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ABSTRACT Introduction: Minimally invasive methods have become more preferred in cardiac surgery today. In this study, the comparative results of patients who underwent an aortic root, arch or hemiarch replacement by ministernotomy and full sternotomy in our clinic are presented. Methods: Between January 2017 and October 2019, a series of operations including aortic root, ascending aorta, and aortic arch replacements were performed on 278 patients. The ministernotomy technique was used in 25 of them. Twenty patients who underwent full sternotomy were selected and matched to this group for comparison. Results: The ministernotomy group had a longer cross-clamping time (128.3±30.8 vs. 104.7±23.4 min, P=0.007) but the total operating time was similar in the two groups (249.76±28.56 vs. 248.25±37.53 min, P=0.879). The number of red blood cell (RBC) transfusions per patient was higher in the full sternotomy group (4.65±3.74 vs. 2.44±1.85 unit, P=0.020). The ministernotomy group had shorter ventilation times (7.60±4.88 vs. 32.30±32.25 h, P<0.001) and shorter ICU stay (1.56±0.58 vs. 3.35±1.46 d, P<0.001). The 30-day mortality was 0% in the ministernotomy group. Conclusion: Early results of our study show that, in combined or isolated aortic root, ascending aorta, and aortic arch surgeries, ministernotomy can be applied with relatively safety and low mortality and morbidity rates.

RESUMEN

INTRODUCTION: Minimally invasive methods have become more preferred in cardiac surgery today. In this study, the comparative results of patients who underwent an aortic root, arch or hemiarch replacement by ministernotomy and full sternotomy in our clinic are presented. METHODS: Between January 2017 and October 2019, a series of operations including aortic root, ascending aorta, and aortic arch replacements were performed on 278 patients. The ministernotomy technique was used in 25 of them. Twenty patients who underwent full sternotomy were selected and matched to this group for comparison. RESULTS: The ministernotomy group had a longer cross-clamping time (128.3±30.8 vs. 104.7±23.4 min, P=0.007) but the total operating time was similar in the two groups (249.76±28.56 vs. 248.25±37.53 min, P=0.879). The number of red blood cell (RBC) transfusions per patient was higher in the full sternotomy group (4.65±3.74 vs. 2.44±1.85 unit, P=0.020). The ministernotomy group had shorter ventilation times (7.60±4.88 vs. 32.30±32.25 h, P<0.001) and shorter ICU stay (1.56±0.58 vs. 3.35±1.46 d, P<0.001). The 30-day mortality was 0% in the ministernotomy group. CONCLUSION: Early results of our study show that, in combined or isolated aortic root, ascending aorta, and aortic arch surgeries, ministernotomy can be applied with relatively safety and low mortality and morbidity rates.

Asunto(s)

Procedimientos Quirúrgicos Cardíacos , Implantación de Prótesis de Válvulas Cardíacas , Humanos , Aorta Torácica/cirugía , Resultado del Tratamiento , Procedimientos Quirúrgicos Mínimamente Invasivos/métodos , Aorta/cirugía , Procedimientos Quirúrgicos Cardíacos/métodos , Esternotomía/métodos , Estudios Retrospectivos , Válvula Aórtica/cirugía , Implantación de Prótesis de Válvulas Cardíacas/métodos

RESUMEN

OBJECTIVES: To investigate the association between clinical hematologic parameters and saphenous vein graft failure after on-pump coronary artery bypass surgery. METHODS: A total of 1950 consecutive patients underwent isolated on-pump coronary artery surgery between November 2010 and February 2013. Of these, 284 patients met our inclusion criteria; their preoperative clinical hematological parameters were retrospectively obtained for this cohort study. And of them, 109 patients underwent conventional coronary angiography after graft failure was revealed by coronary computed tomography angiography. The primary endpoint was to catch at least one saphenous vein graft stenosis or occlusion following the coronary angiogram. We then analyzed risk factors for graft failure. In sequential or T grafts, each segment was analyzed as a separate graft. RESULTS: In logistic regression analysis, older age, platelet distribution width, and diabetes mellitus were identified as independent predictors of saphenous vein graft failure (P<0.). In contrast, preserved ejection fraction value favored graft patency (P<0.001). CONCLUSION: Increased platelet distribution width is easily measurable and can be used as a simple and valuable marker in the prediction of saphenous vein graft failure.

