bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of test frequency on fatigue strength of low carbon steel
Authors: TSUTSUMI N. , MURAKAMI Y. , DOQUET V. 
Published: April 2009

ABSTRACTUltrasonic fatigue tests (test frequency: 20 kHz) and conventional tension–compression fatigue tests (10 Hz) have been conducted on annealed and 10% pre‐strained specimens of 0.13% carbon steel. Small holes were introduced on the specimen surface to investigate the effect of test frequency on small crack growth. The dynamic stress concentration factor and the stress intensity factor under ultrasonic fatigue tests were checked to be almost the same as those of conventional tension–compression fatigue tests. However, the fatigue properties were dependent on the test frequency. Ultrasonic fatigue tests showed longer fatigue life and lower fatigue crack growth rate for the annealed and 10% pre‐strained specimens. Slip bands were scarce in the neighbourhood of cracks under ultrasonic fatigue tests, while many slip bands were observed in a wide area around the crack under conventional fatigue tests. In order to explain the effect of test frequency on fatigue strength, dynamic compression tests with Split Hopkinson bars were carried out. The stress level increases substantially with the strain rate. Thus, the increase in fatigue strength might be, to a large extent, due to a reduction in crack tip cyclic plasticity during ultrasonic fatigue tests.
About cracks, dunce caps and a new way to stop cracks
Authors: MATTHECK C. , BETHGE K. , SAUER A. , SÖRENSEN J. , WISSNER C. , KRAFT O. 
Published: April 2009

ABSTRACTRecently, the ‘method of tensile triangles’ has been introduced for optimizing the shape of notches by adding material at overloaded regions but also to remove unloaded material from an oversized design proposal.In this work, we apply the method to demonstrate that the unloaded region in the vicinity of a crack has the shape of spindle‐shaped hole, which looks like two dunce caps mirrored at the crack line. Also, these shapes can be predicted by the ‘method of tensile triangles’ without any FEM‐effort. Furthermore, we show a new way to stop cracks by deviating the crack tip into a shape‐optimized pattern leading to a compressive stress that closes the crack tip. This procedure is now used in chemical engineering.
Modified perineal stapled rectal resection with contour transtar for full‐thickness rectal prolapse
Authors: Romano G. , Bianco F. , Caggiano L. 
Published: April 2009

AbstractObjective  We report a modified technique of perineal proctectomy using a new reloadable curved cutter stapler, the Contour® TranstarTM (Ethicon Endo‐Surgery), to treat full‐thickness external rectal prolapse.Method  Between May and July 2008 three female patients were treated. All had a full‐thickness external rectal prolapse up to 10 cm in length. The prolapse was initially divided by a linear cutter in anterior and posterior flaps, and resection of the prolapse was performed with a Contour Transtar stapler.Results  There was no mortality or early or late morbidity. Follow‐up was 2–4 months. All patients had a bowel movement within 3 days of the operation, oral feeding started immediately and the hospital stay was 5 days in all cases. All patients reported an improvement of constipation and continence.Conclusion  Our procedure may be indicated for full‐thickness prolapse with a rectal protrusion up to 10 cm, as it allows a simple resection without any mobilization or dissection of the rectum. The technique is safe, easier and faster to perform than conventional perineal rectosigmoidectomy.
Transanal haemorrhoidal artery echodoppler ligation and anopexy (THD) is effective for II and III degree haemorrhoids: a prospective multicentric study
Authors: Infantino A. , Bellomo R. , Dal Monte P. P. , Salafia C. , Tagariello C. , Tonizzo C. A. , Spazzafumo L. , Romano G. , Altomare D. F. 
Published: April 2009

