Mandarin peel ethanolic extract attenuates diclofenac sodium induced hepatorenal toxicity in rats by mitigating oxidative stress and inflammation.

Nonsteroidal anti-inflammatory drugs (NSAIDs) constitute approximately one-third of the global pharmaceutical market and are the first drugs of choice when treating fever and pain. Furthermore, among NSAIDs, the use of diclofenac sodium (DS) is preferred as it is a strong inhibitor of cyclooxygenase enzyme. However, despite its strong efficacy, DS is known for its potential to cause hepatorenal damage. Currently, to mitigate the adverse effects of certain drugs, medically effective agricultural products are often preferred as they are inexpensive, effective and safe. One such agricultural product-mandarin-is noteworthy for its high phenolic contents. The purpose of the present study was to assess the efficacy of mandarin peel ethanolic extract (MPEE) in protecting against hepatorenal damage induced by DS. Four groups (six/group) of adult male albino rats received oral administration of physiological saline (control group), DS (10 mg/kg body weight), MPEE (200 mg/kg body weight), and DS + MPEE for 7 days. Rats in the DS group showed increased serum levels of ALT, AST, ALP, BUN, CRE, and UA. Furthermore, the hepatic and renal tissue levels of MDA, TNF-α and IL-1ß increased, whereas those of GSH, SOD, GP-x and IL-10 decreased (p < 0.05). Investigation of MPEE in terms of its effects on biochemical, oxidative and inflammatory parameters, it exerted protective and healing effects. Therefore, MPEE can be used to ameliorate DS-induced hepatorenal damage.

Protective effects of polydatin and grape seed extract in rats exposed to cadmium.

The current study aimed to investigate the protective role of polydatin (PD) and grape seed extracts (GSEs) against the effects of cadmium chlorine (CD) application in the rats. Forty-nine adult Wistar albino male rats were used in the study. Rats were assigned into control (saline), CD (5 mg/kg CdCI2), PD (120 mg/kg PD), GSE (120 mg/kg GSE), CD + PD (5 mg/kg CdCI2 + 120 mg/kg PD), CD + GSE (5 mg/kg CdCI2 + 120 mg GSE), and CD + PD + GSE (5 mg/kg CdCI2+120 mg/kg PD +120 mg/kg GSE) treatments (n = 7 per group). The treatments were administered orally for four weeks. CD accumulation was observed in all tissues studied except for the brain tissue. PD and GSE inhibited CD accumulation in erythrocytes and tissues at varying levels. The liver, kidney, brain, and testes showed extensive degenerative histopathological changes in CD group. Liver total oxidant status (TOS) in the CD group increased significantly compared to the control. TOS of kidney, brain, and testis suggested that PD and GSE did not show a strong antioxidant effect in these tissues. Malondialdehyde (MDA) levels in blood and liver raised significantly in CD-treated rats compared to controls. PD, GSE, and their combinations increased antioxidant potential in all tissues and decreased MDA levels in blood plasma and liver. Overall, the protective effects of PD were more effective than GSE. Results suggested that although the initiation of histopathological changes was present in all tissues, the initiating factor was not the oxidative stress in the tissues studied except for the liver and blood.

Effects of preoperative magnesium therapy on arrhythmias and myocardial ischemia during off-pump coronary surgery.

BACKGROUND: Heart manipulation during off-pump coronary artery bypass surgery may cause hemodynamic instability, and temporary coronary arterial occlusion may lead to myocardial ischemia. To reduce this, perioperative ß-blocking agents or calcium antagonists can be administrated. The effects of perioperative administration of magnesium on myocardial function were studied in patients undergoing coronary artery bypass grafting. OBJECTIVE: The aim of the study was to evaluate the effects of preoperative magnesium administration on perioperative hemodynamia, ventricular arrhythmias and myocardial protection. MATERIALS AND METHODS: We reviewed 2 groups of patients undergoing off-pump coronary artery bypass surgery - 24 patients (control group) that had not received preoperative intravenous infusion of magnesium and 23 patients (treatment group) that had received preoperative intravenous magnesium sulfate. RESULTS: The results demonstrated that it had reduced the heart rate, changes of ST segments, the need of ß-blocking agents and the use of intra-operative intra-aortic balloon pump and the inotropic usage. CONCLUSION: This treatment may provide hemodynamic optimization during off-pump coronary artery bypass.

