Neonatal Outcomes of Critical Congenital Heart Defects: A Multicenter Epidemiological Study of Turkish Neonatal Society : Neonatal Outcomes of CCHD.

Critical congenital heart disease (CCHD) is one of the leading causes of neonatal and infant mortality. We aimed to elucidate the epidemiology, spectrum, and outcome of neonatal CCHD in Türkiye. This was a multicenter epidemiological study of neonates with CCHD conducted from October 2021 to November 2022 at national tertiary health centers. Data from 488 neonatal CCHD patients from nine centers were entered into the Trials-Network online registry system during the study period. Transposition of great arteria was the most common neonatal CHD, accounting for 19.5% of all cases. Sixty-three (12.9%) patients had extra-cardiac congenital anomalies. A total of 325 patients underwent cardiac surgery. Aortic arch repair (29.5%), arterial switch (25.5%), and modified Blalock-Taussig shunt (13.2%). Overall, in-hospital mortality was 20.1% with postoperative mortality of 19.6%. Multivariate analysis showed that the need of prostaglandin E1 before intervention, higher VIS (> 17.5), the presence of major postoperative complications, and the need for early postoperative extracorporeal membrane oxygenation were the main risk factors for mortality. The mortality rate of CCHD in our country remains high, although it varies by health center. Further research needs to be conducted to determine long-term outcomes for this vulnerable population.

Posterior pericardial window: a simple and reproducible technique in order to prevent pericardial tamponade in paediatric cardiac surgery.

OBJECTIVE: Pericardial tamponade, which increases postoperative mortality and morbidity, is still not uncommon after paediatric cardiac surgery. We considered that posterior pericardiotomy may be a useful and safe technique in order to reduce the incidence of early and late pericardial tamponade. Herein, we present our experience with creation of posterior pericardial window following congenital cardiac surgical procedures. METHODS: This retrospective study evaluated 229 patients who underwent paediatric cardiac surgical procedures between June 2021 and January 2023. A posterior pericardial window was created in all of the patients. In neonates and infants, pericardial window was performed at a size of 2x2 cm, whereas a 3x3 cm connection was established in elder children and young adults. A curved chest tube was placed and positioned at the posterolateral pericardiophrenic sinus. An additional straight anterior mediastinal chest tube was also inserted in every patient. Transthoracic echocardiographic evaluations were performed daily to assess postoperative pericardial effusion. RESULTS: A total of 229 (135 male, 94 female) patients were operated. Mean age and body weight were 24.2 ± 26.7 months and 10.2 ± 6.7 kg, respectively. Eight (3.5%) of the patients were neonates where 109 (47.6%) were infants and 112 (48.9%) were in childhood. Fifty-two (22.7%) re-do operations were performed. Six (2.6%) patients underwent postoperative surgical re-exploration due to surgical site bleeding. Any early or late pericardial tamponade was not encountered in the study group. CONCLUSIONS: Posterior pericardial window is an effective and safe technique in order to prevent both the early and late pericardial tamponade after congenital cardiac surgery.

Management of a Wilms' tumor with intracardiac extension using extracorporeal circulation and deep hypothermic circulatory arrest: Case report and review of the literature.

Wilms' tumor is a relatively common malignancy among childhood cancers. However, intracardiac extension of the lesion is rare and challenging. In this report, the authors present a successful management of intracardiac extension of Wilms' tumor in a 3-year-old child using cardiopulmonary bypass and deep hypothermic circulatory arrest. The authors also reviewed the published literature on Wilms' tumor with cardiac extension, which were managed by cardiopulmonary bypass and deep hypothermic circulatory arrest to provide an optimum management plan in this challenging condition.

Risk Factors for Polyautoimmunity among Patients with Celiac Disease: A Cross-Sectional Survey.