AbstractAim  We report a multicentric prospective study which aimed to evaluate Doppler‐assisted ligation of the terminal haemorrhoidal arteries (THD) for II and III degree haemorrhoids.Method  A total of 112 patients from five colorectal units, including 81 men, mean age 48 ± 13 years, with II degree (39) and III degree (73) haemorrhoids were treated by Doppler‐guided transanal de‐arterialization and anopexy using a new device (THD).Results  The mean operative time was 33.9 ± 8.8 minutes, and the mean number of ligatures applied was 7.2 ± 1.5. Postoperatively, 72% of patients did not need analgesics and the other 28% used nonsteroidal anti‐inflammatory drugs 1–3 times/day for less than 2 days. All the patients were operated as a day case. Early postoperative complications included haemorrhoidal thrombosis (2 patients), bleeding (1) treated by haemostatic suture, dysuria (6) and acute urinary retention (1). After a mean follow‐up of 15.6 ± 6.5 months (range 6–32), 2/105 (20.9%) patients complained of minor bleeding, while mild pain was still present in 4/51 patients (7.8%). There were no statistically significant differences in the sample population regarding the gender or stage of the disease. Tenesmus was cured in 15/17 patients, dyschaezia in 20/22 patients and mucous soiling in 10/10 patients. No new cases of altered defaecation or faecal incontinence were recorded. Overall, 85.7% of patients were cured and 7.1% improved. Residual haemorrhoids were treated by elastic band ligation in nine (8%) patients and by surgical excision in further five patients (4.5%).Conclusion  Doppler‐assisted ligation of the terminal branches of the haemorrhoidal arteries for II and III degree haemorrhoids is highly effective and painless. Complications are few and the technique can be performed as a day case.
Cetuximab‐based therapy vs noncetuximab therapy in advanced or metastatic colorectal cancer: a meta‐analysis of seven randomized controlled trials
Authors: Liu L. , Cao Y. , Tan A. , Liao C. , Mo Z. , Gao F. 
Published: April 2009

AbstractPurpose  A meta‐analysis was performed to assess the efficacy and safety of cetuximab‐based therapy vs noncetuximab therapy in advanced or metastatic colorectal cancer.Method  A total of 4617 patients from seven randomized controlled trials were available for analysis, with 2305 patients in the cetuximab group and 2312 patients in the noncetuximab group. The efficacy data included progression‐free survival (PFS), overall survival (OS) and overall response rate (ORR). The safety data that contained overall grade 3 and 4 adverse events (AEs), specific grade 3 and 4 toxicity such as acneiform rash, cetuximab‐related skin toxicity, diarrhoea, fatigue, neutropenia, hypertension, nausea and hand–foot skin reaction are evaluated.Result  There was a significant PFS benefit in favour of cetuximab‐based therapy (HR = 0.68, 95%CI: 0.63 to 0.73) and OS benefit (HR = 0.90, 95%CI: 0.81 to 1.00). The ORR was significantly higher in the cetuximab‐based arm (OR = 2.19, 95% CI: 1.30 to 3.68). The incidence of overall grade 3–4 toxicity was significantly higher in the cetuximab arm compared with the noncetuximab arm (61.2%vs 43.0%, OR = 2.32, 95%CI: 1.59–3.39). This difference was mainly attributed to cetuximab‐related skin toxicity (OR = 5.86, 95%CI: 1.38–24.88), especially acneiform rash (OR = 51.37, 95%CI: 22.75–116.02). In addition, cetuximab resulted in a significant increase in grade 3 and 4 diarrhoea, fatigue and neutropenia, except for hypertension, nausea and hand–foot skin reaction.Conclusion  Cetuximab‐based therapy improves PFS and OS resulting in better ORR vs noncetuximab therapy. Its most common and severe AE is skin toxicity that should be predictable and manageable.
Successful switch from insulin therapy to treatment with pioglitazone in type 2 diabetes patients with residual β‐cell function: results from the PioSwitch Study
Authors: Hohberg C. , Pfützner A. , Forst T. , Lübben G. , Karagiannis E. , Borchert M. , Schöndorf T. 
Published: April 2009

Aim:  Insulin treatment is considered to be the final option for patients with progressive type 2 diabetes. This study investigated, whether reconverting type 2 patients from insulin treatment to oral treatment using pioglitazone is possible without deterioration of blood glucose control.Methods:  The PioSwitch study was a prospective, open label, proof of concept study. Thiazolidinedione‐naïve patients with residual β‐cell function were switched from an existing insulin therapy to treatment with pioglitazone and glimepiride for 6 months. Efficacy was assessed by laboratory parameters and scores for evaluation of metabolic control, β‐cell function, insulin resistance and cardiovascular risk.Results:  In total, 98 patients [66 men, 32 women, age (mean ± s.d.): 59 ± 9 years; disease duration: 5.6 ± 3.6 years; Hemoglobin A1c (HbA1c): 6.9 ± 0.8%; body mass index (BMI): 33.9 ± 5.2 kg/m2, initial daily insulin therapy dose: 0.36 ± 0.3 U/kg body weight] out of 117 screened patients were treated. During the observation period, 23 patients were prematurely terminated because of an increase in HbA1c from baseline > 0.5% or other reasons. In 75 patients (76%), no deterioration of glucose metabolism occurred and additional improvements were seen in the majority of the observation parameters [baseline vs. endpoint; HbA1c: 6.79 ± 0.74%/6.66 ± 0.69% (p < 0.05), glucose: 6.4 ± 1.5/5.2 ± 1.4 mmol/l (p < 0.001), adiponectin: 7 ± 3 mg/l/17 ± 8 mg/l (p < 0.001), C‐peptide: 987 ± 493/1756 ± 789 (p < 0.001), sensitivity index derived from the intravenous glucose tolerance test (SI(ivGTT)): 1.21 ± 0.85/1.49 ± 0.95 (p < 0.05), hsCRP: 3.3 ± 2.4/2.6 ± 2.4 mg/l (p < 0.01), macrophage chemo‐attractant protein 1 (MCP1): 487 ± 246/382 ± 295 ng/l (p < 0.05)]. BMI increased from 33.8 ± 5.1 to 34.4 ± 5.3 kg/m2 (p < 0.001).Conclusions:  The switch from insulin therapy resulting in a moderately HbA1c level, to oral treatment with pioglitazone was successful in a majority of patients with sufficient residual β‐cell function. It allows a simple and less expensive therapy with a better cardiovascular risk marker profile.
Reproducibility of hepatic triglyceride content assessment in normals using localized magnetic resonance spectroscopy
Authors: Kullberg J. , Ortiz‐Nieto F. , Johansson L. 
Published: April 2009

