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Objective: The pathogenesis of atherosclerosis is multifactorial, however the impact of inflammatory cells in this process is well known. Different traditional cardiovascular risk factors (CVRFs) may have specifically different effects on leukocyte subtype. Thus, these special interactions may induce different vascular involvement forms due to the altered endothelial damage and vascular repair mechanisms. The aim of the present study was to investigate whether there is any specific relationship between the leukocyte subtypes and the traditional CVRFs and to evaluate the independency of possible relationships. Methods: The study had a cross-sectional observational design. The study population consisted of the patients who underwent coronary angiography with a suspicion of coronary artery disease (CAD) at our institution in an outpatient manner. We enrolled 677 consecutive eligible patients with CAD or normal coronary arteries (NCA) and investigated the associations of traditional CVRFs, demographic properties and biochemical parameters including fasting plasma glucose (FPG), creatinine, serum uric acid level (SUA) and lipids with total circulating inflammatory cell (WBC, leukocytes) and subtype counts including neutrophils (N), lymphocytes (L) and monocytes (M). As a dependent variable, total leukocyte count and subtypes, and neutrophil/lymphocyte ratio (N/L ratio) which has been found to being related with increased vascular risk and events were investigated in the groups determined by the presence or absence of CVRFs and CAD by the univariate analyses and then multiple linear regression analyses. Results: When we performed multiple linear regression analyses to determine the independent associations of inflammatory cell subtypes, we have found that FPG had an independent incremental association with WBC (β±SE:4.2±1.4, p=0.004) and N (β±SE:4.2±1.2, p=0.001). Current smoking had an independent incremental association with WBC and all cell subtypes (for WBC, N, L, and M: β±SE: 748±161, p<0.001; β±SE: 556±136, p<0.001; β±SE: 185±69, p=0.007; β±SE: 38±20, p=0.061, respectively) and SUA had an independent incremental association with WBC (β±SE: 115±43, p=0.008), N (β±SE: 107±38, p=0.005) and M (β±SE: 26±6, p<0.001). Hypertension had an independent incremental association with WBC (β±SE: 431±140, p=0.002) and N (β±SE: 315±118, p=0.008). Male gender had an independent incremental association with only M (β±SE: 52±20, p=0.010). Family history of CAD had an independent decremental association with WBC (β±SE: -327±139, p=0.019) and N (β±SE: -326±121, p=0.007). Finally, age had an independent decremental association with WBC (β±SE: -32±7, p<0.001) and L (β±SE: -16±3, p<0.001). The N/L ratio was independently related with increased age (p<0.001), FPG (p=0.003) and SUA (p=0.012). Conclusion: Our study results demonstrate that leukocyte subtypes have different specific associations with traditional CVRFs. We found that FPG affects specifically N while SUA affects specifically N and M, and current smoking affects nonspecifically on all cell subtypes. While hypertension with N and male gender with M were specifically related, age and family history of CAD were only related to L. These different interactions may lead to different endothelial damage and vascular repair mechanisms. [ABSTRACT FROM AUTHOR]

Objective: To investigate functional status of patients (Killip class), left ventricular contractility, angiographic anatomy and severity of coronary lesions in patients with and without right bundle branch block (RBBB) in the setting of anterior myocardial infarction (MI). Methods: Patients who admitted to coronary care unit with the diagnosis of acute anterior MI between 1999 and 2005 were retrospectively searched from our database. Out of 792 patients, 37 had RBBB (RBBB group) either at admission or in the course of anterior MI. Forty patients who developed no intraventricular conduction defect during the course of anterior MI with the same demographic characteristics were selected as the control group. Results: Out of 37 patients, 30 had RBBB on admission and 7 developed RBBB in the course of acute MI. Left anterior descending artery (LAD) proximal lesion was more commonly detected in the RBBB group [23 (62.2%) vs. 11 (27.5%) patients, p=0.003]. Left ventricular ejection fraction was lower (33.0+/-4.2% vs 36.7+/-4.9%, p=0.003) and end-systolic volume was higher (84.1+/-24.9 ml vs 74.6+/-22.0 ml, p=0.012) in patients with RBBB. Number of patients with high Killip grade (III and IV) was more in the RBBB group [7 (18.9%) vs 3 (7.5%), RR: 1.75, %95 CI 0.92-3.32, p=0.14], and number of patients with Killip grade I was more in the control group [34 (85.0%) vs 22 (59.5%), p=0.012]. Besides mean Killip class was higher in the RBBB group (1.65+/-0.90 vs 1.25+/-0.67, p=0.03). Three patients (8.1%) in the RBBB group and 2 patients (5.0%) in the control group died during hospitalization (p=0.67). Conclusion: Left ventricular ejection fraction decreases and Killip grade increases in case of RBBB in the setting of acute anterior MI. Culprit lesion in patients with RBBB is more commonly a LAD proximal lesion and threatened myocardial tissue is larger in patients with RBBB. [ABSTRACT FROM AUTHOR]

