116 research outputs found
Law and Orders: The Problem of Presidental Legislation
Kostnaden för att bygga hus stiger mer Ă€n kostnaden för vanliga konsumtionsprodukter vilket leder till allt dyrare hus. En anledning till detta Ă€r att byggprocessen inte hĂ€nger med i utvecklingen och att Ă€ldre metoder fortfarande anvĂ€nds. För att fĂ„ ett effektivare byggande behöver metoderna dĂ€rför utvecklas eller nya metoder behöver trĂ€da fram, ett exempel pĂ„ en ny metod Ă€r tredjepartslogistik som fler och fler byggföretag anvĂ€nder sig av. I denna rapport fĂ„r du lĂ€sa om företaget Arcona AB (Arcona) som samarbetar med logistikföretaget Servistik och som vill undersöka hur arbetarnas attityd Ă€r till logistikkonceptet som Arcona anvĂ€nder sig av. Ett projekt, BryggmĂ€staren, Ă€r undersökt i det hĂ€r arbetet och det Ă€r en ombyggnation frĂ„n kontor till hotell i Stockholm city. Anledningen till att Arcona hade intresse av en attitydundersökning av deras koncept var för att de vill fĂ„ fram information till möjliga förbĂ€ttringar, för att se om företaget Ă€r pĂ„ rĂ€tt spĂ„r med konceptet och för att se hur redan gjorda förĂ€ndringar har pĂ„verkat arbetet pĂ„ byggarbetsplatsen. Logistikkonceptet kan sammanfattas enligt följande. Lagbasarna pĂ„ byggarbetsplatsen bestĂ€ller material frĂ„n olika grossister. Det bestĂ€llda materialet levereras till Servistiks lager och tas emot, inspekteras och lagras. NĂ€r materialet behövs pĂ„ byggarbetsplatsen gör lagbasarna avrop till Servistiks lager som i sin tur packar ihop ordern och levererar det till byggarbetsplatsen. VĂ€l framme lastar Servistiks personal av material och distribuerar runt det pĂ„ byggarbetsplatsen. Leveranstiden frĂ„n att avropet har gjorts till det att materialet Ă€r pĂ„ plats pĂ„ bygget Ă€r 3 dagar. Studien har baserats pĂ„ intervjuer som har gjorts med Arconas egen personal och med underentreprenörer som har arbetat för Arcona pĂ„ projektet BryggmĂ€staren. Ă
tta stycken intervjuer har gjorts pÄ Arconas platskontor pÄ BryggmÀstaren varav en var via telefon. De intervjuade var platschefer, projektchefer, produktionsledare, projektingenjörer, lagbas och underentreprenör. Samtliga av respondenterna Àr positivt instÀllda till logistikkonceptet som Arcona driver i samarbete med Servistik. De tycker att det Àr en bra idé och att det lÄter bra i teorin men de menar ocksÄ pÄ att ifall det ska fungera sÄ behövs det en viss utveckling eller förÀndring av konceptet för att det Àven ska gÄ att tillÀmpas i praktiken pÄ ett framgÄngsrikt sÀtt. Ett antal förbÀttringsförslag som dyker upp Àr: Leveranstiden frÄn lagret behöver minskas för att göra konceptet lite mer flexibelt. Materialkunskapen hos Servistiks personal behöver förbÀttras sÄ att de har mer koll pÄ vad som exakt kommer in till deras lager. Internetsidan för lagret som visar materialstatus pÄ lagret mÄste förenklas sÄ att allt ska gÄ smidigare
Histopathological Determinants of Survival in Resected Cases of Pancreas Cancer
We have examined the histopathological factors affecting the degree of local spread, regional lymph
node (RLN) metastases, and overall survival (O.S.) in a group of 39 cases of resected carcinoma of the
exocrine pancreas. Although the mean O.S. for the group was 14.3 months, resected patients without
RLN involvement had a mean survival of 24 months. In contrast the mean O.S. rate was 8 months for
patients with RLNs involved. Size, tumor location, and histological grade were compared to RLN
involvement and O.S. The mean size of primary tumor did not differ significantly between patients with
or without RLN's (r.1 versus 4.6cms). However, 7 or 8 T1 tumors were <4cm and 35% of tumors <4cm
were T1 lesions. In contrast, only of 17 tumors (6%) >4cm was T1. Histological grade was correlated with nodal status and O.S. There was a significant difference between histological grade and the
presence of metastatic lymph nodes (G1, 37% positive, G2-4.50% positive). Patients with well
differentiated tumors had a mean survival of 21 months compared to a mean survival of 10 months for
less differentiated tumors (p<0.05). This difference was even more significant when stratified for nodal
status. The patients with well differentiated tumors and no RLN involvement had a mean survival of
32.5 months compared to 8.6 months for well differentiated tumors with RLN involvement. In
summary, we have shown that size, histological grade, and local spread predict for nodal status.
