Percutaneous transluminal balloon angioplasty in stenosis of native hemodialysis arteriovenous fistulas: technical success and analysis of factors affecting postprocedural fistula patency

PURPOSEWe aimed to determine the predictors of technical success and patency after percutaneous transluminal angioplasty (PTA) of de novo dysfunctional hemodialysis arteriovenous fistulas (AVF).METHODSWe performed a retrospective analysis of first time PTA in 228 patients (129 men, 99 women; mean age, 56.8±14.6 years). Anatomical (location, length, grade, and number of stenoses) and clinical variables (sex, age, prior AVF, diabetes mellitus, AVF age, side, and location) were reviewed.RESULTSA total of 330 stenoses were found in 228 patients. PTA was technically successful in 96.3% of the stenoses (n=319). Clinical success was achieved in 97.2% (n=321). Early dysfunction (within six months) was positively correlated with patient age (P < 0.001) and diabetes (P < 0.005). Older age (P < 0.001) and diabetes (P = 0.002) were associated with a lower primary patency rate. Patient age (P < 0.001), presence of diabetes (P = 0.023), length of stenosis (P = 0.003), early recurrence (P = 0.003) and presence of residual stenosis (P = 0.014) were associated with a lower secondary patency rate. CONCLUSIONPatency of dysfunctional hemodialysis fistulas can be maintained safely with continuous follow-up and repeated interventions without shortening the venous segment by surgical revision. Percutaneous approach to hemodialysis access stenosis is an alternative to the conventional surgical approach and PTA is an effective treatment method for dysfunctional AVF

Enhancement of Tissue Expansion by Calcium Channel Blocker: A preliminary study

BACKGROUND: Reconstruction of the defects after surgical resection of tumors is one of the important issues in surgical oncology. It is essential that the defect should be covered with a tissue quite similar to the original one and is best achieved by harvesting tissue from an area adjacent to the defect. Tissue expansion is one of the most frequently used reconstructive techniques. A number of studies evaluated blood circulation, capsule formation, tissue tolerance, histomorphological changes and complications of expander placement. However, only a few attempted to enhance tissue expansion. This study we aimed to evaluate verapamil, a calcium channel blocker, to enhance tissue expansion. MATERIAL AND METHOD: Twelve New Zealand rabbits weighing between 900 gm and 1200 gm were assigned into study and control groups. High volume expanders (100, 200 or 300 cc) were placed into the subcutaneous tissue. Rabbits in the study group received verapamil. Expanders in the control group were inflated every three days to achieve same pressure as the study group. The size of the flaps was assessed by applying pressure on tip of the flap to demonstrate the contraction. Histopathological examinations were performed. RESULTS: By administering liquid earlier and more quickly less flap retraction was observed in the study group. In the control group expanders were exposed in two rabbits while no complication occurred in the study group. Following extraction of the expanders, the flaps were elevated and less retraction was observed in the study group compared to controls. CONCLUSION: Verapamil is safe when used topically and provides less retracted flaps. It can be suggested that verapamil acts on the myofibroblasts in the capsule around tissue expanders and thus increases efficiency of the expanders

Asırı Sulamanın Toplumsal-Ekinsel Nedenlerinin Çözümlenmesi - Harran Ovası Örneği-

The construction of Ataturk Dam, and the establishment of the irrigation facilities were created wrong irrigation, economic and environmental problems in addition to a heavy cost to the Republic of Turkey. The purpose of this study is to analyze the socio-cultural connection of producer’ over-irrigation on Harran Plain and may help to develop a research outline for similar studies. Theoretical study is based on the "Situational Functional Approach". Research under the Harran Plain a questionnaire were made with the 163 subjects constist of 86 producers in eight villages, 12 irrigation union presidents and general secretaries, 5 agricultural chamber presidents and agricultural engineers working in these officers, 26 pesticide dealers, 34 extentionst at provincial and district directorates of agriculture

Asırı Sulamanın Toplumsal-Ekinsel Nedenlerinin Çözümlenmesi - Harran Ovası Örneği-

The construction of Ataturk Dam, and the establishment of the irrigation facilities were created wrong irrigation, economic and environmental problems in addition to a heavy cost to the Republic of Turkey. The purpose of this study is to analyze the socio-cultural connection of producer’ over-irrigation on Harran Plain and may help to develop a research outline for similar studies. Theoretical study is based on the "Situational Functional Approach". Research under the Harran Plain a questionnaire were made with the 163 subjects constist of 86 producers in eight villages, 12 irrigation union presidents and general secretaries, 5 agricultural chamber presidents and agricultural engineers working in these officers, 26 pesticide dealers, 34 extentionst at provincial and district directorates of agriculture

Analyzing Socio-Cultural Causes of Excessive Irrigation in Tribal Societies and Extension Needs: A Case Study of Harran Plain, Şanlıurfa

Besides, natural and technical factors effecting excessive irrigation, training activities of some governmental offices also have some influences on excessive irrigation tendencies of farmers, but they do not have a distinctive role. The main hypothesis of this research is that, in Harran Plain more than natural factors and extension activities and training, socio-cultural system affects irrigation behaviour of farmers. In other words, the main cause of excessive irrigation is socio cultural system. The main aim of this study is to analyze tribal system, to explain the excessive irriga-tion tendencies of farmers, and to develop and discuss a model which will help further studies. In this survey, 86 farmers, heads and secretaries of 12 irrigation unions, directors and agriculturalists working for 5 chamber of farmers, 26 agricultural chemical deal-ers, and 34 agricultural extension workers working at government agricultural prov-ince and county offices, in total 163 people, have been interviewed. In the survey the situation-specific approach has been used as the theoretical basis

