The histopathological changes associated with allograft rejection and drug toxicity in renal transplant recipients maintained on FK506: Clinical significance and comparison with cyclosporine

The histopathological changes in 51 renal allograft biopsies from patients immunosuppressed with FK506 were compared with those seen in 30 needle biopsies obtained from patients on cyclosporine. The frequency and severity of rejection episodes were similar in both groups. Tubular vacuolation and myocyte vacuolation were found to be useful morphological markers to monitor short-term drug toxicity associated with both drugs. Long-term administration of FK506 led to striped interstitial fibrosis and arteriolar hyalinosis, similar to that previously documented for cyclosporine. One case each of hemolytic uremic syndrome and necrotizing arteriopathy was noted in patients receiving FK506. FK506 and cyclosporine are structurally unrelated compounds; hence the parallelism observed in their nephrotoxicity profile suggests that the interactions of these drugs with renal tissue involves the operation of two different initial signal-transducing mechanisms, ultimately activating the same final metabolic pathways

ДВОСТОРОННЯ КРОВОТЕЧА З НАДНИРКОВИХ ЗАЛОЗ У ПЛОДА: (клінічний випадок)

Background. Fetal supra renal mass revealed incidentally by routine antenatal ultrasound is a great challenge for diagnosis and management by a surgeon. This is a matter of parental anxiety and diagnostic dilemma to a physician. Indeed, such masses turn out to be complicated by an intra-tumor hemorrhage in neuroblastoma or antenatally diagnosed adrenal hemorrhage. The first one needs intensive management and the latter needs watchful observation. Objective. A case of bilateral fetal adrenal mass revealed by routine fetal ultrasound examination at 28th week of gestation which turned out to be adrenal hemorrhage is presented. This is aimed to make awareness to ensure that clinicians always keep benign etiologies first and thoroughly investigate in case of incidentally detected fetal adrenal mass. Methods. The study is a single case report of incidentally revealed supra renal mass. This case report encompasses differentiating features between the two and investigations that aid the surgeon to avoid unnecessary intervention in a benign hemorrhage. Results. The baby was kept on follow up with serial ultrasound scans in the postnatal period and by the second scan in a month, the hemorrhage had resolved completely. Conclusion. In cases of benign looking masses like adrenal hemorrhage or spontaneously resolving neuroblastoma, appropriate antenatal assessment and close monitoring with serial ultrasound scans can avoid surgery.Вступ. Утворення в наднирниках плода, випадково виявлені під час звичайного допологового ультразвукового дослідження, створюють для хірургів велику проблему в діагностиці та лікуванні. Вони викликають занепокоєння батьків і створюють діагностичну проблему для лікуючого лікаря. Такі утворення можуть виявитися ускладненим внутрішньопухлинним крововиливом у нейробластому або антенатально діагностованим крововиливом у надниркові залози. Перший потребує інтенсивного лікування, а другий потребує уважного спостереження. Мета. Представлено випадок двостороннього утворення в надниркових залозах плода, виявленого під час планового ультразвукового дослідження плода на 28-му тижні вагітності, які виявилися крововиливом у надниркові залози. Випадок представлено для того, щоб клініцисти завжди звертали увагу на доброякісну етіологію та проводили ретельне обстеження у випадку випадкового виявлення новоутворень надниркових залоз плода. Методи. Представлено випадок випадково виявлених утворень надниркових залоз. Описано відмінності між ними та дослідження, які допомагають хірургу уникнути непотрібного втручання при доброякісному крововиливі. Результати. У післяпологовому періоді дитину спостерігали за допомогою серійних ультразвукових досліджень. До другого УЗД через місяць крововилив повністю розсмоктався. Висновки. У випадках доброякісних новоутворень, таких як крововилив у надниркові залози або нейробластома, що спонтанно розсмоктується, відповідна антенатальна оцінка та ретельний моніторинг за допомогою серійних ультразвукових досліджень можуть допомогти уникнути операції

