SUMMARY Calcitonin (CT) is a diagnostic and follow-up marker of medullary thyroid carcinoma. Heterophile antibodies (HAbs) may interfere during immunometric assay measurements and result in falsely high CT levels and different markers. A 50-year-old female patient was referred to our institution for elevated CT levels (3,199 pg/mL [0-11,5]). Physical examination and thyroid ultrasonography show no thyroid nodules. Because of the discrepancy between the clinical picture and the laboratory results, various markers and hormones were examined to determine whether there was any interference in the immunometric assay. Thyroglobulin (Tg) and Adrenocorticotropic hormone (ACTH) levels were also found inaccurately elevated. After precipitation with polyethylene glycol, CT, Tg, and ACTH levels markedly decreased, showing macro-aggregates. Also, serial dilutions showed non-linearity in plasma concentrations. Additionally, CT samples were pretreated with a heterophilic blocking tube before measuring, and the CT level decreased to < 0.1 pg/mL, suggesting a HAb presence. Immunoassay interference should be considered when conflicting laboratory data are observed. This may help reduce the amount of unnecessary laboratory and imaging studies and prevent patients from complex diagnostic procedures. (CT followup follow up carcinoma HAbs (HAbs 50yearold yearold 50 year old 3,199 3199 3 199 (3,19 pgmL pg mL 011,5. 0115 0 11,5 . 11 5 [0-11,5]) nodules results Tg (Tg (ACTH glycol macroaggregates. macroaggregates macro aggregates. aggregates macro-aggregates Also nonlinearity non linearity concentrations Additionally measuring 01 1 0. presence observed procedures 3,19 319 19 (3,1 011 011,5 115 11, [0-11,5] 3,1 31 (3, 011, [0-11,5 3, (3 [0-11, ( [0-11 [0-1 [0- [0 [

ABSTRACT Introduction: Custodiol (histidine-tryptophan-ketoglutarate) and repetitive blood cardioplegia are the solutions for myocardial protection and cardiac arrest. In this study, we aimed to compare immunohistochemical analysis, clinical outcomes, and cardiac enzyme values of Custodiol and blood cardioplegia groups. Methods: This was a randomized prospective study consisting of 2 groups and 20 patients, 10 patients for each group, who underwent mitral and mitral/tricuspid valve surgery. Group 1 was formed for Custodiol cardioplegia and group 2 for blood cardioplegia. Perioperative and postoperative cardiac events were recorded, cardiac enzymes were analyzed with intervals, and myocardial samples were taken for immunohistochemical analysis. Recorded data were statistically evaluated. Results: There was no significant difference for the Custodiol and blood cardioplegia groups in perioperative and postoperative cardiac performance and adverse events. Cardiac enzyme analysis showed no significant difference between groups. However, two parameters (eNOS, Bcl-2) were in favor of the Custodiol group in immunohistochemical studies. Custodiol performed better in cellular oxidative stress resistance and cellular viability. Conclusion: Clinical outcomes and cardiac enzyme analysis results were similar regarding myocardial protection. However, Custodiol performed better in the immunohistochemical analysis.

Abstract Objectives: In the past decade, advances in immunological therapy have increased the survival of kidney recipients and their grafts. However, it has not achieved the desired level of improvement. This study aims to reveal the mortality among kidney recipients. Methods: Medical data of the patients, who had undergone kidney transplantation (KT) between November 2010 and December 2020, were retrospectively reviewed. Inclusion criteria were adult kidney recipients, who had died. Exclusion criteria were pediatric recipients, recipients of en bloc and dual KT, recipients with missing data, and recipients with a primary non-functioning graft. The recipients were grouped according to their donor type; Group 1 (from a living donor) and Group 2 (from a deceased donor). Subgroup analyses were done for mortality by time-period post-transplant and for infectious causes of mortality. Results: Of 314 recipients, 35 (11.14%) died. Twenty-nine recipients were included in the study (Group 1: 17 and Group 2: 12). The most common cause of mortality was infection (58.6%), and the second was cardiovascular disease (CVD) (24.1%). Sepsis developed in 29.4% of infection-related deaths, while COVID-19 constituted 23.5% of infection-related deaths. Conclusion: Early diagnosis and treatment of infectious and CVD are important to improve survival in kidney recipients.

