnetization up to 90 percent have also been observed.

7.
Sci Adv ; 5(8): eaaw3415, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31497642

RESUMO

Topological surface states (TSSs) in a topological insulator are expected to be able to produce a spin-orbit torque that can switch a neighboring ferromagnet. This effect may be absent if the ferromagnet is conductive because it can completely suppress the TSSs, but it should be present if the ferromagnet is insulating. This study reports TSS-induced switching in a bilayer consisting of a topological insulator Bi2Se3 and an insulating ferromagnet BaFe12O19. A charge current in Bi2Se3 can switch the magnetization in BaFe12O19 up and down. When the magnetization is switched by a field, a current in Bi2Se3 can reduce the switching field by ~4000 Oe. The switching efficiency at 3 K is 300 times higher than at room temperature; it is ~30 times higher than in Pt/BaFe12O19. These strong effects originate from the presence of more pronounced TSSs at low temperatures due to enhanced surface conductivity and reduced bulk conductivity.

8.
Nat Commun ; 9(1): 3280, 2018 08 16.
Artigo em Inglês | MEDLINE | ID: mdl-30115927

RESUMO

An ordinary Hall effect in a conductor arises due to the Lorentz force acting on the charge carriers. In ferromagnets, an additional contribution to the Hall effect, the anomalous Hall effect (AHE), appears proportional to the magnetization. While the AHE is not seen in a collinear antiferromagnet, with zero net magnetization, recently it has been shown that an intrinsic AHE can be non-zero in non-collinear antiferromagnets as well as in topological materials hosting Weyl nodes near the Fermi energy. Here we report a large anomalous Hall effect with Hall conductivity of 27 Ω-1 cm-1 in a chiral-lattice antiferromagnet, CoNb3S6 consisting of a small intrinsic ferromagnetic component (≈0.0013 µB per Co) along c-axis. This small moment alone cannot explain the observed size of the AHE. We attribute the AHE to either formation of a complex magnetic texture or the combined effect of the small intrinsic moment on the electronic band structure.

9.
Eur Rev Med Pharmacol Sci ; 22(20): 6991-6998, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30402866

RESUMO

OBJECTIVE: To investigate the possible role of hox transcript antisense intergenic RNA (HOTAIR) in the pathogenesis of atherosclerosis and its underlying mechanism. PATIENTS AND METHODS: The expression of HOTAIR in peripheral blood lymphocytes of atherosclerosis (AS) and healthy controls was detected by quantitative Real-time-polymerase chain reaction (qRT-PCR). In vitro AS model was established by ox-LDL induction in Raw264.7 cells. Viability of Raw264.7 cells after ox-LDL induction was detected by cell counting kit-8 (CCK-8) assay. Levels of TC (total cholesterol), TG (triglyceride), LDL-C (low density lipoprotein cholesterol) and HDL-C (high density lipoprotein cholesterol) in Raw264.7 cells were detected by enzyme-linked immunosorbent assay (ELISA). Overexpression plasmid of HOTAIR was constructed. Levels of TG, TC, LDL-C, and HDL were detected again after HOTAIR overexpression by ELISA. CD68+ cells and CD168+ cells in Raw264.7 cells were detected by flow cytometry. Protein expressions of pro-inflammatory and anti-inflammatory genes were detected by Western blot. Lipid metabolism in Raw264.7 cells was evaluated by oil red O staining and Western blot, respectively. Finally, rescue experiments were conducted to explore the specific mechanism of HOTAIR in regulating AS development. RESULTS: HOTAIR was lowly expressed in peripheral blood lymphocytes of AS patients and Raw264.7 cells induced by ox-LDL. Overexpression of HOTAIR upregulated adipose genes (PPARα and CPT-1) and downregulated lipogenesis genes (SREBP-1c and ACS). Besides, overexpression of HOTAIR decreased expressions of pro-inflammatory cytokines (TNF-α and IL-1ß), but increased expressions of anti-inflammatory cytokines (IL-4 and IL-10). In the in vitro AS model, FXR1 was remarkably downregulated in Raw264.7 cells. HOTAIR reduced inflammatory response via promoting FXR1 expression in Raw264.7 cells. Rescue experiments showed that the effect of HOTAIR on nuclear factor-kappa B (NF-κB) pathway was reversed by FXR1 knockdown. CONCLUSIONS: We found that TAIR was lowly expressed in AS patients. Overexpression of HOTAIR can reduce the lipid accumulation and inhibit inflammatory response by suppressing FXR1 via NF-κB pathway.