AIM: To define the prevalence of polyautoimmunity (PAI) among celiac disease (CD) patients and to compare clinical and laboratory features of CD patients with or without PAI in order to determine the risk factors for PAI in CD. MATERIAL AND METHOD: Patients diagnosed with CD in our clinic between 2007 and 2014 with at least 1 year of follow-up were retrospectively evaluated. Totally 145 patients were included in the study. Information on patient demographics and laboratory data were obtained from patient records. The study participants were divided into 2 groups. Group 1 was the CD-alone group consisting of patients without any other autoimmune diseases (AIDs), while group 2 was the PAI group consisting of patients with accompanying one or more AIDs. RESULTS: The mean age of 145 CD patients (106 female and 39 male) included in the study was 37.2 ± 12.3 years. Of the 145 patients included, 48 (33.1%) were in the PAI group. When two groups were compared with each other in terms of the demographic features and laboratory data, the following were identified as risk factors for PAI: female gender, family history for AIDs, antigliadin IgG positivity, vitamin D deficiency, antinuclear antibody positivity ≥1/80 titer and having any musculoskeletal disease. CONCLUSION: To the best of our knowledge, this is one of the largest studies in the literature on CD patients for the PAI prevalence and related risk factors. Identification of the risk factors in early stages is important to explore PAI among CD patients. Larger, prospective studies are warranted about the risk factors and autoimmune characteristics of CD.

Carotid endarterectomy using a "home-constructed" shunt for patients intolerant to cross-clamping.

PURPOSES: There is a small minority of patients with occlusive carotid artery disease, who are at high-risk for general anesthesia because of their intolerance to carotid flow blockage, even if only for seconds, without neurologic deficit. Even <30 s of temporary clamping of the carotid arteries to deploy a shunt may prove eventful in this patient group. We define safe carotid endarterectomy after the insertion of a novel shunt that we made from simple medical equipment in this patient population. METHODS: Among 65 patients who underwent carotid endarterectomy between March 2010 and December 2012, 5 (7.7 %; 3 men and 2 women; age range 56-77 years) could not tolerate carotid clamping. We used an alternative carotid shunt, made by us from simple equipment in our clinic, during surgery for these patients. RESULTS: Two patients had bilateral lesions and the remainder had unilateral disease. The degree of stenosis ranged from 70 to 95 %. Temporary carotid clamping resulted in neurologic events, such as loss of consciousness in all and tremor in one, in <10 s (range, from immediately to 8 s after clamping). Full neurologic function was regained 15-30 s after releasing the clamps. All of the patients tolerated the procedures well with the support of our novel shunt. Shunt flow was adequate in all patients and no neurologic deterioration occurred after carotid clamping. The mean carotid clamp time was 28.11 ± 14.19 min. There was no mortality and all patients were followed up for a mean period of 9.3 ± 3.6 months, uneventfully. CONCLUSIONS: An alternative, simple shunt, which is easily constructed in the operating room or clinic, using an angiocatheter, a three-way stopcock, and a serum line can provide adequate cerebral flow and permit safe carotid endarterectomy for those rare patients with carotid artery stenosis, who cannot tolerate even seconds of carotid occlusion.

Effects of Ginkgo biloba extract on spinal cord ischemia-reperfusion injury in rats.

BACKGROUND: We aimed to assess the biochemical and histopathologic effects of Ginkgo biloba extract (EGb) in an ischemia-reperfusion (IR) model of spinal cord ischemia induced by cross-clamping of the infrarenal abdominal aorta. METHODS: A total of 24 Sprague-Dawley rats were divided into 3 groups as group 1: control (sham laparotomy), group 2: IR, and group 3: IR+EGb treatment (IR+T) group. All subjects were euthanized 2 days postsurgery and their spinal cords were removed. Tissue malondialdehyde, superoxide dismutase, glutathione (GSH), and glutathione peroxidase levels were measured, and the spinal cord tissue samples were examined histopathologically. RESULTS: No significant difference was detected in ischemia markers between control, IR, and IR+T groups, with the exception of GSH, which was significantly lower in the IR group. GSH levels in group 1 and group 3 were similar. The group 2 displayed significant ischemic damage to the medulla spinalis. This damage was less pronounced in group 3 compared with group 2 only, but in extent and intensity comparable with the controls. CONCLUSIONS: Although we were not able to demonstrate a uniform effect of EGb on biochemical markers of IR injury, the histopathologic data appear to show a protective effect conferred on the spinal cord tissue by EGb.

