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    Does preoperative administration of allopurinol protect the lungs from ischemia-reperfusion injury occuring during cardiopulmonary bypass?
    (COMENIUS UNIV, 2013) Gormus, Z., I; Celik, J. B.; Ergene, N.; Gormus, N.; Baltaci, A. K.
    Background: It is investigated whether preoperative allopurinol administration protects lung injury induced by cardiopulmonary bypass (CPB). Methods: Sixty patients with coronary artery disease who need elective coronary artery bypass grafting operations by using CPB were taken into this study. They were divided into two groups; control and allopurinol. Allopurinol (300 mg/day) was administered to the latter group during the preoperative period of 5 days. Standard CPB procedures were used in all cases. Blood was sampled for TNF-alpha, IL-6, IL-8, IL-10 before anesthesia (T0), after anesthesia and before skin incision (T1), before CPB (T2), after aortic declamping (T3), at the end of CPB (T4), 6 hours after operation (T5), 12 hours after operation (T6), and 24 hours after operation (T7). Pulmonary function test (PFT) was performed before and following the 6th day of operation. Results: TNF-alpha, IL-6, IL-8 increased in both groups at T3, T4, T5 and T6 compared to control (p<0.05). TNF-alpha, IL-6, and IL-8 levels were lower in group A at T3, T4, T5 and T6 (p<0.05). Creatinin phosphokinase (CK) levels were lower in group A at T6 (p<0.05). CK-MB levels were lower in group A than in group C (p<0.05). Pulmonary function test (PFT) did not yield any differences between the groups. Conclusions: Preoperative allopurinol administration decreases the inflammation and myocardial injury according to biochemical markers of ischemia reperfusion injury. However, this biochemical success does not rebound to PFT (Tab. 5, Ref. 15). Full Text in PDF www.elis.sk.
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    Primary cardiac myxomas: report of 28 cases and review the literature
    (ZERBINIS MEDICAL PUBL, 2011) Durgut, K.; Onoglu, R.; Gormus, N.
    Purpose: Although primary cardiac tumors are rare, cardiac myxoma is the most common seen intracardiac tumor This study summarizes our surgical experience with cardiac myxomas. Methods: Twenty-eight cases of cardiac myxoma that were surgically treated in our center between January 1990 and March 2010 were retrospectively reviewed. In all patients the New York Heart Association (NYHA) functional classification was used to assess the functional status, and C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) levels were measured before and after surgery. Results: Nineteen patients were female and 9 male. The mean age was 53.3 +/- 12.7 years (range 4-73). The most common symptom was dyspnea (86%). Two patients presented with peripheral embolism. In preoperative assessment of functional status, 24 of the patients were in NYHA Class II, 2 of them were in Class land the other 2 patients were in Class III. All patients were in NYHA class fin the early postoperative period up to long-term follow up. The mean preoperative CRP and ESR levels were 47.3 +/- 14.6 mg/l (range 30-79) and 52.8 +/- 21.4 mm/h (range 28-82), respectively. One month after surgery, CRP and ESR levels returned back to normal values. Postoperative CRP and ESR levels were 8.4 +/- 2.6 mg/l (range 1-12) and 7.9 +/- 4.8 mm/h (range 3-18), respectively. Conclusion: Myxomas should be considered in all patients with embolism. After surgical resection of cardiac myxomas, the functional status of patients improve and CRP and ESR levels become normal.
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    Successful surgical treatment of Nicolau's syndrome combined with intravenous iloprost
    (VERLAG HANS HUBER, 2009) Gormus, N.; Tanyeli, O.; Senaran, H.; Duman, A.; Gormus, Z. I. Solak; Durgut, K.
    A 4 year-old boy was admitted to our clinic with symptoms of pain and ecchymosis in his right leg and foot after injection of benzathine penicilline. There was a localized gangrenous area at the femoral injection site. Doppler ultrasonography showed no arterial flow in the femoral artery and clear evidence of acute thrombosis of the superficial femoral and popliteal veins. Femoral arterial and venous thrombectomy and fasciotomy were performed immediately. After surgery the boy was treated by Iloprost infusion and enoxaparine. One week later necrotic changes had regressed, fasciotomies were closed and only the distal phalanx of the third toe needed amputation. Early surgical intervention and standard management combined with Iloprost infusion may help in healing the lesions by increasing extremity perfusion and may prevent extremity loss.