The ameliorative effects of chrysin on bortezomib-induced nephrotoxicity in rats: Reduces oxidative stress, endoplasmic reticulum stress, inflammation damage, apoptotic and autophagic death.

AIM: Bortezomib is a proteasome inhibitor antineoplastic agent that was the first to be approved for cancer treatment. One of bortezomib's most prominent dose-limiting effects is nephrotoxicity; the underlying mechanism is believed to be oxidative stress. Chrysin is a compound found actively in honey and many plant species and stands out with its antioxidant properties. The present study aimed to determine the ameliorative effects of chrysin in bortezomib-induced nephrotoxicity. MATERIAL-METHOD: Thirty-five male Wistar rats were divided into control, BTZ, CHR, BTZ + CHR25, and BTZ + CHR50. Biochemical, molecular, Western blot, and histological methods analyzed renal function indicators, oxidative stress, endoplasmic reticulum stress, inflammation, apoptosis, and damage pathways. RESULTS: Chrysin decreased oxidative stress by reducing oxidants (MDA) and increasing antioxidants (SOD, CAT, Gpx, GSH, Nrf-2, HO-1, NQO1). Chrysin reduced endoplasmic reticulum stress by decreasing ATF-6, PERK, IRE1, and GRP-78 levels. Chrysin reduced inflammation damage by inhibiting the NF-κB pathway. Chrysin exhibited protective properties against apoptotic damage by decreasing Bax and Caspase-3 levels and increasing Bcl-2 levels. In addition, chrysin improved renal function and structural integrity and exhibited healing properties against toxic damage in tissue structure. CONCLUSION: Overall, chrysin exhibited an ameliorative effect against bortezomib-induced nephrotoxicity.

Naringin protects against paclitaxel-induced toxicity in rat testicular tissues by regulating genes in pro-inflammatory cytokines, oxidative stress, apoptosis, and JNK/MAPK signaling pathways.

Paclitaxel (PTX), which is actively used in the treatment of many types of cancer, has a toxic effect by causing increased oxidative stress in testicular tissues. Naringin (NRG) is a natural flavonoid found in plants, and its antioxidant properties are at the forefront. This study aims to investigate the protective feature of NRG in PTX-induced testicular toxicity. Thirty-five male Sprague rats were divided into five groups: control, NRG, PTX, PTX + NRG50, and PTX + NRG100. Rats were administered PTX (2 mg/kg, BW) intraperitoneally once daily for the first 5 days. Then, between the 6th and 14th days, NRG (50 and 100 mg/kg) was administered orally once a day. NRG reduced PTX-induced lipid peroxidation and increased testicular tissue antioxidant capacity (superoxide dismutase, catalase, glutathione peroxidase, and glutathione). While NRG reduces the mRNA expression levels of nuclear factor kappa B, tumor necrosis factor-alpha, interleukin-1 beta, cyclooxygenase-2, interleukin-6, inducible-nitric oxide synthase, mitogen-activated protein kinase 14 (MAPK)14, MAPK15, c-Jun N-terminal kinase, P53, Apaf1, Caspase3, Caspase6, Caspase9, and Bax in testicular tissues; it caused an increase in Nrf2, HO-1, NQO1 and Bcl-2 levels. NRG also improved the structural and functional integrity of testicular tissue disrupted by PTX. PTX-induced sperm damage was alleviated by NRG. NRG showed a protective effect by alleviating the PTX-induced testicular toxicity by increasing oxidative stress, inflammation, apoptosis, and autophagy.

The Efficiency of Acoustic Radiation Force Impulse (ARFI) Elastography in the Differentiation of Renal Cell Carcinoma and Oncocytoma.

PURPOSE: This study is to investigate the effectiveness of Acoustic Radiation Force Impulse (ARFI) elastography in differentiating radiologically similar renal cell carcinoma (RCC) and oncocytoma in solid masses of the kidney. METHODS: The patients with solid renal mass histopathological diagnosed after excision or tru-cat biopsy who underwent a preoperative ARFI elastography of the lesion during a 4-year period were included in this study. Preoperative shear wave velocity (SWV) values were measured in all the lesions. SWV results of RCCs and oncocytomas were compared by an independent t-test, and cut-off, sensitivity and specificity values were calculated. RESULTS: Forty-two of the 60 patients included in the study were men (70%) and, 18 were women (30%), and the mean age was 59.7 ± 14 (27-94) years. Among 46 RCCs (76.6%), 23 and 14 oncocytomas, 5 (23.4%) were located in the right kidney (p:0.34722). Mean SWV values were found to be significantly higher in RCCs (2.87± 0.74 (0.96-4.14) m/s) than oncocytomas (1.83 ± 0.78 (0.80-3.76) m/s) (p <0.001). In the ROC analysis, a cutoff value of 2.29 m/s was found to havean 80.4% sensitivity and a 78.6% specificity for the discrimination of RCCs from oncocytomas. CONCLUSION: ARFI elastography measurements may be useful in distinguishing RCC and oncocytomas that may have similar solid radiological imaging features.

