The Neuroprotective Effect of Kefir on Spinal Cord Ischemia/Reperfusion Injury in Rats

OBJECTIVE: The main causes of spinal cord ischemia are a variety of vascular pathologies causing acute arterial occlusions. We investigated neuroprotective effects of kefir on spinal cord ischemia injury in rats. METHODS: Rats were divided into three groups : 1) sham operated control rats; 2) spinal cord ischemia group fed on a standard diet without kefir pretreatment; and 3) spinal cord ischemia group fed on a standard diet plus kefir. Spinal cord ischemia was performed by the infrarenal aorta cross-clamping model. The spinal cord was removed after the procedure. The biochemical and histopathological changes were observed within the samples. Functional assessment was performed for neurological deficit scores. RESULTS: The kefir group was compared with the ischemia group, a significant decrease in malondialdehyde levels was observed (p<0.05). Catalase and superoxide dismutase levels of the kefir group were significantly higher than ischemia group (p<0.05). In histopathological samples, the kefir group is compared with ischemia group, there was a significant decrease in numbers of dead and degenerated neurons (p<0.05). In immunohistochemical staining, hipoxia-inducible factor-1alpha and caspase 3 immunopositive neurons were significantly decreased in kefir group compared with ischemia group (p<0.05). The neurological deficit scores of kefir group were significantly higher than ischemia group at 24 h (p<0.05). CONCLUSION: Our study revealed that kefir pretreatment in spinal cord ischemia/reperfusion reduced oxidative stress and neuronal degeneration as a neuroprotective agent. Ultrastructural studies are required in order for kefir to be developed as a promising therapeutic agent to be utilized for human spinal cord ischemia in the future.

Atrial septal defect repair; our early and mid-phase results

Atrial septal defect is one of the most commonly encountered congenital heart diseases in adults. The effect of age of the patient to the surgery is disputable. The purpose of this report was to evaluate surgical repair in patients with ASD who are operated in our clinic. Total 40 patients were subjected to surgical repair due to ASD in Van Yuksek Ihtisas Education and Research Hospital between February 2006 and April 2009. Twenty seven of the patients were female and 13 were male, their ages differed between 8 and 71 and mean age of the patients was 33.70 +/- 14.04. Operative mortality did not occur. Two of our patients had coronary arterial disease in addition to ASD. ASD repair was performed together with coronary bypass surgery. Closing of ASD resulted in an increase in left ventricular ejection fraction, and a decrease in pulmonary arterial pressure and cardiothoracic ratio. Recovery in the functional capacity was observed post-surgery according to NYHA. In this series, surgical results of the patients of various ages, with ASD closed were positive

effects of 21 and 23 milimeter aortic valve prosthesis on hemodynamic performance and functional capacity in young adults

Early and medium-term improvement of functional capacity and regression of left ventricular hypertrophy was evaluated in the young adult patient group following application of 21 mm or 23 mm bileaflet aortic mechanical valve prosthesis due to aortic stenosis. Twenty two patients [10 male, 12 female; mean age 27 +/- 8.2 [19-43]] who underwent isolated aortic valve replacement due to rheumatic aortic stenosis, were included in the study. 21 mm and 23 mm bileaflet mechanical prosthesis was used respectively in eight and fourteen patients. The mean body surface area was 1.86 m[2] and 1.68 m[2] respectively in 23 mm and 21 mm prosthesis while 1.73 +/- 0.25 m[2] for the whole group. Functional capacity was New York Heart Association [NYHA] class II in 9 patients and class III in thirteen patients. Implantation was performed without enlarging the aortic root in all except four patients. In all patients transvalvular gradients, effective orifice area and the diameter of left ventricle were measured with transthoracic echocardiography during rest and after maximal exercise. Mean follow-up was 34 +/- 12 months [range 11-57 months]. There were no postoperative complications or deaths. All the patients were assessed as NYHA class I with regards to functional capacity [p=0.01]. Significant improvements were determined in postoperative mean transvalvular gradient [p=0.005] and left ventricular mass index [p=0.01] when compared with preoperative values. Our findings show that replacement with 21 mm and 23 mm mechanical prosthesis provides a significant improvement in regression of symptoms and increase of functional capacity in young adults in early and mid-period without increasing mortality and morbidity

Fragmented QRS and prediction of paroxysmal atrial fibrillation episodes

Prior studies have demonstrated the relationship between cardiovascular diseases and fragmented QRS [fQRS]. fQRS was also associated with ventricular arrhythmias. Our objective was to find out the relationship between fQRS and paroxysmal atrial fibrillation [PAF]. A total of 301 patients without overt structural heart disease were prospectively included in the study. Patients were divided in to 2 groups according to presence of fQRS. Multivariate logistic regression analysis was used to assess the predictive value of fQRS for predicting PAF. One hundred and three patients had fQRS. Patients with fQRS were older [53 +/- 16.8 vs 45.3 +/- 17.2, p < 0.001], with larger left atrium [LA] [33.2 +/- 5.9 vs 30.1 +/- 5.9 mm, p=0.001], with thicker interventricular septum [IVS] [10.2 +/- 1.9 vs 9.5 +/- 2.3 mm, p=0.032], more diabetic [19.8 vs 10.6%, p=0.029] and have more PAF episodes [22.3 vs 4.1%, p < 0.001] in comparison with patients without fQRS. fQRS was an independent predictor of detecting PAF episode [odds ratio, 9.69; 95% confidence interval, 2.46-38.15, p=0.001]. Hypertension and diabetes mellitus were also predictive. The presence of fQRS independently predicted PAF episodes in holter monitoring [HM]. Further studies are needed to clarify the clinical implications of this finding