Aim:  To investigate the reproducibility of measurements of hepatic triglyceride content (HTGC) in subjects with normal HTGC using localized 1H‐magnetic resonance spectroscopy (1H‐MRS) and a clinical 1.5T scanner.Methods:  The 1H‐MRS acquisition was performed with a common protocol using the whole‐body coil and no respiratory triggering. An upper limit of normal HTGC of 5.56% was used. Duplicate measurements, including subject repositioning, were acquired from 23 subjects, 19 of whom had a normal HTGC.Results:  The mean coefficient of variation (CV) from the duplicate measurements was 14.8% (20.5% before exclusion of a subject who was considered to be an outlier). Mean CVs of subgroups below and above the 1% HTGC limit were 19.8 and 7.0 respectively.Conclusions:  The mean CV calculated in subjects with HTGC in the normal range was found to be higher than CVs of wide range HTGC groups reported in the literature. It is concluded that the reproducibility of HTGC measurements using 1H‐MRS depends on the HTGC range. These findings are of importance in reproducibility studies and in estimations of required study group sizes.
Improvement in quality of life after botulinum toxin‐A injections for idiopathic detrusor overactivity: results from a randomized double‐blind placebo‐controlled trial
Authors: Sahai Arun , Dowson Christopher , Khan Mohammad S. , Dasgupta Prokar 
Published: April 2009

OBJECTIVETo determine whether botulinum toxin‐A (BTX‐A) treatment has an effect on the quality of life (QoL) of patients with overactive bladder (OAB) refractory to anticholinergics.PATIENTS AND METHODSThis was a single centre, randomized, double‐blind, placebo‐controlled trial. Participants were men and women with idiopathic detrusor overactivity (IDO). Participants were randomised to receive either 200 U of BTX‐A (Botox®, Allergan Inc., Irvine, CA, USA; n = 16) or placebo (n = 18) via a trigone‐sparing flexible cystoscopic technique. QoL was assessed using the King’s Health Questionnaire (KHQ) at baseline and at 4 and 12 weeks, after injection. At 12 weeks patients were ‘unblinded’ and a further open‐label follow‐up in the BTX‐A group occurred at 24 weeks. The changes in the subdomains of the KHQ were assessed over the study period.RESULTSOverall QoL was significantly improved in the BTX‐A treated patients compared with placebo in the blinded part of the study. When analysing the KHQ subdomains, ‘Incontinence Impact’, ‘Emotions’, ‘Physical Limitations’, ‘Social Limitations’ and ‘Severity Measures’ were significantly improved in those that received BTX‐A compared with placebo. The ‘Symptom Severity’ domain was also significantly improved at 4 weeks but not at 12 weeks. At 12 weeks ‘Role Limitations’ also became statistically significant in favour of BTX‐A. The open‐label extension study suggested these benefits last for at least 24 weeks.CONCLUSIONSBTX‐A bladder injections at 200 U appear to improve QoL in patients with OAB symptoms and IDO refractory to anticholinergics for at least 24 weeks. As well as the improvement seen in clinical parameters with this form of therapy, perhaps of more importance to the patient, is the improvement in QoL.
Nephrectomy improves survival in patients with invasion of adjacent viscera and absence of nodal metastases (stage T4N0 renal cell carcinoma)
Authors: Capitanio Umberto , Perrotte Paul , Zini Laurent , Jeldres Claudio , Shariat Shahrokh F. , Isbarn Hendrik , Arjane Philippe , Peloquin François , Pharand Daniel , Montorsi Francesco , Karakiewicz Pierre I. 
Published: April 2009