Outcomes of the extracardiac fontan procedure using cardiopulmonary bypass: early results.

BACKGROUND: Although the avoidance of cardiopulmonary bypass during the Fontan procedure has potential advantages, using cardiopulmonary bypass during this procedure has no adverse effects in terms of morbidity and mortality rates. In this study, we assessed the postoperative outcomes of our first 9 patients who have undergone extracardiac Fontan operation by the same surgeon using cardiopulmonary bypass. METHODS: Between September 2011 and April 2013, 9 consecutive patients (3 males and 6 females) underwent extracardiac Fontan operation. All operations were performed under cardiopulmonary bypass at normothermia by the same surgeon. The age of patients ranged between 4 and 17 (9.8 ± 4.2) years. Previous operations performed on these patients were modified Blalock-Taussig shunt procedure in 2 patients, bidirectional cavopulmonary shunt operation in 6 patients, and pulmonary arterial banding in 1 patient. Except 2 patients who required intracardiac intervention, cross-clamping was not applied. In all patients, the extracardiac Fontan procedure was carried out by interposing an appropriately sized tube graft between the inferior vena cava and right pulmonary artery. RESULTS: The mean intraoperative Fontan pressure and transpulmonary gradient were 12.3 ± 2.5 and 6.9 ± 2.2 mm Hg, respectively. Intraoperative fenestration was not required. There was no mortality and 7 patients were discharged without complications. Complications included persistent pleural effusion in 1 patient and a transient neurological event in 1 patient. All patients were weaned off mechanical ventilation within 24 hours. The mean arterial oxygen saturation increased from 76.1% ± 5.3% to 93.5% ± 2.2%. All patients were in sinus rhythm postoperatively. Five patients required blood and blood-product transfusions. The mean intensive care unit and hospital stay periods were 2.9 ± 1.7 and 8.2 ± 1.9 days, respectively. CONCLUSIONS: The extracardiac Fontan operation performed using cardiopulmonary bypass provides satisfactory results in short-term follow-up and is associated with favorable postoperative hemodynamics and morbidity rates.

Pressure-controlled mechanical ventilation is more advantageous in the follow-up of patients with chronic obstructive pulmonary disease after open heart surgery.

OBJECTIVE: Cardiopulmonary bypass deteriorates pulmonary functions to a certain extent. Patients with chronic obstructive pulmonary disease (COPD) are associated with increased mortality and morbidity risks in the postoperative period of open-heart surgery. In this study we compared 2 different mechanical ventilation modes, pressure-controlled ventilation (PCV) and volume-controlled ventilation (VCV), in this particular patient population. PATIENTS AND METHODS: Forty patients with severe COPD were assigned to 1 of 2 groups and enrolled to receive PCV or VCV in the postoperative period. Arterial blood gases, respiratory parameters, and intensive care unit and hospital stays were compared between the 2 groups. RESULTS: Maximum airway pressure was higher in the VCV group. Pulmonary compliance was lower in the VCV group and minute ventilation was significantly lower in the group ventilated with PCV mode. The respiratory index was increased in the PCV group compared with the VCV group and with preoperative findings. Duration of mechanical ventilation was significantly shorter with PCV; however, intensive care unit and hospital stays did not differ. CONCLUSION: There is not a single widely accepted and established mode of ventilation for patients with COPD undergoing open-heart surgery. Our modest experience indicated promising results with PCV mode; however, further studies are warranted.

Introduction to a Norwood program in an emerging economy: learning curve of a single center.