Resumen Objetivos: En la última década, los avances en la terapia inmunológica han aumentado la supervivencia de los receptores de riñón y sus injertos. Sin embargo, no se pudo lograr el nivel de mejora deseado. Este estudio tiene como objetivo revelar la mortalidad entre los receptores de riñón. Materiales y métodos: Se revisaron retrospectivamente los datos médicos de los pacientes, que se habían sometido a un trasplante de riñón entre Noviembre de 2010 y Diciembre de 2020. Los criterios de inclusión fueron los receptores de riñón adultos, que habían fallecido. Los criterios de exclusión fueron los receptores pediátricos, los receptores de trasplantes de riñón dual y en bloque, los receptores con datos faltantes y los receptores con un injerto primario no funcionante. Los receptores se agruparon según su tipo de donante; Grupo 1 (de un donante vivo) y Grupo 2 (de un donante fallecido). Se realizaron análisis de subgrupos para la mortalidad por período de tiempo posterior al trasplante y para las causas infecciosas de mortalidad. Resultados: De 314 beneficiarios, 35 (11,14%) fallecieron. Se incluyeron 29 receptores en el estudio (Grupo 1:17; Grupo 2:12). La causa más común de mortalidad fue la infección (58,6%) y la segunda fue la enfermedad cardiovascular (24,1%). La sepsis se desarrolló en el 29,4% de las muertes relacionadas con la infección, mientras que el COVID-19 constituyó el 23,5% de las muertes relacionadas con la infección. Conclusión: El diagnóstico y tratamiento tempranos de enfermedades infecciosas y cardiovasculares es importante para mejorar la supervivencia de los receptores de riñón.

RESUMEN: Objetivo: El objetivo del presente estudio fue evaluar y comparar los efectos de la aplicación superficial de dos resinas humectantes sobre la microdureza superficial y la decoloración de las resinas compuestas. Material y métodos: El presente estudio utilizó dos resinas humectantes y resinas de modelado diferentes. Las resinas compuestas se colocaron en moldes de plástico. Posteriormente, se aplicaron las resinas humectantes sobre la superficie de los dos grupos. Se evaluó la microdureza y el color de todos los grupos. El presente estudio utilizó las pruebas One-Way ANOVA y Kruskal Wallis, para realizar la evaluación estadística (p<0.05). Resultados: Los valores más altos de microdureza se observaron en el grupo Estelite Asteria, mientras que los menores valores se observaron en el grupo GC Essentia (Ultradent). La mayor decoloración se observó en el grupo control o el grupo GC Essentia, mientras que la menor decoloración se observó en el grupo Estelite Asteria con Ultradent Wetting Resin. Conclusiones: Los resultados del presente estudio demostraron que el uso de resinas humectantes, que facilitan la colocación de resinas compuestas, redujo la microdureza y decoloración de las resinas compuestas. El efecto mencionado anteriormente se puede atribuir a las variaciones en la estructura del relleno. Sin embargo, se necesitan más estudios para respaldar y verificar los resultados del presente estudio.

ABSTRACT: Objective: The aim of this study was to evaluate and compare the effects of the superficial application of two different modeling resins on the surface microhardness and discoloration of composite resins. Material and Methods: The present study used two different composites and modeling resins. The composites were placed in plastic molds. Subsequently, the modeling resins were applied on the surface of the two composite groups. The microhardness and color pertaining to all the groups were evaluated. The current study used the One-Way ANOVA and Kruskal Wallis tests, in order to perform the statistical evaluation (p<0.05). Results: The present study compared the microhardness pertaining to the groups and the highest microhardness values were observed in the Estelite Asteria group (none), whereas the lowest values were observed in the GC Essentia group (Ultradent). Moreover, the current study evaluated the color stability and the greatest discoloration was observed in the control group of the GC Essentia group, whereas the least discoloration was observed in the Estelite Asteria group that included the samples prepared using Ultradent Wetting Resin. Conclusions: The results of the present study demonstrated that the use of modeling resins, which facilitate the placement of composite resins, reduced the microhardness and discoloration of composite resins. The aforementioned effect can be attributed to the variations in the structure of the filling. However, further studies are warranted to support and verify the results of the current study.

Abstract Objective To evaluate the obstetric outcomes of singleton high-risk pregnancies with a small size uterine fibroid. Methods This retrospective cohort study was conducted among 172 high-risk pregnant women who were followed-up by a single surgeon between 2016 and 2019. Pregnant women with preconceptionally diagnosed small size (< 5 cm) single uterine fibroids (n = 25) were compared with pregnant women without uterine fibroids (n = 147) in terms of obstetric outcomes. Results There was no statistically significant difference between the groups in terms of adverse pregnancy outcomes. The size of the fibroids was increased in 60% of the cases, and the growth percentage of the fibroids was 25% during pregnancy. Intrapartum and short-term complication was not observed in women who underwent cesarean myomectomy. Conclusion Small size uterine fibroids seem to have no adverse effect on pregnancy outcomes even in high-risk pregnancies, and cesarean myomectomy may be safelyperformed in properly selected cases.

