Different technical approaches on cardiac binding procedures.
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Animals↗
Biomedical subjects
M Demirtaş
Publications and source records attributed to M Demirtaş.
Lymphocyte subsets in patients with idiopathic dilated cardiomyopathy.
OBJECTIVE: Although chronic myocardial inflammatory process mediated by viral and autoimmune factors has been postulated in the pathogenesis of idiopathic dilated cardiomyopathy (IDC), the role of autoimmune mechanisms still remains unclear. The aim of the present study was to investigate the rates of various T cell subsets and natural killer (NK) cells in peripheral blood in order to see whether they had a role in the immunoregulation of IDC. METHODS: The surface markers of peripheral T and B lymphocytes were detected and percentages of pan T and B cells as well as helper (CD4+) and suppressor (CD8+) T lymphocytes subsets in the peripheral blood and their ratio (CD4+/CD8+) were determined in 27 patients with IDC and in 20 healthy controls. NK cell percentage was also studied. RESULTS: There were no significant differences between IDC and control groups with respect to T and B cell percentages. The percentages of CD4+ T cell subsets were similar in both groups (48.7 +/- 8.7% vs. 43.5 +/- 9.7% respectively; p = 0.107). CD8+ T cell percentage was significantly decreased in patients with IDC than in controls (22.6 +/- 7.7% vs. 28.2 +/- 8.2%, respectively; p = 0.044). CD4+/CD8+ ratio was markedly higher in patients with IDC than controls (2.6 +/- 1.8 vs. 1.6 +/- 0.6, respectively; p = 0.006). There was no significant difference in the NK cell percentage between groups. CONCLUSION: Decreased CD8+ T cell subset is the cause of increased CD4+/CD8+ ratio, which may imply decreased self-tolerance and an immunoregulatory defect in the pathogenesis of IDC.
Adult↗
The role of intraoperative antibiotic irrigation and postoperative antibiotic therapy for contaminated implantable prosthesis: in a rat model in vivo.
The aim of this study was to determine the usefulness of intraoperative antibiotic irrigation solution and long-term effective antibiotic therapy for the infected prostheses. Forty-five male Wistar albino rats were divided into three equal groups and a small piece of silicone prosthesis contaminated with Staphylococcus epidermidis was implanted into the scrotum. In the first group, the silicone pieces were irrigated with an antibiotic solution intraoperatively and antibiotic therapy was applied for 20 days postoperatively. The second group underwent only antibiotic therapy. In the third group (control) neither intraoperative irrigation nor postoperative antibiotic therapy was applied. Postoperative clinical infection was determined as follow-up. All implants were extracted 20 days after the implantation and cultured to observe the bacterial growth. In the first group, in 13 rats the cultures were negative and in two rats, the cultures revealed positive bacterial growth. In the second group, in four rats the cultures were negative, in five rats the cultures were positive and six rats revealed infectious findings. In the third group, 13 rats revealed infectious findings, and in the remaining two rats the cultures were positive. The differences between three groups are statistically significant (P < 0.05). We conclude that intraoperative antibiotic irrigation and postoperative antibiotic therapy are highly beneficial in the infected prosthesis surgery.
Animals↗
Mobile right atrial hydatid cyst with multiorgan involvement.
A 25-year-old woman who had hydatid cysts in her lung was referred to our clinic for the hydatid cyst in her cardiac localization. Multiple hydatid cysts of different cardiac localizations were diagnosed by two-dimensional echocardiography, confirmed by computed tomography and magnetic resonance imaging, supported by enzyme-linked immunosorbent assay (ELISA) for echinococcosis. Surgical resection was performed for the right atrial cyst and pathology confirmed the diagnosis. Oral albendazole treatment was given postoperatively. Cathet. Cardiovasc. Intervent. 49:204-207, 2000.
Adult↗
Correlation of magnetic resonance imaging and intraoperative punctate bleeding to assess the vascularity of scaphoid nonunion.
Thirty-two patients with radiographic evidence of scaphoid nonunion were preoperatively evaluated by magnetic resonance imaging (MRI), then observed intraoperatively for punctate bleeding of the fragments. Although MRI and intraoperative findings matched in 19 patients, there was no correlation in 13 patients. While 7 of these latter patients showed normal MRI but no punctate bleeding during the operation, the remaining 6 had preoperative MRI of avascularity but punctate bleeding during the operation. After internal fixation and bone grafting, all but 1 of these 13 patients achieved union. We conclude that the diagnosis of avascular necrosis should only be made when both MRI and intraoperative findings indicate avascularity.
Bone Transplantation↗
Nitroglycerin-induced hypoxemia does not produce myocardial ischemia.
