Comparison of the Effect of Different Anesthesia Maintenance on Hemodynamics in Coronary Artery Bypass Grafting Surgery: A Retrospective Cohort Study

Objective:General anesthesia management in coronary artery bypass graft surgery (CABGC) should preserve myocardial function, prevent ischemic damage, and maintain stable hemodynamics. There is not a universally accepted technique for anesthetic management during CABGC. Drugs or drug combinations and maintenance of infusions are decided based on the pathophysiological condition of the patient and the individual preference and experience of the anesthesiologist (1). Although there are many studies about an anesthesia induction in CABGC, studies about anesthetic maintenance are very limited. In this study, we compared the hemodynamic effects of three different methods that were used in anesthetic maintenance in CABGC.Method:The retrospective records of 108 patients in ASA II-III group who underwent elective CABGC were divided into 3 groups according to their anesthetic maintenance methods. Group I was maintained with 1-3% sevoflurane and fentanyl 4 mcg/kg/hour infusion, group II with propofol 1.5-4 mg/kg/hour and fentanyl 4 mcg/kg/hour infusion, and group III with propofol 1.5-4 mg/kg/hour and remifentanil infusion of 0.03 mg/kg/hour. Systolic blood pressure, diastolic blood pressure, mean arterial pressure (MAP) and heart rate (HR) were measured and recorded after induction (T0), after sternotomy (T1), after pericardiotomy (T2), 5 minutes after cardiopulmonary bypass (CPB) (T3), after thorax closure (T4), at the end of the operation (T5). The vasodilator requirements in the time period before CBP and the inotropic agent requirements after CPB were noted.Results:Data of 108 patients (88 men/20 women) were analyzed. Demographic characteristics of the patients were similar in all the groups. Statistical analysis was made among the groups depending on coronary artery bypass graft number, cross-clamp time, total fluid administration, total blood transfusion, total urine volume, inotropic agent requirement after CPB, postoperative central venous pressure, and pre- and postoperative lactate levels; however, there was no statistical difference. There was not change more than 20-25% in MAP and HR in group I than the others.Conclusion:Better hemodynamic results were achived with sevoflurane and fentanyl in the anesthetic maintenance of CABGC

Analyzing the post 2nd World War Japanese foreign policy through conservatism

Bu çalışmada Welsh'in (2003) uluslararası politika-muhafazakarlık ilişkisini incelediği makalesinde ortaya koyduğu gelenek, düzen ve kuşkuculuk kavramlarından faydalanılarak Japon dış politikasının ne ölçüde muhafazakar olarak değerlendirilebileceği araştırılmaktadır. Bu çerçevede söz konusu üç kavram üzerinden II. Dünya Savaşı sonrasından yakın döneme uzanan süreçte Japon dış politikası incelenmekte ve sonuç olarak Japon dış politikasının muhafazakar bir niteliğe haiz olduğu iddia edilmektedir. Bunun yanı sıra çalışmanın son bölümünde ise mevcut başbakan Şinzo Abe dönemine değinilmekte ve bu dönemde Japon dış politikasında giderek yüksek sesle dile getirilen dış politikada değişim söylemine yönelik bir değerlendirme yapılmaktadırUtilizing from the concepts of tradition, order, and skepticism derived from Welsh (2003) who inquires the interplay between international politics and conservatism in his relevant article, this present study investigates to what extent Japan’s foreign policy can be evaluated as ‘conservative’. Within this framework, Japan’s foreign policy ranging from post- Second World War to the recent period is examined by using these three concepts and consequently it is claimed that the Japanese foreign policy bears conservative characteristics. Aside from all these, the incumbent Prime Minister of Japan, Shinzo Abe’s tenure is addressed, and accordingly the discourse of foreign policy change, which has become increasingly vocal during this period, is assessed in the last chapter of this stud

Bilateral Congenital Undescended Scapula (Sprengel Deformity)

WOS: 000301389300013PubMed: 21904193

Bilateral volleyball-related deformity of the little fingers: mallet finger and clinodactyly mimic

WOS: 000288680500030PubMed: 24149318A 14-year-old male high school volleyball player was seen to evaluate right-and left-hand little-finger distal interphalangeal joint deformity and pain. His symptoms began during his second season of competitive play. The distal interphalangeal (DIP) joints of the little fingers flexed 20-30, and a 10-15 valgus deformity was seen at the same joints. Pain was relieved with rest but returned immediately after playing volleyball, so plain radiographs were obtained. The flexion and valgus deformity was obvious on plain radiographs and through a clinical examination. Thus, a bilateral little-finger distal phalanx base epiphysis injury was seen. This injury is characterized by a biplanar Salter Harris physeal injury; type 5 on anteroposterior radiographs and type 2 on lateral plain radiographs. The deformity occurred as a result of competitive volleyball play. To our knowledge, this is the first reported case of a bilateral biplanar physial injury of the base of distal phalanges of the little fingers. Flexion and valgus deformities of DIP joints are a result of repeated micro traumas around the physis