RESUMO OBJETIVO Testes laboratoriais de fácil acesso, baixo custo e amplamente utilizados capazes de demonstrar a gravidade da COVID-19 são importantes. Portanto, neste estudo, o nosso objetivo foi investigar a relação entre a mortalidade na COVID-19 e a contagem de plaquetas, volume plaquetário médio (VMP) e largura de distribuição de plaquetas. MÉTODOS No total, 215 pacientes com COVID-19 foram incluídos no estudo. Os pacientes foram divididos em dois grupos. Pacientes com saturação de oxigênio < 90% em ar ambiente foram considerados casos graves de COVID-19 e pacientes com valores ≥90% foram considerados casos moderados. Os registros médicos dos pacientes e o sistema eletrônico de monitoramento de dados de pacientes foram analisados retrospectivamente. As análises foram realizadas utilizando o software estatístico SPSS. Um valor de p <0,05 foi considerado significativo. RESULTADOS A média de idade dos pacientes foi de 64,32 ± 16,07 anos. Com base na saturação de oxigênio, 81 pacientes eram casos moderados e 134 tinham COVID-19 grave. Nosso estudo revelou que a saturação de oxigênio no momento da internação e a diferença nos valores de VPM entre o primeiro e terceiro dia de internação foram parâmetros significativos para predizer mortalidade de pacientes com COVID-19. A mortalidade foi 8,4 vezes maior nos pacientes com saturação abaixo de 90% no momento da internação, mas um aumento de apenas 1 unidade no valor de VPM aumentou a mortalidade 1,76 vezes. CONCLUSÃO Além da capacidade pulmonar dos pacientes, o volume plaquetário médio pode ser utilizado como um teste auxiliar para prever a mortalidade de pacientes com COVID-19.

SUMMARY BACKGROUND Easily accessible, inexpensive, and widely used laboratory tests that demonstrate the severity of COVID-19 are important. Therefore, in this study, we aimed to investigate the relationship between mortality in COVID-19 and platelet count, Mean Platelet Volume (MPV), and platelet distribution width. METHODS In total, 215 COVID-19 patients were included in this study. The patients were divided into two groups. Patients with room air oxygen saturation < 90% were considered as severe COVID-19, and patients with ≥90% were considered moderate COVID-19. Patient medical records and the electronic patient data monitoring system were examined retrospectively. Analyses were performed using the SPSS statistical software. A p-value <0.05 was considered significant. RESULTS The patients’ mean age was 64,32 ± 16,07 years. According to oxygen saturation, 81 patients had moderate and 134 had severe COVID-19. Our findings revealed that oxygen saturation at admission and the MPV difference between the first and third days of hospitalization were significant parameters in COVID-19 patients for predicting mortality. While mortality was 8.4 times higher in patients who had oxygen saturation under 90 % at hospital admission, 1 unit increase in MPV increased mortality 1.76 times. CONCLUSION In addition to the lung capacity of patients, the mean platelet volume may be used as an auxiliary test in predicting the mortality in COVID-19 patients.

Abstract Objective To evaluate the outcomes of cases of prenatally-diagnosed congenital pulmonary airway malformation (CPAM). Methods We retrospectively evaluated cases of prenatally-diagnosed CPAM between 2004 and 2018. Ultrasonographic features such as visualization of a fetal lung mass and heterogeneous pulmonary parenchyma were used for CPAM diagnosis. Prenatal and postnatal findings were compared in terms of accuracy regarding the CPAM diagnosis. Results The sample consisted of 27 cases. There were four cases in which the patients opted for the termination of pregnancy due to the severity of the lesion. A total of 23 neonates were delivered, and CPAM was confirmed in 15 cases. Themedian gestational age at delivery was 37 weeks (28-40 weeks) and the mean birth weight was 2,776 g. There were two neonatal deaths, one due to pneumothorax, and the other due to hypoplastic left heart syndrome (HLHS). A total of five patients with respiratory problems were operated in the postpartum period. There were eight misdiagnosis: bronchopulmonary sequestration (five cases), congenital lobar emphysema (two cases), and congenital diaphragm hernia (one case). Conclusion A precise postnatal diagnosis is very important to organize the proper management of the pregnancies with fetuses with CPAM. The positive predictive value of the prenatal diagnosis of CPAM via ultrasonography is of 70.3%. The differential diagnosis of CPAM may be prolonged to the postpartum period in some cases.

