This study shows that in spite of undergoing therapy, the subsequent QoL scores did not improve significantly, indicating that CVD continued to negatively affect the patient's life.

Introduction. Extracorporeal circulation (ECC) related systemic oxidative stress is a well-known entity but the underlying mechanisms are not clearly described. Our aim was to investigate the relation between the oxidative stress indices, inflammatory markers, and phosphorylcholine-coated (PCC) ECC systems. Patients and Methods. Thirty-two consecutive coronary artery bypass grafting (CABG) cases were randomly assigned to Group I (PCC, n = 18) and Group II (noncoated, n = 14) ECC circuits. Total Antioxidant Status (TAS), Total Oxidant Status (TOS), Tumor Necrosis Factor-α (TNF-α), Interleukin-1β (IL-β), Interleukin-6 (IL-6), Interleukin-8 (IL-8), Interleukin-10 (IL-10), and Procalcitonin (PCT) levels were measured at 5 different time points. The association between the oxidative indices levels and PCC system used was analyzed. Results. In Group I TOS and TAS statuses were increased at T1, T2, T3, and T4, while IL-10 and TNF-α levels accompanied those raises only at T2 (Group I-Group II, 4.73 ± 2.04 versus 2.79 ± 0.63, p = 0.002, and 30.56 ± 8.11 versus 23.97 ± 7.8, p = 0.031, resp.). In contrast, mean TAS and TOS levels were similar to baseline at all time points in Group II but IL-6 and IL-8 levels were increased at T2 (Group I-Group II, 16.84 ± 5.63 versus 44.81 ± 17.0, p = 0.001, and 38.88 ± 9.8 versus 46.14 ± 9.25, p = 0.038, resp.). Conclusion. Even coated ECC systems are still incapable of attenuating the inflammatory response to cardiopulmonary bypass (CPB).

The results of this study emphasise that the successful treatment of chronic non-healing wounds require a multidisciplinary team approach under the control of a wound care specialist. Whatever the disinfectant used, consistency in the approach to treatment may be more important. We suggest that increasing the use of PHMB and adoption of this team approach in other cardiac centres or other populations may decrease the healing period, especially in chronic non-healing wounds.

In this study, we investigated the factors affecting survival in patients who were operated for penetrating cardiac and vascular injuries due to penetrating thoracic trauma. Ninety-six patients with penetrating thoracic trauma (90 males, 6 females, mean age 26±8 years) who were admitted to our clinic between January 2010 and January 2013 were recruited to the study. Retrospective evaluation of the cause of trauma, age, gender, concomitant organ injuries, Rohman classification, Glasgow coma score, Heart Injury Scale, Lung Injury Scale, penetrating thoracic trauma index, surgical intervention, and mortality were determined. The mortality rate was 39.6% in our study and correlated with cardiac tamponade, systolic blood pressure, heart rate, Glasgow coma score, heart injury scale and penetrating thoracic trauma index. However, a significant relationship was found only between mortality and systolic blood pressure in a binary logistic regression model (p=0.024). In patients with penetrating thoracic trauma, rapid assessment and management of fluid and blood resuscitation that can hold the systolic blood pressure above 80 mmHg and prompt surgical intervention may reduce mortality and may affect the outcomes in penetrating cardiac and other major vascular injuries. Keywords: Cardiac wounds; penetrating cardiac injuries; penetrating chest wounds Özet Bu çalışmada, sadece penetran toraks travması olan, kardiyak ve büyük damar hasarlanması nedeni ile ameliyat edilen hastalarda sağ kalıma etki eden faktörler incelenmiştir. Ocak 2010-Ocak 2013 yılları arasında acil servise penetran toraks travması nedeni ile başvuran 632 hasta dosyası retrospektif olarak incelenmiş ve 96 hasta (90 erkek ve 6 kadın, ortalama yaş 26±8 yıl) çalışmaya alınmıştır. Hastaların yaşı, cinsiyeti, yaralanma şekli, eşlik eden diğer yaralanmaları, Rohman sınıflaması, Glasgow koma skorlaması (GKS), kalp hasar skalası, akciğer hasar skalası, penetran toraks travma sınıflaması, uygulanan cerrahi girişim ve mortaliteleri incelenmiştir. Çalışmadaki mortalite oranı %39.6 olarak bulunmuştur. Mortalite; kardiyak tamponad, sistolik arter basıncı, kalp hızı, Glasgow koma skoru, kalp hasar skalası ve penetran toraks travma sınıflaması ile korole bulunurken ikili lojistik regresyon modellemesinde sadece sistolik arter basıncının 80 mmHg altında oluşu mortalite ile ilişkili bulunmuştur (p=0.024). Penetran toraks travması bulunan hastalarda hızlı klinik değerlendirme sonrasında sistolik arter basıncını 80 mmHg üstünde tutacak şekilde sıvı resüsitasyonu ve kan replasmanı yapılması ve hızlı cerrahi müdahale mortaliteyi düşürebilir ve penetran kalp ve damar yaralanması olan hastaların sağ kalımına olumlu etki edebilir. Anahtar kelimeler: Kardiyak yaralanma; penetran kalp yaralanması; penetran göğüs travması