Analyzing Socio-Cultural Causes of Excessive Irrigation in Tribal Societies and Extension Needs: A Case Study of Harran Plain, Şanlıurfa

Besides, natural and technical factors effecting excessive irrigation, training activities of some governmental offices also have some influences on excessive irrigation tendencies of farmers, but they do not have a distinctive role. The main hypothesis of this research is that, in Harran Plain more than natural factors and extension activities and training, socio-cultural system affects irrigation behaviour of farmers. In other words, the main cause of excessive irrigation is socio cultural system. The main aim of this study is to analyze tribal system, to explain the excessive irriga-tion tendencies of farmers, and to develop and discuss a model which will help further studies. In this survey, 86 farmers, heads and secretaries of 12 irrigation unions, directors and agriculturalists working for 5 chamber of farmers, 26 agricultural chemical deal-ers, and 34 agricultural extension workers working at government agricultural prov-ince and county offices, in total 163 people, have been interviewed. In the survey the situation-specific approach has been used as the theoretical basis

Idiopathic isolated clitoromegaly: A report of two cases

BACKGROUND: Clitoromegaly is a frequent congenital malformation, but acquired clitoral enlargement is relatively rare. METHODS: Two acquired clitoromegaly cases treated in Atatürk Training Hospital, Izmir, Turkey are presented. RESULTS: History from both patients revealed clitoromegaly over the last three years. Neither gynecological nor systemic abnormalities were detected in either patient. Karyotype analyses and hormonal tests were normal. Abdominal and gynaecological ultrasound did not show any cystic lesion or other abnormal finding. Computerized tomography scan of the adrenal glands was normal. Clitoroplasty with preservation of neurovascular pedicles was performed for the treatment of clitoromegaly. CONCLUSION: The patients were diagnosed as "idiopathic isolated" clitoromegaly. To the best of our knowledge, there has been no detailed report about idiopathic clitoromegaly in the literature

The creation of new rotation arc to the rat latissimus dorsi musculo-cutaneous flap with delay procedures

BACKGROUND: Latissimus dorsi musculocutaneous flap is one of the most frequently performed reconstructive techniques in surgery. Latissimus dorsi muscle has two arcs of rotation. It is classified as type V muscle. This muscle can be elevated on the thoracodorsal artery to cover large defects in the anterior chest and also, the muscle can be elevated on the segmental vessels to cover midline defects posteriorly. The aim of this study was to create a new arc of rotation on a vertical axis for the muscle and investigate effectiveness of vascular and chemical delays on the latissimus dorsi muscle flap with an inferior pedicle in an experimental rat model. We hypothesized that the latissimus dorsi muscle would be based on inferior pedicle by delay procedures. METHODS: We tested two different types of delay: vascular and combination of vascular and chemical. We also tried to determine how many days of "delay" can elicit beneficial effects of vascular and combination delays in an inferior pedicled latissimus dorsi musculocutaneous flap. To accomplish this, 48 male Sprague-Dawley rats were randomly subjected to vascular or combination delay (vascular and chemical). In addition, one ear of each rat was assigned into a delay procedure and the other ear was used as a control. Results were evaluated macroscopically, and micro-angiography and histological examinations were also performed. As a result, there was a significant difference in viable flap areas between vascular delay alone and control groups (p < 0.05). RESULTS: The higher rate of flap viability was obtained in seven-day vascular delay alone. However, there was no significant difference in the viability between seven-day vascular delay and five-day vascular delay (p < 0.05), so the earliest time when the flap viability could be obtained was at five days. The rate of flap viability was significantly higher in the vascular delay combined with chemical delay than the control group (p < 0.05). CONCLUSION: The combination of vascular and chemical delays increased the rate of viability. Nevertheless, there was no significant difference between vascular delay alone and combination of vascular and chemical delays. Chemical delay did not significantly decrease the delay period. Better histological and microangiographical results were achieved in delay groups compared to control groups. We concluded that the arch of the latissimus dorsi musculocutaneous flap can be changed and the flap can be used for various purposes with the delay procedures

Measurement of (anti)deuteron and (anti)proton production in DIS at HERA

The first observation of (anti)deuterons in deep inelastic scattering at HERA has been made with the ZEUS detector at a centre-of-mass energy of 300--318 GeV using an integrated luminosity of 120 pb-1. The measurement was performed in the central rapidity region for transverse momentum per unit of mass in the range 0.3<p_T/M<0.7. The particle rates have been extracted and interpreted in terms of the coalescence model. The (anti)deuteron production yield is smaller than the (anti)proton yield by approximately three orders of magnitude, consistent with the world measurements.Comment: 26 pages, 9 figures, 5 tables, submitted to Nucl. Phys.

Operational Research: Methods and Applications

Throughout its history, Operational Research has evolved to include a variety of methods, models and algorithms that have been applied to a diverse and wide range of contexts. This encyclopedic article consists of two main sections: methods and applications. The first aims to summarise the up-to-date knowledge and provide an overview of the state-of-the-art methods and key developments in the various subdomains of the field. The second offers a wide-ranging list of areas where Operational Research has been applied. The article is meant to be read in a nonlinear fashion. It should be used as a point of reference or first-port-of-call for a diverse pool of readers: academics, researchers, students, and practitioners. The entries within the methods and applications sections are presented in alphabetical order