Giant left anterior descending coronary artery aneurysm in a patient with Behçet’s disease

Coronary artery involvement is quite rare in the course of Behçet’s disease. Complications secondary to coronary artery aneurysms, including rupture, dissection, and myocardial ischemia, may be fatal. In young patients without cardiovascular risk factors, systemic inflammatory vasculitis syndromes should be investigated in case of acute coronary syndrome secondary to dilated coronary arteries. In this report, we present our management strategy in a 31-year-old male patient with Bechet’s disease

Imagination Tool: Accessible AI Image Generation Software to Support Child Ideation and Creative Expression

Despite the rising popularity in image AI generation systems, key open questions remain as to both (1) how to design such systems for use by children, and (2) what roles generative AI may play in contexts in which media creation is not the end goal, but is rather used to support other human endeavours such as communication and ideation. We describe a new AI image generation tool, designed to support children engaging in creative ideation, expression, and visually communicating their ideas—in particular, their visions for the future. We describe key aspects of the system’s implementation, including ensuring the system produces child-safe and task-appropriate images, and mechanisms for supporting children in ideation. This work can thus inform researchers in computational creativity who aim to address safety and usability of systems for children

Internal thoracic artery: A major collateral supply in case of Leriche syndrome

We read with great interest the article by Bosse and colleagues,1 in which they presented a case series of cardiac surgery combined with bypass from the ascending aorta to the bilateral femoral arteries in patients with severe aorta-iliac occlusion

Coronary arteries arising from single coronary ostium: A case report

Advanced diagnostic systems and healthcare screening programs enabled increased diagnosis of congenital cardiovascular anomalies, including variations in coronary arteries. Single coronary artery is a rare congenital cardiovascular malformation in which all three main coronary arteries originate from a single coronary trunk. In this report, we present a patient with single coronary ostium giving rise to the left and right coronary artery systems, which was diagnosed incidentally with coronary computerized tomography and confirmed with conventional angiography

İllüzyonun Türkiye'deki tarihi ve gelişimi

Ankara : İhsan Doğramacı Bilkent Üniversitesi İktisadi, İdari ve Sosyal Bilimler Fakültesi, Tarih Bölümü, 2014.This work is a student project of the The Department of History, Faculty of Economics, Administrative and Social Sciences, İhsan Doğramacı Bilkent University.by Aslan, Mustafa Çağatay

The comparison of standard, endoscopic and tunnel harvesting of autolog vena saphena magna in coronary artery bypass grafting operations

Amaç: Otolog Vena Saphena Magna (VSM) koroner arter cerrahisinde kullanılan en yaygın baypas materyalidir. Genellikle Vena Saphena Magna standart uzun medial bacak insizyonu ile hazırlanmakta olup; insizyon hattında iyileşme problemleri sıklıkla izlenmektedir. Bu çalışmada, otolog VSM çıkarılmasında endoskopik yöntem, klasik ve tünel yöntemlerinin karşılaştırması yapılmıştır.Gereç ve Yöntem: Koroner baypas ameliyatı olan 40 hastarandomize ve retrospektif olarak seçildi. 10 hastada endoskopik yöntem ile, 15 hastada tünel ve 15 hastada klasik yöntemile VSM çıkarılmıştır. Çalışmada bacak insizyonu ile ilgili olarakpostop hastanede kalış süresi, kullanılan antibiyoterapi, ek antibiyotik ihtiyacı, üst bacak çapı, sızıntı, hematom, açık yara bakım süresi, kültür antibiyogram, insizyon boyutu, komplikasyon yeri,maliyet, postoperatif şikayet, ortalama VSM çıkarma süresi, VSM uzunluğu, kapalı pansuman günü, elastik bandaj süresi, drenajmiktarı, postoperatif ağrı skorlaması karşılaştırılmıştır.Bulgular: Tünel ve endoskopik yöntem grubunda çalışma sonunda klasik gruba göre, insizyon uzunluğunda, postoperatif ağrıda, major komplikasyon gelişiminde, insizyonu kapama süresinde, insizyonu kapamada kullanılan sütür materyalinde azalma saptanmıştır. Bunun yanında mükemmel bir kozmetik sonuçla hasta memnuniyeti artmış, erken dönemde mobilizasyonda rahatlık sağlanmıştır.Sonuç: Klasik yönteme göre endoskopik teknik ve tünel yöntemiuygulanan hastalarda bacaktaki insizyon sorunlarının daha az görüldüğü ve hastanede kalış süresinin, kullanılan sütür materyalimiktarı ve insizyonu kapama süresinin, insizyon uzunluğunun vepostoperatif ağrının daha az olduğu gözlenmiştir. Hastanın mobilize olma süresinin de kısaldığı saptanmıştır. Bu sonuçlara göreendoskopik ve tünel yöntemlerinin kullanımının klasik yöntemeüstünlüğü göz önünde bulundurulmalıdır.Objective: Autologous vena saphena magna is the most common bypass material used in coronary artery surgery. It is generally prepared with a long medial leg incision, and so healing problems are often observed. In this study, we aimed to compare endoscopic, classical and tunnel techniques in saphen harvesting.Material and Method: Fourty patients, who were selected randomly and retrospectively, were included in the study. Endoscopic saphen harvesting was performed on 10 patients, the tunnel technique was performed on 15 patients and the classical method was performed on 15 patients. Postoperative hospital stay, antibiotics, additional antibiotic requirement, upper leg size, hematoma, open care time, culture antibiogram, incision size, complication site, cost, postoperative complaints, median vena saphena magna harvesting time, vena saphena magna length, closed dressing time, elastic bandage time, drenaige amount, postoperative pain scores (Visual Analogue Scale-VAS) were all factors compared regarding saphen insicion site.Results: In tunnel end endoscopic procedures; insicion length, postoperative pain, major complication rate, incision closure time, the sutur material reqired for closing incisions were lower than the classical technique group. Moreover, the level of patients' satisfaction was increased due to perfect cosmetic results and ease of early mobilization.Conclusion: Comparing classical saphen harvesting techniques with endoscopic and tunnel methods, it was found that incision problems, length of hospital stay, sutur material amounts, incision closure time, incision length and postoperative pain were detected in lower numbers in endoscopic and tunnel methods. Depending on these factors, the patient's mobilization time was shortened. According to these results, the superiority of the endoscopic and tunnel methods compared to the classical method should be considered

