BACKGROUND: Penetrating cardiac injuries are high-risk, high-mortality injuries considering the outcomes. Therefore, it is important to choose the appropriate incision. In general clinical settings, thoracotomy and median sternotomy are choices of incisions to explore the injury. In this study, the results of median sternotomy and thoracotomy in penetrating cardiac injuries were compared.

Atrial fibrillation (AF) is a cardiac dysrhythmia commonly seen in clinical practice especially after cardiac surgery. It is associated with increased morbidity and mortality for the patients. The pathogenesis of AF is not exactly understood yet, but there is growing data about the relationship between AF and inflammation. Cardiac surgery itself is a big source for inflammation. It causes major surgical trauma, ischemia/reperfusion injury, hypothermia, low arterial pressure, and the equipment of cardiopulmonary bypass makes a large foreign surface thus it activates inflammatory response. There is a large number of data about the treatment options of AF and there are also strategies, which are related to reduction of inflammatory activation during cardiopulmonary bypass. In order to review the relationship between cardiac surgery, inflammation, AF and treatment strategies in patients with AF, we conducted a search through Pubmed for articles in English using the keywords: "atrial fibrillation, cardiac surgery, inflammation, medical therapy, surgical therapy, ablation therapy" from January 2012 to present. We also searched separately for each alternative treatment modality on Pubmed. To identify further articles, we also looked into related citations in review articles and commentaries. We searched thoroughly the guidelines published by the European Society of Cardiology (2016), and the American Heart Association/ American College of Cardiology/ Heart Rhythm Surgery (2014). Many studies concluded that inflammation contributes in the occurrence of AF. Inflammatory markers, such as CRP, interleukins and complements have high sensitivity and specificity for prediction of AF whether the patient having cardiac surgery or not. Betablockers, diltiazem and amiodarone are the most commonly used drugs for rate control in AF following surgery. Although there are some new therapeutic approaches to reduce postoperative inflammatory activation, such as the use of vitamins, fatty acids, statins, or technical improvements to cardiopulmonary bypass unit like miniaturized bypass circuits, heparin coating of the circuits, leukocyte filters, or various surgical approaches like off-pump coronary bypass surgery, we still need more effective strategies to reduce both postoperative inflammation and postoperative AF risk after cardiac surgery. Today we use more advanced invasive and surgical treatment strategies for AF although we need far more advanced technics to reduce perioperative inflammatory activation, which actually causes AF.

Endovenous laser ablation procedure of great saphenous vein with a 1470-nm diode laser is a minimally invasive, safe, and efficient treatment option in all-suitable patients with high short- and mid-term success rate.

Objective Since the systemic drugs have been used to reduce the hyperplasic response in the tunica intima, the periadventitial local drug applications to the vascular wall have gained more popularity. In this study, we investigated the effect of bovine serum albumin-glutaraldehyde and polyethylene glycol polymer on neointimal hyperplasia in rabbit carotid artery anastomosis to explore the effects of these two different agents. Methods 21 New Zealand male rabbits were randomly divided into three groups. The carotid artery transection and anastomosis was performed onthe control group. The bovine serum albumin-glutaraldehyde and the polyethylene glycol polymer were applied locally on the other two groups seperatley after transection and anastomosis of the carotid arteries. At the end of 28-day follow-up, the histological and the immunohistochemical results related to neointimal hyperplasia were compared. Results The glue residues were detected in the BSA-glutaraldehyde group, but in the PEG polymer group there was no glue residue. The intima thickness and the intima/media thickness ratio in the control group was significantly higher (p<0.05) than the other groups. These values did not differ significantly between the BSA-glutaraldehyde group and the PEG polymer group (p>0.05). The lumen diameter and the area in the control group were significantly higher (p < 0.05) than the BSA-glutaraldehyde group. These values between the control group and the PEG polymer group did not differ significantly (p>0.05). aSMA-positive staining score in the Control group was found to be significantly lower (p < 0.05) than the BSA-glutaraldehyde and PEG polymer group and the VEGF-positive staining score in the control group was found to be significantly higher (p < 0.05) than the BSA-glutaraldehyde and the PEG polymer group. Conclusions Although the both agents have positive results on neointimal hyperplasia, it would be favorable to use polyethylene glycol polymer, since it does not seem to affect the lumen area and the lumen diameter of the vessel.

Bu çalışmada bir sıçan modelinde alt ekstremite iskemi reperfüzyonunun karaciğer üzerindeki etkisi ile karaciğerin spesifik iskemi reperfüzyonunun karaciğer üzerindeki etkisi karşılaştırıldı.Ça lış mapla nı:Otuz adet Sprague-Dawley tipi erkek sıçan 10'arlı olarak rastgele üç gruba ayrıldı: kontrol grubu (Grup 1), alt ekstremite iskemi reperfüzyon grubu (Grup 2) ve karaciğer iskemi reperfüzyon grubu (Grup 3). Grup 2'de sol alt ekstremiteye bir saat süreyle iskemi uygulandı. Grup 3'te karaciğere bir saat süreyle iskemi ve ardından 24 saat süreyle reperfüzyon uygulandı. Reperfüzyon sonrası karaciğer dokuları çıkarıldı ve gruplar biyokimyasal ve histolojik olarak değerlendirildi.Bul gu lar: Karaciğer malondialdehit düzeyleri Grup 2 ve Grup 3'te kontrol grubuna kıyasla anlamlı olarak yüksek idi (p<0.001). Grup 2'de malondialdehit düzeyleri Grup 3'e kıyasla anlamlı olarak yüksek idi (p= 0.019). Karaciğer glutatyon düzeyleri Grup 2 ve Grup 3'te kontrol grubuna kıyasla anlamlı olarak düşük idi (p<0.001). Ancak, Grup 2'de glutatyon düzeyleri Grup 3'e kıyasla anlamlı olarak yüksek idi (p= 0.005). Histolojik değerlendirmede karaciğer hasar skoru Grup 3'te Grup 2'ye kıyasla daha yüksek olmakla birlikte (p= 0.015), TUNEL(+) hücre sayısı açısından iki grup arasında anlamlı bir fark yoktu (p>0.05). So nuç:Alt ekstremite iskemi reperfüzyonu sonrası karaciğerde reperfüzyon hasarı, spesifik olarak karaciğerde meydana getirilen iskemi reperfüzyon hasarı kadar önemlidir. Özellikle vasküler travma sonrası yapılan reperfüzyon ameliyatlarında veya alt ekstremite vasküler travma sonrası kanamayı durdurmak için ayak turnikelerinde bu durum göz önünde bulundurulmalıdır.

Different systems for delivering tumescent solution exist in endovenous laser ablation (EVLA). This study evaluated three different tumescent delivery systems in patients with primary varicose veins due to great saphenous vein reflux who were treated with EVLA. In this prospective non-randomized study, 60 patients with isolated GSV varicose veins were divided into three groups. All patients received EVLA treatment. Three different tumescent solution delivery systems were used. Systems consisted of a needle and a syringe in Group 1, a needle connected to an infusion bag system in Group 2 and a peristaltic infiltration pump in Group 3. Tumescent delivery durations were in Group 1: 6.56 SD 1.18 minutes, Group 2: 6.05 SD 2.19 minutes and Group 3: 5.19 SD 1.15 minutes (P = 0.014). In the outcomes of the study there were no significant difference between groups. Although peristaltic pump systems might provide shorter tumescent delivery durations without hand fatigue, shorter duration does not have any practical importance (about 1 minute and also it is not cost-effective. For delivering tumescent solutions in EVLA procedures, there was no major superiority between systems.

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