Could proteinuria evaluation be helpful in predicting renal progression in apolipoprotein E-deficient (E-/-) mice with chronic renal failure?

Sir, We read with interest the recent article by Buzello et al. [1]on renal changes in apo E^-/- mice after subtotal nephrectomy.They compared renal lesion development in male wild-type C57BL/6mice with that of genetically modified male apo E^-/- mice aftereither sham operation, unilateral nephrectomy or subtotal nephrectomy(SNX) by removal of 75% of the cortex in one kidney and removalof the contralateral kidney. They found     

Objectives and tasks of projects of the medical laboratory in space "Medilab"

This paper discusses goals and objectives of the Soviet project to build a space medical laboratory "Medilab". Special attention is given to the design, structure and mathematical support of the dedicated biomedical laboratory.     

Fractures of the scaphoid bone in soldiers]

The conservative treatment and results obtained in the treatment of 30 scaphoid bone fractures in soldiers aging from 18 to 22 years are reported. The immobilization was performed after acute posttraumatic edema, the latest 4 days after injury, first using the plaster splint and then the "plaster gloves." The immobilization lasted two months. The complete healing was achieved in 29 injured and pseudoarthrosis occurred in one case only.     

Kidney transplantation in Macedonia

During the last 10 years we performed 92 renal transplantations in our Skopje hospital (Macedonia), using 22 cadaver donors and 70 living donors. We also performed 15 explanations from cadavers and seven kidneys were allocated to former Yugoslavia. Standard surgical procedures were used for both living and cadaver donor explantations and transplantations. For living explantations, donors were matching in 66 cases (94.28%) and in four cases (5.7%) non-matching donors who however were relatives of the patient Explantations and transplantations took place only after all ethical- and legal-related problems had been solved. The minimum acceptable HLA mismatch was 50% with negative present or historical cross-match. A quadruple sequential immunosuppressive treatment was used, including either poly- or monoclonal globulins (thymoglobulin [ATG], lymphoglobulin [ALG], daclizumab, OKT-3) as an induction therapy and prednisolone, azathriopin and cyclosporin A as maintenance therapy. Rejection episodes were treated by pulse MP therapy or OKT-3 and increased doses of MMF if the patients were steroid-resistant. Kaplan-Meier survival curves showed that survival at 12, 36 and 60 month reached 90%, 75% and 60%, respectively. Survival was better after transplantation using a graft from a living donor than after transplantation using a graft from a cadaver donor (survival rates: 92%, 82% and 68% at 12, 36 and 60 months after surgery). Delayed graft functioning (DGF) was observed in 16 patients (17.3%), reaching 46.6% after transplantation of a graft from a cadaver donor and 10% after transplantation of a graft from a living donor. The relatively high percentage of DGF in the living donor program was due to the use of grafts from elderly donors (over 65 years of age). We registered 26 (29%) episodes of acute rejection that were predominantly histologically confirmed and further classified according to the BANFF criteria. Treatment of five steroid-resistant rejections proved to be successful. Neither early nor late surgical and medical complications were different from those reported in the literature. Despite the modest number of kidney transplantations, chronic renal failure has decreased in our region. The authors expect further improvement in this powerful therapeutic procedure thanks to links with regional and European transplant centers allowing better cooperation and organ sharing.     

Comparison of peri‐implant and periodontal marginal soft tissues in health and disease

The integrity of the peri‐implant soft‐tissue seal is crucial for maintaining peri‐implant tissue health. Whilst the transmucosal component of the restored implant shares some common features with teeth, namely the presence of a junctional epithelium and a connective tissue component, there are some important differences. A key difference is the nature of the relationship of the connective tissue with the implant surface, whereby there is ‘adaptation’ of collagen fibers in a parallel orientation in relation to the implant, but insertion of fiber attachment perpendicularly into cementum in the case of teeth. This, combined with reduced cellularity and vascularity in the peri‐implant connective tissue, may make implants more susceptible to disease initiation and progression. Furthermore, the presence of a subgingival connection between the implant and the abutment/restoration poses some specific challenges, and maintaining the integrity of this connection is important in preserving peri‐implant tissue health. Implant design features, such as the nature of the connection between the implant and the abutment, as well as the surface characteristics of the abutment and implants, may influence the maintenance of the integrity of soft tissue around implants. Iatrogenic factors, such as incorrect seating of the abutment and/or the restoration, and the presence of residual subgingival cement, will lead to loss of soft‐tissue integrity and hence predispose to peri‐implant disease.     

Development of the Croatian model of organ donation and transplantation

During the past ten years, the efforts to improve and organize the national transplantation system in Croatia have resulted in a steadily growing donor rate, which reached its highest level in 2011, with 33.6 utilized donors per million population (p.m.p.). Nowadays, Croatia is one of the leading countries in the world according to deceased donation and transplantation rates. Between 2008 and 2011, the waiting list for kidney transplantation decreased by 37.2% (from 430 to 270 persons waiting for a transplant) and the median waiting time decreased from 46 to 24 months. The Croatian model has been internationally recognized as successful and there are plans for its implementation in other countries. We analyzed the key factors that contributed to the development of this successful model for organ donation and transplantation. These are primarily the appointment of hospital and national transplant coordinators, implementation of a new financial model with donor hospital reimbursement, public awareness campaign, international cooperation, adoption of new legislation, and implementation of a donor quality assurance program. The selection of key factors is based on the authors'' opinions; we are open for further discussion and propose systematic research into the issue.Transplantation is a widely accepted and successful life-saving treatment providing the best therapeutic benefit for hundreds of thousands of patients (1). Unfortunately, many people die while awaiting an organ transplant. A global shortage of organs available for transplantation raises many bioethical concerns, including the dilemma how to allocate limited resources to an unlimited number of needs and thus offer a fair and equal access to organ transplantation to all patients. Great efforts have been made to increase organ donation worldwide, but with only a moderate success in most of the countries. In contrast with this general trend, Croatia has recently experienced a boom in organ donation and transplantation. In 2011, Croatia had the highest rates of utilized cadaveric donors, kidney transplantations, and liver transplantations in the world (2-5) (Figure 1).Open in a separate windowFigure 1The number of kidney transplantations and the number of patients on the waiting list in Croatia between 2008 and 2011.Remarkably, only one decade ago, Croatia was lagging far behind other European countries with a low donation rate (2.7 donors per million population [p.m.p.] in 2000). The continuous improvement of the organization of the Croatian transplant program resulted in a steadily growing donor rate, which reached the highest level in 2011, with 33.6 utilized donors p.m.p (2). We analyzed the factors that might have contributed mostly to this great success.