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Kromozomların uçlarında tekrarlayan TTAGGG ünitelerinden oluşan telomerik yapılar bulunmaktadır. Her hücresel bölünme ile birlikte telomerik uçlardan bir miktar DNA kaybedilmektedir.Telomeraz, kendi RNA'sını kalıp olarak kullanarak kendini sentezleme yeteneği olan ve heksomerik parçaları [(TTAGGG)n] kromozomal uçlara ekleyerek telomerik DNA'nın uzatılması, kromozomal uçlardaki kaybın dengelemesi ve korunması görevi olan ribonükleoprotein yapıda bir enzimdir.Kanser vakalarında, hücrenin telomer uzunluğu ve telomeraz aktivitesi incelendiğinde in vivo ortamda tümör oluşumu ve telomeraz aktivitesinin birbiri ile ilintili olduğu gösterilmiştir. İyi huylu tümörlerde telomeraz aktivitesi yoktur ve telomerleri kısaldıkça erken evrelerine geri dönmektedirler. Daha saldırgan seyreden metastatik tümörlerde ise yüksek telomeraz aktivitesi gösterilmiştir. CURRENT APPROACHES TOWARDS DNA ABOUT CANCER DIAGNOSIS AND TREATMENT : TELOMERASE/ TERT Keywords Abstract Telomerase TERT Tumorigenesis CancerThere are telomeric regions formed from repetitive TTAGGG sequences at the end of the chromosome. Some of the DNAs are lost from telomeric ends with each duplication. The telomerase is a ribonucleoprotein enzyme, which has the ability to synthesize itself by using its own DNA as a template and balancing loss in chromosomal ends and protecting it by adding heksametric parts to the ends.When cell telomere length and telomerase activity is examined in cancer cases; tumorigenesis and telomerase activity is shown to be related each other. There is no telomerase activity in benign tumors and they return to their early stages as the telomere shortens. High telomerase activity has been shown with metastati c tumors, which are more aggressive.

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IntroductionPatients experience muscle, joint and shoulder pain after heart surgery. We aimed to compare quality of life in 2 groups of patients, one group having an internal mammary artery (IMA) retractor during surgery, the second group undergoing non-coronary heart surgery.Material and methodsGroup 1 was composed of 39 patients receiving an IMA retractor whereas in group 2 there were 29 patients. Patients in groups were compared for postoperative quality of life, shoulder pain, functional status, strength and patient satisfaction.ResultsVisual analog scale (VAS) assessment, pain localization, quality of life SF-36 form, and University of California at Los Angeles (UCLA) functional shoulder scoring were applied in both groups. Mean VAS score in group 1 was significantly higher than in group 2. Only the vitality measure mean score was not significantly different in SF-36 assessment; however, in group 2 physical function and mental health scale mean scores were higher and the pain scale mean score was lower than in group 1. The total UCLA score and UCLA subgroups of pain, function, active flexion angle and strength revealed a statistically significant difference between groups.ConclusionsPatients in whom an IMA retractor was not utilized during surgery exhibited better results in physical functions, emotional status, and shoulder pain in the postoperative period.