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Long-term Durability (long-term + durability)
Selected AbstractsCurrent use of the artificial urinary sphincter and its long-term durability: A nationwide survey in JapanINTERNATIONAL JOURNAL OF UROLOGY, Issue 1 2009Yoichi Arai Objectives: Although the artificial urinary sphincter (AUS) is one of the most effective surgical treatments for severe urinary incontinence, little is known about its use in Japan. A nationwide survey was done to determine contemporary trends in AUS use and its long-term durability. Methods: Data on AUS units sold in Japan were provided directly by Takai Hospital Supply Co., Ltd., Tokyo, Japan, and a survey form was sent to all 44 institutes where AUS implantation had been carried out. The survey included various demographic and preoperative variables, surgical variables, and postoperative outcomes. Results: Between 1994 and 2007, a total of 100 AUS devices had been provided in Japan. Of the 44 institutes, 24 responded to the survey, and a total of 64 patients were enrolled in the study. Post-urological surgery incontinence accounted for 81.3% of the indications. During the mean follow-up of 50 months, mechanical failure occurred in four (6.2%), and the device was removed in 13 (20.3%) due to infection (14.0%), erosion (4.7%), or urination difficulty (1.5%). Of the 58 patients evaluated, 91.4% reported social continence. Five- and 10-year failure-free rates were 74.8% and 70.1%, respectively. On multivariate analysis, operative time was an independent predictor of treatment failure (P = 0.0334). Conclusions: Considering recent trends in prostate surgery, the AUS may be significantly underused in Japan. Although excellent long-term durability has been achieved, a learning effect appears to be evident. The Japanese urological community needs to provide appropriate patients with this treatment option. [source] Developments in Oxide Fiber CompositesJOURNAL OF THE AMERICAN CERAMIC SOCIETY, Issue 11 2006Frank W. Zok Prospects for revolutionary design of future power generation systems are contingent on the development of durable high-performance ceramic composites. With recent discoveries in materials and manufacturing concepts, composites with all-oxide constituents have emerged as leading candidates, especially for components requiring a long service life in oxidizing environments. Their insertion into engineering systems is imminent. The intent of this article is to present a synopsis of the current understanding of oxide composites as well as to identify outstanding issues that require resolution for successful implementation. Emphasis is directed toward material systems and microstructural concepts that lead to high toughness and long-term durability. These include: the emergence of La monazite and related compounds as fiber-coating materials, the introduction of the porous-matrix concept as an alternative to fiber coatings, and novel strategies for enabling damage tolerance while retaining long-term morphological stability. Additionally, materials and mechanics models that provide insights into material design, morphology evolution, and composite properties are reviewed. [source] Effects of Thermal Aging on the Mechanical Properties of a Porous-Matrix Ceramic CompositeJOURNAL OF THE AMERICAN CERAMIC SOCIETY, Issue 3 2002Eric A. V. Carelli The present article focuses on changes in the mechanical properties of an all-oxide fiber-reinforced composite following long-term exposure (1000 h) at temperatures of 1000,1200°C in air. The composite of interest derives its damage tolerance from a highly porous matrix, precluding the need for an interphase at the fiber,matrix boundary. The key issue involves the stability of the porosity against densification and the associated implications for long-term durability of the composite at elevated temperatures. For this purpose, comparisons are made in the tensile properties and fracture characteristics of a 2D woven fiber composite both along the fiber direction and at 45° to the fiber axes before and after the aging treatments. Additionally, changes in the state of the matrix are probed through measurements of matrix hardness by Vickers indentation and through the determination of the matrix Young's modulus, using the measured composite moduli coupled with classical laminate theory. The study reveals that, despite evidence of some strengthening of the matrix and the fiber,matrix interfaces during aging, the key tensile properties in the 0°/90° orientation, including strength and failure strain, are unchanged. This strengthening is manifested to a more significant extent in the composite properties in the ±45° orientation, wherein the modulus and the tensile strength each exhibit a twofold increase after the 1200°C aging treatment. It also results in a change in the failure mechanism, from one involving predominantly matrix damage and interply delamination to one which is dominated by fiber fracture. Additionally, salient changes in the mechanical response beyond the maximum load suggest the existence of an optimum matrix strength at which the fracture energy in the ±45° orientation attains a maximum. The implications for long-term durability of this class of composite are discussed. [source] Off-pump, minimally invasive and robotic coronary revascularization yield improved outcomes over traditional on-pump CABGTHE INTERNATIONAL JOURNAL OF MEDICAL ROBOTICS AND COMPUTER ASSISTED SURGERY, Issue 1 2009Pavan Atluri Abstract Coronary artery disease is a global health concern, with increasing morbidity and mortality. Surgical coronary artery bypass grafting has been performed on cardiopulmonary bypass for nearly four decades, with excellent long-term durability. Beating-heart coronary surgery has been increasing in frequency in an attempt to decrease cardiopulmonary bypass-related morbidity. Furthermore, with increasing expertise and technology, minimally invasive and robotic techniques have been developed to enhance post-operative recovery, patient satisfaction and cosmesis. Several clinical trials have demonstrated decreased morbidity and more rapid recovery following off-pump, minimally invasive and robotic procedures when compared to on-pump coronary artery bypass grafts (CABGs). An equivalent extent of revascularization and medium-term anastomotic patency has been demonstrated among all approaches. Furthermore, for a large number of patients who do not have anatomy amenable to traditional coronary revascularization, adjunctive molecular therapies may provide alternative myocardial micro-revascularization. Copyright © 2008 John Wiley & Sons, Ltd. [source] Long-Term Survivors After Valve Replacement With a Starr-Edwards Mitral Disk Valve ProsthesisARTIFICIAL ORGANS, Issue 6 2006Shigeaki Aoyagi Abstract:, We report four long-term survivors after valve replacement with a Starr-Edwards (S-E) mitral caged-disk valve. A model 6520 disk valve, size 3M, had been used in all of the four patients. Of the four patients, three underwent replacement of the disk valves 23, 24, and 26 years after mitral valve replacement (MVR), respectively. A pacemaker was implanted in the remaining patient 33 years after MVR. The S-E disk valves were considered hemodynamically slightly stenotic compared with modern bileaflet valves. No disk wear was detected in any of the three explanted valves, and in the remaining patient, a noninvasive evaluation of the disk showed that it was functioning normally. These results suggest the favorable long-term durability of the S-E disk valve. [source] Re-examination of organ-cultured, cryopreserved human corneal grafts after 27 yearsACTA OPHTHALMOLOGICA, Issue 2 2009Charlotte Corydon Abstract. Purpose:, To determine the long-term fate of cryopreserved corneas. Review of 17 organ-cultered cryopreserved corneas grafted in 1978,1979. Methods:, We measured visual acuity and refraction and performed biomicroscopy, applanation tonometry and optical pachometri (CCT). Endothelial photos were taken, cells were counted and morphology was studied. Results:, Four of 16 grafted corneas were still clear after 27 years. Mean CCT was 0.52 mm, endothelial cell density was 882 cells/mm2 and visual acuity was 0.25 or better with an average of 0.6 in the four patients. Cell morphology showed irregularity in shape and size. Conclusion:, This study shows that cryopreserved endothelium can function as well as non-frozen corneas and that a regular hexagonal pattern is not essential for corneal clarity. The four grafts showed long-term durability despite the irregularity in shape and size. [source] | ||||||||||