Role of the systemic immune-inflammation index in predicting spontaneous stone passage in patients with renal colic.

OBJECTIVES: Renal colic (RC) is one of the most frequent reasons for presentation to the emergency department (ED) and creates a high economic and medical burden. Management strategies for RC range from waiting for spontaneous passage to surgical intervention. However, factors determining spontaneous stone passage (SSP) are still poorly understood. Therefore, in this study, we aimed to investigate the role of the systemic immune-inflammatory index (SII) in predicting SSP. METHODS: We retrospectively analyzed the data of 924 patients aged over 18 years, who were diagnosed with RC in our clinic between 1 January 2019, and 30 May 2022, and had ureteral stones of ≤ 10 mm. The patients were divided into two groups according to whether they had SSP. The clinical and laboratory characteristics of the patients in the ED were evaluated. The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and SII (neutrophil count x platelet count/lymphocyte count) values of the patients were calculated. Stone size and location were also recorded. RESULTS: In the univariate analysis of SSP, a ureteral stone size of ≤ 5 mm (p < 0.001), distal ureteral location (p < 0.001), SII (p < 0.001), NLR (p < 0.001), and PLR (p = 0.036) were significantly correlated with SSP. ROC analysis showed that an SII level < 721.8 (Sensitivity %82.6, Specificity %74.7, p < 0.001) was an independent predictor of SSP. CONCLUSION: Our findings showed that a low SII level was associated with SSP and could be used as a predictive marker of SSP as a more valuable parameter than NLR. SII and NLR, together with other indicators, are inflammatory markers that can be used in the clinical decision-making process for ureteral stone treatment.

Protective effects of naringin on colistin-induced damage in rat testicular tissue: Modulating the levels of Nrf-2/HO-1, AKT-2/FOXO1A, Bax/Bcl2/Caspase-3, and Beclin-1/LC3A/LC3B signaling pathways.

Antimicrobial agent resistance has become a growing health issue across the world. Colistin (COL) is one of the drugs used in the treatment of multidrug-resistant bacteria resulting in toxic effects. Naringin (NRG), a natural flavonoid, has come to the fore as its antioxidant, anti-inflammatory, and antiapoptotic activities. The aim of the present study was to determine whether NRG has protective effects on COL-induced toxicity in testicular tissue. Thirty-five male Spraque rats were randomly divided into five groups (n = 7 per group): Control, COL, NRG, COL + NRG 50, COL + NRG 100. COL (15 mg/kg b.w., i.p., once per/day), and NRG (50 or 100 mg/kg, oral, b.w./once per/day) were administered for 7 days. The parameters of oxidative stress, inflammation, apoptosis, and autophagic damage were evaluated by using biochemical, molecular, western blot, and histological methods in testicular issues. NRG treatment reversed the increased malondialdehyde level and reduced antioxidants (superoxide dismutase, catalase, glutathione peroxidase, and glutathione) levels due to COL administration (p < 0.001), and oxidative stress damage was mitigated. Nuclear factor erythroid 2-related factor-2 pathway, one of the antioxidant defence systems, was stimulated by NRG (p < 0.001). NRG treatment reduced the levels of markers for the pathways of apoptotic (p < 0.001) and autophagic (p < 0.001) damages induced by COL. Sperm viability and the live/dead ratio were reduced by COL but enhanced by NRG treatment. Testicular tissue integrity was damaged by COL but showed a tendency to improve by NRG. In conclusion, COL exhibited toxic effect on testicular tissue by elevating the levels of oxidative stress, apoptosis, autophagy, inflammation, and tissue damage. NRG demonstrated a protective effect by alleviating toxic damage.

Risk factors for mortality and morbidity in Syrian refugee children with penetrating abdominal firearm injuries: an 1-year experience.