BACKGROUND: There has been a notable improvement in the outcome of stage 1 palliation for hypoplastic left heart syndrome (HLHS) in recent years. Nevertheless, developing a new Norwood program requires a steep learning curve, especially in emerging economies where rapid population growth brings a high volume of patients but, on the other hand, resources are limited. In this paper we aimed to summarize the initial results of a single center. METHODS: Hospital records of 21 patients were reviewed for all patients having a stage 1 palliation procedure for HLHS between May 2011 and May 2013. There were 13 male (62%) and 8 female (38%) patients. Median age was 14 days (range, 4-74 days) and median weight was 3030 g (2600-3900 g). HLHS was defined as mitral or aortic stenosis or atresia (or both) in the presence of normally related great vessels and a hypoplastic left ventricle. Transthoracic echocardiography was the diagnostic modality used in all patients. All procedures but one were performed using an antegrade selective cerebral perfusion method and moderate hypothermia. Cerebral perfusion was monitored with cerebral oximetry in all patients. Modified ultrafiltration was routinely used in all patients. RESULTS: Overall hospital mortality was 47.6% (n = 10). Mortality rates considerably decreased from the first year to second year (69% and 12.5% respectively). No risk factors were identified for mortality. CONCLUSIONS: Surgical palliation of neonates with hypoplastic left heart syndrome continues to be a challenge. To decrease the overall mortality nationwide and improve outcomes, a referral center with a dedicated team is necessary in emerging economies.

Revisiting the central aortopulmonary shunt procedure.

Background: In this study, we present our experience with the central aortopulmonary shunt technique with interposing a polytetrafluoroethylene graft between main pulmonary artery (end-to-end) and the ascending aorta (side-to-side) in a variety of cyanotic congenital heart defects. Methods: Between January 2019 and June 2022, a total of 10 patients (6 males, 4 females; mean age: 4.3±2.8 months; range, 5 days to 10 months) with hypoplastic central pulmonary arteries who underwent central aortopulmonary shunt procedure were retrospectively analyzed. Demographic characteristics, preoperative, operative, and postoperative data of the patients were recorded. The Nakata indices of the patients were also noted before the procedure, as well as before the second stage of palliation or definitive repair. Results: Four (40%) patients were operated as the first-step palliation for univentricular circulation. Six (60%) patients had well-developed ventricles and were palliated to be treated with total correction. The median follow-up after the procedure was 12 (range, 8 to 16) months. The mean systemic arterial saturation level at room air was 89.3±2.9% during follow-up. No mortality was observed in any patient. Conclusion: A central aortopulmonary shunt procedure provides a reliable antegrade blood flow with a relatively non-challenging surgical technique that offers sufficient growth for the hypoplastic and confluent central pulmonary arteries with a very low risk of shunt thrombosis and overflow.

Modified Nikaidoh operation in a patient with dextro-transposition of the great arteries, ventricular septal defect, and left ventricular outflow tract obstruction.

The optimal surgical management for patients with transposition of the great arteries (TGA), ventricular septal defect (VSD) and left ventricular outflow tract obstruction (LVOTO) remains controversial. We describe the case of a patient with TGA, a remote restrictive VSD, and LVOTO who underwent a successful modified Nikaidoh operation.

Additive effectiveness of everolimus plus tamoxifen therapy in treatment of encapsulating peritoneal sclerosis.

Peritoneal dialysis (PD) is one of the commonly used choices of continuous renal replacement therapies. Peritoneal membrane is damaged by using solutions with lower biocompatibility, peritonitis episodes, and vintage of PD therapy. Encapsulating peritoneal sclerosis (EPS) is a rare complication of PD and is presented by progressive fibrosis of the peritoneum. Fibrous tissue entrapment of the intestine, leading to complete intestinal obstruction, is referred to as EPS, the most severe form of sclerosing peritonitis. EPS is irreversible fibrosis of the peritoneal membrane usually associated with high rates of morbidity and mortality. Preventive strategies are the best choice of treatment. Also there is no proven effective therapy for EPS; there are only small-sized trials. Herein we present a case of EPS who improved with everolimus plus tamoxifen therapy.