OBJECTIVE: Nitroglycerin has been the drug of choice for relieving myocardial ischemia for more than a hundred years. Several studies have indicated that a significant reduction in arterial oxygen tension (PaO2) occurs after the administration of sublingual nitroglycerin to patients with coronary artery disease breathing room air. Because available oxygen in arterial blood is reduced, it would be reasonable to assume that oxygen delivery to the myocardium would also be impaired. The purpose of this study was to investigate whether nitroglycerin-induced arterial desaturation results in compromised oxidative metabolism of myocardium assessed by coronary sinus lactate concentration and oxygen content in patients with coronary artery disease undergoing coronary artery bypass surgery. PARTICIPANTS: Ten randomly selected patients undergoing coronary bypass surgery. SETTING: All studies were performed at Siyami Ersek Cardiovascular and Thoracic Surgery Center. METHODS: A catheter was inserted into the radial artery to measure blood gases and arterial lactate concentration. After sternotomy, and aortic and venous cannula placement, a coronary sinus catheter was introduced into the coronary sinus to measure oxygen content and lactate concentration. Control coronary sinus and arterial blood samples were obtained before nitroglycerin infusion. Nitroglycerin was then given in a dose of 2 micrograms/kg/min for a period of 5 minutes. At the end of 5 minutes, second samples were obtained from the coronary sinus and arterial catheters. MAIN RESULTS: It was found that arterial and coronary sinus oxygen tension decreased significantly. Arterial lactate concentration did not change, coronary sinus lactate concentration decreased. Despite a substantial fall in arterial oxygen tension after administration of nitroglycerin, a significant reduction in coronary sinus lactate concentration occurred. CONCLUSION: Nitroglycerin-induced hypoxia does not compromise oxidative metabolism of myocardium as can be assessed by a concomitant decrease in coronary sinus lactate concentration.
Adult↗
A serious complication of percutaneous mitral valvuloplasty: systemic embolism. How can we decrease it? Case history.
Systemic embolism is a potential and severe complication of percutaneous balloon mitral valvuloplasty (PBMV). The incidence of systemic embolism during PBMV has been reported to be less than 5% and only 0.6% with the Inoue technique. This is less than that reported in closed commissurotomy series and about the same as in open commissurotomy. In the authors' series of 50 cases, the incidence of systemic embolism was 2% (1 case). The patient had mitral restenosis (after closed commissurotomy) with mild to moderate valvular and subvalvular calcification, and cerebral embolism occurred during the procedure. To prevent systemic embolism, the authors' standard policy was to perform transesophageal echocardiography (TEE), computed tomography, and magnetic resonance imaging before the procedure and to give heparin during the procedure and two months preceding it in cases with atrial fibrillation or with a history of previous embolism and to limit manipulation of the catheter in the left atrium. The authors believe that a close scrutiny in the selection of patients, improved technology of the dilating system, good experience with PBMV, and adequate heparinization are also of great importance in the prevention of thromboembolic complications.
Anticoagulants↗
Comparative assessment of the effects of vasodilators on peripheral vascular reactivity in patients with systemic scleroderma and Raynaud's phenomenon: color Doppler flow imaging study.
The aim of the present study was assessment of peripheral vascular reactivity during cold test effects of different types of vasodilators on vascular resistance in patients with progressive systemic sclerosis and Raynaud's phenomenon with use of color Doppler flow imaging of upper extremity.
Adult↗
Hydatid disease presenting as cardiac tamponade. A case history.
Although hydatid disease has been reported in almost all human tissues, cardiac involvement is uncommon. The authors report a case of cardiac hydatid disease presenting with cardiac tamponade. The diagnostic value of transthoracic and transesophageal echocardiography, computed tomography, and angiography in hydatid heart disease is also discussed.
Adult↗
Repair of the supradiaphragmatic inferior vena cava lacerated during redo open-heart surgery.
Laceration of the inferior vena cava is among the more lethal of the vascular traumas. True mortality is higher if the lacerated segment is located in the upper part of the inferior vena cava, especially in the supradiaphragmatic portion. Knowledge of injuries of the inferior vena cava is mostly limited to those related to external trauma. The inferior vena cava may be lacerated during reoperation because of inappropriate dissection or uncontrolled traction. The authors used a diaphragmatic pericardial flap to repair the lacerated anterior wall of the supradiaphragmatic inferior vena cava and obtained good results in two cases requiring repeat open-heart surgery.
Adult↗
Low blood pressure and amyloidosis.
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Adult↗
AA-amyloidosis presenting with chronic diarrhea and cardiac manifestations.
In secondary amyloidosis (AA type), clinically significant cardiac and gastrointestinal involvement are uncommon, in contrast to the primary type. We report a case presenting with chronic diarrhea and cardiac manifestations who was diagnosed as having AA-amyloidosis with unknown predisposing illness based on endomyocardial, rectal and subcutaneous fat tissue biopsies.
Aged↗
Primary rhabdomyosarcoma of the heart presenting with increased intracranial pressure.
An 18-month-old boy presented with signs of increased intracranial pressure. Computed tomographic scans of the brain and lungs showed multiple masses in the brain and lungs. Echocardiography revealed homogeneous, irregular pericardial thickening, minimal pericardial effusion, and irregular echogenic areas in the left ventricular inferoposterior and apical regions. Postmortem examination of tumor tissue showed that the masses were primary rhabdomyosarcoma of the left ventricle with multiple metastases. Primary rhabdomyosarcoma of the heart is uncommon, especially in patients under 2 years of age.
Brain↗