BACKGROUND: Despite improvements in technology and surgical techniques, abdominal injuries caused by firearms in children are traumatic with high complication rates and mortality. In this study, factors affecting mortality and complications in penetrating abdominal firearm injuries caused by high-velocity bullets and shrapnel in children as a result of the civil war in Syria were evaluated. METHODS: This study was conducted as a case series with 53 patients admitted to Kilis State Hospital with penetrating abdominal firearm injuries between January 2016 and February 2017. Patients aged between 6 months and 17 years who suffered penetrating abdominal firearm injuries (PAFI) as a result of the civil war in Syria in the state hospital in Kilis Türkiye border province with Syria and were transferred to our hospital and operated on were included in the evaluation. Patients' sociodemographic information, time to surgery, number of abdominal organs injured, type of firearm causing injury, presence of large vessel injury and extremity injury, presence of thoracic injury requiring thoracotomy in addition to laparotomy, colostomy, penetrating abdominal trauma index, pediatric trauma score (PTS), and shock status were evaluated. RESULTS: In our study, it was found that a high penetrating abdominal trauma index significantly increased complication rates and mortality (P<0.001 and P=0.002, respectively). In addition, it was found that lower PTSs significantly increased the development of complications and mortality (P=0.001 and P<0.001, respectively). Mortality was not observed in any of the patients with a PTS>8, whereas mortality was observed in 27.3% of patients with a PTS≤8, and this result was statistically significant (P=0.003). Shock sig-nificantly increased mortality, and no patient who was not in shock died (P<0.001). In our study, it was determined that the increase in the number of injured intra-abdominal organs had a significant effect on both complications and mortality (P<0.001 and P=0.002, respectively). CONCLUSION: The penetrating abdominal trauma index and PTS were found to be effective in predicting mortality and morbidity in pediatric patients with PAFI. It is crucial in this patient group to provide appropriate transport after the first intervention is done rapidly and effectively in conflict zones.

Relationship between systemic immune inflammation index and amputation in patients with diabetic foot ulcer.

AIM: The systemic immune inflammation index (SII) is a cost-effective biomarker calculated by lymphocyte, neutrophil and platelet counts and is currently being studied in various diseases. Since there is no study examining the relationship between SII and diabetic foot ulcers (DFU) in the literature, our aim was to investigate the relationship between SII and amputation rate in DFU. METHODS: Type 2 DM 511 patients with DFU were screened from 2017 to 2021. Laboratory data obtained on the first day of hospitalization were considered. Platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR) and SII were calculated from routine blood count. Participants were divided into two groups as amputation (Group 1) and non-amputation (Group 2). RESULTS: Amputation rate was 18.8%. The A1c (8.80 (3.26) % vs. 9.52 (3.10) %, p = 0.007) and HGB (10.17 ± 2.16 g/dL vs. 12.05 ± 2.20 g/dL, p < 0.001) levels, and lymphocyte count (1.81 (1.16) vs. 2.05 (1.11), p = 0.015) were significantly lower in Group 1 than Group 2. The counts of WBC (14.01 (9.16) × 109/L vs. 10.41 (5.82) × 109/L), PLT (393.35 (196.98) × 109/L vs. 312.05 (141.33) × 109/L), neutrophil (11.52 (8.75) × 109/L vs. 6.93 (5.96) × 109/L), PLR (226.04 (159.24) × 109/L vs. 153.12 (101.91) × 109/L), NLR (6.64 (6.93) vs. 3.34 (3.99)) and SII (2505.86 (3957.47) × 109/L vs. 1092.50 (1476.08) × 109/L), and the levels of CRP (14.12 (12.66) mg/dL vs. 3.86 (12.63) mg/dL) and ESR (87.50 (50.50) mm/h vs. 63.00 (57.25) mm/h) were significantly higher in Group 1 than Group 2 (all p < 0.001). AUC of ROC analysis of PLR was 0.666 (95% CI, 0.604-0.728), NLR was 0.695 (95% CI, 0.638-0.752) and SII was 0.716 (95% CI, 0.661-0.772) for the predicting of amputation and the SII had the best AUC with 67.4% sensitivity and 63.3%specificty. CONCLUSION: SII is a cost-effective and readily available marker, but alone may not be sufficient to predict the risk of amputation in DFU. In our results, the predictive role of SII alone or with other markers for future DFU and its role in predicting other chronic diabetic complications will be evaluated in extensive studies.

Protective Effects of Fuziline on Dobutamine-Induced Heart Damage in Mice.