Assuntos
Aterosclerose/patologia , Citocinas/metabolismo , Lipoproteínas LDL/metabolismo , RNA Longo não Codificante/genética , Animais , Aterosclerose/sangue , Regulação para Baixo , Humanos , Interleucina-1beta/metabolismo , Metabolismo dos Lipídeos , Camundongos , NF-kappa B/metabolismo , Células RAW 264.7 , Proteínas de Ligação a RNA/genética , Fator de Necrose Tumoral alfa/metabolismo , Regulação para Cima
10.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi ; 30(15): 1224-1226, 2016 Aug 05.
Artigo em Zh | MEDLINE | ID: mdl-29798334

RESUMO

Objective:The aim of this study is to discuss the influence on the peeling off time of the tunica albuginea after 4-8℃ cool water was applied to children 's low temperature plasmaassisted tonsillectomy.Method:One hundred and seventeen benign hypertrophy of tonsil patients were recruited,the 56 cases of them were served as experimental group,who were treated with plasma tonsillectomy using 4-8℃ normal saline as medium,while the 61 cases were served as control group,who were treated with plasma tonsillectomy using 22-25℃ normal saline as medium.Then,we analyzed the peeling off time of the tunica albuginea between experimental and control group.Result:The difference of formation time between experimental group and control group was not statistically significant(P >0.05).The average peeling off time of the tunica albuginea was (11.32±2.51) days in experimental group,while time was(15.03±4.12) days in control group.There was a statistical difference between them.Conclusion:The use of 4-8℃ cold water in children's low temperature plasma-assisted tonsillectomy can reduce the peeling off time of the tunica albuginea,and it indicate that the ice water medium can reduce the heat injury caused by the plasma operation.


Assuntos
Temperatura Baixa , Tonsilectomia/métodos , Criança , Humanos , Tonsila Palatina , Temperatura , Água
11.
Nat Commun ; 7: 12688, 2016 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-27581060

RESUMO

As an in-plane charge current flows in a heavy metal film with spin-orbit coupling, it produces a torque on and thereby switches the magnetization in a neighbouring ferromagnetic metal film. Such spin-orbit torque (SOT)-induced switching has been studied extensively in recent years and has shown higher efficiency than switching using conventional spin-transfer torque. Here we report the SOT-assisted switching in heavy metal/magnetic insulator systems. The experiments used a Pt/BaFe12O19 bilayer where the BaFe12O19 layer exhibits perpendicular magnetic anisotropy. As a charge current is passed through the Pt film, it produces a SOT that can control the up and down states of the remnant magnetization in the BaFe12O19 film when the film is magnetized by an in-plane magnetic field. It can reduce or increase the switching field of the BaFe12O19 film by as much as about 500 Oe when the film is switched with an out-of-plane field.

12.
J Mol Biol ; 243(1): 100-15, 1994 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-7932732

RESUMO

Solvation in macromolecular crystal structures was studied by analyzing X-ray diffraction data of two proteins, penicillopepsin and neuraminidase. The quality of several solvent models was assessed by complete cross-validation in order to prevent overfitting the diffraction data. Radial solvent distribution functions were computed from electron density maps using phases obtained from multiple isomorphous replacement and from the protein's atomic model combined with the best solvent model. Distribution functions were computed around hydrophilic and hydrophobic groups on the protein's surface. Averaging of the distribution functions was performed in order to reduce the influence of noise. The first solvation shell is characterized by a peak in the average distribution functions. At 1.8 A resolution, polar groups show a sharp peak while non-polar groups show a broad one. The distinction between hydrophobic and hydrophilic solvation sites is lost when using lower resolution (2.8 A) diffraction data. Higher-order solvation shells are not observed in the average distribution functions. We hope that site-specific radial distribution functions obtained from high-quality diffraction data will produce a picture of macromolecular solvation consistent with available experimental data and computational results.