Determination of some heavy metal levels and oxidative status in Carassius carassius L., 1758 from Eber Lake.

In this study, the levels of some heavy metals (Al, Cd, Co, Cr, Cu, Fe, Li, Mn, Ni, Pb and Zn) in muscle, gill, and liver of Carassius carassius and in the water samples from Eber Lake (Afyonkarahisar, Turkey) have been investigated. Additionally, one of the lipid peroxidation markers, malondialdehide (MDA) and glutathion (GSH) levels were investigated. All the metal analysis was performed by using ICP-AES. According to results obtained, it was observed that heavy metals were accummulated in liver in the highest degree and lowest one in the muscle tissues. MDA and GSH levels varied in the seasons but their winter levels were found to be statistically meaningful when compared with other seasons. The obtained data of metals from the study were compared with the acceptable levels of Turkish governmental regulation and they were found not to be harmful for human health. On the other hand, it was suggested that oxidative stress markers should be checked regularly in order to get important data for continuous life of aquatic organisms.

Permanent pacemaker lead implantation via azygous vein in a patient with silent superior vena cava syndrome.

Occlusion of the superior vena cava is a rare but serious complication of transvenous endocardial pacing. We describe an unusual approach for permanent pacemaker implantation using the azygous vein in a patient with occlusion of the bilateral total subclavian and innominate veins after previous bilateral pectoral pacemaker implantation. Endocardial pacing using the azygous vein with minimal invasive thoracotomy may be a good option for patients with inaccessible subclavian route.

Transesophageal echocardiographic diagnosis of ventricular noncompaction associated with an atrial septal aneurysm in a patient with dilated cardiomyopathy of unknown etiology.

The present report discusses a case of noncompaction of the ventricular myocardium in a 51-year-old woman with dilated cardiomyopathy of unknown etiology. Multiple transthoracic echocardiography examinations had failed to show myocardial noncompaction, but subsequently performed transesophageal echocardiography clearly demonstrated the characteristic findings of this unusual disease. Also, an atrial septal aneurysm was identified by transesophageal echocardiography. Patients with cardiomyopathy of unknown origin should be investigated to define the presence or absence of myocardial noncompaction, even if transthoracic echocardiography fails to show anatomical features of this disease. The present case is the first reported case of ventricular noncompaction associated with an atrial septal aneurysm as a congenital anomaly.

Role of endogenous adenosine in atrial fibrillation after coronary artery bypass graft.

BACKGROUND: Atrial fibrillation (AF) is the most common complication following coronary artery bypass graft (CABG). The mechanism of AF after CABG is not well defined; however, it is suggested that endogenous adenosine, released in response to tissue hypoxia, may play a mechanistic role in these arrhythmias. HYPOTHESIS: The purpose of this study was to examine whether intravenous theophylline, via adenosine A1 receptor antagonism, would correct or modify new-onset early (<48 h post CABG) atrial fibrillation in patients post CABG, and thereby implicate endogenous adenosine as an inciting agent. METHODS: A prospective double-blind, placebo-controlled study design was applied to 385 consecutive patients with coronary artery disease who had undergone CABG. Any patient who developed AF within 48 h of the operative procedure was randomly assigned to receive 5 mg/kg of intravenous theophylline (Group A) or matched intravenous placebo (Group B). The patients who converted to sinus rhythm within 15 min of drug administration were accepted as showing positive responses. RESULTS: Thirty patients comprised the study group. In Group A, 8 of the 15 patients (53%) converted from AF to sinus rhythm within 15 min of theophylline administration. One patient who converted to sinus rhythm 20 min after theophylline administration was accepted as showing a negative response. In the placebo-treated group, no patient converted to sinus rhythm within 15 min (p<0.007 compared with Group A). CONCLUSIONS: The mechanism of AF after CABG is not well defined and is probably multifactorial. However, this study demonstrated that antagonism of the adenosine A1 receptor can promptly convert many of these patients back to sinus rhythm, and thereby implicates endogenously released adenosine in a mechanistic role for inciting early (<48 h) post-CABG AF.

