Mesenchymal stem cells (MSCs), which may be obtained from the bone marrow, have been studied for more than a decade in the setting of coronary artery disease (CAD). Adipose tissue-derived MSCs have recently come into focus and are being tested in a series of clinical trials. MSC-like cells have also been derived from a variety of sources, including umbilical cord stroma, or HUC-MSCs. The HUC-HEART trail (ClinicalTrials.gov Identifier: NCT02323477) is a phase 1/2, controlled, multicenter, randomized clinical study of the intramyocardial delivery of allogeneic HUC-MSCs in patients with chronic ischemic cardiomyopathy. A total of 79 patients (ages 30-80) with left ventricle ejection fractions ranging between 25 and 45% will be randomized in a 2:1:1 pattern in order to receive an intramyocardial injection of either HUC-MSCs or autologous bone marrow-derived mononuclear cells (BM-MNCs) in combination with coronary arterial bypass grafting (CABG) surgery. The control group of patients will receive no cells and undergo CABG alone. Human HUC-MSCs will be isolated, propagated and banked in accordance with a cGMP protocol, whereas the autologous BM-MNCs will be isolated via aspiration from the iliac crest and subsequently process in a closed-circuit cell purification system shortly before cell transplantation. The cell injections will be implemented in 10 peri-infarct areas. Baseline and post-transplantation outcome measures will be primarily utilized to test both the safety and the efficacy of the administered cells for up to 12 months.

Background:Aortic valve stenosis (AVS) is the most common cause of left ventricular outflow obstruction, and its prevalence among elderly patients causes a major public health burden. Recently, platelet-to-lymphocyte ratio (PLR) has been recognized as a novel prognostic biomarker that offers information about both aggregation and inflammation pathways. Since PLR indicates inflammation, we hypothesized that PLR may be associated with the severity of AVS due to chronic inflammation pathways that cause stiffness and calcification of the aortic valve.Materials and Methods:We retrospectively enrolled 117 patients with severe degenerative AVS, who underwent aortic valve replacement and 117 control patients in our clinic. PLR was defined as the absolute platelet count divided by the absolute lymphocyte count. Severe AVS was defined as calcification and sclerosis of the valve with a mean pressure gradient of >40 mmHg.Results:PLR was 197.03 ± 49.61 in the AVS group and 144.9 ± 40.35 in the control group, which indicated a statistically significant difference (P < 0.001). A receiver operating characteristic (ROC) curve analysis demonstrated that PLR values over 188 predicted the severity of aortic stenosis with a sensitivity of 87% and a specificity of 70% (95% confidence interval = 0.734–0.882; P < 0.001; area under ROC curve: 0.808).Conclusion:We suggest that the level of PLR elevation is related to the severity of degenerative AVS, and PLR should be used to monitor patients' inflammatory responses and the efficacy of treatment, which will lead us to more closely monitor this high-risk population to detect severe degenerative AVS at an early stage.

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Renal failure requiring hemodialysis after CABG often results in high morbidity and mortality. Factors affecting microcirculation and atherosclerosis, like diabetes mellitus, carotid artery stenosis, and postoperative vasopressor use remain the major risk factors for the development of renal failure.

ÖZAmaç: Biz bu çalışmamızda, cerrahi tedavi uygulanan pilonidal sinüs tanılı hastalarımızın histo-patolojik verilerinden yola çıkarak, kliniğimizde seçilen cerrahi tekniğin belirlenmesinde göz önüne alınan morfolojik parametreleri retrospektif olarak ortaya çıkarmayı ve ileride uygulanacak olan cerrahi girişimlerin seçiminde kullanılabilir algoritmaların oluşturulması için bir temel oluşturabilmeyi amaçladık.Yöntemler: Bu çalışmada, İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi Genel Cerrahi Anabilim Dalı'nda 2007 ile 2011 yılları arasında pilonidal sinüs tanısı ile farklı cerrahlar tarafından opere edilen 594 hastanın histopatoloji raporları retrospektif olarak incelendi. Piyesin boyutu, orifis sayısı ve çapı, eksizyon materyalinin boyutu, cerrahi sınır (fistül ağzının en yakın cerrahi sınıra olan mesafesi) parametreleri elde edildi. Histo-patolojik verilerin yanı sıra, hastaların yaş ve cinsiyetlerinin operasyon seçimine etkisi de araştırıldı.Bulgular: Limberg flebi ile onarım, %68,7'lik oran ile en çok tercih edilen yöntem olarak belirlendi. Limberg grubunda fleb alanı ve cerrahi sınır diğer üç ameliyat grubundan anlamlı olarak yüksek bulunmuştur (p<0,05). Marsupiyalizasyon yönteminin, limberg, karydakis ve primer tamir ameliyatlarına göre, her geçen yıl kendi içinde anlamlı düzeyde daha fazla tercih edildiği gözlenmiştir (p<0,05). Tüm yöntemler incelendiğinde Karydakis ve primer tamir uygulanan kadınların erkek hastalara göre oranı, diğer iki yöntemdeki orandan anlamlı fazla bulunmuştur (p<0,001).Sonuç: Patolojik verilerden yola çıkarak yaptığımız inceleme sonucunda cerrahların pilonidal sinüs tedavi yöntemi tercihinde hastanın cinsiyetine, hastalığın derecesine, iyileşme sürecine, uyguladıkları cerrahi yönteme alışkanlıklarına ve rezeksiyon materyalinin genişliğine göre karar verdikleri görülmektedir. Anahtar Kelimeler: Pilonidal sinüs, limberg, karydakis, primer tamir, marsupiyalizasyonObjective: In this study we aimed to reveal the morphological parameters which are taken into account when determining the surgical technique and to define an algorithm to determine the surgical procedure for future patients, based on the histopathological data of patients who underwent surgical treatment for pilonidal disease, retrospectively. Methods:In this study histopathology reports of 594 patients who were operated by different surgeons between 2007 and 2011 at Istanbul University Cerrahpasa School of Medicine General Surgery Department were evaluated retrospectively. By evaluating the histopathology reports of patients retrospectively, we acquired data on specimen size, number and radius of orifice, size of excision material and surgical margin. Besides histopathological findings, we also researched the effects of patient age and gender on the surgical selection. Results:The Limberg flap was the most preferred method with a ratio of 68.7%. The Limberg flap region and surgical margin were significantly higher than the other three surgical groups (p<0.05). Unlike the limberg, karydakis and primary repair methods; patie...

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KEYWORDSNutcracker syndrome; Ultrasound; Doppler; MDCT.Abstract Posterior nutcracker syndrome is caused by compression of the left renal vein between the abdominal aorta and the vertebral column. We present the case of a 14-yearold girl with vague left loin pain, mild haematuria and proteinuria. Diagnosis of this rare syndrome was achieved using color Doppler US and multidetector computed tomography (MDCT) angiography.Sommario La sindrome da schiaccianoci posteriore è dovuta alla compressione della vena renale sinistra tra l'aorta addominale e la colonna vertebrale. Viene presentato il caso di una ragazza di 14 anni con lombalgia sinistra, lieve ematuria e proteinuria, in cui la diagnosi di questa rara sindrome è stata ottenuta con Eco-color Doppler e con l'Angio-TC. ª

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