Assuntos
Ácido Aspártico Endopeptidases/química , Modelos Químicos , Neuraminidase/química , Solventes/química , Algoritmos , Cristalografia por Raios X , Substâncias Macromoleculares , Água/química
13.
J Mol Biol ; 227(1): 253-64, 1992 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-1522589

RESUMO

The crystal structure of a chimeric Fab' fragment of a monoclonal antibody is presented. The Fab' comprises the murine light chain and heavy chain variable domains of the carcinoma-binding antibody B72.3 fused to the constant domain of human kappa, and the first constant domain and hinge domain of human gamma 4, respectively. A model for the Fab' has been determined by molecular replacement and refined to a resolution of 3.1 A with an R-factor of 17.6%. The additional residues that distinguish a Fab' from a Fab fragment are seen to be disordered in the crystals. The H3 hypervariable loop is short and adopts a sharp hairpin turn in a conformation that results from an interaction between the lysine side-chain of H93 and the main-chain carbonyl group of H96. The remaining hypervariable loops display conformations similar to those predicted from the canonical structures approach, although loop H2 is apparently displaced by a salt-bridge formed between H55 Asp and the neighbouring H73 Lys. These and other features of the structure likely to be important in grafting the hypervariable loops to an otherwise human framework are discussed.


Assuntos
Anticorpos Antineoplásicos/ultraestrutura , Fragmentos Fab das Imunoglobulinas/ultraestrutura , Sequência de Aminoácidos , Animais , Anticorpos Monoclonais/ultraestrutura , Carcinoma/imunologia , Cristalografia , Humanos , Camundongos , Dados de Sequência Molecular , Aceleradores de Partículas , Conformação Proteica , Proteínas Recombinantes de Fusão/ultraestrutura
14.
J Infect ; 48(1): 23-31, 2004 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-14667789

RESUMO

OBJECTIVES: To describe the clinical characteristics and outcomes of patients with severe acute respiratory syndrome (SARS). METHODS: Between March 28 and June 30 '2003, 29 patients with probable SARS seen at Shin Kong Wu Ho-Su Memorial Hospital, Taipei, were analysed. RESULTS: Presenting symptoms included fever (100%), cough (69.0%), chills or rigor (62.1%), and shortness of breath (41.4%). Mean days to defervescence were 6.8+/-2.9 days, but fever recurred in 15 patients (51.7%) at 10.9+/-3.4 days. Common laboratory features included lymphopenia (72.4%), thrombocytopenia (34.5%) and elevated C-reactive protein (CRP), lactate dehydrogenase (LDH), and aspartate aminotransferase (AST) (93.1, 62.1, 44.8%, respectively). All patients except one had initial abnormal chest radiographs and 20 (69.0%) had radiological worsening at 7.5+/-2.6 days. Nine patients (31.0%) subsequently required mechanical ventilation with four deaths (13.8%). Most patients with clinical deterioration responded to pulse corticosteroid therapy (14 out of 17) but six complicated with nosocomial infections. The risk factors associated with severe disease were presence of diarrhoea, high peak LDH and CRP, high AST and creatine kinase on admission and high peak values. CONCLUSIONS: Prudent corticosteroid use, vigilant microbiological surveillance and appropriate antibiotics coverage are the key to successful treatment.


Assuntos
Síndrome Respiratória Aguda Grave/epidemiologia , Corticosteroides/uso terapêutico , Adulto , Antibacterianos/uso terapêutico , Distribuição de Qui-Quadrado , Surtos de Doenças , Feminino , Humanos , Masculino , Radiografia Torácica , Fatores de Risco , Síndrome Respiratória Aguda Grave/complicações , Síndrome Respiratória Aguda Grave/diagnóstico por imagem , Síndrome Respiratória Aguda Grave/terapia , Estatísticas não Paramétricas , Taiwan/epidemiologia
15.
J Formos Med Assoc ; 99(9): 689-92, 2000 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-11000731

