Turhan Yavuz

Cardiotoxicity in rats induced by methidathion and ameliorating effect of vitamins E and C.

We have examined the effect of subchronic methidathion (MD) administration on heart damage, and have evaluated possible ameliorating effects of a combination of vitamins E and C against MD toxicity. The experimental groups were: control group, rats treated with 5 mg/kg MD and rats treated with 5 mg/kg body weight MD plus vitamin E and vitamin C (MD+Vit). The groups were given MD by gavage 5 days a week for four weeks at a dose level of 5 mg/kg/day (MD and MD+Vit) by using corn oil as the vehicle. Vitamin E and vitamin C were injected at doses of 50 mg/kg i.m. and 20 mg/kg i.p., respectively, after the treatment with MD in the MD+Vit group. The levels of malondialdehyde (MDA) were determined in the heart tissue, and the levels of cardiac troponin I (TnI) in serum. An autoanalyser was used to determine the serum activities of cholinesterase (ChE). Histopathological examination was carried out in the heart tissue. MDA significantly increased in the MD group as compared to controls (P <0.01). When MD was given concurrently with vitamins E and C, the increase in MDA was significantly less (P <0.01). ChE activity significantly decreased in the MD group as compared to controls (P <-0.01). When MD was given concurrently with vitamins E and C, the decrease in ChE activity was significantly higher (P <-0.05). The serum TnI levels significantly increased in the MD group as compared to controls (P <-0.01). When MD was given concurrently with vitamins E and C, the increase in the serum TnI was significantly less (P <-0.01). MD caused the diffuse loss of striation and myocytolysis of the cardiomyocytes, whereas the combination of vitamins E and C caused a significant decrease in these effects of MD. In conclusion, subchronic MD administration caused heart damage and, in addition, treatment with a combination of vitamins E and C after the administration of MD reduced heart damage caused by MD.

Left atrial myxoma associated with acute myocardial infarction

A 38-year-old male was admitted to our institution with left atrial myxoma complicated with acute myocardial infarction. The patient had no risk factor for coronary artery disease. A transthoracic echocardiographic study revealed the presence in the left atrium of an echogenic, mobile mass, compatible with myxoma. There were no endocrine hyperactivity, any other tumor and family history. Coronary angiography revealed normal coronary arteries and aorto-coronary bypass surgery was not required in this patient. The tumor was successfully removed surgically. In conclusion, there could be no other etiologic possibility identified and therefore left atrial tumor causing coronary embolization and MI was considered the most likely event in this patient.

An evaluation of the lower extremity muscle strength of patients with chronic venous insufficiency

Objective In this study, the aim was to evaluate the lower extremity muscle strength in patients with chronic venous insufficiency using an isokinetic dynamometer. Methods The study comprised a group of 36 lower extremities of 23 patients diagnosed with chronic venous insufficiency and a control group of 40 lower extremities of 20 patients who did not have chronic venous insufficiency. In the diagnosis and evaluation of chronic venous insufficiency, photoplethysmography was used to evaluate the venous return circulation time. Visual Analog Scale scoring was applied to define the level of pain of the patients. Muscle strength measurements were made in all the lower extremities by using an isokinetic dynamometer. Results A statistically significant difference was detected between the groups in terms of the muscle strength parameters in the ankle plantar flexion, and knee flexor and extensor muscles. However, no statistically significant difference was found between the groups in the ankle dorsiflexion muscle strength parameters. A significant difference was determined in the ratio of ankle dorsiflexion/plantar flexion muscle strength between the mild, moderate and severe venous insufficiency groups. A statistically considerable negative correlation was found between the Visual Analog Scale scores and the photoplethysmography results. According to the Visual Analog Scale results, as the degree of venous insufficiency increased, so did the level of pain. Conclusion Impaired lower extremity muscle strength was observed in chronic venous insufficiency patients. Although the current study was consistent with literature in respect of impaired calf muscle strength, this finding was also seen in the thigh muscles. Furthermore, we concluded that if venous insufficiency becomes more severe, impaired calf muscle strength becomes more evident.

Surgically revascularized dual LAD

Dual left anterior descending artery (or dual anterior interventricular artery, LAD) is a rare coronary artery anomaly. Dual but normally originated LAD has been usually reported to have no clinical significance. In this case report, we present a case of 75 year old male with anginal symptoms in whom coronary arteriography showed normally originated dual LAD with two branches of almost equal caliber. The course of both branches were supplying the usual territory of LAD and both of the branches had significant proximal stenosis. The patient underwent a coronary artery bypass grafting operation and both branches were grafted. This normally originated dual LAD case may be considered to be interesting, because dual LAD branches were symmetrically involved with the atherosclerotic process in their proximal segments. In addition, this condition was demonstrated intraoperatively and the two branches were revascularized with bypass grafting.