However, specific patient subsets (G1, node negative) may exhibit an excellent survival when curative
pancreas resection is successful
Interleukin 1 is a key driver of inflammatory bowel disease-demonstration in a murine IL-1Ra knockout model
Interleukin 1 (IL-1) is an important mediator of inflammation and tissue damage in inflammatory bowel disease (IBD). The balance between IL-1 and IL-1Ra as a natural inhibitor plays a vital role in a variety of diseases. Here, we investigated whether changes seen during IBD are induced spontaneously in mice lacking a functional IL-1rn gene. Histological staining was performed on the jejunum and ileum of BALB/c IL-1rn+/+ and IL-1rn-/- mice to characterize crypt-villus height, villus width, and number of goblet cells per villus. Pro-inflammatory cytokines, immune cell infiltration and matrix-degrading enzymes, together with the production of intestinal enzymes and the integrity of tight and adherent junction proteins were determined using immunohistochemistry. In the small intestine of BALB/c IL-1rn-/- mice the villus heights were significantly reduced; and in the ileum this was accompanied by a decrease in villi width. There was also an increase in goblet cell number and mucin production compared to wild-type mice. IL-1α and IL-1ÎČ immunopositivity were increased, whilst IL-1R1 expression was decreased in IL-1rn-/- mice. IL-15 and TNFα were also increased in older IL-1rn-/- mice. Increased polymorphonuclear and macrophage infiltration were seen in IL-1rn-/- mice, whilst expression of matrix-degrading enzymes and digestive enzymes were unchanged, except for dipeptidyl peptidase IV which was increased in younger IL-1rn-/- mice compared to wild type mice. The expression of tight and adhesion junctions were also dramatically decreased in IL-1rn-/- mice. In conclusion, IL-1rn-/- mice developed spontaneous abnormalities which displayed features associated with IBD, demonstrating a clear role for IL-1 in IBD
Splenectomy for splenomegaly and secondary hypersplenism
Splenomegaly and secondary hypersplenism may be associated with acute and chronic infections, autoimmune states, portal hypertension or splenic vein thrombosis, and a number of infiltrative and neoplastic conditions involving the spleen. Our experience and that of others with these various conditions demonstrates that the decision to perform splenectomy should be based on well-defined and often strictly limited indications. Except for idiopathic splenomegaly, the presence and severity of secondary hypersplenism or severely symptomatic splenomegaly should be well documented. In each case, the potential for palliation and known mean duration of expected response must be weighed against the increased morbidity and mortality of splenectomy (as compared to operation for âprimaryâ hypersplenism) . La splĂ©nomĂ©galie avec hypersplĂ©nisme secondaire relĂšve de multiples causes: infection aigue ou chronique, Ă©tats autoimmunologiques, hypertension portale, thrombose de la veine splĂ©nique, lĂ©sions tumorales splĂ©niques. L'expĂ©rience de l'auteur qui rejoint celle de nombreux collĂšgues lui permet d'affirmer que les indications de la splĂ©nectomie doivent ĂȘtre bien dĂ©finies et sont strictement limitĂ©es. A l'exception de la splĂ©nomĂ©galie idiopathique, l'existence et l'intensitĂ© de l'hypersplĂ©nisme, l'importance des symptomes provoquĂ©s par la splĂ©nomĂ©galie doivent ĂȘtre aprrĂ©ciĂ©es avec prĂ©cision. Dans chaque cas le potentiel de la rĂ©mission de l'affection et la durĂ©e de la rĂ©mission doivent ĂȘtre pris en considĂ©ration en fonction de l'Ă©ventuelle morbiditĂ© et de l'Ă©ventuelle mortalitĂ© de la splĂ©nectomie (par comparaison avec la splĂ©nectomie pour hypersplĂ©nisme primaire). Eplenomegalia e hiperesplenismo secundario pueden estar asociados con infecciones agudas y crĂłnicas, estados autoinmunes (sĂndrome de Felty, lupus eritematoso sistĂ©mico), âesplenomegalia congestivaâ por hipertensiĂłn portal o trombosis de la vena esplĂ©nica y con una variedad de entidades de tipo infiltrativo y neoplĂĄsico que afectan al bazo (sarcoidosis, enfermedad de Gaucher, varios desĂłrdenes mieloproliferativos y linfomas). Nuestra experiencia, y aquella de otros autores, con tales condiciones demuestra que la decisiĂłn de realizar esplenectomĂa debe estar fundamentada en indicaciones bien definidas y estrictamente limitadas. Excepto en casos de esplenomegalia idiopĂĄtica, la presencia y severidad del hiperesplenismo secundario o de esplenomegalia severamente sintomĂĄtica debe ser bien documentada. En cada caso debe determinarse el potencial de paliaciĂłn y la duraciĂłn de la respuesta que se espera obtener frente a la incrementada morbilidad y mortalidad de la esplenectomĂa (en comparaciĂłn con la operaciĂłn que se realiza por hiperesplenismo âprimarioâ).Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/41318/1/268_2005_Article_BF01655279.pd
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