Asherman's syndrome, which can occur during the regeneration of damaged uterine tissue after surgical interventions, is a significant health problem in women. This study aimed to acquire and characterize cyclodextrin-based hydrogels, which can be used to prevent Asherman's syndrome, and investigate their effectiveness with biomedical applications. A series of hydrogels were synthesized from the cross-linking of β-cyclodextrin and different polyphenols with epoxy-functional PEG. Their chemical, physical, and biological properties were subsequently determined. The results demonstrated that the cyclodextrin-based hydrogels had a porous structure, high swelling ratio, good injectability, drug release ability, and antioxidant activity. Cell culture results illustrated that the hydrogels had no significant cytotoxicity toward L929 fibroblast cells. Considering all properties, the β-CD-PEG-600-Ec hydrogel showed the most satisfactory properties rather than other ones. The potential of this hydrogel in preventing Asherman's syndrome was evaluated in a rat model. The results revealed that the β-estradiol- and melatonin-loaded cyclodextrin-based multifunctional hydrogel group both structurally and mechanically showed an antiadhesion effect in the uterus and a therapeutic effect on the damage with the β-estradiol and melatonin that it contains compared to the Asherman (ASH) group. This double drug-loaded hydrogel can be a promising candidate for preventing Asherman's syndrome due to its versatile properties., Competing Interests: The authors declare no competing financial interest., (© 2024 The Authors. Published by American Chemical Society.)

The use of wire cerclage after sternal closure is the standard method because of its rigidity and strength. Despite this, they have many disadvantages such as tissue trauma, operator-induced failures, and the risk of infection. To avoid complications during sternotomy and promote tissue regeneration, tissue adhesives should be used in post-surgical treatment. Here, we report a highly biocompatible, biomimetic, biodegradable, antibacterial, and UV-curable polyurethane-acrylate (PU-A) tissue adhesive for sternal closure as a supportive to wire cerclage. In the study, PU-As were synthesized with variable biocompatible monomers, such as silk sericin, polyethylene glycol, dopamine, and an aliphatic isocyanate 4,4'-methylenebis(cyclohexyl isocyanate). The highest adhesion strength was found to be 4322 kPa, and the ex vivo compressive test result was determined as 715 kPa. The adhesive was determined to be highly biocompatible (on L-929 cells), biodegradable, and antibacterial (on Escherichia coli , Pseudomonas aeruginosa, and Staphylococcus aureus bacteria). Finally, after opening the sternum of rats, the adhesive was applied to bond the bones and cured with UV for 5 min. According to the results, there was no visible inflammation in the adhesive groups, while some animals had high inflammation in the cyanoacrylate and wire cerclage groups. These results indicate that the adhesive may be suitable for sternal fixation by preventing the disadvantages of the steel wires and promoting tissue healing.

Hard or soft tissue adhesives have been presented as a promising candidate to replace traditional wound closure methods. However, there are mechanical strength problems in biological adhesives and biocompatibility problems in synthetic-based adhesives. At this point, we aimed to remove all these disadvantages and produce a single adhesive that contains all the necessary features and acrylate functionalized UV-curable polyurethane formulations were produced with high crosslink density, high adhesion strength, biocompatibility and injectable property for easy application as potential biomedical adhesives. Aliphatic isophorone diisocyanate (IPDI) was used as the isocyanate source and β-cyclodextrin was used for host-guest relationship with gentamicin by crosslinking. Proteins (gelatin (GEL), collagen (COL)) and PEGs of various molecular weight ranges (P200, P400, P600) were selected as the polyol backbone for polyurethane synthesis due to their multiple biological activities such as biocompatibility, biodegradability, biomimetic property. Several techniques have been used to characterize the structural, thermal, morphological, and various other physicochemical properties of the adhesive formulations. Besides, the possibility of its use as a hard tissue adhesive was investigated by evaluating the tissue adhesion strength in vitro and ex vivo via a universal testing analyzer in tensile mode. Corresponding adhesive formulations were evaluated by in vitro and in vivo techniques for biocompatibility. The best adhesion strength results were obtained as 3821.0 ± 214.9, and 3722.2 ± 486.8 kPa, for IPDI-COL-P200 and IPDI-GEL-P200, respectively. Good antibacterial activity capability toward Escherichia coli Pseudomonas aeruginosa, and Staphylococcus aureus were confirmed using disc diffusion method. Moreover, cell viability assay demonstrated that the formulations have no significant cytotoxicity on the L929 fibroblast cells. Most importantly, we finally performed the in vivo biodegradability and in vivo biocompatibility evaluations of the adhesive formulations on rat model. Considering their excellent cell/tissue viability, fast curable, strong adhesion, high antibacterial character, and injectability, these adhesive formulations have significant potential for tissue engineering applications., (Copyright © 2021 Elsevier B.V. All rights reserved.)