Asunto(s)

Plaquetas/fisiología , Puente de Arteria Coronaria/efectos adversos , Vena Safena/trasplante , Grado de Desobstrucción Vascular/fisiología , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Angiografía Coronaria/métodos , Puente de Arteria Coronaria/métodos , Enfermedad de la Arteria Coronaria/etiología , Ecocardiografía , Femenino , Pruebas Hematológicas , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Recuento de Plaquetas , Valor Predictivo de las Pruebas , Curva ROC , Valores de Referencia , Estudios Retrospectivos , Factores de Riesgo , Vena Safena/fisiopatología , Estadísticas no Paramétricas , Insuficiencia del Tratamiento

RESUMEN

Abstract Objectives: To investigate the association between clinical hematologic parameters and saphenous vein graft failure after on-pump coronary artery bypass surgery. Methods: A total of 1950 consecutive patients underwent isolated on-pump coronary artery surgery between November 2010 and February 2013. Of these, 284 patients met our inclusion criteria; their preoperative clinical hematological parameters were retrospectively obtained for this cohort study. And of them, 109 patients underwent conventional coronary angiography after graft failure was revealed by coronary computed tomography angiography. The primary endpoint was to catch at least one saphenous vein graft stenosis or occlusion following the coronary angiogram. We then analyzed risk factors for graft failure. In sequential or T grafts, each segment was analyzed as a separate graft. Results: In logistic regression analysis, older age, platelet distribution width, and diabetes mellitus were identified as independent predictors of saphenous vein graft failure (P<0.). In contrast, preserved ejection fraction value favored graft patency (P<0.001). Conclusion: Increased platelet distribution width is easily measurable and can be used as a simple and valuable marker in the prediction of saphenous vein graft failure.

Asunto(s)

Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Vena Safena/trasplante , Plaquetas/fisiología , Grado de Desobstrucción Vascular/fisiología , Puente de Arteria Coronaria/efectos adversos , Recuento de Plaquetas , Valores de Referencia , Vena Safena/fisiopatología , Enfermedad de la Arteria Coronaria/etiología , Ecocardiografía , Modelos Logísticos , Puente de Arteria Coronaria/métodos , Valor Predictivo de las Pruebas , Estudios Retrospectivos , Factores de Riesgo , Curva ROC , Factores de Edad , Angiografía Coronaria/métodos , Insuficiencia del Tratamiento , Estadísticas no Paramétricas , Pruebas Hematológicas

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Abstract The present study aimed to investigate the protective effects of silymarin (SMN), an antioxidant, on methotrexate (MTX)-induced damage in rat testes. Thirty-two Wistar albino rats were divided into four groups (n = 8): control, MTX (20 mg/kg, i.p. on days 1 and 5), SMN (200 mg/kg, orally), and MTX + SMN (20 mg/kg, i.p. on days 1 and 5 and SMN 200 mg/kg orally) groups. At the end of the 6-week trial period, histopathological, immunohistochemical, biochemical, and spermatological analyses were performed on testes tissues. Histopathologically, MTX-induced damage, including depletion of germ cell and loos of spermatozoa, was significantly improved with SMN treatment. Immunohistochemically, the immunoreactivity of glutathione peroxidase 1 (GPx1) and manganese superoxide dismutase 2 (SOD2) were detected more intensely in the MTX + SMN group than in the MTX group. Biochemical examinations revealed that SMN supplementation decreased the lipid peroxidation and increased enzymatic antioxidants in the SMN-treated rats. Spermatologically, significant differences were found in the density, motility, dead-to-live sperm ratio, and abnormal sperm rate in the MTX + SMN group compared to the MTX group. In conclusion, SMN seems to have protective effects as an antioxidant against MTX-induced damage in rat testes.

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Animales , Masculino , Ratas , Silimarina/efectos adversos , Testículo/anomalías , Sustancias Protectoras/análisis , Metotrexato/análisis

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BACKGROUND: Localized scleroderma is a chronic inflammatory skin disease characterized by sclerosis of the dermis and subcutaneous tissue. Platelets play an important role in inflammation. Following activation, platelets rapidly release numerous mediators and cytokines, which contribute to inflammation. OBJECTIVES: To evaluate whether there was any relation between localized scleroderma and platelet parameters. METHODS: Forty-one patients with localized scleroderma were enrolled in the study. The control group consisted of 30 healthy subjects. RESULTS: The mean platelet volume level in the patient group was 9.9 ± 1.3 fl and in the control group was 7.6 ± 1.1 fl. This difference was statistically significant (p< 0.001). The plateletcrit values are minimally higher in the patient group as compared to the control group. It was statistically significant (p<0.001). There was no significant difference in the platelet counts between the two groups (p= 0.560) In the patient group, there was no significant relation between the mean platelet volume levels and clinical signs of disease (p=0.09). However, plateletcrit values are higher in generalized than localized forms of disease (p=0.01). STUDY LIMITATIONS: The limited number of patients and the retrospective nature of the study were our limitations. CONCLUSIONS: This study suggests that platelets might play a role in the pathogenesis of scleroderma. Platelet parameters may be used as markers for evaluating disease severity and inflammatory processes. Thus, there is a need for more detailed and prospective studies.