Production of Silicomanganese Alloy from Low Manganese Containing Leached Sea Nodules Residue

Leached sea nodules residue was used for the present study for exploring its utilization. The residue generated in ammoniacal-SO2 pressure leaching was water washed to reduce the sulphur content. To improve the Mn/Fe ratio in the residue, it was blended with Fe-Mn slag or Mn ore in the calculated amount and smelting was carried out in 50 kVA submerged arc furnace. Various parameters such as holding time, amount of reductant, power input etc. were investigated. The maximum recovery of Mn from residue blended with Fe-Mn slag and Mn ore was 58% and 65% respectively in the form of silicomanganese

Management practices in Australian healthcare: can NSW public hospitals do better?

© 2016, © Emerald Group Publishing Limited. Purpose – The purpose of this paper is to investigate the determinants of best management practices in an Australian state-run healthcare system, namely New South Wales (NSW), and studies the impact of a range of hospital factors in driving best management practices as a means of enhancing healthcare delivery. Design/methodology/approach – This study adapts a unique survey instrument globally tested to quantify the multi-dimensional nature of hospital management practices in 42 acute care public hospitals of NSW. The authors then analysed the role of hospital-specific characteristics in driving best management practices, namely hospital size (measured by the number of hospital beds, employees and doctors), level of skill and education, degree of hospital manager autonomy and organisational hierarchy. Findings – The findings of this study show the areas of strength and potential areas of improvement in NSW hospitals. The authors find a positive association between the adoption of better management practices and hospital size (measured by the number of hospital beds and employees), level of skills and education, degree of hospital manager autonomy and organisational hierarchy. However, hospital size as measured by the number of doctors did not have a statistically significant relationship. Practical implications – This paper is of interest to both hospital administrators, clinical doctors and healthcare policy-makers who want to improve and develop strategies for better management in the healthcare sector. Originality/value – This study provides an internationally comparable robust measure of management capability in public hospitals, and contributes to the evidence-base of management practices and performance in hospitals

Lead sorption by sea nodule residue generated in reduction roasting – ammonia leaching.

Residue generated in reduction roast – ammonia leaching of sea nodules has been utilised for the remediation of aqueous lead. Characterization of sea nodule residue (SNR) reveals fine granulometry (d50 = 11.4 µm) and high surface area of 66.7 m2 g-1. Batch adsorption experiments have been performed varying different parameters. Equilibrium experimental data fitted well in the Langmuir isotherm and derived maximum adsorption capacity (qm) of lead onto SNR has been found to be 840.34 mg Pb(II)/g SNR at 303 K. The qm enhanced to very high value of 2500 mgPb/gSNR upon raising the temperature to 323 K. The pseudo second-order model has been found applicable to the lead removal kinetics

Viticulture in the tropical regions of India

By an intelligent appreciation of the vine's physiology grapes are being grown successfully in the tropical regions of India, where the vine stays evergreen throughout the year. The vines are pruned twice a year, once in April for vegetative growth and again in October for the fruiting cycle. The canes which bear the fruit al·e less than one year old. But, since the growth is continuous and rapid, the canes are equivalent in development differentiation to one-year-old canes of the warm temperate and sub-tropical grape growing regions.The ever present over-abundant crop potential of the vine has been exploited by separating out the period of maturity of fruit and maturity of the wood for the next crop. The yields are very high as the depressive effects of high crops are eliminated by 1back or foundation' pruning in April and by heavy doses of fertilizers and manures at the time of pruning.The growers have been able to harvest grapes almost the year round of the 'Bangalore Blue' (V. labrusca type) by staggering the pruning. In the V. vinifera types, the grape season is also extended, within limits, by adjusting the pruning time.Because of shorter period in which the vines come into bearing, ready germination of seeds and the year round availability of flowers, this area is ideal for breeding and genetic studies.As has been shown by the successful grape cultivation in the tropical regions of India, it seems probable that some grapes will do equally well in other tropical regions of the world where the climatological conditions are similar

Different applications of waste generated in reduction roasting – ammonia leaching of manganese nodules.

