Internal thoracic artery-inferior epigastric artery as a collateral pathway in aortoiliac occlusive disease

ObjectiveIn patients with aortoiliac occlusion, the internal thoracic artery-inferior epigastric artery (ITA-IEA) collateral is one of the collaterals supplying blood flow to the lower extremity, and the interruption of this collateral may cause severe leg ischemia. The aim of this study was to evaluate by color duplex ultrasonography scans the ITA-IEA pathway and its significance as a collateral in providing lower-extremity perfusion in aortoiliac occlusive disease.MethodsColor duplex ultrasonography scans were prospectively performed in 64 consecutive patients with aortoiliac occlusion. Blood flow measurement in the ITA, IEA, and common femoral artery was done on both sides. The patients were stratified according to occlusion level (aorta, common iliac artery, external iliac artery), and the data obtained from such groups were compared.ResultsIn 95% of patients with aortoiliac occlusion, the ITA-IEA pathway was functioning as a collateral, with mean collateral flow of 66 ± 48 mL/min, and its average contribution to lower-extremity perfusion was 38% ± 23%. Additionally, a moderately positive correlation was found between flows of ITA and IEA (r = 0.55, P < .0001). Depending on the level of occlusion, the collateral flow and its contribution to perfusion progressively decreased from the proximal to distal aortoiliac occlusion level. Furthermore, the difference in the ITA-IEA flow volume was statistically significant between occlusion levels (P = .009), but the differences in the perfusion contribution were not different among levels (P = .311). There was also no statistical difference between the groups concerning collateral flow volume and contribution to lower-extremity perfusion in relation to unilateral or bilateral occlusion of the iliac artery, the state of distal run-off being good or poor, or the clinical findings being mild or severe.ConclusionIn patients with aortoiliac occlusion, the ITA-IEA collateral pathway is an important route providing lower-extremity perfusion. Additionally, Doppler sonographic flow measurements of the contribution of the ITA-IEA route to lower-extremity perfusion may provide beneficial diagnostic information necessary for the pretreatment work-up of patients with aortoiliac occlusion, especially for whom the ITA is planned to be used as a coronary artery graft

Yonga levha endüstrisi işletmelerinde ekonomik açıdan başarı düzeyinin belirlenmesi: Orman Mahsulleri Entegre Sanayi ve Ticaret AŞ (ORMA) örneği

Ülkemizde yonga levha endüstrisi 1957 yılında, İstanbul’da, “Sunta Tahta Sanayi” adıyla faaliyetine başlamıştır. Gelişen teknoloji ve ekonomi ile birlikte, yonga levha endüstrisi işletmelerinin yenileri kurulmuştur. Sektör içindeki sayıları artan işletmeler arasında, rekabetçi bir ortam oluşmuştur. Bu ortam içinde bazı işletmeler başarılı olacaklar, diğerleri ise olamayacaktır. Tek başına başarı, göreceli bir kavramdır. Bu nedenle başarının gerçek değerlerle tanımlanması gereklidir. Yonga levha endüstrisi işletmelerinde ekonomik açıdan başarı düzeyinin belirlenmesi konusunu ele alan bu çalışma, Isparta İlinde faaliyet gösteren “Orman Mahsulleri Entegre Sanayi ve Ticaret AŞ (ORMA)” bünyesinde yürütülmüştür. Çalışmada, yonga levha endüstrisi işletmelerinde başarının çok boyutlu olarak tanımlanması, en önemli başarı değişkenlerinin belirlenmesi, başarının ölçülmesi ve değerlendirilmesi araştırılmıştır. Araştırmada yonga levha endüstrisi işletmelerinde ekonomik açıdan başarıyı etkileyebilecek 32 değişken belirlenmiştir. Uygulanan istatistiki analizler sonucunda en önemli başarı değişkenlerinin; UBTEK, KMO, KV, KAR, ISV, UGYYL, UGYE, UE, SBY, DSYLY, DSYE, DSYDOE, USOE, USOYL ve PDH olduğu bulunmuştur. Bu sonuçlarla, yonga levha endüstrisi işletmelerinin ekonomik açıdan başarısının belirlenmesinde yardımcı olacak bir model geliştirilmiştir. Anahtar kelimeler: Orman ürünleri endüstrisi, Yonga levha işletmeleri, Verimlilik, Başarı düzeyi, Karlılık, Performans ölçüm

A Novel Safe Merging Algorithm for Connected Vehicles Using NetLogo

In this paper, we present two new algorithms for MetroCar System (MCS) vehicles at a merging zone. First algorithm states the regulations of vehicles in the same road such as control the following vehicle's to prevent collision with the frontier vehicle. Second algorithm is for merging section of roads in order to prevent any collision at merging point. The proposed algorithms are verified and validated by using simulation results of the NetLogo simulation software. The simulation results show that the proposed algorithms guarantees that no collision occur at the merging zone

Heart rate variability improvement in children using transcatheter atrial septal defect closure

Objective: We evaluated autonomic behavior by examining heart rate variability (HRV) in the time domain and frequency domain in pediatric patients who underwent transcatheter closure of atrial septal defect (ASD)

Factors affecting perioperative mortality in tetralogy of Fallot

BackgroundWe evaluated the preoperative, operative and postoperative risk factors affecting early mortality in patients who underwent total correction of tetralogy of Fallot (TOF)

Heart rate variability improvement in children using transcatheter atrial septal defect closure

Objective: We evaluated autonomic behavior by examining heart rate variability (HRV) in the time domain and frequency domain in pediatric patients who underwent transcatheter closure of atrial septal defect (ASD)