Three dimensional patient-specific guides for guide pin positioning in reverse shoulder arthroplasty: An experimental study on different glenoid types.

INTRODUCTION: Incorrect positioning is one of the main factors for glenoid component loosening in reverse shoulder arthroplasty and component placement can be challenging. This study aimed to assess whether Patient-Specific Instrumentation (PSI) provides better guide pin positioning accuracy and is superior to standard guided and freehand instrumentation methods in cases of glenoid bone deformity. MATERIALS AND METHODS: Based on the Walch classification, five different scapula types were acquired by computed tomography (CT). For each type, two different surgeons placed a guide pin into the scapula using three different methods: freehand method, conventional non-patient-specific guide, and PSI guide. Each method was repeated five times by both surgeons. In these experiments, a total of 150 samples of scapula models were used (5 × 2 × 3 × 5 = 150). Post-operative CT scans of the samples with the guide pin were digitally assessed and the accuracy of the pin placement was determined by comparison to the preoperative planning on a three-dimensional (3D) model. RESULTS: The PSI method showed accuracies to the preoperative plan of 2.68 (SD 2.10) degrees for version angle (p < .05), 2.59 (SD 2.68) degrees for inclination angle (p < .05), and 1.55 (SD 1.26) mm for entry point offset (p < .05). The mean and standard deviation errors compared to planned values of version angle, inclination angle, and entry point offset were statistically significant for the PSI method for the type C defected glenoid and non-arthritic glenoid. CONCLUSION: Using the PSI guide created by an image processing software tool for guide pin positioning showed advantages in glenoid component positioning over other methods, for defected and intact glenoid types, but correlation with clinical outcomes should be examined.

Assessment of knee osteoarthritis by ultrasonography and its association with knee pain.

BACKGROUND: Pain is a significant cause of disability in knee osteoarthritis. Conventional radiography is widely used in the assessment of knee osteoarthritis, however radiographic findings do not correlate well with pain. Ultrasonography can be used to evaluate the soft tissue structures of the knee that can be related to pain. OBJECTIVE: To evaluate pain-related soft tissue structures of the knee with ultrasonography. METHODS: This cross-sectional study included a total of 198 knees from 99 patients with knee osteoarthritis. Knee pain and functional status were evaluated by performing visual analogue scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). On the ultrasound, cartilaginous thickness, knee effusion and presence of Baker's cyst were assessed and the correlation to pain was investigated. RESULTS: Baker's cyst was significantly more frequent in symptomatic knees (13.9%) compared to asymptomatic knees (2.5%). Patients with Baker's cyst had a significantly more limited degree of knee flexion, significantly higher resting VAS pain scores and worse WOMAC scores compared to patients without Baker's cyst. In log-linear analysis, presence of Baker's cyst increased the risk of pain by 2.94 times. CONCLUSION: Ultrasound as a modality that is easily accessible, inexpensive and without radiation exposure is helpful to demonstrate factors related to pain in knee osteoarthritis by allowing assessment of soft tissue structures.

[Pulsatile thoracal mass: a rare case of large left ventricular pseudoaneurysm]. / Pulsatil torakal kitle: Nadir görülen bir sol ventrikül psödoanevrizmasi.

Left ventricular pseudoaneurysms (LVPA) develop after myocardial infarction, trauma, infection and either valvular or ventricular surgery. We present here an unusual case of LVPA appearing like a pulsatile mass, which was easily seen from the chest wall. A 55-year-old woman was admitted to our clinic with a pulsatile mass and trill, easily seen on the anterior chest wall 6 weeks after coronary artery bypass graft (CABG) surgery and endoaneurysmorrhaphy operation. Contrast-enhanced tomography showed a soft tissue mass detected close to the subcutaneous fat tissue of the anterior chest wall located in the left hemithorax. Left ventriculography was consistent with a large pseudoaneurysm in the apical wall of the left ventricle. Cardiopulmonary bypass was established with femoral cannulation, and endoaneurysmorrhaphy and CABG x 1 operations were carried out. The patient was discharged home on postoperative day 15. Follow-up echocardiography showed successful repair and shrinkage of the aneurysm, and the patient remained asymptomatic without any clinical event during our follow-up. LVPA usually present with heart failure. However, some patients may have recurrent tachyarrhythmia, progressive dyspnea, nonspecific chest pain, or thromboembolism, or remain clinically silent. When a patient is seen after cardiac surgery with a pulsatile mass detected on the chest wall, LVPA should be considered in the differential diagnosis.