OBJECTIVETo examine the cancer‐specific mortality (CSM) of patients with T4N0–2M0 renal cell carcinoma (RCC) treated with either nephrectomy (RN) or no surgery (NS).PATIENTS AND METHODSOf 43 143 patients with RCC identified in the Surveillance, Epidemiology and End Results database, 310 had tumours involving adjacent organs with no evidence of distant metastases (T4NanyM0) and had RN (246, 79.4%) or NS (64, 20.6%). Kaplan‐Meier analyses, Cox regression and competing‐risks regression models were used to compare the effect of RN vs NS on CSS.RESULTSIn patients with T4N0 disease the median survival benefit associated with RN vs NS was 42 months (48 vs 6 months, P < 0.001). Conversely, the median survival in patients T4N1‐2 was no different between RN and NS (9.3 vs 9.1 months, P = 0.9). Multivariable analyses in T4N0 cases indicated a substantial survival disadvantage for patients having NS vs RN (hazard ratio 4.8, P < 0.001). Conversely, in patients with N1‐2 stages, the CSS was virtually the same for NS and RN (hazard ratio 0.9, P = 0.9). Competing‐risks regression models confirmed the benefit of RC in patients with T4N0 and the lack of benefit in those with T4N1‐2 disease, after controlling for other‐cause mortality.CONCLUSIONOur data suggest a survival benefit in patients with T4N0 RCC treated with RC. By contrast, RN seems to have no effect on survival in patients with evidence of nodal metastases.
Ureteric response to abdominal radiotherapy and metallic double‐pigtail ureteric stents: a pig model
Authors: Liatsikos Evangelos , Kyriazis Iason , Kallidonis Panagiotis , Tsamandas Athanasios , Karnabatidis Dimitrios , Sakellaropoulos Georgios , Flaris Nicolaos , Kalogeropoulou Christina , Filos Kriton , Stolzenburg Jens‐Uwe , Kardamakis Dimitrios 
Published: April 2009

OBJECTIVETo examine the safety and compatibility of full‐length metal ureteric stents with abdominal radiotherapy.MATERIALS AND METHODSFour ureteric stents (ResonanceTM, Cook Urological, Ireland) (RS) and four RSs specially modified to contain thermocouples were placed unilaterally in eight pigs. The contralateral ureters of the same pigs served as their controls, and contained two polymeric ureteric catheters and two similar specially modified to contain thermocouples, while the remaining four control ureters remained intact. All pigs were exposed to abdominal radiotherapy. The dose rate was ≈5.3 Gy/min and a total radiation dose of 10 Gy was administered. Throughout the treatment the temperature was monitored by the RSs and catheters containing the thermocouples. The pigs were killed at 1 day (four), 7 days (two) and 15 days (two) after treatment, and all ureters examined histologically.RESULTSThere was no statistically significant increase in RS and catheter temperature throughout the treatment in any of the treated pigs (P > 0.05). All histological lesions reported were due to radiation treatment. There were no differences in histology between the ureters containing RSs and controls.CONCLUSIONRS usage is unrelated to any increase in stent temperature during abdominal radiotherapy and does not cause any further deterioration in the histology of the ipsilateral ureter, additional to that caused by the initial treatment.
Activation of the mammalian target of rapamycin signalling pathway in prostate cancer and its association with patient clinicopathological characteristics
Authors: Dai Bo , Kong Yun Yi , Ye Ding Wei , Ma Chun Guang , Zhou XiaoYan , Yao Xu Dong 
Published: April 2009