RESUMO

BACKGROUND AND PURPOSE: Self-extubation is a potentially life-threatening event, but may also provide an opportunity to wean patients who should have been extubated earlier. The purpose of this study was to determine the risk factors for re-intubation after self-extubation. METHODS: The medical charts of 69 self-extubated patients treated in Shin Kong Hospital, Taipei, from September 1996 through August 1998 were reviewed. Demographic data, ventilator settings before self-extubation, arterial blood gas values, and the type of respiratory management used after self-extubation were examined to determine their association with re-intubation. RESULTS: Of the 69 self-extubated patients, 38 fared well without further ventilatory support after self-extubation. Four factors were associated with extubation outcome: 1) mean pre-extubation FiO2 (fraction of inspired oxygen), which was significantly higher in the re-intubated group (RI) than in the not re-intubated group (NRI) (0.48 vs 0.33, p = 0.002)--all self-extubated patients receiving an FiO2 of more than 0.40 were re-intubated; 2) PaO2/FiO2 (ratio of arterial oxygen tension to inspired oxygen concentration), which was lower in the RI group than in the NRI group (259.4 vs 346.4, p = 0.005); 3) requirement for assist/control ventilatory mode--patients needing this type of ventilatory support had a greater likelihood of reintubation than those requiring partial ventilatory support (odds ratio [OR], 3.790; confidence interval [CI], 1.055-13.621; p = 0.041); and 4) female sex (OR 0.188; CI 0.048-0.732; p = 0.016). CONCLUSIONS: About half of self-extubated patients may not require re-intubation. Pre-extubation FiO2, PaO2/FiO2, and ventilator mode, as well as gender, may be useful in determining the likelihood that a self-extubated patient will require re-intubation.


Assuntos
Intubação Intratraqueal/efeitos adversos , Respiração Artificial , Respiração , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Sexuais
16.
J Formos Med Assoc ; 98(1): 39-44, 1999 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-10063272

RESUMO

In this study, we investigated the modulatory effects of different types of blood cells on hypoxic pulmonary vasoconstrictive (HPV) response and nitric oxide (NO) release in isolated rat lungs. The lungs were perfused at a constant flow with physiologic saline solution (PSS). The changes in pulmonary arterial pressure (PAP) and NO release were observed. Two hypoxic challenges with a 5% CO2-95% N2 gas mixture were carried out in each experiment. Hypoxia induced pulmonary vasoconstriction, as reflected by an increase in PAP (0.88 +/- 0.22 cmH2O). At the same time, NO (342.9 +/- 78.3 mv) release from the lungs was also increased. Addition of white blood cells (WBCs, 0.70 to 0.88 x 10(5)/mL), platelets (1.48 to 1.96 x 10(5)/mL), or red blood cells (RBCs, 4.6 to 6.6 x 10(5)/mL) into the perfusate produced different effects on PAP and NO changes. WBCs decreased the pulmonary vasoconstriction response and this was accompanied by an increase in NO release. Platelets had no significant effects on either PAP or NO. RBCs significantly potentiated the PAP increase and attenuated the NO release. The results indicate that NO release during hypoxia tends to offset pulmonary vasoconstriction and that NO release and HPV response are modulated by different cell elements.


Assuntos
Células Sanguíneas/fisiologia , Hipóxia/fisiopatologia , Pulmão/metabolismo , Óxido Nítrico/metabolismo , Circulação Pulmonar/fisiologia , Vasoconstrição/fisiologia , Animais , Hipóxia/metabolismo , Masculino , Ratos , Ratos Sprague-Dawley
17.
Zhonghua Zhong Liu Za Zhi ; 9(5): 368-71, 1987 Sep.
Artigo em Zh | MEDLINE | ID: mdl-2838239

RESUMO

118 specimens of rectal cancer were studied pathologically. 40 cases were treated by both preoperative radiotherapy and intracavitary hyperthermia (group 1), 38 treated by preoperative radiotherapy alone (group 2) and 40 by operation alone (group 3). The tumor disappearance rates by gross observation were 57.5% and 5.3% in groups 1 and 2 (P less than 0.001). The moderate to severe damage of cancer cells (X2-X4) was observed in 90% of cases in group 1 and 31.6% in group 2 (P less than 0.05). In the former, the cancer cell disappearance was observed in 8 cases, while in the latter, only 1 case. The cell degenerations by 30 Gy plus hyperthermia were similar to those by 40 Gy plus hyperthermia, but both were more marked than by 30 Gy alone or 40 Gy alone (P less than 0.05). The lymphocyte, plasma cell infiltration and hyperplasia of fibrous tissue around the tumor in group 1 were more marked than those in groups 2 and 3 (P less than 0.05). The thrombosis around the tumor was more in group 1 than in group 2 (P less than 0.01). Every histological type of the tumor was sensitive to radiotherapy combined with hyperthermia. The lymph node metastatic rates were 35% in group 1 and 31.6% in group 2, both being lower than that in group 3 (52.5%). Immune function of the lymph nodes and the damage of the normal tissues around the tumor are observed. It has been clinically confirmed that neither resection rate is influenced nor postoperative complications are increased by preoperative radiotherapy combined with hyperthermia.