In this study, a series of B-ring fluoro substituted bis-chalcone derivatives were synthesized by Claisen-Schmidt condensation reactions and evaluated for their ability to inhibit xanthine oxidase (XO) and growth inhibitory activity against MCF-7 and Caco-2 human cancer cell lines, in vitro. According to the results obtained, the bis-chalcone with fluoro group at the 2 (4b) or 2,5-position (4g) of B-ring were found to be potent inhibitors of the enzyme with IC 50 values in the low micromolar range. The effects of these compounds were about 7 fold higher than allopurinol. The binding modes of the bis-chalcone derivatives in the active site of xanthine oxidase were explained using molecular docking calculations. Also, compound 4g and 4h showed in vitro growth inhibitory activity against a panel of two human cancer cell lines 1.9 and 6.8 μM of IC 50 values, respectively., (Copyright © 2019 Elsevier Inc. All rights reserved.)

In this study, we investigated the effects of SiO 2 nanoparticles (SiO 2 -NPs) (1, 10, 25, 50, and 100 mg/L) for 24 h in vitro on the motility parameters and oxidative stress markers such as total glutathione (TGSH), catalase (CAT), and malondialdehyde (MDA) of rainbow trout, Oncorhynchus mykiss sperm cells. Therefore, SiO 2 -NPs were synthesized with sol-gel reaction from tetraethoxy orthosilicate (TEOS). The prepared nanoparticle structures were characterized for chemical structure, morphology and thermal behavior employing Fourier transform infrared spectroscopy, X-ray spectroscopy, scanning electron micrograph, and thermal analysis (DTA/TGA/DSC) techniques. After exposure, there was statistically significant (p < 0.05) decreases in velocities of sperm cells. CAT activity significantly (p < 0.05) decreased by 9.6% in sperm cell treated with 100 mg/L. In addition, MDA level significantly increased by 70.4% and 77.5% in sperm cell treated with 50 and 100 mg/L SiO 2 -NPs, respectively (p < 0.05). These results showed that SiO 2 -NPs may have toxic effect on rainbow trout sperm cells in 50 mg/L and more.

Developing biocompatible tissue adhesives with high adhesion properties is a highly desired goal of the tissue engineering due to adverse effects of the sutures. Therefore, our work involves synthesis, characterization, adhesion properties, protein adsorption, in vitro biodegradation, in vitro and in vivo biocompatibility properties of xylose-based semisynthetic polyurethane (NPU-PEG-X) bioadhesives. Xylose-based semisynthetic polyurethanes were developed by the reaction among 4,4'-methylenebis(cyclohexyl isocyanate) (MCI), xylose and polyethylene glycol 200 (PEG). Synthesized polyurethanes (PUs) showed good thermal stability and high adhesion strength. The highest values in adhesion strength were measured as 415.0 ± 48.8 and 94.0 ± 2.8 kPa for aluminum substrate and muscle tissue in 15% xylose containing PUs (NPU-PEG-X-15%), respectively. The biodegradation of NPU-PEG-X-15% was also determined as 19.96 ± 1.04% after 8 weeks of incubation. Relative cell viability of xylose containing PU was above 86%. Moreover, 10% xylose containing NPU-PEG-X (NPU-PEG-X-10%) sample has favorable tissue response, and inflammatory reaction between 1 and 6 weeks implantation period. With high adhesiveness and biocompatibility properties, NPU-PEG-X can be used in the medical field as supporting materials for preventing the fluid leakage after abdominal surgery or wound closure.

Purpose: Aside from traditional factors (e.g., diabetes, age, and hypertension), some hematological parameters, such as neutrophil-to-lymphocyte ratio (NLR), red blood cell distribution width (RDW), and mean platelet volume (MPV), have increasingly been reported as measures of systemic inflammation and atherosclerosis in patients with end-stage renal disease (ESRD). This study aimed to determine whether there is an association between these hematological parameters and the extent of coronary artery disease (CAD) in patients with ESRD., Methods: A total of 149 consecutive ESRD patients (66 % males) without established CAD were studied. NLR, RDW, and MPV values in all patients were calculated from the complete blood count before coronary angiography. Angiographic views were assessed by an experienced interventional cardiologist, and the extent of CAD was evaluated by the Gensini score. The patients were divided into quartiles of the Gensini score., Results: Age, time on dialysis, calcium-phosphorus product, C-reactive protein levels, NLR, and MPV were significantly different among the groups (all p < 0.05). The Gensini score was correlated with age, time on dialysis (both p < 0.001), NLR (p = 0.004), and C-reactive protein levels (p = 0.034) and inversely correlated with left ventricular ejection fraction (p = 0.023). Multivariate regression analysis showed that age (p = 0.001), time on dialysis (p < 0.001), NLR (p = 0.001), and MPV (p = 0.005) were independent predictors of the extent of CAD., Conclusions: Aside from the well-known traditional factors, NLR and MPV are independent predictors of the extent of CAD in patients with ESRD.