Unilateral RS3PE with Young-Onset Rheumatoid Arthritis

PubMed ID: 21272737[No abstract available

The Empirical Analysis of Nominal Exchange Rate and Sectoral Output: An Investigation on Turkish Economy

Bu çalışma, Türkiye ekonomisinin yedi alt sektöründe nominal döviz kuru ve sektörel üretim hacmi arasındaki ilişkiyi para arzı, kamu harcamaları, petrol fiyatları ve işsizlik oranı gibi kontrol değişkenlerin yardımıyla tespit etmeyi amaçlamaktadır. Bu doğrultuda 1998.Q1-2015.Q3 dönemi için sınır testi ve ARDL yöntemi kullanılarak uzun dönemli muhtemel ilişkiler saptanmaya çalışılmıştır. Yapılan ekonometrik analizler sonucunda inşaat sektörü dışında kalan diğer sektörlerde, sektörel üretim ve nominal döviz kuru arasında uzun dönem ilişki olduğuna yönelik bulgulara ulaşılmış ve bu doğrultuda altı sektör için uzun dönem katsayılar tahmin edilmiştir. Elde edilen bulgular imalat sanayi gibi ithal girdi kullanımının yüksek olduğu sektörlerde nominal döviz kurundaki yükselişlerin maliyet etkisi yaratarak sektörel çıktı hacmini olumsuz yönde etkilediğini ortaya koymaktadırThis study aims to investigate the relationship between nominal exchange rate and sectoral output in seven subsectors of the Turkish economy by using control variables including money supply, public expenditure, oil prices and unemployment rate. Possible relations were tried to be determined by using bound test and ARDL method for the period 1998.Q1-2015Q3. It was concluded that there is a long-run relationship in all sectors excluding construction and accordingly, long-run coefficients and equations were estimated for six sectors. The estimation of long-run coefficients indicates that the rise in the nominal exchange rate affects sectoral output negatively at sectors where imported inputs are high because of the cost effect such as manufacturing industr

Intramuscular Hemangioma of Flexor Digitorum Brevis Muscle

WOS: 000309222100012PubMed: 21904191

China–Turkey Relations from the Perspective of Neoclassical Realism

There is plenty of studies focusing on China’s global outreach through its Belt and Road Initiative (BRI). In tandem with this, the extensive literature on China depicts it as the next hegemon to succeed in the USA. Along this line, flourishing ties with various Asian nations, including the Middle Eastern countries, as a result of China’s recent foreign policy activism has been addressed extensively. While most research has been stressing the rising assertiveness of China in world politics, only a limited number of studies have touched upon the responses from middle or small powers against China’s ascent. Drawing from neoclassical realism, this article contends two levels of analysis for delineating the interaction between Turkey, a middle power, and China, a rising great power. First, the exchange between Turkey and the USA is vital in determining the cordial relations between Turkey and China. Alteration in the American policy vis-à-vis Turkey in the wake of the Arab Spring is relevant to Turkey’s growing relations with China. Second, is the rising anti-Westernism of foreign policy elites as part of the alteration in the strategic culture of Turkish politics, which makes Turkey’s rapprochement with China possible. Nevertheless, it should be noted that these two levels are intertwined and feed each other. Consequently, employing a neoclassical realist approach, the article argues that the middle powers’ stance against a rising hegemon is conditional upon the bilateral relations with the current hegemon and peculiarities of domestic politics

Progesterone Treatment After Experimental Spinal Cord Injury

WOS: 000327090200002Objective/Background:A growing list of studies gives evidence for the efficacy of progesterone in the nervous systems. Neuroprotective effects of progesterone are well documented for the injured brain models in the literature. However, the effects of progesterone on spinal cord injury (SCI) should be investigated.Methods:Twenty adult male Wistar-Albino rats were included in the study. The rats were randomly allocated into two groups (Control and Progesterone). Progesterone was administered in five days at a dose of 4 mg/kg via intraperitoneal route. Each group underwent motor examination in sixth weeks using Basso, Beattie and Bresnehan (BBB) locomotor test.Results:The score mean values of the control and study groups receiving progesterone treatment after six weeks were 11.40.427 and 14.1 +/- 0.526, respectively (P<0.05). While the improvement process showed a nearly parallel course between the two groups until the end of the third week, the progesterone treated group exhibited a significant difference in BBB scores relative to the control starting from the fourth week (P<0.05). On the examined histological sections, it was determined that progesterone had clear neuroprotective effects.Conclusions:The results supported the fact that progesterone could be a potentially effective therapeutic strategy to treat SCI

Bilateral Fifth-Finger Camptodactyly

WOS: 000305624100013PubMed: 22019975