Çift girişli sol ventriküllü olguda klasik Glenn ameliyatı: 20 yıllık takip

Functional univentricular heart is a rare and complex congenital anomaly. The prognosis is usually poor without any surgical intervention and long-term survival is rare. In this article, we report a 57-year-old female case with a double inlet left ventricle with valvular pulmonary stenosis, left anterior rudimentary right ventricle, ventricular septal defect, discordant ventriculoatrial connection, patent foramen ovale and Glenn shunt who was followed for 20 years. Cardiac catheterization revealed a classic Glenn shunt anatomy. The patient is currently under follow-up with medical treatment

Using possibilites of reinforced greenhouse covering materials in greenhouse cultivation: The case of Bursa

Bu çalışmada Bursa ilinde faaliyet gösteren plastik örtülü seraların hangi tip örtü materyalleri kullandıkları, kullanım olanakları, örtü tercihlerindeki etken unsur, üreticilerin örtü seçimindeki bilgi seviyesi ve önerileri yerinde gözlem anketlerle incelenmiştir. Elde edilen verilerin incelenmesi sonucu edinilen sonuçlara göre çıkarımlar yapılarak yeni bilgiler elde edilmiştir. İncelenen işletmelerin % 93'ünde bireysel, % 7'sinde ise blok seralar kullanılmakta olup % 80'inde Polietilen+UV+IR+AF katkılı örtü malzemesi, % 20'sinde ise standart PE örtü malzemesi kullanıldığı belirlenmiştir. Katkılı plastik örtü malzemesi kullanımının örtü malzemesi değiştirme sürelerinin uzamasına katkıda bulunduğu, örtü malzemesi değiştirme sürelerinin işletmelerin % 60'ında 3 yılda bir, % 40'ında ise 2 yılda bir olduğu belirlenmiştir. Araştırma sonuçları incelenen işletmelerde katkılı plastik örtü malzemesi kullanımı konusunda bir artış olduğunu göstermekle birlikte, örtü malzemesi seçiminde örtü malzemesinin yapının termal performansı ve buna bağlı olarak ısıtma ve soğutma gibi işletme maliyetlerinin düşürülmesi ile iç ortam çevre koşullarının oluşturulmasındaki yararlı etkileri sonucu verim artışına etkisi gibi konularda üreticilerin bilinçsiz olduğunu ortaya koymuştur.In this study, the type of covering materials used by the plastic covered greenhouses operating in Bursa province, usage possibilities, the factors affecting the choice of coverings, the level of knowledge of the producers in the choice of coverings and their suggestions were examined with on-site surveys. As a result of the examination of the data obtained, new information was obtained by making inferences according to the results obtained. The percentage for individual and block greenhouses in examined enterprises are 93% and 7%, respectively. PE covering material with UV + IR + AF additive was used in 80% of the enterprises and standard PE covering material was used in 20%. It is determined that the use of reinforced PE film as covering material contributes to physical life of the covering material and that the covering material replacement period is 3 years in 60% of the enterprises and 2 years in 40%. Although the results of the study show that there is an increase in the use of reinforced plastic covering materials in investigated enterprises, it is determined that greenhouse producers are unaware on the structure's thermal performance which reduce the operating costs of heating and cooling, and its beneficial effects on the creation of indoor environment conditions which are effective in production efficiency

Şans ve şanssızlık bir arada: İnternal juguler ven kateterizasyonu sonrasında ortaya çıkan kalp tamponadı olgusu

Prior to serious surgical interventions, central venous catheterization (CVC) is used with such purposes as obtaining venous tract and hemodynamic monitorization as well as applying medicine. Although it is rare, serious complications might develop after catheterization. A 72-year-old female patient who was being prepared for coronary bypass surgery was inserted a CVC into right internal jugular vein. Her pericardium was opened upon the bradycardia that developed following the sternotomy, and it was observed that hemopericardium had developed. The tip of the central catheter was seen on vena cava superior and was pushed back by the surgery team. Cannulations were completed quickly and the pump was entered, vena cava was repaired and surgery was completed and then the patient was transferred to intensive care unit. In this article cardiac tamponade, which is a rare but potentially fatal complication associated with CVC, has been presented

Ekstrakardiyak fontan ifllemi sonrasında geliflen persistan pleural efüzyonun tedavisinde yüksek doz oktreotid

[No Abstract Available

Anesthesia and surgical collaboration on an extremely low birth weight infant undergoing ligation of patent ductus arteriosus

Patent ductus arteriosus (PDA) is one of the most common congenital cardiac anomalies in infants. Spontaneous closure of ductus arteriosus takes long time in preterm infants. Early ligation is advised in very low birth weight infants but surgical risk is bigger in older infants. In this presentation we report an anesthetic management in a male preterm infant weighing 600 grams, who underwent PDA ligation. He was born at gestation age of 24 weeks at another hospital, and since his birth he has been observed to have infant respiratory distress syndrome. Hemodynamic deterioration, ventilator dependency, increase in heart murmur, deterioration of the general status and irresponsivity to indomethacine was observed in the patient and the patient was referred to our center for surgical ligation of the PDA. He was transferred to our center in an incubator and with diagnosis of PDA. Bradycardia (50 beats/min) developed during echocardiography in our center and the patient was intubated and transported to the operating room. General anesthesia was induced by fentanyl 5µg, 0.4mg rocuronium and ketamine 0.15 mg intravenously. Anesthesia was maintained with 1.5-2.5 % sevoflurane in 50 % air and oxygen at an inspired concentration titrated to stabilize the vital signs. Because of the extreme low weight of the infant, invasive arterial monitorization and positioning was difficult. The PDA was ligated with titanium clips through left thoracotomy. The postoperative course was uneventful and he was discharged on the 77 th day,1750g of weight

Amerika Birleşik Devletleri ve Türkiye'de koroner arter hastalığı nedeni ile güçlendirilmiş eksternal kontpulsasyon tedavisi gören hastalarda olaysız sağkalım oranları ve uzun dönem klinik sonuçlarının karşılaştırılması

OBJECTIVES This study assessed the long-term efficacy of EECP (Enhanced External Counterpulsation) in Turkish (TR) patients initially and compared these results with the United States (US) in a real world setting. STUDY DESIGN In this study, 2072 patients were treated and followed in the US and 82 patients were treated and followed in TR. The International EECP Patient Registry Phase I and II was initiated and coordinated at the University of Pittsburgh. The aim of the “registry” was to assess the outcomes of clinical trials in a real world setting. Another unique feature of this study was to enroll patients not only from university hospitals but also from private hospitals, educational hospitals, and treatment centers. RESULTS TR patients had less diabetes, hypertension, and hyperlipidemia than US patients (p<0.01). TR patients also had a higher proportion of diastolic augmentation (p<0.001). Both groups showed a significant reduction in the severity of angina after a 35h EECP course (p<0.001). Major Adverse Cardiac Events (MACE) rate (death, coronary artery bypass graft, percutaneous coronary intervention, myocardial infarction) was low in both groups during treatment (2.5% vs. 2.7%). At 1 year follow up, 84% of TR and 76% of US patients had maintained the improvement of angina. CONCLUSION Patients presenting for EECP treatment from TR had different baseline profiles from US patients. However, despite the high risk baseline characteristics, both cohorts achieved similar reduction in angina. In the long term follow-up, the MACE rate was low and the improvement after EECP was sustained in most of the patients