Influence of microstructure on fatigue property of ultra high-strength steels

Ultra-high-strength steels (with tensile strength higher than 980 MPa) are widely used in automobile manufacturing owing to their lightweight that contributes to fuel efficiency. The fatigue strength of ultra-high-strength steels with a notch tends to decrease, which is known as the effect of notch sensitivity. In this study, 4-point bending fatigue tests were performed to examine the fatigue strength and notch sensitivity of four steels; namely 590 MPa class steel, 980 MPa class martensitic steel, 980 MPa class bainitic steel, and 980 MPa class precipitation hardening steel plates with three different stress concentration factors. The results indicate that the fatigue strength and notch sensitivity of 980 MPa class steel specimens were higher than those of 590 MPa class steel specimens. The notch sensitivities of tested plate specimens were lower than those reported for cylindrical specimens of bainitic ultra-high-strength steels. Fatigue crack observation revealed that the cracks initiated in 590 MPa class steel, 980 MPa class bainitic, and martensitic steel propagated vertically from the lowest bottom of notch. Although similar initial crack propagation pattern was detected in precipitation hardening steel, the crack changed direction when it reached the central part of the specimen

Influence of microstructure on fatigue property of ultra high-strength steels

Ultra-high-strength steels (with tensile strength higher than 980 MPa) are widely used in automobile manufacturing owing to their lightweight that contributes to fuel efficiency. The fatigue strength of ultra-high-strength steels with a notch tends to decrease, which is known as the effect of notch sensitivity. In this study, 4-point bending fatigue tests were performed to examine the fatigue strength and notch sensitivity of four steels; namely 590 MPa class steel, 980 MPa class martensitic steel, 980 MPa class bainitic steel, and 980 MPa class precipitation hardening steel plates with three different stress concentration factors. The results indicate that the fatigue strength and notch sensitivity of 980 MPa class steel specimens were higher than those of 590 MPa class steel specimens. The notch sensitivities of tested plate specimens were lower than those reported for cylindrical specimens of bainitic ultra-high-strength steels. Fatigue crack observation revealed that the cracks initiated in 590 MPa class steel, 980 MPa class bainitic, and martensitic steel propagated southward from the lowest bottom of notch. Although similar initial crack propagation pattern was detected in precipitation hardening steel, the crack changed direction when it reached the central part of the specimen

The impact of triple drug immunosuppression on clinical results of cadaveric kidney transplantation: a comparison of conventional immunosuppression.

A retrospective study was carried out in 110 cadaveric kidney transplant recipients to compare the effects of low doses of cyclosporine (CsA), azathioprine (AZP) and steroids (triple-drug therapy) with those of higher doses of steroids plus AZP (conventional immunosuppression). Graft survival rate in the triple-drug therapy was 77%, 69%, and 69% at 1, 3, and 5 years, respectively. This was significantly better than 48%, 34%, and 29% in conventional immunosuppression. The incidence of acute rejection episodes was significantly lower in the triple-drug therapy than in conventional immunosuppression (25% vs 58%). In conclusion, our study shows that triple-drug therapy using low-dose cyclosporine is the safest of the immunosuppressive regimens and provides a beneficial effect on the long-term survival of cadaveric kidney transplants.</p

Renal transplantation from HLA-haploidentical living-related donors: the effects of donor-specific blood transfusions and different immunosuppressive regimens.

One-hundred-nine HLA-haploidentical living related renal transplants have been retrospectively analysed to compare the effect of donor-specific blood transfusion (DST) and different immunosuppressive regimens on graft survival and acute rejection. The recipients were divided into four groups according to the immunosuppressive therapy. Group 1 (n = 44): conventional therapy with posttransplant azathioprine (AZP) + methylprednisolone (MP). Group 2 (n = 25): pretransplant DST + posttransplant AZP + MP. Group 3 (n = 12): triple-drug therapy with posttransplant AZP + MP + cyclosporine (CS). Group 4 (n = 25): pretransplant DST + posttransplant AZP + MP + CS. The five-year actuarial survival rates for groups 1, 2, 3 and 4 were 48%, 73%, 79%, and 89%, respectively. The graft survival rate in group 3 was significantly (p less than 0.01) better than that in group 1. The transfusion effect was reduced, and appears as a 10% improvement in the graft survival in the cyclosporin era compared with a 25% improvement at pre-cyclosporin era. Furthermore, the incidence of the first rejection episode was decreased in recipients that received DST. The present study revealed that DST, as pretransplant conditioning has a definite impact on rejection-free long-term graft survival in HLA-haploidentical living-related kidney recipients and the most favorable outcome in such patients could be achieved by DST pretreatment in conjunction with posttransplant triple-drug therapy including cyclosporine.</p

Current status of a helicopter transportation system on remote islands for patients undergoing mechanical thrombectomy

Background: Mechanical thrombectomy (MT) is standard treatment for acute ischemic stroke (AIS) with large-vessel occlusion within 6 h of symptom onset to treatment initiation (OTP). Recent trials have extended the therapeutic time window for MT to within 24 h. However, MT treatment remains low in remote areas. Nagasaki Prefecture, Japan has many inhabited islands with no neurointerventionalists. Our hospital on the mainland is a regional hub for eight island hospitals. We evaluated clinical outcomes of MT for patients with AIS on these islands versus on the mainland. Methods: During 2014–2019, we reviewed consecutive patients with AIS who received MT at our hospital. Patients comprised the Islands group and Mainland group. Patient characteristics and clinical outcomes were compared between groups. Results: We included 91 patients (Islands group: 15 patients, Mainland group: 76 patients). Seven patients (46.7%) in the Islands group versus 43 (56.6%) in the Mainland group achieved favorable outcomes. Successful recanalization was obtained in 11 patients (73.3%) on the islands and 67 (88.2%) on the mainland. The median OTP time in the Islands was 365 min. In both the Islands and Mainland groups, the OTP time and successful recanalization were associated with functional outcome. The modified Rankin Scale (mRS) score at 90 days ≤2 was obtained in two patients and mRS = 3 in four patients among eight patients with OTP time >6 h. Conclusions: Few patients with AIS on remote islands have received MT. Although patients who underwent MT on the islands had longer OTP, the clinical outcomes were acceptable. OTP time on remote islands must be shortened, as this is related to functional outcome. In some cases with successful recanalization, a favorable outcome can still be obtained even after 6 h. Even if OTP exceeds 6 h, it is desirable to appropriately select patients and actively perform MT