Acute kidney injury, formerly known as acute renal failure, is a pathological condition in which ischemia or toxic damage contributes to the loss of renal proximal tubule epithelial cells. Pathophysiological events such as oxidative stress, mitochondrial dysfunction, and direct renal tubular epithelial cells toxicity are responsible for the progression of the disease. This devastating decline in renal function affects mostly patients in the intensive care units and requires costly and invasive treatments such as dialysis and organ transplant. Fortunately, recent therapies such as the use of mesenchymal stem cells (MSCs) were proven to be effective in ameliorating renal failure via paracrine and immunomodulatory mechanisms. These fibroblast-like adult stem cells that differentiate multilineagely can be isolated from dental pulps, umbilical cords, amniotic fluids, adipose tissues, and bone marrows. Depending on their sources, the therapeutical application of each MSC type has its own capacities, advantages, and drawbacks. The review discusses and compares the latest research studies on the use of different MSCs sources to treat renal failure. Concerns about the future clinical application of MSCs such as homing, toxicity, and the risk of immune rejection are also highlighted.
Hibiscus rosa sinensis is known as China rose belonging to the Malvaceae family. This plant has various important medicinal uses for treating wounds, inflamation, fever and coughs, diabetes, infections caused by bacteria and fungi, hair loss, and gastric ulcers in several tropical countries. Phytochemical analysis documented that the main bioactive compounds responsible for its medicinal effects are namely flavonoids, tannins, terpenoids, saponins, and alkaloids. Experiment from recent studies showed that various types of extracts from all H. rosa sinensis parts exhibited a wide range of beneficial effects such as hypotensive, anti-pyritic, anti-inflammatory, anti-cancer, antioxidant, anti-bacterial, anti-diabetic, wound healing, and abortifacient activities. The few studies on toxicity exhibited that most extracts from all parts of this plant did not show any signs of toxicity at higher doses according to histological analysis. However, some of the extracts did alter biochemical and hematological parameters. Therefore, further research must be conducted to isolate the phytochemicals and explore their specific mechanism of action. This review summarizes the phytochemistry, pharmocology, and medicinal uses of this flower with the purpose of finding gaps demanding for future research and investigating its therapeutic potential through clinical trials.
Vertebrobasilar intracranial stenoses seem to carry a higher risk of brain stem ischemia than proximal vertebral artery stenoses. Our aim was to assess the value of transcranial Doppler sonogr~p~y versus angiography in detecting and quantifying these intracranial stenoses. All consecutive patients who underwent transcranial Doppler sonography prior to angiography from 1989 to 1994 and whose sonograms showed a stenosis of greater than 50% of one vertebral artery (21 cases) or of the basilar artery (eight cases) were included in the study. These patients were compared with 60 other consecutive stroke patients studied via transcranial Doppler sonography prior to normal vertebrobasilar angiography. The transcranial Doppler sonographic criteria for stenosis were a peak systolic frequency shift greater than 2 KHz. A tight stenosis was identified by this pattern combined with direct and reverse I ntracranial VA and basilar artery stenoses greater than 50% in diameter were found to carry a higher risk of brain stem ischemia than low frequencies of high spectrum energy. The sensitivity of transcranial Dopr.ler sonography using a peak systolic frequency shtft in diagnosing stenoses reached 80% and its specificity was 97% if only atheromatous stenoses were considered. The main diagnostic failures concerned bilateral stenoses or contralateral occlusion, tandem lesions, and upper basilar artery stenosis. Transcranial Doppler sonography underestimated the degree of stenosis compared to angiography in 55% of the cases. We conclude that transcranial Doppler sonography is accurate in recognizing a stenOsed vessel in the intracranial vertebrobasilar circulation, but if this finding will alter therapy, the examination must be comple--mented by magnetic resonance angiography. KEY WORDS: Transcranial Doppler sonography; Angiography; Intracranial stenosis; Vertebrobasilar arteries. extracranial VA stenoses in the studies by Moufarrij and coworkers.•..l These authors observed a 27% prevalence of defined vertebrobasilar ischemia in intracranial lesions versus 0% in extracranial lesions during a 5 year average follow-up period. Moreover, these ICVB stenoses are not uncommon.3.A The prevalence of stenosis was found to be 7.7% for the basilar artery and 6.6% for the VA in an angiographic popu• lation of 4748 patients with cerebrovascular events.'Noninvasive detection using TDS complemented by magnetic resonance angiography might be the future method of choice in this field. However, few TDS studies have investigated these intracranial stenoses, and each has studied only a small series of cases.s.n The purpose of this prospective study was to assess the value of TDS versus intraarterial angiography in detecting ICVB stenoses and in determining their topographic location and their quantification.
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