N-acetyl cysteine for the conversion of atrial fibrillation into sinus rhythm after cardiac surgery: A prospective, randomized, double-blind, placebo-controlled pilot study

cardiac surgery: A prospective, randomized, double-blind, placebo-controlled pilot study Mehmet Ozaydin ⁎, Dogan Erdogan , Habil Yucel , Oktay Peker , Atilla Icli , Selahaddin Akcay , Mustafa Etli , Betul M. Ceyhan , Recep Sutcu , Ercan Varol , Abdullah Dogan , Turhan Yavuz b a Department of Cardiology, Suleyman Demirel University, Isparta, Turkey b Department of Cardiovascular Surgery, Suleyman Demirel University, Isparta, Turkey c Department of Biochemistry, Suleyman Demirel University, Isparta, Turkey

Congenital Cleft of Anterior Tricuspid Leaflet in Adolescent

The diagnostic findings and treatment of an isolated congenital cleft of the anterior leaflet of the tricuspid valve in a 14-year-old boy are described. An atrial septal defect was closed by primary suturing, and the tricuspid valve was successfully reconstructed by De Vega annuloplasty.

A retrospective study of a new n-butyl-2-cyanoacrylate glue ablation catheter incorporated with application guiding light for the treatment of venous insufficiency: Twelve-month results

Objective This study aims to present the early results of a retrospective study of the use of novel n-butyl-2-cyanoacrylate (VenaBlock)-based nontumescent endovenous ablation with a guiding light for the treatment of patients with varicose veins. Methods Patients with lower limb venous insufficiency were treated with n-butyl-2-cyanoacrylate (VenaBlock Venous Closure System) between April 2016 and July 2016. The study enrolled adults aged 21–70 years with symptomatic moderate to severe varicosities (C2–C4b) and great saphenous vein reflux lasting longer than 0.5 s with great saphenous vein diameter between 5.5 and 15 mm assessed in the standing position. No compression stockings were used after the procedure. Duplex ultrasound imaging and clinical follow-up were performed on the third day, first month, sixth month, and 12th month. Clinical, etiological, anatomical, pathophysiological classification; venous clinical severity score; and completed Aberdeen varicose vein questionnaire were recorded. Results Five hundred thirty-eight patients with great saphenous vein incompetency underwent n-butyl-2-cyanoacrylate ablation. The mean ablation length was 25.69 ± 4.8 cm, and the average amount of n-butyl-2-cyanoacrylate delivered was 0.87 ± 0.15 ml. The mean procedure time was 11.7 ± 4.9 min. Procedural success was 100%, and complete occlusion was observed after treatment and at the third-day follow-up. We observed ecchymosis in five patients (1.00%) at the entry site at the third-day follow-up. Phlebitis was encountered with six (1.20%) patients. No skin pigmentation, hematoma, paresthesia, deep vein thrombosis, or pulmonary embolism was observed. Kaplan–Meier analysis yielded an occlusion rate of 99.4% at the 12-month follow-up. All patients had significant improvement in venous clinical severity score and Aberdeen varicose vein questionnaire scores postoperatively (p <0.0001). Venous clinical severity score scores decreased from 5.43 ± 0.87 to 0.6 ± 0.75. Aberdeen varicose vein questionnaire scores decreased from 18.32 ± 5.24 to 4.61 ± 1.42. Conclusions The procedure appears to be feasible, safe, and efficient in treating the great majority of incompetent great saphenous veins with this technique.

Effects of isokinetic calf muscle exercise program on muscle strength and venous function in patients with chronic venous insufficiency

Objective The aim of this study was to observe the change of the ankle joint range of motion, the muscle strength values measured with an isokinetic dynamometer, pain scores, quality of life scale, and venous return time in chronic venous insufficiency diagnosed patients by prospective follow-up after 12-week exercise program including isokinetic exercises. Methods The patient group of this study comprised 27 patients (23 female, 4 male) who were diagnosed with chronic venous insufficiency. An exercise program including isokinetic exercise for the calf muscle was given to patients three days per week for 12 weeks. At the end of 12 weeks, five of the patients left the study due to inadequate compliance with the exercise program. As a result, control data of 22 patients were included. Ankle joint range of active motion, isokinetic muscle strength, pain, quality of life, and photoplethysmography measurements were assessed before starting and after the exercise program. Results Evaluating changes of the starting and control data depending on time showed that all isokinetic muscle strength measurement parameters, range of motion, and overall quality of life values of patients improved. Venous return time values have also increased significantly (p < 0.05). Conclusion In conclusion, increase in muscle strength has been provided with exercise therapy in patients with chronic venous insufficiency. It has been determined that the increase in muscle strength affected the venous pump and this ensured improvement in venous function and range of motion of the ankle. In addition, it has been detected that pain reduced and quality of life improved after the exercise program.