Asunto(s)

Volúmen Plaquetario Medio , Esclerodermia Localizada/sangre , Adolescente , Adulto , Biomarcadores , Estudios de Casos y Controles , Niño , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven

RESUMEN

Abstract: Background: Localized scleroderma is a chronic inflammatory skin disease characterized by sclerosis of the dermis and subcutaneous tissue. Platelets play an important role in inflammation. Following activation, platelets rapidly release numerous mediators and cytokines, which contribute to inflammation. Objectives: To evaluate whether there was any relation between localized scleroderma and platelet parameters. Methods: Forty-one patients with localized scleroderma were enrolled in the study. The control group consisted of 30 healthy subjects. Results: The mean platelet volume level in the patient group was 9.9 ± 1.3 fl and in the control group was 7.6 ± 1.1 fl. This difference was statistically significant (p< 0.001). The plateletcrit values are minimally higher in the patient group as compared to the control group. It was statistically significant (p<0.001). There was no significant difference in the platelet counts between the two groups (p= 0.560) In the patient group, there was no significant relation between the mean platelet volume levels and clinical signs of disease (p=0.09). However, plateletcrit values are higher in generalized than localized forms of disease (p=0.01). Study Limitations: The limited number of patients and the retrospective nature of the study were our limitations. Conclusions: This study suggests that platelets might play a role in the pathogenesis of scleroderma. Platelet parameters may be used as markers for evaluating disease severity and inflammatory processes. Thus, there is a need for more detailed and prospective studies.

Asunto(s)

Humanos , Masculino , Femenino , Niño , Adolescente , Adulto , Persona de Mediana Edad , Adulto Joven , Esclerodermia Localizada/sangre , Volúmen Plaquetario Medio , Biomarcadores , Estudios de Casos y Controles

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The aim of this study was to elucidate the presence of components of the innate immune system inthe bovine corpus luteum (CL) by detecting the expression and cell-specific localization of TLR2 and TLR4 during different stages of the estrous cycle in a control study design. Bovine CL samples were collected from a local slaughterhouse and assigned to three groups as follows: developing CL (dCL; n = 6, approx. days 3–6), mature CL (mCL; n = 5, approx. days 8–12), and regressing CL (rCL; n = 5, approx. days 17–19). An upregulation of TLR2 mRNA was detected only in rCL(P < 0.05). Localization of the TLR2 protein was particularly apparent in luteal cells and a prominent immunofluorescent signal corresponding to TLR2 was detected only in rCL. TLR4 mRNA were higher in mCLand rCL compared to dCL(P < 0.05). The presence of the TLR4 protein in bovine CL was clearly detected in the luteal cells of both mCL and rCL. The results of this study suggest a role for TLRs in the development, maintenance, and regression of bovine CL. TLR signaling mediated pathway in luteal cells may involve in the regression of CL via regulation of TLR2 and TLR4.

Asunto(s)

Femenino , Animales , Bovinos , Bovinos/fisiología , Ciclo Estral , Cuerpo Lúteo/anomalías , /análisis , /análisis

RESUMEN

The aim of this study was to elucidate the presence of components of the innate immune system inthe bovine corpus luteum (CL) by detecting the expression and cell-specific localization of TLR2 and TLR4 during different stages of the estrous cycle in a control study design. Bovine CL samples were collected from a local slaughterhouse and assigned to three groups as follows: developing CL (dCL; n = 6, approx. days 3–6), mature CL (mCL; n = 5, approx. days 8–12), and regressing CL (rCL; n = 5, approx. days 17–19). An upregulation of TLR2 mRNA was detected only in rCL(P < 0.05). Localization of the TLR2 protein was particularly apparent in luteal cells and a prominent immunofluorescent signal corresponding to TLR2 was detected only in rCL. TLR4 mRNA were higher in mCLand rCL compared to dCL(P < 0.05). The presence of the TLR4 protein in bovine CL was clearly detected in the luteal cells of both mCL and rCL. The results of this study suggest a role for TLRs in the development, maintenance, and regression of bovine CL. TLR signaling mediated pathway in luteal cells may involve in the regression of CL via regulation of TLR2 and TLR4.(AU)

Asunto(s)

Animales , Femenino , Bovinos , Bovinos/fisiología , Cuerpo Lúteo/anomalías , Ciclo Estral , Receptor Toll-Like 2/análisis , Receptor Toll-Like 4/análisis