Abstract Introduction: Various surgical procedures for minimally invasive cardiac surgery have been described in recent decades as alternatives to median sternotomy. Cardiopulmonary bypass via femoral arterial and venous cannulation is the foundation of these procedures. In this study, we evaluated the mid-term outcomes of femoral cannulation performed with U-suture technique in patients undergoing robotic heart surgery. Methods: A total of 216 patients underwent robotic-assisted cardiac surgery between January 2013 and April 2017. Cardiopulmonary bypass was performed via femoral artery, jugular, and femoral vein cannulation, and a Chitwood clamp was used for aortic occlusion. A total of 192 patients attended the outpatient follow-up, and femoral arterial and venous flow pattern was examined using Doppler ultrasound (DUS) in 145 patients. Results: Hospital mortality occured in 4 of the 216 (1.85%) cases, but there was no late mortality in this patient group. Postoperatively, seroma (n=9, 4.69%) and cannulation site infection (n=3, 1.56%) were managed with outpatient treatment. DUS in 145 patients revealed triphasic flow pattern in the common femoral arteries in all patients except for 2 (1.38%). These patients were determined to have asymptomatic arterial stenosis. Chronic recanalized thrombus in the common femoral vein was also detected in 2 (1.38%) patients. Conclusion: Femoral artery cannulation with the U-suture technique can be successfully performed in robotic-assisted cardiac surgery, with good mid-term results.

Abstract Purpose: To investigate the possible effects of argan oil on the healing of colorectal anastomoses. Methods: I n Group 1 (sham), laparotomy was performed and the colon was mobilized. In the control (Group 2) and argan oil (Group 3) groups, colonic resection and anastomosis were applied. To the control and sham groups, 2 mL of 0.9% NaCl was administred rectally, and in the argan oil group, 2 mL/day argan oil was applied rectally for 7 days. Results: The mean bursting pressures of the argan oil and sham groups were significantly higher than the values in the control group. A significant difference was determined between the tissue hydroxyproline and prolidase levels of control group and other groups. Histopathologically, argan oil showed significant beneficial effects on colonic wound healing. In the argan oil and sham groups, the tissue malondialdehyde and fluorescent oxidation product levels were found to be lower and total sulfhydryl levels were higher than the control group. Conclusions: The rectally administered argan oil was observed to have significantly ameliorated wound healing parameters and exerted a significant antioxidant effect. This is the first study in the literature about the beneficial effects of argan oil on colorectal anastomoses.

RESUMO Introdução: Embora os efeitos nocivos do fumo nos sistemas cardiovascular e respiratório tenham sido estabelecidos há muito, o efeito sobre os parâmetros fisiológicos e físicos em bailarinas de dança moderna não foi bem documentado ainda. Objetivo: Determinar as diferenças em funções pulmonares selecionadas, parâmetros bioquímicos e composição corporal em bailarinas de dança moderna fumadoras e não-fumadoras, universitárias e pós-universitárias. Métodos: Vinte e duas bailarinas de dança moderna (média de idade de 24,6 ± 4,3 anos), não fumantes (n = 11) e fumantes (n = 11), participaram voluntariamente no estudo. As fumantesconsumiram de 1 a 20 cigarros por dia durante uma média de sete anos. Foi aplicado o teste funcional pulmonar Mir Spirobank Spirometer, (Itália), alguns parâmetros biomédicos selecionados foram testados e foram realizadas várias medições antropométricas (altura, peso e sete espessuras de pregas cutâneas). Os resultados da composição corporal foram avaliados usando equações Jackson-Pollock. As comparações intergrupo foram realizadas usando o teste "U" de Mann-Whitney. Resultado: Não foram encontradas diferenças significativas entre as bailarinas fumantes e não fumantes quanto à composição corporal (gordura corporal, % massa gorda, massa corporal magra) e nos parâmetros bioquímicos selecionados (p > 0,05). No entanto, as não fumantes tinham valores de predição do volume expiratório forçado no primeiro segundo (VEF1) e pico de fluxo expiratório (PFE) significativamente melhores (p < 0,05). O efeito do tabagismo no desempenho de bailarinas de dança moderna deveria ser examinado num estudo longitudinal, com um maior número de participantes. Conclusão: Foi observado que o fumo reduz a capacidade pulmonar a uma certa taxa, embora os padrões bioquímicos e a composição corporal das bailarinas fumantes e não fumantes fossem semelhantes.

