This study investigated the protective effects of carvedilol, a potent antioxidant, in a rat model of tourniquet-induced ischaemia-reperfusion injury of the hind limb. Thirty rats were divided equally into three groups: the control group (group 1) was only anaesthetized, without creating an ischaemia-reperfusion injury; group 2 was submitted to ischaemia (4 h), followed by a 2-h reperfusion period; and group 3 was pre-treated with carvedilol (2 mg/kg per day) for 10 days prior to ischaemia-reperfusion. Ischaemia-reperfusion produced a significant decrease in superoxide dismutase and glutathione peroxidase activities in the liver, lungs, muscle and serum compared with control treatment, and pre-treatment with carvedilol prevented these changes. Ischaemia-reperfusion caused a significant increase in malondialdehyde and nitric oxide (NO) levels in liver, lungs, muscle (except NO) and serum compared with control treatment, and carvedilol prevented these changes. In conclusion, it might be inferred that carvedilol could be used safely to prevent oxidative injury during reperfusion following ischaemia in humans.

BackgroundVarious types of markers have been used so far in order to reveal myocardial perfusion defect. However, these markers usually appear in the necrosis phase or in the late stage. Having been the focus of various investigations recently, ischemia-modified albumin (IMA) is helpful in establishing diagnosis in the early stages of ischemia, before necrosis develops.Methods and Results30 patients that underwent only coronary bypass surgery due to ischemic heart disease within a specific period of time have been included in the study. IMA levels were studied in the preoperative, intraoperative, and postoperative periods. The albumin cobalt binding assay was used for IMA determination. Hemodynamic parameters (atrial fibrillation, the need for inotropic support, ventricular arrhythmia) of the patients in the postoperative stage were evaluated. Intraoperative measurement values (mean ± SD) of IMA (0.67677 ± 0.09985) were statistically significantly higher than those in the preoperative (0.81516 ± 0.08894) and postoperative (0.70477 ± 0.07523) measurements. Considering atrial fibrillation and need for inotropics, a parallelism was detected with the levels of IMA.ConclusionsIMA is an early-rising marker of cardiac ischemia and enables providing a direction for the treatment at early phases.

Behçet's syndrome is a multisystem disorder presenting with recurrent oral and genital ulcerations as well as uveitis often leading to blindness. Although vascular lesions are a common complication of this disease, cardiac involvement is extremely rare. In this unusual case a young man had symptoms primarily related to recurrent right-atrial and right-ventricular thrombi unresponsive to medical treatment. The intracardiac lesion was successfully treated by surgical excision with the use of cardiopulmonary bypass. Surgical treatment should be considered in Behçet's disease complicated by cardiac thrombi, when a thrombus recurs despite medical treatment.

Centrifugal pumps are nonocclusive pumps that offer centrifugal blood pumping known as the constrained force vortex principle.Of 2405 open heart procedures, 370 (15.4%) were performed with a centrifugal pump (CP). In the rest of the cases extracorporeal circulation (ECC) was established with conventional roller pump (RP). The operations performed with a CP were: 34 reoperations, 11 ascending aortic aneurysms + coronary artery bypass graft (CABG), 47 multivalve replacements, 125 CABG + left ventricular aneurysmectomies, and 153 CABGs alone. This prospective study consisted of two groups, each group including 50 patients undergoing CABG surgery. In group I ECC was established with a CP and in group II with a conventional RR The two selected groups of patients were considered to be similar in terms of clinical, hemodynamic, and angiographic data. Hemodynamic study concerned flow rate, systemic vascular resistance (SVR), and urinary output. No difference was found between the CP and RP hemodynamically. Nevertheless, the alteration of the flow rate in response to variation of SVR is accepted as an advantage.As for hemolytic effect during ECC of CP compared with RP: Plasma free hemoglobin, hemotocrit, platelet count, platelet factor 4, and fibrinogen levels, were investigated. These parameters revealed that there was significant hemolysis and trauma to the blood components in the RP group when compared with the CR (p < 0.05, p < 0.01). at NORTH CAROLINA STATE UNIV on March 15, 2015 ves.sagepub.com Downloaded from 124There was no significant difference in psychoneurologic complications, but behavioral and sensory disorders were encountered sevenfold more in the RP group. This might be due to spoliation of the tubing set or to microair embolism.Compared with the conventional RP the CP proved to have no hemodynamic advantage. The effects on blood components showed significant trauma to the RP group. Postoperative drainage verified this observation (p < 0.05).In this study the CP appears to be superior to the RP especially in complicated and prolonged ECC.

AEF is a catastrophic complication of TEVAR. Conservative treatment is often associated with fatal results. If possible, these patients should be treated with secondary major surgical procedures.

