Heterogeneity of glomerular size in normal donor kidneys: impact of race

Glomerular size has been the subject of many studies and, in a number of settings, has a direct association with the development of glomerular sclerosis. However, the normal distribution of glomerular size has not been thoroughly evaluated in the general population in the United States. To address this issue, we analyzed the baseline biopsy specimens of 103 human donor kidneys to determine the maximal planar area (MPA) of the glomerular tuft in a heterogeneous human population. The MPA of each glomerulus was determined by measurement of sections through the vascular pole and/or origin of the proximal tubule, and was determined on each section by two methods: point counting and computer planimetry. There was very high agreement between these two methods. Multivariate analysis was used to identify significant correlates with MPA. Overall, younger donors had smaller glomeruli (P < 0.0001). Black donors had a larger MPA (23.4+/-8.6 mm2 x 10(-3)) than white donors (17.9+/-6.7 mm2 x 10(-3); P < 0.001), independent of donor age. MPA was not significantly different between genders. This heterogeneity in glomerular size may confound clinical studies if not recognized and may help explain differences in glomerular structure and function in response to injurious processes.     

DIFFICULTIES AND DILEMMAS IN THE MANAGEMENT OF CONGENITAL ANOMALIES IN TWIN PREGNANCY

Both the incidence of twin pregnancy and the demand for prenatal diagnosis are increasing. Unfortunately, biochemical screening and ultrasound scanning are less reliable for prenatal diagnosis in twin pregnancies than in singletons. Amniocentesis and chorionic villous biopsy are usually diagnostic in singleton pregnancies but may be marred by sampling errors in twin gestations. Where a congenital anomaly has been diagnosed in a twin pregnancy, difficult decisions may have to be made, especially if one twin is unaffected. In these cases, special skills are required to ensure that adequate information, psychological support and optimal medical care are provided.     

Comparison of orthopantomographs and conventional tomography images for assessing the relationship between impacted lower third molars and the mandibular canal.

PURPOSE: A comparative analysis was made of the relationship between impacted lower third molars and the mandibular canal by means of orthopantomography and conventional mandibular tomography. Consideration was given to the association between the existence or absence of a close relationship according to gender, age, and tooth involved, as well as the resolution of the mandibular canal tomograph of the mesial and distal roots. MATERIALS AND METHODS: The sample consisted of 19 patients of both genders with impacted third molars that exhibited a close relationship between impacted lower third molars and the mandibular canal on the orthopantomograph. Thirty-one relationships were assessed, for each of which a conventional mandibular tomograph was requested. Cases were verified for a true relationship. All cases were appraised by the same radiologist. RESULTS: A close relationship with the mandibular canal was found on the tomograph in 77.4% of cases. The reported data showed that the most common relationship criterion was darkening of the roots (14 cases; 45.2%). A true relationship was confirmed on the tomograph in 92.1% of these cases. CONCLUSION: The presence of the radiographic sign of a close relationship found on the orthopantomograph represents, in most cases, a true relationship, requiring the classification of the type of radiographic sign to prevent injury to the nerve.     

Influence of a lipophilic drug on the stability of emulsions: an important approach on the development of lipidic carriers

The aim of this work was to investigate the influence of a lipophilic drug, Ibuprofen, on the stability of o/w emulsions. Five formulations were prepared by the phase inversion temperature (PIT) method, and Ibuprofen was incorporated into their oil phase. Emulsion stability was evaluated by short- and long-term studies. Concerning the former, stability under centrifugation showed an improved profile for Ibuprofen-loaded emulsions. The latter confirmed such findings. In conclusion, a rather resistant interfacial film may take place when Ibuprofen was incorporated into the emulsions. Therefore, the critical hydrophilic-lipophilic-balance (HLB) of o/w emulsions can be affected by a lipophilic drug into their oil phase. Such approach is of great importance on the development of lipid carriers for therapeutic drug targeting.     

Magnetic carriers: a promising device for targeting drugs into the human body

Suboptimal disposition behavior of drugs requires innovative delivery approaches. Magnetic drug targeting seems to be a promising one. Magnetic particles develop magnetic polarization and magnetophoretic mobility, and because of such unique properties, these carriers may be eligible candidates for delivering drugs to specific locations within the body. Their special properties also allow other uses, such as those in magnetic separation, hyperthermia, and magnetic resonance imaging. This review focuses on a brief discussion of magnetic drug targeting, the properties and fate of magnetic carriers, the methods used to produce and characterize them, and their other uses in biotechnology.     

Pushing the limits of liver surgery for colorectal liver metastases:Current state and future directions

Liver surgery for the treatment of colorectal liver metastases is the standard treatment in a dynamic surgical field with many variables that should be considered in a curative intent scenario. Hepatectomy for colorectal liver metastases has undergone constant changes over the last 30 years, including indications until the need for rescue procedures of recurrent and advanced diseases as well as minimally invasive surgery. These advancements in liver surgery have not only resulted from overall improvements in the surgical field but have also resulted from a better understanding of the biological behavior of the disease, liver regeneration, and homeostasis during and after surgery.Improvements in anesthesiology, intensive care medicine, radiology, and surgical devices have correlated with further advancements of hepatectomies. Moreover,changes are still forthcoming, and both fields of augmented reality and artificial intelligence will likely have future contributions in this field in regard to both diagnoses and the planning of procedures. The aim of this editorial is to emphasize several aspects that have contributed to the paradigm shifts in colorectal liver metastases surgery over the last three decades as well as to discuss the factors concerning patient selection and the technical aspects of liver surgery. Finally, this editorial will highlight the promising new features of this surgery for diagnoses and treatments in this field.