ABSTRACT Introduction: Although the harmful effects of smoking on the cardiovascular and respiratory systems have been established for a long time, the effect on physiological and physical parameters in modern female dancers is not well documented. Objective: To determine differences in selected pulmonary functions, biochemical parameters, and body composition in female smoker and non-smoker modern dancers who are university or graduate students. Methods: A total of twenty-two female modern dancers (mean age of 24.6 ± 4.3 years), who were non-smokers (n = 11) and smokers (n = 11), voluntarily participated in the study. The smokers had been smoking 1 to 20 cigarettes per day for an average period of seven years. The pulmonary function test Mir Spirobank Spirometer, (Italy) was applied; selected biochemical parameters were tested, and various anthropometric measurements (height, weight and seven skinfold thickness) were performed. The results of body composition were evaluated using Jackson-Pollock equations. Intergroup comparisons were performed using the Mann-Whitney U test. Result: No significant differences were found between smoker and non-smoker dancers in terms of body composition (body fat, % body fat, lean body fat) and selected biochemical parameters (p > 0.05). However, non-smokers had prediction values of forced expiratory volume during the first second (FEV1) and peak expiratory flow (PEF) significantly better (p < 0.05). The effect of smoking on the performance of female modern dancers should be examined in a longitudinal study, with a higher number of participants. Conclusion: It was observed that smoking reduces lung pulmonary capacity at a certain rate, although the biochemical parameters and body composition of the female smoker and non-smoker dancers were similar.

RESUMEN Introducción: Aunque los efectos nocivos del tabaco en los sistemas cardiovascular y respiratorio hayan sido establecidos hace mucho, el efecto sobre los parámetros fisiológicos y físicos en bailarinas de danza moderna no fue aún bien documentado. Objetivo: Determinar las diferencias en funciones pulmonares seleccionadas, parámetros bioquímicos y composición corporal en bailarinas de danza moderna fumadoras y no fumadoras, universitarias y post universitarias. Método: Veintidós bailarinas de danza moderna (edad promedio de 24,6 ± 4,3 años), no fumadoras (n=11) y fumadoras (n=11), participaron voluntariamente en el estudio. Las fumadoras habían fumado desde 1 hasta 20 cigarrillos por día durante un promedio de siete años. Fue aplicado el test funcional pulmonar espirómetro Mir Spirobank, (Italia), y fueron hechos algunos tests de parámetros biomédicos seleccionados y hechas varias mediciones antropométricas (altura, peso y siete espesores de los pliegues cutáneos). Los resultados de la composición corporal fueron evaluados usando ecuaciones Jackson-Pollock. Las comparaciones intergrupales fueron realizadas usando el test Mann-Whitney U. Resultado: No fueron encontradas diferencias significativas entre bailarinas fumadoras y no fumadoras en la composición corporal (grasa corporal, % de masa grasa, masa corporal magra) y en los parámetros bioquímicos seleccionados (p > 0,05). Sin embargo, las no fumadoras tuvieron valores de predicción del volumen espiratorio forzado en el primer segundo (VEF1) y del flujo espiratorio máximo (FEM) significativamente mejores (p < 0,05). El efecto del tabaco en el desempeño de bailarinas de danza moderna debería ser examinado en un estudio longitudinal, con un aumento del número de participantes. Conclusión: Se observó que el tabaco reduce la capacidad pulmonar a una cierta tasa, aunque los estándares bioquímicos y la composición corporal de las bailarinas fumadoras y no fumadoras fueron similares.

Objective The aim of this study was to investigate retrorenal colon incidence in percutaneous nephrolithotomy (PNL) interventions made in our clinic. Materials and Methods Clinical data of 804 PNL patients, accumulated over a 7 year period (2006-2012), was surveyed. The patient files were reviewed retrospectively, and only those who had abdominal computed tomography (CT) images before PNL intervention were included in the study. In the CT images, the position of both the ascending and descending colon in relation to the right and left kidneys were evaluated. Results According to our hospital reports, 394 patients with CT images were included in the present study 27 patients (6.9%) had retrorenal colon, of which 18 (4.6%) were on the left side, 4 (1.0%) on the right side and 5 (1.3%) had bilateral retrorenal colons. Colonic perforation complication was seen only in two patients and the colonic perforation rate was 0.3%. These two cases had no CT images. Conclusions PNL, in the process of becoming the standard treatment modality, is a safe and reliable technique for renal stone treatment. Colonic injury should be taken into consideration during PNL interventions of the lower pole of the kidney (especially on the left side) due to the location of retrorenal colon.