OBJECTIVETo evaluate the activation level of the mammalian target of rapamycin (mTOR) signalling pathway in Chinese patients with prostate cancer, as this pathway is over‐activated in many human cancers and is an attractive target for cancer therapy.PATIENTS AND METHODSWe used immunohistochemistry to investigate the activation level of five important markers of the mTOR pathway, including PTEN, p‐Akt, p‐mTOR, p‐p70S6K and p‐4E‐BP1, in tissues from 182 patients with prostate cancer, 20 with benign prostatic hyperplasia (BPH) and 10 with high‐grade prostatic intraepithelial neoplasia (HGPIN). The expression levels of these five markers were associated with patient clinical and pathological characteristics.RESULTSExpression levels of p‐Akt, p‐mTOR, p‐4E‐BP1 and p‐p70S6K were significantly higher in prostate cancer tissues than in BPH and HGPIN tissues. In 182 patients with prostate cancer the p‐mTOR expression level significantly and positively correlated with its upstream p‐Akt and downstream p‐4E‐BP1 and p‐p70S6K expression levels. The cancer Gleason score was significantly correlated with p‐Akt and p‐mTOR expression level but not with p‐4E‐BP1 and p‐p70S6K expression level. However, the p‐4E‐BP1and p‐p70S6K expression levels in primary cancer lesions were statistically significantly correlated with patient T stage and distant metastases.CONCLUSIONSMost patients with prostate cancer have at least one component of the mTOR signalling pathway activated. The activation of the mTOR pathway might be involved in prostate cancer development and progression. The association between activation of mTOR pathway and patient clinicopathological variables suggested that not all patients are equally amenable to treatment strategies targeting the mTOR pathway.
A single‐institution experience with induction and maintenance intravesical docetaxel in the management of non‐muscle‐invasive bladder cancer refractory to bacille Calmette‐Guérin therapy
Authors: Barlow LaMont , McKiernan James , Sawczuk Ihor , Benson Mitchell 
Published: April 2009

OBJECTIVETo analyse the durability of response for patients with non‐muscle‐invasive bladder cancer (NMIBC) refractory to bacille Calmette‐Guérin (BCG) therapy and treated with intravesical docetaxel in a combined induction and maintenance regimen.PATIENTS AND METHODSA previous phase I trial showed docetaxel to be safe for intravesical therapy, with no systemic absorption and minimal toxicity after six weekly instillations for patients with BCG‐refractory NMIBC. In that trial, docetaxel gave a 56% complete response (CR) rate at 12 weeks, but the durability was only 22%. Thus a second group of patients was treated with a 6‐week induction and then given monthly maintenance therapy with intravesical docetaxel. Thirteen patients with BCG‐refractory Ta, T1, or Tis transitional cell carcinoma were treated. Induction therapy was administered as six weekly intravesical instillations of 75 mg followed by single‐dose monthly maintenance therapy for nine additional instillations in patients who had a CR. The initial response at 12 weeks from the start of induction therapy was evaluated by cystoscopy with biopsy, and urine cytology. The follow‐up consisted of quarterly cystoscopy with biopsy and cytology, and periodic imaging.RESULTSThe median follow‐up was 13 months; 10 of 13 patients had a CR after induction, and six have remained disease‐free during the follow‐up. Of those in who the treatment failed, six had transurethral resection of the tumour and one a cystectomy. All 10 initial responders completed at least three instillations of maintenance therapy to date (median nine instillations), of whom six have remained recurrence‐free.CONCLUSIONMonthly maintenance therapy with intravesical docetaxel appears to extend the durability of response to induction treatment for a selected group of patients with BCG‐refractory NMIBC, and might decrease the overall risk of recurrence in high‐risk NMIBC.
Xanthogranulomatous pyelonephritis: presentation and management in the era of laparoscopy
Authors: Guzzo Thomas J. , Bivalacqua Trinity J. , Pierorazio Phillip M. , Varkarakis John , Schaeffer Edward M. , Allaf Mohamad E. 
Published: April 2009

OBJECTIVETo report a contemporary series of patients with xanthogranulomatous pyelonephritis (XGP, an inflammatory condition of the kidney that has traditionally been treated with open nephrectomy, ON), managed with either ON or laparoscopic nephrectomy (LN), as early reports suggest that the benefits of LN do not extend to patients with XGP.PATIENTS AND METHODSThe medical and procedural records of patients with pathologically confirmed XGP between December 1993 to February 2004 were reviewed retrospectively. During this period, 26 patients (mean age 43.5 years, range 17–85) had surgical management of XGP; information on the mode of presentation, surgical management, hospital course and complications were analysed.RESULTSTwelve (46%) and 14 (54%) patients had ON and LN, respectively. The LN group had significantly lower blood loss (P = 0.002), transfusion rates (P = 0.02), time to resumption of oral intake (P = 0.002) and length of hospital stay (P = 0.002) than the ON group. One (7%) LN was converted to ON due to failure to progress. The overall complication rates between the ON and LN groups were not significantly different (P = 0.95).CONCLUSIONSLN in the setting of XGP is often difficult and requires advanced laparoscopic skills. In highly selected patients this approach can be offered, with acceptable morbidity, allowing for lower blood loss and shorter convalesce times.