INTRODUCTION: Fuziline is one of the many antioxidants currently being tested to treat cardiac damage. In our study, histopathological and biochemical effects of fuziline were investigated in mice with dobutamine-induced heart damage in vitro. METHODS: Thirty-two adult male BALB/c mice, average weight of 18-20 g, were randomly divided into four groups - Group 1 (sham, n=8), Group 2 (control, dobutamine, n=8), Group 3 (treatment 1, dobutamine + fuziline, n=8), and Group 4 (treatment 2, fuziline, n=8). Biochemical parameters and total antioxidant status (TAS), total oxidant status (TOS), and oxidative stress index (OSI) values were measured. Interleukin 1 beta (IL-1ß), NLR family, pyrin domain containing protein 3 (NLRP3), 8-hydroxy-deoxyguanosine (8-OHDG), gasdermin D (GSDMD), and galectin 3 (GAL-3) levels were analyzed by enzyme-linked immunosorbent assay method, and histopathological examination of heart tissues was performed. RESULTS: When dobutamine + fuziline and fuziline groups were compared, troponin-I (P<0.05), NLRP3 (P<0.001), GSDMD (P<0.001), 8-OHDG (P<0.001), IL-1ß (P<0.001), and GAL-3 (P<0.05) were found to be statistically significant. TOS level was the highest in the dobutamine group (P<0.001) and TAS level was the highest in the fuziline group (P<0.001). OSI level was statistically significant between the groups (P<0.001). In histopathological examination, focal necrosis areas were smaller in the dobutamine + fuziline group than in the dobutamine group, and cardiac myocytes were better preserved. CONCLUSION: Fuziline markedly reduced cardiac damage and pyroptosis in mice with dobutamine-induced heart damage by lowering the levels of GSDMD, 8-OHDG, IL-1ß, and GAL-3. It also prevented necrosis of cardiac myocytes in histopathological evaluation.

Cardioprotective Effect of Pistacia vera L. (Green Pistachio) Hull Extract in Wistar Albino Rats with Doxorubicin-Induced Cardiac Damage.

BACKGROUND: Pistacia vera L. (green pistachio) has been shown to increase antioxidant capacity and protect against cardiovascular diseases and cancer. This study investigated the protective effect of the Pistacia vera L. hull in rats with experimental cardiac damage induced by doxorubicin. METHODS: Sixty adult Wistar albino rats were randomly divided into 5 groups (n = 12). Sham, doxorubicin, doxorubicin + Pistacia vera L. extract 50 mg/kg, doxorubicin + Pistacia vera L. extract 100 mg/kg, and Pistacia vera L. extract 100 mg/kg. Biochemistry parameters, total antioxidant status, total oxidant status, oxidative stress index, 8-hydroxydeoxy guanosine, and caspase 3/7 values were measured in serum samples. Excised heart tissues were examined histopathologically. RESULTS: The groups were statistically significantly different in 8hydroxydeoxy guanosine, caspase 3/7, total antioxidant status, total oxidant status, oxidative stress index, and basal biochemical parameter values (P <.05, P <.001). In group II, 8-hydroxydeoxy guanosine, caspase 3/7, and total oxidant status values increased while the total antioxidant status value decreased (P <.001). In the treatment groups (group III and group IV), 8-hydroxydeoxy guano sine and caspase 3/7 values decreased compared to group II (P < .001). While total oxidant status and oxidative stress index values decreased in the treatment groups, total antioxidant status values increased (P <.001). The histopathological examination of the heart revealed fewer areas of focal necrosis in the treatment groups compared to group II. CONCLUSION: In this study, the cardioprotective effect of Pistacia vera L. hull extract was investigated in vivo. It was shown that Pistacia vera L. hull extract reduced apoptosis and deoxyribonucleic acid damage in the face of cardiac damage and had antioxidant activity. Future studies will increase our knowledge on this subject.