Aims: To study heart rate (HR) variability and HR turbulence parameters in mild-to-moderate aortic stenosis (AS) and to disclose whether any relationship exists between these parameters and echocardiographic findings., Methods and Results: Forty-three asymptomatic patients with mild-to-moderate AS (AS group) were studied. Echocardiographic parameters and HR variability and HR turbulence indices obtained over 24 Holter ECG recordings were compared with those of an age and sex matched control population free of cardiovascular disease. Correlation between echocardiographic findings and HR variability and HR turbulence indices was also studied in the AS group. All HR variability parameters except mean RR interval, RMSSD, and pNN50 and one HR turbulence parameter, turbulence onset, were significantly disturbed in the AS group. Echocardiographic findings of diastolic dysfunction had significant correlations with HR variability and HR turbulence parameters in AS patients., Conclusion: Symphatovagal imbalance as shown by disturbed HR variability and HR turbulence parameters was demonstrated for the first time in patients with mild-to-moderate AS. This imbalance, which was shown to be correlated with echocardiographic findings of diastolic dysfunction, may lead to arrhythmic complications in this seemingly low-risk patient population.

Dual left anterior descending coronary artery (LAD) originating from the left main stem and the right coronary artery (RCA) (Type IV dual LAD) is a very rare coronary artery anomaly. Association of this anomaly with the anomalous origin of the circumflex artery from the RCA is a very rare occurrence. In this report, we describe a patient presenting with acute lateral wall myocardial infarction who subsequently was found to have this coronary anomaly.

Objective: To investigate the plasma homocysteine level and the relationship between plasma homocysteine level and duke treadmill score (DTS) in cardiac syndrome X (CSX) patients., Methods: Seventy-nine patients (36 male, 43 female, mean age: 50 +/- 8.8 years) admitted to Gazi University Hospital, Ankara, Turkey with typical effort angina, positive stress test, and angiographically normal coronary arteries between January and September 2006 were included in this prospective and controlled study. Thirty asymptomatic patients (11 male, 19 female, mean age: 47.6 +/- 8.3 years) with 2 cardiovascular risk factors were chosen as a control group. Plasma homocysteine level was measured in both groups and DTS was calculated in the CSX group. Plasma homocysteine was measured with the AxSYM homocysteine immunoassay method in both groups., Results: Plasma homocysteine level was higher in the CSX group compared to the control group (16.5 +/- 4.9 micromol/L, n=79, versus 12.4 +/- 4.1 micromol/L, n=30, p<0.001). The DTS was -2.7 +/- 5.3 in the CSX group. There was a negative correlation between the DTS and homocysteine levels in the CSX group. (r= -0.506, p<0.001)., Conclusion: Plasma homocysteine level, which is known to cause endothelial dysfunction and microvascular ischemia were higher in CSX patients. Also, this increase in homocysteine level inversely correlated with the DTS, which represents the magnitude of ischemia.

Objective: To evaluate the impact of long term tirofiban infusion before percutaneous coronary intervention (PCI) on the angiographic results in the setting of visible intracoronary thrombus and compare this with conventional PCI performed without tirofiban., Methods: Out of 2,835 PCI procedures performed in Gazi University Hospital, Ankara, Turkey between 1999 and 2006, 156 (5.5%) patients with massive thrombus in whom PCI were applied, were included in this retrospective study. Out of these 156 patients, 82 (53%) had PCI in the presence of angiographically apparent thrombus without tirofiban and named as group A. The remaining 74 (47%) received long term tirofiban infusion before PCI and were named as group B., Results: Although the baseline thrombolysis in myocardial infarction (TIMI) 0-2 flow was no different between the groups, it is significantly lower in group B compared to group A after the PCI (8.1% versus 23.2%, p=0.015). The decrease in thrombus burden in group B after tirofiban infusion was also statistically significant compared to pre-tirofiban levels (1.77 -/+ 1.05 versus 3.42 -/+ 0.76, p<0.001). Group B had better flow characteristics with a 91.9% TIMI 3 flow after PCI. Intervention was successful in the majority technically, however, no reflow was observed in 17 patients (20.7%) in group A and in 2 patients (2.7%) in group B (p<0.001). Major bleeding requiring transfusion was observed in both groups A (3 patients) and B (4 patients) due to gastrointestinal bleeding or access site hematomas (3.7% versus 5.4%, non significant)., Conclusion: Pre-PCI longterm tirofiban infusion strategy in thrombus containing lesions seems to be a safe and feasible approach in avoiding no re-flow and dissolving the massive thrombus.