CSIR-NML, Jamshedpur has been engaged in technology development to recover valuable metals (Cu, Ni & Co) from manganese nodules (MN). Extensive R&D work led to development of a process based on reduction roast – ammonia leaching – solvent extraction (SX) – electrowining (EW) route. This process generates large amount of waste/residue (70% of the MN weight) after selective leaching of Cu, Co and Ni, which may be considered hazardous, if untreated, due to its fineness and heavy metal contents. Characterisation studies have shown that this leaching residue waste contains oxides/oxyhydroxides of Fe, Mn, Al and Si with a high porosity and surface area, which are suitable for catalytic activity and adsorption of various aqueous pollutants. In addition, appreciable amount of manganese content of the manganese nodule leached waste may be recovered for the improvement of the economics of MN processing. Keeping these in view, studies for utilisation of waste leach residue have been carried out in three different ways: i) The use of leaching residue as catalyst has been successfully assessed for decolourisation of methylene blue (MB). The surface complex between wMNR and MB at a rate limiting step followed by electron transfer from MB to active metal centre of wMNR and release of products has been found to be operative during the decolourisation process. ii) The potential of water washed leaching residue as adsorbent has been evaluated for removal of anionic pollutants phosphate (PO43-), selenite (SeO32-) and cationic pollutants like Cu2+ and Cd2+, showing a maximum phosphate uptake of 9.88 mgP g-1 and selenite uptake of 15.17 mg Se g-1 for wMNR calcined at 400 C. The monolayer adsorption capacities (Qo) has been found to be temperature dependent showing 26.95 mg g-1 and 40.32 mg g-1 at 303 and 323 K, respectively for Cu2+ ion while the values are 32.23 and 38.14 mg g-1 at 303 and 323 K, respectively for Cd2+ adsorption. iii) In the third application of leached residue, a value added material like silicomanganese alloy has been produced by smelting of MN leaching waste in a 50 kVA electric arc furnace, with manganese recovery of about 77%

Benchmarking management practices in Australian public healthcare

© 2016, © Emerald Group Publishing Limited. Purpose – The purpose of this paper is to investigate the quality of management practices of public hospitals in the Australian healthcare system, specifically those in the state-managed health systems of Queensland and New South Wales (NSW). Further, the authors assess the management practices of Queensland and NSW public hospitals jointly and globally benchmark against those in the health systems of seven other countries, namely, USA, UK, Sweden, France, Germany, Italy and Canada. Design/methodology/approach – In this study, the authors adapt the unique and globally deployed Bloom et al. (2009) survey instrument that uses a “double blind, double scored” methodology and an interview-based scoring grid to measure and internationally benchmark the management practices in Queensland and NSW public hospitals based on 21 management dimensions across four broad areas of management – operations, performance monitoring, targets and people management. Findings – The findings reveal the areas of strength and potential areas of improvement in the Queensland and NSW Health hospital management practices when compared with public hospitals in seven countries, namely, USA, UK, Sweden, France, Germany, Italy and Canada. Together, Queensland and NSW Health hospitals perform best in operations management followed by performance monitoring. While target management presents scope for improvement, people management is the sphere where these Australian hospitals lag the most. Practical implications – This paper is of interest to both hospital administrators and health care policy-makers aiming to lift management quality at the hospital level as well as at the institutional level, as a vehicle to consistently deliver sustainable high-quality health services. Originality/value – This study provides the first internationally comparable robust measure of management capability in Australian public hospitals, where hospitals are run independently by the state-run healthcare systems. Additionally, this research study contributes to the empirical evidence base on the quality of management practices in the Australian public healthcare systems of Queensland and NSW