Protective Effects of Fuziline on Dobutamine-Induced Heart Damage in Mice

ABSTRACT Introduction: Fuziline is one of the many antioxidants currently being tested to treat cardiac damage. In our study, histopathological and biochemical effects of fuziline were investigated in mice with dobutamine-induced heart damage in vitro. Methods: Thirty-two adult male BALB/c mice, average weight of 18-20 g, were randomly divided into four groups - Group 1 (sham, n=8), Group 2 (control, dobutamine, n=8), Group 3 (treatment 1, dobutamine + fuziline, n=8), and Group 4 (treatment 2, fuziline, n=8). Biochemical parameters and total antioxidant status (TAS), total oxidant status (TOS), and oxidative stress index (OSI) values were measured. Interleukin 1 beta (IL-1β), NLR family, pyrin domain containing protein 3 (NLRP3), 8-hydroxy-deoxyguanosine (8-OHDG), gasdermin D (GSDMD), and galectin 3 (GAL-3) levels were analyzed by enzyme-linked immunosorbent assay method, and histopathological examination of heart tissues was performed. Results: When dobutamine + fuziline and fuziline groups were compared, troponin-I (P<0.05), NLRP3 (P<0.001), GSDMD (P<0.001), 8-OHDG (P<0.001), IL-1β (P<0.001), and GAL-3 (P<0.05) were found to be statistically significant. TOS level was the highest in the dobutamine group (P<0.001) and TAS level was the highest in the fuziline group (P<0.001). OSI level was statistically significant between the groups (P<0.001). In histopathological examination, focal necrosis areas were smaller in the dobutamine + fuziline group than in the dobutamine group, and cardiac myocytes were better preserved. Conclusion: Fuziline markedly reduced cardiac damage and pyroptosis in mice with dobutamine-induced heart damage by lowering the levels of GSDMD, 8-OHDG, IL-1β, and GAL-3. It also prevented necrosis of cardiac myocytes in histopathological evaluation.

Antioxidant Actions of Thymoquinone, Silymarin, and Curcumin on Experimental Aortic Ischemia-Reperfusion Model in Wistar Albino Rats.

INTRODUCTION: Medical improvements are needed to prevent ischemia-reperfusion injury in thoracoabdominal aortic surgery. The aim of this study was to determine the antioxidant effects of thymoquinone, silymarin, and curcumin against ischemia-reperfusion injury associated with abdominal aorta. METHODS: Twenty-five Wistar albino rats were included in the study. Sham, control, and treatment (thymoquinone, silymarin, and curcumin) groups were set in equal numbers. Ischemia-reperfusion was applied by clamping (120 minutes) and de-clamping (60 minutes) the infrarenal aorta of all groups, except the sham group. Before reperfusion, thymoquinone, silymarin, and curcumin were given intraperitoneally to the treatment groups. After reperfusion, blood samples were taken from the right ventricle. Total antioxidant status (TAS), total oxidant status (TOS), and oxidative stress index (OSI) were studied in serum samples and histopathological examination was performed on the gastrocnemius muscle. RESULTS: There was a significant difference in TOS and OSI values between the control and sham groups. Both values were found higher in the control group than in the sham group (P<0.05). OSI values were found to be lower in the thymoquinone group compared to the control group (P<0.05). All three parameters were found to be lower in the silymarin group than in the control group (P<0.05). TAS and TOS levels were found to be higher in the curcumin group than in the control group (P<0.05). There was no histopathological difference between the groups. CONCLUSION: Silymarin and thymoquinone administration decreases oxidative stress in experimental aortic ischemia-reperfusion injury. Antioxidant effect of curcumin was lower than silymarin and thymoquinone.

Are H1 and H3 haplotypes of endothelial protein C receptor (PROCR) an important factor in contracting COVID-19?

The development of cardiovascular disease shows increase after contracting coronavirus 2019 (COVID-19) disease and myocardial damage is observed in patients who have had the disease severely. The relationship between genetic cardiovascular risk factors with COVID-19 infection was investigated in our study. One hundred thirty-five patients, 27 of whom were COVID-19 (-) and 108 were COVID-19 (+) patients, were included in the study. Patients were divided into three groups ([COVID-19 [-], COVID-19 [+] asymptomatic, and COVID-19 [+] symptomatic + patients with pulmonary involvement]). Genetic cardiovascular risk factors were examined in blood samples taken from the patients with new generation sequencing analysis. In the clinical classification, there were no significant differences between the three groups in fibrinogen beta chain-455G>A, human platelet antigen 1 (HPA1b)/platelet receptor GPIIIa/(ITGB3) (HPA1a/b; GpIIIa; integrin beta 3 L33P), ACE I/D, AGT (M268T), AGTR1 (1166A>C), Apo E (E2/E3/E4) (rs7412, rs429358), eNOS (786T>C), eNOS (894G>T) genes (p > 0.05). However, significant differences were observed in PROCR H3 haplotype/G (endothelial protein C receptor gene [EPCR] 4600A>G [A3 haplotype]), PROCR H1 haplotype/C (EPCR 4678G>C [A1 haplotype]) genes (p < 0.05). When COVID-19 (+) and COVID-19 (-) groups were compared, it was observed that the infection was more common in people with PROCR H1 haplotype/C and PROCR H3 haplotype/G genotypes (p < 0.05). PROCR H1 and PROCR H3 haplotypes may be an important factor in contracting COVID-19 disease. In people with COVID-19 disease, revealing PROCR genetic differences and measuring sEPCR levels will be beneficial in the follow-up of the disease.

