Background: Aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio (AST/ALT) frequently is used in the diagnosis and prognosis of liver diseases, however it is also used in the diagnosis and prognosis of many other diseases, such as myocardial infarction, acute ischemic stroke, and peripheral artery disease. Acute kidney injury (AKI) is one of the most important complications after cardiac surgery and is one of the main causes of morbidity and mortality. The purpose of the study was to analyze the relationship between AST to ALT and AKI after isolated coronary artery bypass graft surgery (CABG). Methods: We retrospectively reviewed the prospectively collected data of 253 adult patients, who underwent isolated CABG surgery with normal renal function (baseline serum creatinine value <1.4 mg/dL). Preoperative (T0) and postoperative day 1 and day 3 (T1 and T2) serum AST and ALT levels were analyzed, and AST/ALT was calculated. A preoperative AST/ALT of 1.22 was found to be the best cutoff point for predicting postoperative AKI. Kidney injury was interpreted, according to RIFLE classification. The effect of AST to ALT ratio on AKI after CABG was determined using logistic regression analysis, and the results were expressed as odds ratio (OR) with a 95% confidence interval (CI). A P value < .05 was considered statistically significant. Results: Postoperative AKI occurred in 40 patients (15.8%). On logistic regression analysis, higher AST/ALT both preoperatively and postoperatively were associated with an increased incidence of postoperative AKI (T0: OR, 3.983; 95% CI, 1.940-8.180, P < .001, T1: OR, 2.760; 95% CI, 1.381-5.515, P = .004, T2: OR, 2.515; 95% CI, 1.195-5.294, P = .015). Conclusion: Preoperative and postoperative elevated AST to ALT ratio seems to be associated with an increased incidence of AKI after elective isolated CABG surgery.

Aim:The aim of this study is to evaluate the effectiveness of internal compression therapy (ICT), a new technique used in the treatment of chronic venous insufficiency (CVI), and to share the early results. Material and Method: Between September 2018 and June 2019, 27 patients with superficial venous insufficiency due to saphenofemoral junction (SFJ) insufficiency and who underwent ICT were included in the study. Demographic data, venous color doppler ultrasonography (RDUS) results, CEAP (clinical etiology, anatomy, pathophysiology) classification, venous clinical severity score (VCSS) and visual analog scale (VAS) results were retrospectively analyzed from the files of the patients. Results: It was determined that 14 of the 27 patients were female and 13 were male in the study. While the mean CEAP classification scores were 3.9±0.5 before the procedure, it was 2.3±0.7 at the 3rd month after the procedure (p<0.001). While the mean duration of venous reflux before the procedure was 4.7±0.3 seconds, pathological reflux was detected in 2 patients at the 3rd month after the procedure (p<0.001). While the mean VCSS score was 11.2±3.3 before the procedure, it was 5.4±1.2 at 3 months (p<0.001). While the mean VAS score was 6.5±1.3 preoperatively, the mean VAS score was 2.7±1.4 at 3 months after the procedure (p<0.001). No complications were observed in any of the patients. Conclusion:We think that ICT can be used as an alternative treatment method in the treatment of superficial venous insufficiency due to valve dysfunction in SFJ.

A case of aortopulmonary window associated with anomalous origin of the right coronary artery from the pulmonary artery in a four-month-old boy is reported in this paper with a different method of repair. In this patient, surgical repair was done by transferring the right coronary artery from the pulmonary artery to the aorta at the aortopulmonary window side. The defect at the pulmonary artery was repaired by a pericardial patch, so no other secondary opening was used for the aorta in order to reimplant the coronary artery.

