Improvement of cast nephropathy with plasma exchange depends on the diagnosis and on reduction of serum free light chains

Cast nephropathy is the most common cause of renal disease in multiple myeloma, however, treatment with plasma exchange remains controversial even after 3 randomized controlled studies. We sought to determine the importance of diagnostic confirmation and goal directed therapy in the treatment of cast nephropathy in forty patients with confirmed multiple myeloma and renal failure who underwent plasma exchange. A positive renal response was defined as a decrease by half in the presenting serum creatinine and dialysis independence. No baseline differences were noted between eventual renal responders and non-responders. Three quarters of the patients with biopsy proven cast nephropathy resolved their renal disease when the free light chains present in the serum were reduced by half or more but there was no significant response when the reduction was less. The median time to a response was about 2 months. In patients without cast nephropathy, renal recovery occurred despite reductions in free light chain levels of the serum. No association was found between free light chains in the serum, urinary monoclonal proteins, overall proteinuria and cast nephropathy. We found that the relationship between renal recovery and free light chain reduction was present only in patients with biopsy proven cast nephropathy showing the importance of extracorporeal light chain removal in this disease

Characteristics of pulse plated ZnTe films

Stoichiometric films of ZnTe are electrodeposited on stainless steel and conducting glass substrates from an aqueous solution consisting of ZnSO4 (50 mM), TeO2 (17 μM) and H2SO4 to maintain a pH of 2.5. Structure, morphology, composition, and optical are studied using XRD, SEM, EDAX and optical transmittance spectroscopy The films are composed of small crystallites (50 nm) with cubic crystal structure. The films were polycrystalline in nature with peaks corresponding to the cubic phase. Direct band gap of 2.30 eV was observed. XPS studiers indicated the formation of ZnTe. EDAX measurements were made on the films and it was found that there was a slight excess of Te. AFM studies indicated a surface roughness of 15 nm and a crystallite size of 10–50 nm

Performance of hybrid steel fiber-reinforced self-compacting concrete RC beam under flexure

Hybrid steel fiber-reinforced self-compacting concrete (HSFRSCC) has desirable properties for improving the performance of structures. But the literature is sparse on the flexural performance of the reinforced concrete (RC) beam reinforced with hybrid fibers. The impact of the combined action of micro- and hooked-end steel fibers on the flexural performance of the SCC beam to which mineral admixtures and superplasticisers have been added to improve their workability is investigated in this study. In the experiment, beam specimens, reinforced with micro-steel and hooked-end fibers, with a compressive strength of 60 and 80 MPa and of size 150×230×3000 mm were prepared. The results clearly demonstrate that the flexural performance of the SCC beam significantly improved with the addition of hybrid steel fibers. The combination of 0.5% of hooked-end steel fibers and 0.25% of micro-steel fibers offers a better flexural performance than the addition of hybrid fibers in other proportions. Adding hybrid steel fibers in RCSCC beam increases the beam’s load- and moment-carrying capacities by 40.64% and 40%, respectively, compared to the RCSCC beam without hybrid steel fibers. The crack spacing and crack width are also reduced by 16–45% and 25–75%