Micromechanical modeling of tension stiffening in FRP-strengthened concrete elements

This article presents a micromodeling computational framework for simulating the tensile response and tension-stiffening behavior of fiber reinforced polymer–strengthened reinforced concrete elements. The total response of strengthened elements is computed based on the local stress transfer mechanisms at the crack plane including concrete bridging stress, reinforcing bars stress, FRP stress, and the bond stresses at the bars-to-concrete and fiber reinforced polymer-to-concrete interfaces. The developed model provides the possibility of calculating the average response of fiber reinforced polymer, reinforcing bars, and concrete as well as the crack spacing and crack widths. The model, after validation with experimental results, is used for a systematic parameter study and development of micromechanics-based relations for calculating the crack spacing, fiber reinforced polymer critical ratio, debonding strength, and effective bond length. Constitutive models are also proposed for concrete tension stiffening and average response of steel reinforcing bars in fiber reinforced polymer–strengthened members as the main inputs of smeared crack modeling approaches

Influence of FK 506 (tacrolimus) on circulating CD4 ⁺ t cells expressing cd25 and cd45ra antigens in 19 patients with chronic progressive multiple sclerosis participating in an open label drug safety trial

We have taken the opportunity of a clinical trial of the potential efficacy and safety of FK 506 (tacrolimus) in chronic progressive multiple sclerosis (MS) to examine the influence of this potent new immunosuppressant on circulating T-lymphocytes in an otherwise healthy non-transplant population. Peripheral blood levels of subsets of CD4+ T lymphocytes expressing the activation molecule interleukin-2 receptor (p55 α chain; CD25) or the CD45RA isoform were determined sequentially in 19 patients that were treated continuously with oral FK 506 (starting dose 0.15 mg/kg/day) for 12 months. No significant change in the proportion of circulating CD25 + CD4+ cells was observed over the study period in which the mean trough plasma FK 506 level rose from 0.3 ±0.2 to 0.5 ±0.4 ng/ml. There was also no significant effect of FK 506 on the percentage of CD45RA + CD4 + cells in the peripheral blood at 12 months compared with pretreatment values. Analysis of a subgroup of 7 patients, who showed a sustained reduction in CD25 + CD4+ cells and a reciprocal increase in CD45RA* CD4 * cells for at least 6 months after start of treatment, did not reveal any difference in disability at one year compared with the treatment group as a whole. The side effects of FK 506 were mild and the overall degree of disability estimated by the mean Kurtzke expanded disability status scale (EDSS) score or the ambulation index did not deteriorate significantly in the 19 patients studied over the 12 months of FK 506 administration. © 1994 Informa UK Ltd All rights reserved: reproduction in whole or part not permitted

Multiple early gastric cancer with duodenal invasion

This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

オーストラリア ニ オケル ニホンゴ キョウイン ヨウセイ プログラム カイハツ カテイ ノ ロンテン

ここ数年来の日本語学習熱の非常な高まりに伴い日本語教員への需要が増大している。この要請に応じて教員養成過程も企画開発しなければならない。本稿は日本語教員養成過程を設立する場合に教員養成者(teacher educators)にとって是非考慮すべきいくつかの論点と問題点について考察する。この試案は、教育学士号の教科課程内か、または教員免許コース、あるいはすでに大学から取得している資格のアップグレイドを希望する教師のためのコンバージョン・コースのような枠組の中で設定している。内容は日本語教員養成プログラムの前提条件、目的および方法等について論じ、更に対象学習者別 、地理条件、期間、補助教材の充実状況(利用可能度)、そしてプログラムを推進、操作する教育機関のアプローチについて記している。本稿は遠隔地教育についても考察を加え、サテライト・コース、ネットワーキング、実習(見習)型学習についていくつかの提案をした。Japanese language learning has boomed during the last few years in Australia, creating a greater demand for teachers of Japanese. In response to this need, teacher training programs have to be planned and developed. This paper looks at some of the issues and problems that should be considered by teacher educators when they are creating and establishing a Japanese language teacher training program. The setting of this examination is within a pre-service Bachelor of Education degree, a Diploma of Education course, or a conversion course for teachers who are upgrading their qualifications at university. The paper looks at issues and problems associated with basic assumptions, aims, and methods of Japanese language teacher training programs, and notes the effects of the type of student, the location of a program, the duration of a course, the availability of resources, and the educational approach used by the teaching institution upon the development and operation of a program. The article also examines distance education and makes some suggestions about satellite courses networking, and apprentice-style learning modes

The primary therapy chosen for patients with localized prostate cancer between the university hospital and its affiliated hospitals in Nara Uro-oncological research group registration