Assuntos
Adenocarcinoma Mucinoso/terapia , Carcinoma Intraductal não Infiltrante/terapia , Radioterapia de Alta Energia , Neoplasias Retais/terapia , Adulto , Idoso , Terapia Combinada , Diatermia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cuidados Pré-Operatórios , Prognóstico
18.
J Phys Condens Matter ; 26(6): 064214, 2014 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-24469386

RESUMO

The development of the optimal exchange-spring permanent magnet balances exchange hardening, magnetization enhancement, and the feasibility of scalable fabrication. These requirements can be met with a rational design of the microstructural characteristics. The magnetization processes in several model exchange-spring structures with different geometries have been analyzed with both micromagnetic simulations and nucleation theory. The multilayer geometry and the soft-cylinders-in-hard-matrix geometry have the highest achievable figure of merit (BH)max, while the soft-spheres-in-hard-matrix geometry has the lowest upper limit for (BH)max. The cylindrical geometry permits the soft phase to be larger and does not require strict size control. Exchange-spring permanent magnets based on the cylindrical geometry may be amenable to scaled-up fabrication.


Assuntos
Imãs , Estudos de Viabilidade , Fenômenos Magnéticos , Modelos Teóricos
20.
Respirology ; 4(2): 161-5, 1999 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-10382235

RESUMO

Extubation failure is significantly associated with increased morbidity and mortality in mechanically ventilated patients. In respiratory distress after extubation, non-invasive positive pressure ventilation (NIPPV) has been suggested to avoid the complications of invasive mechanical ventilation. The purpose of this study was to evaluate the effect of early application of NIPPV on extubation outcome. We conducted a prospective study in 93 extubated patients with a mean age of 72.7 +/- 14.7 years (range, 24-93). Elective extubation was performed in 56 patients and unplanned extubation occurred in 37 patients. After extubation, patients randomly received either biphasic positive airway pressure (BIPAP) therapy (n = 47) or unassisted oxygen therapy (n = 46). Non-invasive positive pressure ventilation was delivered via face mask in BIPAP group. Of the 93 extubated patients, 73 (78.5%) were successfully extubated, and 20 (21.5%) had to be re-intubated. There were no significant differences in age, sex, pre-extubation blood gas data between re-intubated patients and those who were not re-intubated. While seven of the 46 patients in the unassisted oxygen therapy group required re-intubation, 13 of the 47 BIPAP-treated patients also required re-intubation. This difference was not statistically significant. The postextubation respiratory management, BIPAP or unassisted oxygen therapy, did not correlate with the extubation outcome, but the elective extubation had significantly better outcome than unplanned extubation. Patients with excessive bronchial secretions and intolerance to the equipment are poor candidates for NIPPV. We conclude that early application of BIPAP support did not predict a favourable extubation outcome. Our experience did not support the indiscriminate use of NIPPV to facilitate ventilator weaning.


Assuntos
Ventilação com Pressão Positiva Intermitente/métodos , Insuficiência Respiratória/terapia , Desmame do Respirador/métodos , Doença Aguda , Adulto , Idoso , Idoso de 80 Anos ou mais , Gasometria , Feminino , Humanos , Ventilação com Pressão Positiva Intermitente/instrumentação , Máscaras Laríngeas , Masculino , Pessoa de Meia-Idade , Oxigenoterapia/métodos , Fatores Desencadeantes , Estudos Prospectivos , Insuficiência Respiratória/etiologia , Insuficiência Respiratória/metabolismo , Insuficiência Respiratória/fisiopatologia , Fatores de Tempo , Resultado do Tratamento , Desmame do Respirador/efeitos adversos
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