Objective: This study aimed to compare the results of oneand two-stage basilic vein transposition (BVT) in haemodialysis patients. Methods: This was a non-randomised, retrospective study between January 2007 and January 2012 on 96 patients who were diagnosed with end-stage renal failure (ESRF) (54 males, 42 females; mean age 43.6 ± 14 years) and underwent one-or two-stage BVT in our clinic. All patients who were not eligible for a native radio-cephalic or brachio-cephalic arterio-venous fistula (AVF) were scheduled for one-or twostage BVT after arterial (brachial, radial and ulnar) and venous (basilic and cephalic) Doppler ultrasonography.Patients were retrospectively divided into two groups: group 1, basilic vein diameter > 3 mm and patients who underwent one-stage BVT; and group 2, basilic vein diameter < 3 mm and patients who underwent two-stage BVT. In group 1, the basilic vein with a single incision was anastomosed to the brachial artery, followed by superficialisation. In group 2, the basilic vein was anastomosed to the brachial artery and they underwent the superficialisation procedure one month postoperatively. Fistula maturation and postoperative complications were assessed. Results: The mean diameter of the basilic vein was statistically significantly higher in group 1 (3.46 ± 0.2 mm) than in group 2 (2.79 ± 0.1 mm) (p < 0.05). In terms of postoperative complications, thrombosis, haemorrhage and haematoma were significantly higher in group 1 (34, 36 and 17%, respectively) than in group 2 (23, 14 and 6%, respectively) (p < 0.05). The rate of fistula maturation was significantly lower in group 1 (66%), compared to group 2 (77%) (p < 0.05). Time to fistula maturation was significantly shorter in group 1 (mean 41 ± 14 days), compared to group 2 (mean 64 ± 28 days) (p < 0.05). Conclusion: Two-stage BVT was superior to one-stage BVT due to its lower rate of postoperative complications and higher fistula maturation, despite its disadvantage of late fistula use. Although the diameter of the basilic vein was larger in patients who underwent one-stage BVT, we observed that one-stage BVT was disadvantageous in terms of postoperative complications and fistula maturation.

Background. Cardiac tamponade (CT) represents a life-threatening condition, and the optimal method of draining accumulated pericardial fluid remains controversial. We have reviewed 100 patients with CT at our institution over a five-year period and compared the results of echo-guided pericardiocentesis, primary surgical treatment, and surgical treatment following pericardiocentesis with regard to functional outcomes. Methods. The study group consisted of 100 patients with CT attending Yuzuncu Yil University from January 2005 to January 2010 who underwent one of the 3 treatment options (echo-guided pericardiocentesis, primary surgical treatment, and surgical treatment following pericardiocentesis). CT was defined by clinical and echocardiographic criteria. Data on medical history, characteristics of the pericardial fluid, treatment strategy, and follow-up data were collected. Results. Echo-guided pericardiocentesis was performed in 38 (38%) patients (Group A), primary surgical treatment was preformed in 36 (36%) patients (Group B), and surgical treatment following pericardiocentesis was performed in 26 (26%) patients (Group C). Idiopathic and malignant diseases were primary cause of tamponade (28% and 28%, resp.), followed by tuberculosis (14%). Total complication rates, 30-day mortality, and total mortality rates were highest in Group C. Recurrence of tamponade before 90 days was highest in Group A. Conclusions. According to our results, minimal invasive procedure echo-guided pericardiocentesis should be the first choice because of lower complication and mortality rates especially in idiopathic cases and in patients with hemodynamic instability. Surgical approach might be performed for traumatic cases, purulent, recurrent, or malign effusions with higher complication and mortality rates.

Objectives: The aim of the study was to assess the effect of paricalcitol on the experimental contrast-induced nephropathy (CIN) model. We hypothesised that paricalcitol may prevent CIN. Methods: 32 Wistar albino rats were divided into four groups (n58 each): control group, paricalcitol group, CIN group and paricalcitol plus CIN group. Paricalcitol (0.4 mg kg -1 day -1 ) was given intraperitoneally for 5 consecutive days prior to induction of CIN. CIN was induced at day 4 by intravenous injection of indometacin (10 mg kg -1 ), Nv-nitro-L-arginine methyl ester (L-NAME, 10 mg kg -1 ) and meglumine amidotrizoate (6 ml kg -1 ). Renal function parameters, oxidative stress biomarkers, histopathological findings and vascular endothelial growth factor (VEGF) immunoexpression were evaluated. Results: The paricalcitol plus CIN group had lower mean serum creatinine levels (p50.034) as well as higher creatinine clearance (p50.042) than the CIN group. Serum malondialdehyde and kidney thiobarbituric acid-reacting substances levels were significantly lower in the paricalcitol plus CIN group than in the CIN group (p50.024 and p50.042, respectively). The mean scores of tubular necrosis (p50.024), proteinaceous casts (p50.038), medullary congestion (p50.035) and VEGF immunoexpression (p50.018) in the paricalcitol plus CIN group were also significantly lower. Conclusion: This study demonstrates the protective effect of paricalcitol in the prevention of CIN in an experimental model.