Amaç: Çalışmanın amacı, kliniğimizde yapılan ilk 200 açık kalp ameliyatının sonuçlarını değerlendirmektir. Gereç ve Yöntemler: Yapılan 200 kalp ameliyatı hastane kayıt sistemi taranarak geriye dönük olarak incelendi. Hastaların yaş, cinsiyet, komorbiditeleri, ameliyat tipleri, hastane ve yoğun bakımda yatış süreleri, morbidite ve mortalite oranları değerlendirildi. Bulgular: Hastaların 128'i kadın,72'si erkekti. Yaşları 38-90 yıl arasında olup, ortalama 68±5 yıldı. Komorbit faktörleri olarak, kronik obstrüktif akciğer hastalığı, hipertansiyon, diabetes mellitus, hiperlipidemi, serebro-vasküler hastalık, periferik arter hastalığı ve kronik böbrek yetmezliği ve miyokart enfarktüsü görüldü. Toplam 162 koroner arter bypass grefti (KABG) yapıldı. Bunlardan 24 tanesi çalışan kalpte gerçekleştirildi. Eş zamanlı olarak 5 karotis endarterektomi ve 15 koroner endarterektomi yapıldı. Dört KABG ve mitral kapak replasmanı (MVR), 2 KABG ve aort kapak replasmanı (AVR), 6 AVR, 12 MVR, 4 AVR ve MVR, 3 MVR ve tricuspit anuloplasti yapıldı. İki hastaya aort diseksiyonu nedeniyle asenden aort replasmanı ve 3 hastanın asenden aort anevrizmasına supra koroner aort replasmanı yapıldı. İki hastaya kardiyak yaralanma nedeniyle sağ ventrikül tamiri yapıldı. Düşük kardiyak debi nedeniyle 10 hastaya intra-aortik balon pompası takıldı. Komplikasyon olarak 38 hastada atrial fibrilasyon, 4 hastada akut böbrek yetmezliği, 3 hastada serebrovaskuler olay gelişti. Hastaların 4'ünde postoperatif kanama ve 3'ünde sternal dehisens nedeniyle revizyon yapıldı. Bir hastada mediastinit görüldü. Yoğun bakımda kalış süresi ortalama 2,2±1,7 gün olup, hastanede kalış süresi 7,5±4 gündü. Hastane mortalitesi 8 hastada (%4) görüldü. Sonuç: Kırıkkale Üniversitesi Tıp Fakültesi Araştırma ve Uygulama Hastanesi kalp ve damar cerrahisi kliniği, açık kalp ameliyatlarının literatüre uygun morbidite ve mortalite oranları ile yapıldığı bir merkez olmuştur. Objective:The aim of the study is to evaluate the results of the first 200 open heart surgeries performed in our clinic. Material and Methods: Two hundred heart surgeries performed were analyzed retrospectively by scanning the hospital registry system. Patients' age, gender, comorbidities, types of surgery, hospital stay and intensive care unit stay, morbidity and mortality rates were evaluated. Results: One hundred and twenty-eight of the patients were women and 72 were men. Their age was between 38-90 years and the mean age was 68±5 years. Comorbid factors included, chronic obstructive pulmonary disease, hypertension, diabetes mellitus, hyperlipidemia, cerebro-vascular disease, peripheral artery disease, chronic renal failure, and myocardial infarction. A total of 162 coronary artery bypass graft (CABG) surgeries were performed and 24 of them were off-pump. Five carotid endarterectomies and 15 coronary endarterectomies were performed simultaneously. Four CABG and mitral valve replacement (MVR), 2 CABG surgery and aortic valve replacement (AVR), 6 AVR, 12 MVR, 4 AVR and MVR, 3 MVR and tricuspid annuloplasty were perf...

When pesticides are sprayed, a significant portion of the droplets drifts away from the target. Using an adjuvant in spray liquid is an easy option for reducing droplet drift because there is no need to make any changes to the sprayer. The objective of the study was to determine the effects of seven commercially available adjuvants (Surfeco plus, Starguar, Kantor, Sterling, Control, Control WM, and Control DUO) with varying active ingredients on droplet size, surface tension, and viscosity. Since these properties affect droplet formation, these adjuvants were evaluated in terms of their drift-reducing performance in a wind tunnel at various wind speeds (2.0, 3.5, and 5.0 m/s) and spray pressures (3, 4, and 5 bars). The ground and airborne components of drift were evaluated. With the use of a patternator, the potential for the ground drift of adjuvants was measured; for airborne drift, polyethylene lines that were stretched along the cross-section area of the wind tunnel at various heights were employed. The number of deposits of a tracer dye–adjuvant mixture that was sprayed on the polyethylene lines was measured via fluorometric methods for determining the airborne drift potential. The test results showed that the adjuvant Control Duo containing a polymer blend, which had the highest dynamic viscosity (4.27 mPa.s), increased the Dv0.5 droplet diameter up to 192 μm at 3 bar with nozzle XR11002. This adjuvant reduced the ground drift potential (Dc) by 60.53 % compared to tap water. The maximum airborne drift potential reduction percentage (DPRP) was obtained as 85.76% with Surfeco plus containing organic silicone at a pressure of 3 bar and a wind velocity of 5 m/s. When considering the airborne drift-reduction potential of the adjuvants used, it was found that the adjuvants Control WM, Control, Starguar, and Surfeco plus significantly reduced the airborne droplet drift compared to spraying tap water.