The Effect of Low Tidal Volume Ventilation on Inflammatory Cytokines During Cardiopulmonary Bypass.

INTRODUCTION: Halting ventilation during cardiopulmonary bypass (CPB) is implemented to operate in a less bleeding setting. It sustains a better visualization of the operation area and helps to perform the operation much more comfortably. On the other hand, it may lead to a series of postoperative lung complications such as atelectasis and pleural effusion. In this study, we investigated the effects of low tidal volume ventilation on inflammatory cytokines during CPB. METHODS: Twenty-eight patients undergoing cardiovascular surgery were included in the study. Operation standards and ventilation protocols were determined and patients were divided into two groups: patients ventilated with low tidal volume and non-ventilated patients. Plasma samples were taken from patients preoperatively, perioperatively from the coronary sinus and postoperatively after CPB. IL-6, IL-8, TNF-α and C5a levels in serum samples were studied with enzyme-linked immunosorbent assay (ELISA) kits. RESULTS: C5a, IL-6, IL-8 and TNF-α levels were similar when compared to the low tidal in volume ventilated and non-ventilated groups (P>0.05). Comparing the groups by variables, IL-6 levels were increased during CPB in both groups (P=0.021 and P=0.001), and IL-8 levels decreased in the ventilation group during CPB (P=0.018). CONCLUSION: Our findings suggest that low tidal volume ventilation may reduce the inflammatory response during CPB. Although the benefit of low tidal volume ventilation in CPB has been shown to decrease postoperative lung complications such as pleural effusion, atelectasis and pneumonia, we still lack more definitive and clear proofs of inflammatory cytokines encountered during CPB.

Hybrid Approach to Complex Stanford Type B Dissection: Unusual Extra-anatomical Bypass (Aorto-Celiac-Mesenteric Bypass) + Thoracic Endovascular Aortic Repair (TEVAR) + Cholecystectomy

Abstract Patients with complex Stanford type B aortic dissection are very difficult to treat. Many methods have been proposed so far in the treatment of these patients, and the emergence of hybrid techniques has made the treatment easier. In this article, we shared the extra-anatomical bypass (aorto-celiac-mesenteric bypass) + thoracic endovascular aortic repair + cholecystectomy operation technique applied to a patient with complex type B aortic dissection.

Nuclear factor erythroid 2-related factor 2 (Nrf2), tumor necrosis factor alpha protein (TNF-α), heme oxygenase-1 (HO-1) gene expressions during cardiopulmonary bypass.

OBJECTIVE: During extracorporeal circulation, blood is in contact with nonendothelial surfaces. The increase in the amount of blood touching the non-endothelial surface increases the damage to the blood elements. This initiates and increases oxidative stress. Increased oxidative stress leads to the activation of antioxidant systems. These two systems work gradually in the process of Cardiopulmonary Bypass. This study aims to investigate the changes of TNF-α, Nrf2 and HO-1 gene expression in extracorporeal circulation. MATERIALS AND METHODS: Fifteen patients who underwent open heart surgery were included in the study. Blood samples were taken preoperatively, during cardiopulmonary bypass (CPB) and 24 hours postoperatively. TNF-α, Nrf2 and HO-1 gene expressions in plasma samples were studied by using appropriate kits. Changes in gene expressions were compared. RESULTS: TNF-α gene expression increased during CPB compared to preoperative levels (p <0.05). Similarly, Nrf-2 gene expression increased significantly during CPB (p <0.001) and decreased postoperatively (p <0.001). There was a significant increase in HO-1 gene expression during CPB (p <0.01). Postoperatively, this increase was found to decrease similar to Nrf2 (p <0.05). CONCLUSIONS: According to the results, TNF-α, Nrf2, HO-1 gene expressions increase during CPB and these values decrease after the operation. This shows that oxidative stress and inflammatory processes start with CPB and antioxidant processes start similarly. With the termination of CPB, both processes are terminated. This has been demonstrated by gene expressions. Future studies will make it easier to understand these processes.