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Oxidative stress is accepted as a nonclassical cardiovascular risk factor in chronic renal failure patients. The aim of this study was to evaluate the relation between oxidative DNA damage (8-hydroxy-2'-deoxyguanosine/deoxyguanosine [8-OHdG/dG] ratio), oxidative stress biomarkers, antioxidant enzymes, and carotid artery intima-media thickness (CIMT) in hemodialysis (HD) patients. Forty chronic HD patients without known atherosclerotic disease and 48 age- and sex-matched healthy individuals were included in the study. Plasma malondialdehyde (MDA) levels and 8-OHdG/dG ratio were determined as oxidative stress markers. Superoxide dismutase (SOD) and glutathione peroxidase (GPx) activities were measured as antioxidants. CIMT was assessed by carotid artery ultrasonography. 8-OHdG/dG ratios and MDA levels were higher; SOD and GPx activities were lower in HD patients compared to controls. HD patients had significantly higher CIMT compared to controls (0.61 ± 0.08 vs. 0.42 ± 0.05, p < 0.001). There was a significant positive correlation between CIMT and 8-OHdG/dG ratio (r = 0.57, p < 0.01) and MDA levels (r = 0.41, p < 0.01), while there was a significant negative correlation between CIMT and SOD (r = -0.47, p < 0.01) and GPx levels (r = -0.62, p < 0.01). It is firstly demonstrated that CIMT is positively correlated with oxidative DNA damage in HD patients without known atherosclerotic disease.

No abstract

Amaç: Hemodiyaliz (HD) için eş zamanlı olarak safen ven (SV) greft ve politetrafloroetilen (PTFE) greft ile sekonder arteriyovenöz fistül (AVF) oluşturulmuş hasta grupları, açıklık ve komplikasyon oranları yönünden gözden geçirildi. Ça lış ma pla nı: Ocak 2006 ile Ocak 2010 tarihleri arasında ardışık 40 hastada 40 HD erişim işlemi uygulandı. Tüm erişim girişimleri kol ve önkolun venlerinde ameliyat öncesi dubleks ultrasonografi (USG) taramaları ile gerçekleştirildi. Fonksiyonel açıklık hastanın başarılı bir şekilde HD yapılabilmesi olarak tanımlandı. Safen ven ve PTFE greftlerin toplam primer ve sekonder fonksiyonel açıklıkları Kaplan Meier yöntemi ile açıklık oranları arasındaki farklar Log-Rank testi ile tomboliz, trombektomi ve ameliyata bağlı revizyonlar gibi revizyon oranları arasındaki farklar ise Z testi ve Fisher exact t-testi ile belirlendi. Bul gu lar: Ortalama takip süresi 48 ay (dağılım 43-54 ay) idi. Her iki grubun risk faktörleri benzer idi. Safen ven greft daha uzun süreli açıklık oranlarına sahip idi. Hemodiyaliz giriş komplikasyonları SV greft grubunda daha yüksek iken, enfeksiyon ve tromboz PTFE greft grubunda daha yüksek idi. So nuç: Bizim verilerimiz üst ekstremitesinde sekonder AVF açılabilecek hastalarda, anatomik kriterlere bağlı olarak SV greftin PTFE greftten daha önce düşünülmesi gerektiğini kuvvetle desteklemektedir. Anah tar söz cük ler: Arteriyovenöz fistül; hemodiyaliz; politetrafloroetilen greft; safen ven greft. Background:Patient groups with secondary arteriovenous fistula (AVF) management with saphenous vein (SV) graft and polytetrafluoroethylene (PTFE) graft for hemodialysis (HD) were reviewed in terms of patency and complication rate. Methods: Forty HD access procedures were performed in 40 consecutive patients between January 2006 and January 2010. All access procedures were planned on the basis of preoperative duplex ultrasonography (USG) scans of arm and forearm veins. Functional patency was defined as ability to cannulate for HD successfully for the patient. Primary and secondary cumulative functional patency of SV and PTFE grafts were determined with Kaplan Meier test; differences in patency rates were analyzed with Log Rank test and differences in revision rates including thrombolysis, thrombectomies and operative revisions were analyzed with the Z test and the Fisher's exact t-test. Results: Mean follow-up was 48 months (range 43-54 months). Risk factors were similar between the two groups. Saphenous vein graft had better patency rates. The HD access complications were higher in SV graft group, while infection and thrombosis were higher in PTFE group. Conclusion: Our data strongly support the necessity that SV graft should be considered initially, compared to PTFE graft, for the patient who is a candidate for an upper arm secondary AVF creation based on anatomical criteria.

The biodegradable ring annuloplasty technique may be used easily and safely in moderate and severe cases of tricuspid regurgitation; however, larger clinical series are necessary to confirm our promising results.