There are various causes of the formation of arterial pseudoaneurysms, including trauma, surgical procedures, infection and iatrogenic injuries. A popliteal aneurysm was detected in a patient with pain and discomfort in his leg. The patient had a history of knee surgery. The aneurysm was treated surgically. Aneurysms following penetrating arterial injury resulting from surgical intervention requiring the use of surgical devices is one of the possible traumatic causes.

Bu çalışmada kalıcı hemodiyaliz kateterlerinin takılmasında en uygun ve güvenilir yöntemler, bu yöntemlerin komplikasyonları ve kateterlerin açıklık oranları değerlendirildi. Ça lış mapla nı:Ocak 2008-Haziran 2012 tarihleri arasında kliniğimizde kalıcı hemodiyaliz kateteri takılan ve halen hastanemiz hemodiyaliz ünitesinde hemodiyaliz programında olan 127 hasta (72 erkek, 55 kadın; ort. yaş 65.0±14.7 yıl; dağılım 17-85 yıl) retrospektif olarak değerlendirildi. Hastaların yaşı ve cinsiyeti, kateterlerin takılma endikasyonları, takılma yerleri, çıkarılma nedenleri, kullanım süreleri ve katetere bağlı komplikasyonlar kaydedildi. Kateter ömrü, kateterin takıldığı tarihten katetere bağlı gelişen komplikasyonlardan dolayı çıkarıldığı tarihe kadar geçen süre olarak tanımlandı. Bul gu lar: Yüz yirmi yedi hastaya toplam 155 adet kalıcı hemodiyaliz kateteri yerleştirildi. Kateterlerin 79'u sağ juguler ven, 22'si sol juguler ven, 13'ü sağ subklaviyan ven, sekizi sol subklaviyan ven, beşi sağ femoral venden yerleştirildi. Kateterler yedi hastada enfeksiyon, 13 hastada kateter içi tromboz, beş hastada kateter malpozisyonu, üç hastada ise diğer nedenlerle yeni bir kalıcı kateter ile değiştirildi. So nuç: Kalıcı hemodiyaliz kateterlerinin kullanım süresi uygun kateter seçimi, uygun kateter giriş yeri, klinisyenin deneyimi ve işlemin ultrasonografi veya floroskopi kılavuzluğunda yapılması ile doğrudan ilişkilidir. Anah tar söz cük ler: Kronik böbrek yetmezliği; hemodiyaliz; kalıcı kateter. Background: In this article, we evaluated the most appropriate and safest methods to insert permanent hemodialysis catheters, the complications of these methods and catheter patency rates. Methods: Between January 2008 and June 2012, 127 patients (72 males, 55 females; mean age 65.0±14.7 years; range, 17 to 85 years) in whom a permanent hemodialysis catheter was inserted in our clinic and who continued to undergo hemodialysis program in the hemodialysis unit of our hospital were retrospectively analyzed. Age and sex of the patients, indication for catheter insertion, the localization, reasons for catheter removal, duration of use and catheter-related complications were recorded. Life of the catheter was defined as the period of time from the date in which the catheter was inserted to the date in which the catheter was removed due to catheter-related complications. Results:A total of 155 permanent hemodialysis catheters were inserted to 127 patients. Seventy-nine were inserted via the right jugular vein, 22 via the left jugular vein, 13 via the right subclavian vein, eight via the left subclavian vein, five via right femoral vein. A new permanent catheter was inserted due to infection in seven patients, due to catheter thrombosis in 13 patients, catheter malposition in five patients, and other complications in three patients. Conclusion: The duration of use of a permanent hemodialysis catheter is directly related to an appropriate catheter choice, appropriate localization for insertion, experience of the clinician and with the guidance of ultra...

SummaryBackgroundObtaining vascular access suitable for long-term use in hemodialysis patients is of utmost importance. In these patients, autogenous methods are generally used for access. There are various techniques for obtaining autogenous access in hemodialysis patients.Material/MethodsOur objective was to evaluate the outcomes of the “diamond-shaped anastomosis” technique used as a surgical technique during the creation of arteriovenous fistulas in patients with chronic renal failure. We randomly selected and retrospectively examined 67 patients on whom the “diamond-shaped anastomosis” technique had been performed.ResultsWe found an 89% patency rate in the 67 randomly selected patients on whom we applied this technique in the early stage (first 6 months).ConclusionsMaintaining fistula patency in the early postoperative period is important in fistula functioning. The diamond-shaped anastomosis is a simple technique with proven efficiency. This method can be applied in all situations and contributes to postoperative early stage latency.