Is there any association between EBV infection and carotid artery stenosis?

Objective: Atherosclerosis is the mainly etiologic factor of coronary artery disease, carotid artery disease and peripheral artery disease. In our study, we aimed to show the presence and effect of Epstein-Barr virus (EBV) on the carotid artery stenosis leading chronic inflammatory process by producing pro-inflammatory cytokines and causing atherosclerosis. Material and methods: Between April 2017 and April 2018, thirty-six patients, who underwent carotid endarterectomy at Department of Cardiovascular Surgery, Istanbul University Istanbul Medical Faculty, are included in this study upon their consent. Each voluntary patient was initially recorded for age, sex, height and weight. Among 36 patients included in the study, 58.3% (n = 21) were male and 41.7% (n = 15) were female. The comorbidities such as hypertension, diabetes mellitus were considered. Results: There was not significant difference in EBV (DNA) positivity according to hyperlipidemia presence, sex, and age factors. However, the EBV (DNA) positivity was higher in the patients with co-morbidities such as hypertension and diabetes mellitus; no significant difference was detected. EBV (DNA) positivity in patients with bilateral carotid artery stenosis was 42.1% and it was 0% in patients without bilateral carotid artery stenosis (p: 0,002). The EBV (DNA) positivity was significantly higher in patients with bilateral carotid artery stenosis Conclusion: We believe that our significantly high EBV (DNA) rates in the patients with bilateral carotid artery stenosis may encourage the studies that claim the role of viral etiology on atherosclerosis, however, further studies are needed

Increased CRP/albumin ratio is associated with superficial venous reflux disease and varicose vein formation