Surgical Repair of Internal Carotid Artery Aneurysm: Case Report.

Extracranial carotid artery aneurysms are extremely rare aneurysms. Treatment options are conventional open surgery, endovascular surgery, and conservative treatment. Surgical treatment of such aneurysms is challenging and it is important to determine the treatment strategies wisely. There is still no definite association for treatment modalities. In this case report, we present open surgical treatment of a 58-year-old female patient with internal carotid artery aneurysm. The patient was admitted to our clinic with spontaneous pulsatile mass in the right jugular region. Computed tomography angiography shown right internal carotid artery aneurysm. Aneurysm cranial distance was enough to perform end to end anastomosis. Aneurysm was excised by preserving cranial nerves. No complications developed during the postoperative period.

Micro-RNA gene expressions during cardiopulmonary bypass.

INTRODUCTION: Cardiopulmonary bypass (CBP) is the most widely used method in cardiac surgery. During the CPB procedure, studies are conducted to maintain myocardial perfusion adequacy, reduce oxidative stress caused by immune reactions, and understand the longevity of the procedure. Recently, microRNAs (miRNAs) have come to the fore to understand the changes in the CPB. In vivo studies have shown that many different miRNAs regulate critical signaling molecules including cytokines, growth factors, transcription factors, proapoptotic, and antiapoptotic proteins. Our study aims to investigate the changes of miR-34a, miR-15a, and miR-320a gene expression in extracorporeal circulation. METHODS: Fifteen patients who underwent elective open-heart surgery were included in the study. Serum plasma samples were taken from the patients preoperatively, at the time of CPB, and at 24 h postoperatively. Gene expression of miR-34a, miR-15a, and miR-320a in plasma samples was studied. Differences in gene expression were compared. RESULTS: miR-15a gene expression increased during CPB compared with preoperative levels (p < .001). This increase was decreased after the operation (p < .05). miR-34a gene expression increased significantly during CPB (p < .01). Similar to the other two gene expressions, miR-320a gene expression was significantly increased during CPB (p < .01). CONCLUSIONS: miRNAs may play a key role in the initiation and maintenance of pathophysiological cascades during CPB. Our study showed the gene expression of miR-34a, miR-15a, and miR-320a in the CPB process. Our study will be a pioneer among future studies to investigate the molecular pathophysiology of the CPB process.

Hybrid Approach to Complex Stanford Type B Dissection: Unusual Extra-anatomical Bypass (Aorto- Celiac-Mesenteric Bypass) + Thoracic Endovascular Aortic Repair (TEVAR) + Cholecystectomy.

Patients with complex Stanford type B aortic dissection are very difficult to treat. Many methods have been proposed so far in the treatment of these patients, and the emergence of hybrid techniques has made the treatment easier. In this article, we shared the extra-anatomical bypass (aorto-celiac-mesenteric bypass) + thoracic endovascular aortic repair + cholecystectomy operation technique applied to a patient with complex type B aortic dissection.

Results of a three-year follow-up after endovascular therapy with multilayer flow modulator in complex thoracoabdominal aortic aneurysm: A case report.

OBJECTIVES: Studies on the short-, medium and long-term effects of flow guiding stents are still limited. In this case report, we present three-year follow-up of the multilayer flow modulator stent in a 55-year-old patient with Crawford Type 2 thoracoabdominal aortic aneurysm. METHODS: A 55-year-old male patient with Crawford Type 2 thoracoabdominal aortic aneurysm had applied to our medical center. The aneurysm involved coeliac truncus and superior mesenteric artery and extended to the renal artery ostia. Multilayer flow modulator stent was successfully placed, and follow-up CT (Computed tomography) angiographic examination images recorded intermittently (36 months). RESULTS: After three years, it was observed that the left renal artery was thrombosed and the left kidney went to atrophy. Other major vascular branches were observed to be open. During this time, the aneurysm was completely closed with thrombus, but the diameter of the aneurysm continued to increase. CONCLUSIONS: Multilayer flow modulator stents are safe in complex aortic aneurysms. The device increases the thrombus load in the aortic aneurysm and maintains the flow of the main vascular branches. But re-interventions, dilatation of the aneurysm sac and visceral branch obstructions are still challenging for multilayer flow modulator stents.