Neste estudo, a xantina oxidase (XO), o malondialdeído (MDA), mieloperoxidase ( MPO ) e glutationa ( GSH) nos tecidos do ovário de ratos, durante o desenvolvimento de isquemia e reperfusão induzida por pós-isquemia foi investigada, e o efeito de ATP em isquemia e reperfusão (I/R). O dano foi verificado por provas bioquímicas e por histopatologia. Os resultados das análises bioquímicas mostraram que o ATP reduziu significativamente o nível de XO e MDA e aumentou a quantidade de GSH em ambas as isquemia e no tecido do ovário de I / R - aplicado nas doses administradas. Além disso, o ATP suprimiu significativamente o aumento na atividade de MPO que ocorreu na sequência da aplicação de pós-isquemia reperfusão no tecido ovariano. Os resultados bioquímicos obtidos no presente estudo coincidem com os achados histológicos. A gravidade dos achados patológicos, como a dilatação, congestão, hemorragia, edema e polimorfonucleares leucócitos nucleares (PMNLs), aumentou em paralelo com o aumento observado nos produtos do metabolismo XO. Em conclusão, aplicando exogenamente ATP impedido de I/R, houve danos pela redução da formação de tecido de ovário de XO na isquemia.

In this study, xanthine oxidase (XO), malondialdehyde (MDA), myeloperoxidase (MPO) and glutathione (GSH) levels in the ovarian tissues of rats during the development of ischemia and postischemia-induced reperfusion were investigated, and the effect of ATP on ischemia-reperfusion (I/R) damage was biochemically and histopathologically examined. The results of the biochemical analyses demonstrated that ATP significantly reduced the level of XO and MDA and increased the amount of GSH in both ischemia and I/R-applied ovarian tissue at the doses administered. Furthermore, ATP significantly suppressed the increase in MPO activity that occurred following the application of post ischemia reperfusion in the ovarian tissue. The biochemical results obtained in the present study coincide with the histological findings. The severity of the pathological findings, such as dilatation, congestion, haemorrhage, oedema and polymorphonuclear nuclear leukocytes (PMNLs), increased in parallel with the increase observed in the products of XO metabolism. In conclusion, exogenously applied ATP prevented I/R damage by reducing the formation of XO in ischemic ovarian tissue.

PURPOSE: To analyze the effect of maintenance hemodialysis on left ventricular diastolic function in patients with end-stage renal disease. METHODS: Study population consisted of 42 patients with end-stage renal disease. Before an arteriovenous fistula was surgically created, the patients were evaluated by conventional and Doppler echocardiography and Doppler tissue imaging. Then, the patients undergoing hemodialysis treatment when the arteriovenous fistula was compleated. After the first hemodialysis session (mean 76.14 ± 11.37 days) the second echocardiographic evaluations were performed. RESULTS: Mean age was 58 ± 13 years and 21 (%50) of the patients were female. After maintenance hemodialysis treatment; peak early (E) and peak late (A) diastolic mitral inflow velocities and E/A ratio were not significantly change however the deceleration time of E wave and left atrial diameter were significantly increased. Also there was no change in the early (Em) and late (Am) diastolic myocardial velocities and Em/Am ratios of lateral and septal walls of left ventricular. E/Em ratio was decreased insignificantly. Pulmonary vein velocities and right ventricular functions are remained almost unchanged after hemodialysis treatment. DISCUSSION: The acute and long-term effect of hemodialysis on left ventricular diastolic function is unclearly. Patients with end-stage renal disease treatment with hemodialysis via arteriovenous fistula experience a variety of hemodynamic and metabolic abnormalities that predispose to alterations in left and right ventricular functions. The present study showed that left ventricular diastolic function except left atrial diameter and right ventricular functions were not significantly change, however left ventricular systolic functions were impaired after maintenance hemodialysis treatment in patients with end-stage renal disease. CONCLUSION: It has been suggested that echocardiographic parameters are useful markers for evaluation of left ventricular and right ventricular functions in patients with end-stage renal disease. However, in patients with endstage renal disease treated with hemodialysis, repeated assessment of echocardiographic examinations to observe serial changes in left and right ventricular functions are not yet well established. In this study, we showed that acute changes of volume status and electrolytes and autonomic regulation by hemodialysis session did not affect left ventricular diastolic and right ventricular functions in a relatively long term.