[The effect of glutamate and aspartate on myocardial protection at cardiopulmonary bypass]. / Kardiyopulmoner Baypasta Glutamat ve Aspartatin Miyokardiyal Koruma Uzerine Etkisi.

OBJECTIVE: To determine whether glutamat and aspartat enriched cold crystalloid cardioplegia which was given in antegrade way has any effect on the myocardial protection during cardiopulmonary bypass. METHODS: Thirty-four patients who were electively undergone open heart surgery at Osmangazi University Faculty of Medicine, thoracic and cardiovascular surgery department, between March 2001 and May 2001 were included in this study. The patients were divided in two groups, each consisting of 17 patients. In group 1 coronary artery bypass surgery (CABG) was performed in 11 patients, mitral valve replacement (MVR) in 3 patients, aortic valve replacement (AVR) in 1 patient and AVR and MVR in 2 patients. While in group 2 CABG was performed in 13 patients and MVR was done in 4 patients. Group 1 patients received antegrade glutamat and aspartat (15 mmol/L) enriched cold crystalloid cardioplegia and group 2 patients were given cold crystalloid cardioplegia by antegrade route. Age, gender, diabetes mellitus, hypertension, preoperative myocardial infarction, smoking, ejection fraction, aortic cross-clamp time, need to defibrillation, inotropic support, and intraaortic balloon pump were recorded. The levels of cardiac troponin I (cTI) and creatine kinase myocardial band fraction (CK-MB) were measured in arterial blood samples at five different times. Statistical analysis was performed using Student's t-test and Chi-square test. RESULTS: There were no statistically significant differences in cTI and CK-MB values in blood samples taken at 5 different times pre and postoperatively between group 1 and group 2. CONCLUSION: It is concluded that glutamat and aspartat enriched cold crystalloid cardioplegia does not have any effect on myocardial protection.

[Experiments on minimally invasive open heart surgery using right anterolateral minithoracotomy]. / Açik Kalp Cerrahisinde Minimal Invazif Sag Anterolateral Minitorakotomi Deneyimlerimiz.

OBJECTIVE: Minimal invasive cardiac surgical techniques recently have been applied in the management of various cardiac lesions. The aim of the study was to evaluate right anterolateral minithoracotomy as an alternative procedure with a better cosmetic and clinical outcomes. METHODS: Fifteen male and 64 female patients underwent open heart surgery during cardiopulmonary bypass through a right anterolateral minithoracotomy at the fourth intercostal space. The average age was 41+/-6 years. Fifty-two (65.8%) patients underwent mitral valve replacement, 5 (6.3%) patients underwent mitral valve replacement + tricuspid annuloplasty, 5 (6.3%) patients underwent tricuspid valve replacement, 7 (8.9%) patients underwent closure of the atrial septal defect (ASD), 3 (3.8%) patients underwent closure of the ventricular septal defect (VSD), 1 (1.2%) patient underwent closure of the ASD+VSD and 5(6.3%) patients underwent mitral re-replacement. RESULTS: The postoperative average ventilation time was 6+/-2 h in 38 (48.1%) patients and 11+/-3 h in 41 (51.9%) patients. The postoperative average mediastinal drainage was 350+/-110 ml during first 24 hours, and postoperative stay in intensive care was 1.8+/-0.8 days. CONCLUSION: As a result, the right anterolateral minithoracotomy incision is a safe and effective alternative to the median sternotomy for open heart surgical procedures. Most of minimal surgical accesses can be achieved with better cosmetic results and faster recovery.

Traumatic total occlusion of left main coronary artery caused by blunt chest trauma.

Myocardial infarction is a rare complication that can occur immediately after a blunt chest trauma. We report a 36-year-old male who experienced a fatal anterolateral myocardial infarction after a nonpenetrating chest injury sustained in a car accident. Injuries of the coronary arteries associated with blunt chest trauma predominantly affect the left anterior descending artery. This is the first case of traumatic complete occlusion of the left main coronary artery (LMCA) demonstrated by coronary angiography.