Pulmonary Arterial Bypass Surgery for Fibrosing Mediastinitis Causing Severe Pulmonary Hypertension.

This case report describes a patient with mediastinal fibrosis. The mass lesion was expanding from the mediastinum to the cervical region and surrounding the major vascular structures. The patient had symptomatic dyspnea at rest and pulmonary hypertension secondary to stenosis of the bilateral main pulmonary arteries. To decrease pulmonary artery pressure and improve blood flow to the lungs, grafting from the pulmonary trunk to the bilateral interlobar pulmonary arteries was performed using cardiopulmonary bypass.

Efficacy of remote ischaemic preconditioning for spinal cord protection against ischaemic injury: association with heat shock protein expression.

INTRODUCTION: We aimed to determine the efficacy of remote ischaemic preconditioning in the hind limb of rats for ischaemic damage of the spinal cord through neurological and histological investigation and examination of heat shock proteins (HSP). MATERIAL AND METHODS: Thirty male Sprague-Dawley rats were divided into three groups as Group 1 (control group, n=10), Group 2 (ischaemia control group, n=10), and Group 3 (remote ischaemia preconditioning group, n=10). The right lower limb of the rats in the study group was compressed with a tourniquet for three cycles of ten-minute ischaemia followed by ten-minute reperfusion. After a period of 8 hours, the peritoneal cavity was accessed through a midline vertical incision. The abdominal aorta was clamped between the origin of the renal arteries and the iliac arteries for 45 minutes and spinal cord ischaemia was induced. The same procedure of abdominal aorta clamping was performed in the control group without creating leg ischaemia. The rats were evaluated for neurological parameters at 24 and 48 hours. At the end of this time period, all rats were sacrificed and the spinal cords were stained for determination of HSP and histopathological classification. For immunohistochemical evaluation, the samples were analyzed according to the degree of staining with HSP70 rabbit antibody. RESULTS: After completing the neurological examinations and histological evaluations, we determined the spinal cords of the animals in the sham group to be completely normal. The post-operative neurological examination scores of Group 3 at 24 and 48 hours were significantly higher than scores measured in the other two groups. There were seven rats with HSP expression and this was detected in animals pretreated with remote ischaemic preconditioning. There were also two rats in Group 2 with HSP expression. CONCLUSION: Our results show that production of transient remote ischaemia preconditioning in the lower extremities reduces damage in the spinal cord secondary to ischaemia probably by the increase of HSP.

Comparison of 3 different incisions used for atrial-septal defect closure.