<p>Abstract</p> <p>Background</p> <p>We investigated the differences between the preferential primary therapy conceived by the primary doctors and the primary therapy actually conducted for prostate cancer patients in Nara, Japan.</p> <p>Methods</p> <p>The distribution of primary therapy and clinical characteristics of 2303 prostate cancer patients - diagnosed between 2004 and 2006 at Nara Medical University and its 23 affiliated hospitals - were assessed. Moreover, the preferential primary therapy for the patients at each clinical stage (cT1-T3bN0M0) conceived by the primary doctors was investigated and compared to the actual therapy.</p> <p>Results</p> <p>Of all patients, 51% received primary androgen deprivation therapy (PADT), 30% underwent radical prostatectomy (RP), and 14% received radiation therapy (RT). The preferential primary therapy for cT1-2N0M0 was RP (92%) while 38% of the patients actually received PADT (RP: 40%). For cT3aN0M0, the preferential primary therapy was both RP and external beam radiation therapy (EBRT) while 58% of the patients actually received PADT (RP: 16%, EBRT: 24%). For cT3bN0M0, the most preferential primary therapy was EBRT (46%) while 67% of the patients actually received PADT (EBRT: 21%). This trend was more notable in the affiliated hospitals than in the University hospital. The hospitals with lower volume of RP per year significantly conducted PADT compared with those with higher volume of RP.</p> <p>Conclusions</p> <p>PADT was commonly used to treat localized prostate cancer as well as locally advanced prostate cancer in Japan. There was a definite discrepancy between the preferential primary therapy conceived by the primary doctors and the actual therapy provided to the patients.</p

Usefulness and safety of 0.4% sodium hyaluronate solution as a submucosal fluid "cushion" for endoscopic resection of colorectal mucosal neoplasms: A prospective multi-center open-label trial

<p>Abstract</p> <p>Background</p> <p>Sodium hyaluronate (SH) solution has been used for submucosal injection in endoscopic resection to create a long-lasting submucosal fluid "cushion". Recently, we proved the usefulness and safety of 0.4% SH solution in endoscopic resection for gastric mucosal tumors. To evaluate the usefulness of 0.4% SH as a submucosal injection solution for colorectal endoscopic resection, we conducted an open-label clinical trial on six referral hospitals in Japan.</p> <p>Methods</p> <p>A prospective multi-center open-label study was designed. A total of 41 patients with 5–20 mm neoplastic lesions localized in the colorectal mucosa at six referral hospitals in Japan in a single year period from December 2002 to November 2003 were enrolled and underwent endoscopic resection with SH. The usefulness of 0.4% SH was assessed by the <it>en bloc </it>complete resection and the formation and maintenance of mucosal lesion-lifting during endoscopic resection. Safety was evaluated by analyzing adverse events during the study period.</p> <p>Results</p> <p>The usefulness rate was high (82.5%; 33/40). The following secondary outcome measures were noted: 1) steepness of mucosal lesion-lifting, 75.0% (30/40); 2) intraoperative complications, 10.0% (4/40); 3) time required for mucosal resection, 6.7 min; 4) volume of submucosal injection, 6.8 mL and 5) ease of mucosal resection, 87.5% (35/40). Two adverse events of bleeding potentially related to 0.4% SH were reported.</p> <p>Conclusion</p> <p>Using 0.4% SH solution enabled sufficient lifting of a colorectal intramucosal lesion during endoscopic resection, reducing the need for additional injections and the risk of perforation. Therefore, 0.4% SH may contribute to the reduction of complications and serve as a promising submucosal injection solution due to its potentially superior safety in comparison to normal saline solution.</p

A case of esophageal cancer with mesojejunal lymph node metastasis after total gastrectomy

A 56-year-old man was diagnosed with esophageal cancer by upper gastrointestinal endoscopy for examination of dysphagia. The patient had undergone total gastrectomy and jejunal interposition 4 years previously for a gastric cancer at the pT1N0M0 stage according to the UICC-TNM classification. Enhanced CT findings revealed a 3-cm-diameter mass located near the superior mesenteric artery. We conducted subtotal esophagectomy associated with partial jejunectomy including mesojejunectomy. The mass was histologically diagnosed to be mesojejunal lymph node metastasis from esophageal cancer. Mesojejunal lymph node metastasis from esophageal cancer developing after total gastrectomy has been reported in only three cases including ours. The present lymph node metastases may have occurred via the newly developed lymphatic drainage route through the esophagojejunostomy, and this metastatic lymph node can be considered the regional lymph node. Therefore, resection of the interposed jejunal limb with mesojejunectomy may be rational in surgery on esophageal cancer developing after total gastrectomy