Çıkış öncesi ilaçlama, Çıkış sonrası ilaçlama, Hava emişli meme Nohut, Yabancı ot.Öz: Bu çalışmada, kışlık nohut yetiştiriciliğinde sorun olan yabancı otlara karşı bazı çıkış öncesi ve çıkış sonrası ilaçlama yöntemlerinin başarısı saptanmıştır. Araştırmada kullanılan yöntemler; (M1) standart yelpaze hüzmeli meme (çıkış öncesi), (M2) çıkış öncesi meme tipi (çıkış öncesi) ,(M3) çarpmalı meme tipi (Çıkış öncesi), (M4) hava emişli meme (çıkış sonrası), (M5) ikiz hüzmeli hava emişli meme (çıkış sonrası) iki farklı uygulama hacminde (200 ve 400 l/ha) uygulanmıştır. Yöntemlere ait ilaçlama başarısı iki aşamalı olarak ölçülmüştür. Birinci aşamada, iz maddesi (BSF) uygulamaları yapılmış, burada parsellere yerleştirilen filtre kâğıtları ile kalıntı (birikim) miktarları ve suya duyarlı kartlar ile kaplama oranları belirlenmiştir. İkinci aşamada, iz maddesi sonrası gerçek herbisit uygulamaları yapılmıştır. Herbisit uygulamalarında çıkış öncesi seçilen meme tipleri ile Linuron ve çıkış sonrası meme tipleri ile Aclonifen etken maddeli herbisitler etiket dozlarında kullanılmıştır. Herbisit uygulamalarına bağlı olarak parsellerde, yabancı ot kontrol etkinlikleri ve verim değerleri belirlenmiştir. Elde edilen sonuçlara göre, 400 l/ha uygulama hacmi ve hava emişli meme (M4), %86.6 biyolojik etkinlik değerleri ve 476 kg/da verim değeri ile en yüksek sonuçları sağlamıştır.

No abstract

Orjinal Araştırma / Original Article Sternotomi kapatılmasında rijit fiksasyon yerine sadece aşırı kuvvet karşısında esneyebilen fiksasyon yönteminin bilinen yöntemlerle karşılaştırılması Comparison of the sternotomy fixation methods: Stiff-rigid fixation vs. adjustable semi-elastic fixation for excessive forces: An experimental biomechanic study Amaç: Monofilament paslanmaz çelik tel (tel), multifilaman paslanmaz çelik halat (halat), polipropilen bant kelepçe (kelepçe) ve multifilaman elastan fiber (elastan) sütürler, deneysel düzenekle in vitro olarak kemik hasarı, elastik modül, çekme dayanımı, uzama ve kopma parametreleriyle karşılaştırılmıştır. Gereç ve Yöntem: Koyun göğüs kafesleri median sternotomiyle iki parçaya ayrıldı ve sonrasında ilgili kapama yöntemiyle bir araya getirildi. Bu haliyle deneysel düzeneğe sabitlenerek 100-800N çekme testine (Instron, USA) tabi tutuldu. İlk aşamada sütür parçaları teker teker, sonra halka yapılıp düğümlenerek ve son aşamada sütüre edilmiş koyun göğüs kafesi şekinde test edildi. Sternumun maksimum kuvvetteki ayrışma mesafesi, sütürün kopma ve uzaması, elastik-plastik faz seviyeleri ve akma noktaları her aşamada kaydedildi. Bulgular: Sütür-kemik temas yüzeyi kelepçede (3.5 mm: en yüksek), elastanda (2 mm), halatta (1.1 mm), tel'de (0.8 mm: en düşük) iken, kemik doku hasarı elastanda hiç olmadı, halatta %11, telde %29 seviyesinde oldu, kelepçe grubunda ise kemik hasarı oluşacak kuvvete erişmeden kopma gözlendi. Sütürde uzamanın başladığı ortalama seviyeler ise telde 210N (en dayanıksız), kelepçede 320N, halatta (800N: en dayanıklı) ve elastanda (800N: en dayanıklı) şeklinde izlendi.800N'luk anlık aşırı kuvvet oluşmasının simüle edildiğiya aşamada kemik veya sütür hasarı oluşmadan kemiğin bir arada kalabildiği tek yöntem elastan oldu. Sonuç: Deney sonuçlarımıza göre sütür temas alanı ile kemik hasarının ters korele olduğu ve polipropilen materyal dayanımının Introduction: Monofilament stainless steel wire (wire), multifilament stainless steel rope (rope), polypropylene band clamp (clamp) and multifilament elastane fiber (elastane) sutures were compared by using bone damage, elastic modulus, tensile strength, elongation and breaking parameters. Methods: Sheep rib cages were divided into two parts by median sternotomy and then were combined with the related closure method. It was subjected to a 100-800N tensile test (Instron, USA) by fixed to the experimental apparatus. In the first stage, the suture pieces were tested one by one, then by looping and knotting, and in the last stage, they were tested on the sheep rib cage. The dissociation distance of the sternum at maximum strength, breaking and elongation of the suture, elastic-plastic phase levels and yield points were recorded at each stage. Results: The suture-bone contact surface was in clamp (3.5 mm: highest), elastane (2 mm), rope (1.1 mm), wire (0.8 mm: lowest). Bone tissue damages were 11% in rope, 29% in wire and 0% in elastane group. Ruptures were observed before reaching the force that would cause bone damage in cl...