BACKGROUND: Surgical closure of atrial-septal defects is now associated with low morbidity and mortality rates. We assessed surgical, cosmetic, and psychological results of 3 different surgical approaches to atrial-septal defect repair. METHODS: Study participants were 82 patients who underwent surgery for atrial-septal defect. Mean age was 21 +/- 8 years, and the female:male ratio was 23:59. Patients were divided into 3 groups according to the incision used; group 1 (n = 26), partial lower sternotomy; group 2 (n = 34), right anterolateral thoracotomy via a submammary incision, and group 3 (n = 22), conventional median sternotomy. RESULTS: There was no operative or late mortality. No significant differences between groups were associated with the surgical technique used. Direct closure was the procedure of choice performed in 53 patients (64.6%). In the remaining patients the repair was performed with a pericardial patch (29 patients, 35.4%). One patient in group 1 required conversion to median sternotomy because transoesophageal echocardiography performed at the operating theater revealed a partial anomalous pulmonary venous connection of right pulmonary veins to the inferior vena cava. This patient was excluded from the study group. All patients were symptom free postoperatively, and control echocardiography revealed a trivial shunt in only 1 patient, with a Qp:Qs ratio of 1.3. Rhythm abnormalities, including atrioventricular block, atrial fibrillation, and flutter, were observed in 7 patients but were found to be unrelated to the surgical incision (P = .3). Cardiopulmonary bypass, cross-clamp, and operative times were longer with minimally invasive approaches; but these differences were not statistically significant. Intensive care unit and hospital stay periods were significantly shorter in groups 1 and 2. During the postoperative follow-up period, patients in groups 1 and 2 showed superior results in satisfaction with their cosmetic outcomes. CONCLUSIONS: With the development of minimally invasive techniques that yield surgical results comparable to those of standard techniques, surgeons have changed their focus from survival to cosmetic and psychological outcomes, especially in the repair of simple cardiac defects. Operations performed via limited skin incisions are surgically safe and provide superior cosmetic and psychological results.

Papaverine solution improves preservation of saphenous vein grafts used during cardiac surgery.

The purpose of this study was to assess the viability and dilator response of the saphenous vein segments harvested during cardiac surgery. The saphenous veins were incubated with either normal saline (group A) or papaverine solutions (group B). The viability of saphenous vein endothelial cells was assessed by counting the number of total cells. Maximal endothelium-dependent vasodilator response to acetylcholine was also investigated. Cell viability of vein samples was decreased after 4 hours of incubation with normal saline (34 +/- 6.5%) as compared to solution containing papaverine (92 +/- 3.7%). By 24 hours, the viabilities of the endothelial cells incubated with saline and papaverine solutions were 22 +/- 4.5% and 87 +/- 5%, respectively.There was significant difference in vasodilatation responses to acetylcholine between saline-incubated and papaverine-incubated groups. By 4 hours of incubation, the relaxation response to acetylcholine significantly deteriorated in group A when compared to the initial value (P < 0.001). Furthermore, the decrease in this vasorelaxation response has also continued throughout the observation period and the values obtained by 24 hours were observed to be significantly lower than those obtained at the end of 4 hours (P < 0.01). In contrast, although a decrease was noticed in group B over time, this decrease was not statistically significant (P, not significant). We thus conclude that the use of papaverine solution improves endothelial cell viability and is associated with preservation of the maximal endothelial-dependent vasodilator response of a vein segment.

The Quantum Chemical and QSAR Studies on Acinetobacter Baumannii Oxphos Inhibitors.

BACKGROUND: Acinetobacter is a Gram-negative, catalase-positive, oxidase-negative, non-motile, and no fermenting bacteria. OBJECTIVE: In this study, some of the electronic and molecular properties, such as the highest occupied molecular orbital energy (EHOMO), lowest unoccupied molecular orbital energy (ELUMO), the energy gap between EHOMO and ELUMO, Mulliken atomic charges, bond lengths, of molecules having impact on antibacterial activity against A. baumannii were studied. In addition, calculations of some QSAR descriptors such as global hardness, softness, electronegativity, chemical potential, global electrophilicity, nucleofugality, electrofugality were performed. METHOD: The descriptors having impact on antibacterial activity against A. baumannii have been investigated based on the usage of 29 compounds employing two statistical methods called Linear Regression and Artificial Neural Networks. RESULTS: Artificial Neural Networks obtained accuracies in the range of 83-100% (for active/inactive classifications) and q2=0.63 for regression. CONCLUSION: Three ANN models were built using various types of descriptors with publicly available structurally diverse data set. QSAR methodologies used Artificial Neural Networks. The predictive ability of the models was tested with cross-validation procedure, giving a q2=0.62 for regression model and overall accuracy 70-95 % for classification models.