ObjectiveIschemia-reperfusion injury after acute ischemia treatment is a serious condition with high mortality and morbidity. Ischemia-reperfusion injury may result in organ failure particularly in kidney, lung, liver, and heart. In our study, we investigated the effects of papaverine and vitamin C on ischemia-reperfusion injury developed in the rat liver after occlusion-reperfusion of rat aorta.Methods32 Sprague-Dawley female rats were randomized into four groups (n=8). Ischemia was induced with infrarenal aortic cross-clamping for 60 minutes; then the clamp was removed and reperfusion was allowed for 120 minutes. While the control group and the ischemia-reperfusion group did not receive any supplementary agent, two other groups received vitamin C and papaverine hydrochloride (papaverine HCL). Liver tissues were evaluated under the light microscope. Histopathological examination was assessed by Suzuki's criteria and results were compared between groups.ResultsIn ischemia-reperfusion group, severe congestion, severe cytoplasmic vacuolization, and parenchymal necrosis over 60% (score 4) were observed. In vitamin C group, mild congestion, mild cytoplasmic vacuolization and parenchymal necrosis below 30% (score 2) were found. In papaverine group, moderate congestion, moderate cytoplasmic vacuolization and parenchymal necrosis below 60% (score 3) were observed.ConclusionAn ischemia of 60 minutes induced on lower extremities causes damaging effects on hepatic tissue. Vitamin C and papaverine are helpful in reducing liver injury after acute ischemia reperfusion and may partially avoid related negative conditions.

Background: Postoperative atrial fibrillation (PoAF) is one of the most common complications to occur after open heart surgery. It has been shown that hypoalbuminemia accompanies some cardiovascular disorders. The present study evaluates the effects of pre-procedural albumin, blood urea nitrogen (BUN), and creatinine levels on PoAF. Methods: The data of 81 patients who underwent off-pump coronary artery bypass graft (CABG) surgery was evaluated. Patients who developed atrial fibrillation (AF) in the first 48 hours post surgery constituted the PoAF (+) group, while those without AF constituted the PoAF (-) group. The pre-procedural hematological parameters of patients in both groups were included in the analysis. Results: The PoAF (+) group was comprised of 57 patients (70.3%) with a mean age of 65.5 ± 9.8 years, while the PoAF (-) group was comprised of 24 patients (29.7%) with a mean age of 60.6 ± 9.6 years. A comparison of the demographic characteristics of the two groups showed that age (P = .036), frequency of renal failure (P = .007), and frequency of DM (P = .001) were higher in the PoAF (+) group. An examination of the laboratory data revealed a negative correlation between Hct (P = .001) and albumin (P = .000) levels and presence of PoAF. Also, the MPV (P = .02), BUN (P = .007), and Cr (P = .043) values were higher in the PoAF (+) group. Conclusion: The present study, whose focus was on the effects of albumin levels on the occurrence of PoAF, found that low levels of pre-procedural albumin, as one of the major proteins in the blood, is a risk factor for the development of PoAF.

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Acute dissection involving ascending aorta contains high risk of mortality and requires surgical treatment immediately. Venous thrombosis can manifested as deep vein thrombosis or pulmonary embolism. It may be isolated or complication of another disease. Because of pulmonary thromboembolism risk, treatment of deep vein thrombosis is strongly recommended. A 61-year-old male patient with severe back pain and shortness of breath presented to the emergency service. The findings of the physical examinations, chest x-ray and electrocardiogram were normal. Contrast-enhanced computerized tomography showed an aortic intimal tear that started just below the subclavian artery and extended into the iliac arteries. The patient was hospitalized and the medical treatment started. On the 4 th day of clinical follow-up, pain and swelling started at his right leg with severe shortness of breath. Venous Doppler ultrasound was performed and there were thrombosis at popliteal, femoral and even at iliac veins. Computed tomography showed pulmonary embolism at pulmonary trunk. Aortic dissection treated with endovascular stent graft firstly to prevent aortic rupture because of anticoagulation and then pulmonary embolism treated with anticoagulant drugs. Hypercoagulation is a self defence of the body for limiting the aortic intimal tear to prevent aortic rupture. So many complications could be seen because of this situation and the physicians should be awaken for this.

Patients with end-stage renal disease require vascular access for hemodialysis. Repeated insertions and longterm duration of permanent central venous catheters may cause venous stenosis and thrombosis in central veins, which may result in superior vena cava syndrome. A 38-year-old male patient with end-stage renal disease was admitted with complaint of dyspnea, edema of the face, neck and bilateral upper extremities. We had created a radiocephalic arteriovenous fistula at the level of left wrist two weeks ago, he had a permanent catheter in the right internal jugular vein for 2 months. The Doppler ultrasound and venographic examinations of central veins showed that the permanent catheter in the right internal jugular vein had caused the edema of the neck, face and bilateral upper extremities by narrowing the superior vena cava. The catheter was removed and the patient was anticoagulated. The patient's symptoms of shortness of breath were alleviated on hospital discharge and the swelling of the upper extremities diminished after one week. The hemodialysis patients should be directed to arteriovenous fistula surgery instead of central venous catheterization as soon as possible to avoid superior vena cava syndrome due to central venous catheters.

Pulmonary sequestration is defined as nonfunctioning lung tissue that is not in normal continuity with the tracheobronchial tree and that has a systemic arterial blood supply. Herein, we aimed to present a case of a 34-year-old male patient who had massive left-sided haemothorax on admission due to a giant intralobar pulmonary sequestration. An emergent repair was performed under cardiopulmonary bypass with axillofemoral cannulation.

Endovasküler anevrizma tamiri sonrası uzun dönemde gelişen akut aort trombozu nadirdir. Yetmiş sekiz yaşında bir erkek hasta dört saattir istirahat ağrısı ve alt ekstremitelerde ani başlangıçlı soğukluk ile başvurdu. Öyküsünden, iki yıl önce infrarenal abdominal aort anevrizması nedeniyle endovasküler anevrizma tamiri uygulanmış olduğu öğrenildi. Hastaya infrarenal akut aort trombozuna bağlı alt ekstremitelerde akut iskemi tanısı kondu. Öncelikle ekstremitenin kurtarılması amacıyla aksillo-bifemoral baypas uygulandı. Uzun dönem takip sırasında greftin sol bacağının tekrarlayan trombozları nedeniyle, yeterli alt ekstremite akımı sağlamak amacıyla aorto-bifemoral baypas işlemi yapıldı.Anah tar söz cük ler: Akut aort trombozu, aorto-bifemoral baypas, aksillo-bifemoral baypas, endovasküler anevrizma tamiri.