Background: It has been recently postulated that inflammation may have an effect on varicose vein development and prognosis, besides increased venous pressure. CRP/albumin (CAR) is a novel inflammatory marker associated with poor prognosis in a various group of patients. Our aim in this study was to investigate the relation between varicose greater saphenous vein (VSM) diameter and CAR. Methods: A total of 150 patients with patients VSM insufficiency (Group 1, n: 114) and normal VSM (n: 36) were included in the study. The diameter of the VSM was measured with B-mode ultrasound, and reflux was quantified based on valve closure time using Doppler spectral tracings. Blood samples were taken during recruitment. The CAR value is determined by dividing the serum CRP level to the albumin level. Results: There were 21 (18.4%) males and 93 (81.5%) females in Group 1 and 7 males and 29 females in Group 2. Mean age of the patients were similar in both groups (48.02 +/- 12.20 years in Group 1 vs. 44.9 +/- 8.92 years in Group 2, p = 0.44). Mean BMI of the patients did not differ significantly (Group 1: 26.4 +/- 3.7 kg/m2 vs. Group 2: 25.7 +/- 4.2 kg/m2, p = 0.13). The mean diameter of VSM was measured 5.70 +/- 0.29 mm in Group 1 whereas 3.21 +/- 0.34 mm in Group 2 (p = 0.0023). Mean CRP and albumin values in Group 1 were 6.18 +/- 4.99 mg/L and 4.45 +/- 0.27 g/dL whereas 4.25 +/- 2.46 mg/L and 6.18 +/- 1.14 g/dL in Group 2, respectively (p value for CRP = 0.049, p value for albumin = 0.074). CRP/albumin was 1.28 +/- 1.34 in Group 1 and 1.11 +/- 1.21 in Group 2, which was not statistically significant (p = 0.58). There was a positive moderately strong correlation between VSM diameter and CRP/albumin ratio as well as superficial venous reflux disease (r: 0.48). Conclusion: CRP/albumin ratio is associated with increased incidence of varicose veins and increased diame-ter of greater saphenous vein; hence, superficial venous reflux disease. The findings support the hypothesis that systemic inflammation may play a role in varicose vein disease.Kontext: Nedávno byl publikován názor, že kromě zvýšeného žilního tlaku může vznik a progresi křečových žil ovlivňovat i zánět. Poměr C-reaktivního proteinu (CRP) a albuminu (CRP/albumin ratio, CAR) představuje nový marker zánětu spojený s nepříznivou prognózou u různých skupin pacientů. Cílem naší studie bylo zjistit vztah mezi průměrem varikózní velké safény (varicose greater saphenous vein, VSM) a parametrem CAR. Metody: Do studie bylo zařazeno celkem 150 pacientů s nedostatečností VSM (skupina 1, n = 114) a nepostiženými VSM (n = 36). Průměr VSM se měřil B-mode ultrazvukem a refl ux se kvantifi koval délkou uzavírání chlopně měřenou spektrální dopplerovskou křivkou. Krevní vzorky se odebíraly při zařazování pacientů do studie. Hodnota CAR se stanovuje vydělením hodnoty CRP hodnotou albuminu v séru. Výsledky: Skupinu 1 tvořilo 21 (18,4 %) mužů a 93 (81,5 %) žen; ve skupině 2 bylo 7 mužů a 29 žen. Průměrný věk pacientů v obou skupinách byl podobný (48,02 ± 12,20 roku ve skupině 1 vs. 44,9 ± 8,92 roku ve skupině 2; p = 0,44). Průměrná hodnota indexu tělesné hmotnosti (BMI) pacientů se významně nelišila (skupina 1: 26,4 ± 3,7 kg/m2 vs. skupina 2: 25,7 ± 4,2 kg/m2 ; p = 0,13). Průměrné hodnoty průměru VSM byly 5,70 ± 0,29 mm ve skupině 1 a 3,21 ± 0,34 mm ve skupině 2 (p = 0,0023). Průměrné hodnoty CRP a albuminu ve skupině 1 byly 6,18 ± 4,99 mg/l, resp. 4,45 ± 0,27 g/dl; ve skupině 2 to bylo 4,25 ± 2,46 mg/l, resp. 6,18 ± 1,14 g/dl (hodnota p pro CRP = 0,049, hodnota p pro albumin = 0,074). Poměr CRP/albumin ve skupině 1 činil 1,28 ± 1,34; ve skupině 2 byla naměřena hodnota 1,11 ± 1,21, tedy statisticky nevýznamný rozdíl (p = 0,58). Byla nalezena středně těsná korelace mezi průměrem VSM a poměrem CRP/albumin i refl uxem povrchových žil (r: 0,48). Závěr: Zvýšený poměr CRP/albumin je spojen se zvýšenou incidencí varixů a větším průměrem velké safény, a tedy i vyšší incidencí refl uxu povrchových žil. Zjištění podporují hypotézu, že ve vzniku křečových žil může hrát jistou úlohu systémový zánět

Evaluation of chronic inflammation in the aetiology of venous insufficiency by investigating cytomegalovirus DNA

Introduction: Lower extremity venous insufficiency is a significant health problem with economic and sociological consequences, lowering the quality of life, and sometimes leading to serious complications. The aim of this study is to evaluate the cytomegalovirus (CMV) effect on chronic inflammation in the aetiology of chronic venous insufficiency. Material and methods: Between November 2017 and August 2018, 468 patients who underwent radio-frequency ablation therapy and phlebectomy were included in the study. PCR analyses for CMV DNA were performed on the venous tissue samples. Patients with post-thrombotic syndrome were excluded from the study. After ethical approval, the relationship between the presence of CMV DNA, gender, body mass index, and bilaterality of chronic venous insufficiency were investigated. Results: When the relationship between CMV DNA and gender or body mass index was examined, a significant relationship was not detected. But when the patients with bilateral chronic venous insufficiency and patients with unilateral chronic venous insufficiency were compared regarding CMV DNA positivity, the patients with bilateral chronic venous insufficiency had significantly higher CMV DNA positivity (p = 0.002). Also, the incidence of venous ulcers in the CMV DNA exposed group was significantly higher. Conclusions: In the literature there are many studies showing that CMV triggers atherosclerosis, but there is no study in which CMV directly produces chronic venous insufficiency. The high rates of positivity suggest that CMV, which is the basis of chronic inflammation, may be a significant factor in the aetiology of chronic venous insufficiency