Delayed presentation of a penetrating subclavian arterial injury: case report

Subklavian arter yaralanması lokalizasyonu nedeniyle oldukça nadir görülür. Yaralanma bazen çok rahatlıkla saptanabilirken, bazen de arteriyel yaralanmaya ait bariz bulgular saptanamaz. Elli sekiz yasında olan ve atesli silah yaralanması nedeniyle getirilen bayan olguda, basvurusu esnasında arter yaralanmasını düsündürecek bulgular saptanamadı. Olguda yaralanmayı düsündürecek tek bulgu travmanın lokalizasyonuydu. Indirekt bulgular nedeniyle hastanede gözlenen olgunun yapılan tetkiklerinde arteriyel yaralanma saptandı. Klinik takibinin yirminci saatinde genel durumu ve hemodinamik parametreleri aniden bozulan olgu cerrahi uygulanarak basarılı bir sekilde tedavi edildi. Subklavian bölgesinden yaralanmıs olgularda, damar yaralanmasının kesin bulguları olmasa da, yaralanma süphesi bulunan olguların hastane ortamında belirli bir süre gözlenmesi olası ölümcül komplikasyonları engelleyecektir.Subclavian artery injuries are quite rare. While the arterial injuries can be detected easily at times, the related symptoms may not be detected at all in some cases. Indirect evidences of arterial injury were detected in our fifty eight year old case brought in with firearm injury. Arterial injury was confirmed by the tests performed while the case was under observation in hospital due to indirect symptoms. Successful surgical therapy was performed on the patient whose condition had suddenly worsened in the 20 hour of the clinical follow-up.Acertain period of follow-up in the hospital setting of patients with injury in the subclavian area even when they show no initial signs will prevent possible lethal complications

Analysis of Pericardial Effusion from Idiopathic Pericarditis Patients by Two-Dimensional Gel Electrophoresis

Pericardial fluid (PF) is often considered to be reflection of the serum by which information regarding the physiological status of the heart can be obtained. Some local and systemic disorders may perturb the balance between synthesis and discharge of PF and may cause its aberrant accumulation in the pericardial cavity as pericardial effusion (PE). PE may then lead to an increased intrapericardial pressure from which the heart function is undesirably affected. For some cases, the causes for the perturbance of fluid balance are well understood, but in some other cases, they are not apparent. It may, thus, be helpful to understand the molecular mechanisms behind this troublesome condition to elucidate a clinical approach for therapeutic uses. In this study, protein profiles of PEs from idiopathic pericarditis patients were analyzed. Control samples from patients undergoing elective cardiac surgery (ECS) were included for comparison. In addition to high abundant serum-originated proteins that may not hold significance for understanding the molecular mechanisms behind this disease, omentin-1 was identified and its level was higher for more than two-fold in PE of IP patients. Increased levels of omentin-1 in PE may open a way for understanding the molecular mechanisms behind idiopathic pericarditis (IP)

Ischemia-modified albumin use as a prognostic factor in coronary bypass surgery

<p>Abstract</p> <p>Background</p> <p>Various types of markers have been used so far in order to reveal myocardial perfusion defect. However, these markers usually appear in the necrosis phase or in the late stage. Having been the focus of various investigations recently, ischemia-modified albumin (IMA) is helpful in establishing diagnosis in the early stages of ischemia, before necrosis develops.</p> <p>Methods and Results</p> <p>30 patients that underwent only coronary bypass surgery due to ischemic heart disease within a specific period of time have been included in the study. IMA levels were studied in the preoperative, intraoperative, and postoperative periods. The albumin cobalt binding assay was used for IMA determination. Hemodynamic parameters (atrial fibrillation, the need for inotropic support, ventricular arrhythmia) of the patients in the postoperative stage were evaluated. Intraoperative measurement values (mean ± SD) of IMA (0.67677 ± 0.09985) were statistically significantly higher than those in the preoperative (0.81516 ± 0.08894) and postoperative (0.70477 ± 0.07523) measurements. Considering atrial fibrillation and need for inotropics, a parallelism was detected with the levels of IMA.</p> <p>Conclusions</p> <p>IMA is an early-rising marker of cardiac ischemia and enables providing a direction for the treatment at early phases.</p