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Amaç: Bu çalışmada, abdominal aort cerrahisinde iskemi/ reperfüzyon (İ/R) sonrası uzak organ hasarı olarak akciğer üzerine silostazol, levosimendan ve bu ilaçların kombinasyonunun etkileri araştırıldı.Ça lış ma pla nı: Çalışma ortalama 219±26 g ağırlığında 35 erkek Wistar albino türü sıçan ile gerçekleştirildi. Sıçanlar her bir grupta yedi sıçan olacak şekilde randomize olarak beş gruba ayrıldı. Sıçanlara silostazol, levosimendan ve bu iki ilacın kombinasyonu ile tedavi uygulandıktan sonra, infrarenal aortik oklüzyon ile alt ekstremitelere 120 dakika iskemi ve sonrasında 60 dakika reperfüzyon uygulandı. Sıçanlar derin anestezi altında sakrifiye edildi ve akciğer dokuları çıkarıldı. Akciğer dokularında malondialdehid (MDA) düzeyleri, süperoksit dismutaz (SOD) aktiviteleri ve glutatyon (GSH) düzeyleri ölçüldü. Doku örnekleri ayrıca ışık mikroskobu ile histopatolojik olarak incelendi. Bul gu lar:Çalışmada İ/R'nin akciğer dokusunda MDA düzeylerini yükseltirken, SOD aktivitesini ve GSH düzeylerini azalttığı belirlendi (p<0.05). Silostazol, levosimendan ve bu ilaçların kombinasyonu ile MDA düzeyleri, SOD aktiviteleri, GSH düzeyleri ve akciğer hasarı skorunda iyileşme gözlendi (p<0.05). Bu ilaçların tek veya kombine kullanılması arasında anlamlı farklılık yoktu (p>0.05). So nuç:Bu bulgular ışığında, vasküler cerrahi sırasında ekstremite iskemisi öncesi silostazol ve levosimendan kullanımı akciğer dokusunu İ/R hasarından korumakta faydalı olabilir. Bununla birlikte, bu iki ilacın kombine kullanımı, İ/R hasarına karşı koruyuculuğu artırmamaktadır.Anah tar söz cük ler: Abdominal aort; silostazol; iskemi-reperfüzyon; levosimendan; akciğer hasarı.Background:In this study, we aimed to investigate the effects of cilostazol and levosimendan, and the combination of these agents on the lung remote organ damage after ischemia/reperfusion (I/R) following abdominal aortic surgery. Methods:The experiments were performed on 35 male Wistar albino rats weighing mean 219±26 g. The rats were randomly assigned into five groups, including each of seven rats. Rats were pretreated with cilostazol and levosimendan, alone or in combination, and then lower extremities were subjected to I/R induced by a infrarenal aortic occlusion for duration of 120 minutes, followed by a-60 minute-reperfusion. The rats were sacrificed under deep anesthesia and the lung tissues were removed. Malondialdehyde (MDA) levels, superoxide dismutase (SOD) activity, and glutathione (GSH) levels were measured in the lung tissues. The tissue samples were further examined histopathologically under light microscopy.Results: It was found that I/R elevated MDA levels accompanied by a reduction in SOD activities and GSH levels (p<0.05). Cilostazol and levosimendan, and their combination restored MDA levels, SOD activity, GSH levels and lung injury scores (p<0.05). There was no significant difference among individual or combined treatment of these agents (p>0.05). Conclusion:In light of these findings, cilostazol and levosimendan may be useful for protecting the lung tissue from...

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The administration of diclofenac sodium for 10 days following tetracycline pleurodesis reduces the effectiveness of pleurodesis in rabbits.

Antegrade cardioplegic delivery via the aorta ensures distribution of cardioplegic solution through open arteries, but distribution may not be adequate beyond a stenotic coronary artery. This potential problem can be overcome by direct delivery of cardioplegia via a vein graft. The purpose of this study was to compare simultaneous antegrade/vein graft cardioplegia with antegrade cardioplegia during coronary artery bypass surgery. Twenty patients were divided into 2 groups. In group 1, intermittent antegrade cardioplegia was provided (n=10). In group 2, intermittent antegrade cardioplegia was supplemented by antegrade perfusion of vein grafts after distal anastomoses were completed (n=10). Data on enzyme release and hemodynamics were obtained preoperatively, before the induction of anesthesia, just before cross-clamping, immediately after aortic unclamping, and at 1, 6, 12, 24, and 48 h after unclamping. Enzyme release (creatinine phosphokinase-isoenzyme MB, cardiac troponin I, myoglobin) was similar in both groups (P>.05). Furthermore, no significant difference was noted in the incidence of postoperative low cardiac output syndrome, perioperative myocardial infarction, or ventricular arrhythmia (P>.05). In conclusion, both techniques permitted rapid postoperative recovery of myocardial function. Supplementation of antegrade perfusion of vein grafts with antegrade cold blood cardioplegia offered no advantage to study patients.However, hemostasis of a distal anastomosis may be controlled by this technique.