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The purpose of this prospective study was to evaluate the efficiency, feasibility, and surgical outcomes of microlaparoscopy-assisted pull-through (MAPT) for Hirschsprung's disease.Starting in 2005, pull-through procedures for Hirschsprung's disease were performed exclusively using 2-mm instruments and miniscopes (microlaparoscopy). Three miniports were inserted laterally in the right abdominal wall in one line, with the miniscope at the level of the umbilicus and the working trocars cranially/caudally of the scope. The left colon was dissected, and transanal pull-through was performed.MAPT was performed in 16 children (10 boys and 6 girls; average age: 5.7 months). Six patients had previous abdominal surgeries. A 1.9-mm cystoscope or a 2.4-mm arthroscope was used in the first 5 cases. In the remainder, a recently developed 2.4-mm miniscope was used for visualization. The length of the resected colon segment was up to the left colonic flexur in 5 children, up to the middle of the descending colon in 4 cases and up to the sigmoid-descending segment in 7 children. The average operation time was 185 minutes (range: 120-330 minutes). The only intraoperative complication that occurred was an injury of the right iliac vein by inadvertent slippage of an electrocautery hook requiring laparotomy. At follow-up, 80% of the parents were unable to identify the scars after microlaparoscopy.MAPT is a safe and practical procedure regardless of age or previous surgery.

The goal of the present study was to evaluate the efficacy of the LigaSure™ Vessel Sealing System (LVSS) when used for cystic duct closure during laparoscopic cholecystectomy in children and adolescents. The laparoscopic cholecystectomy was performed beginning with visualization of Calot’s triangle, and dissection of Calot’s triangle was achieved using a monopolar cautery device. Once the cystic duct was exposed, sealing was performed proximally and distally, and the cystic duct was divided midway using the LVSS. The procedure was completed in the standard fashion. The closure of the cystic duct was performed in seven cases of simultaneous cholecystectomy and splenectomy and in 15 cases of microlaparoscopic cholecystectomy. The patients’ ages ranged from 7 to 21 years (average = 14.5 years), and body weight ranged from 42 to 83 kg (average = 58 kg). There was no bile leakage noted, and the closure of the cystic duct was sufficient in all cases. We noted one case of common bile duct obstruction on postoperative day 1. In this case, an exploration of the biliary tree was performed by laparotomy. No direct injury to the common bile duct was found during exploration, but thermal changes were detected in the surrounding tissues as a result of transmitted thermal energy caused by bipolar cautery device. The closure of the cystic duct using the LVSS is feasible and effective in laparoscopic cholecystectomy in children. However, it is important to keep a safe distance from other intra-abdominal structures when using thermal energy devices to prevent thermal collateral damage.

This brief note presents a case study for clocking links in multi-chip packages. A particular co-packaged multichip system design based on multi-Gbps silicon photonics global interconnect provides the context for our study of near-short range links, and we explore its design space. A preliminary exploration of phase noise suggests that the links should be clocked mesochronously, with an optically distributed full-rate clock and using local phase adjustment at each receiver.

WOS: 000285677300011 Objective The cum of this study was to compare the effectiveness and safety of argon plasma coagulation (APC) method that has recently been started to be used to epinephrine injection (sclerotherapy) in the endoscopic management of nonvariceal upper gastrointestinal bleeding (UGIB) Material and Method. Patients (8 female 3 male age 61 15 8) applied with nonvariceal UGIB and treated with APC endoscopically were allocated to the study Patients (20 female 10 male age 62 7 18 3) applied with nonvariceal UGIB and treated with sclerotherapy with endoscopic epinephrine (1/10000) were allocated as a control group Age of the patients gender complaints (hematemesis melena) during application drug use (acetyl salicylic acid warfarin nonsteroidal anti inflammatory drugs (NSAI)) hemoglobin (Hb) level during application and discharge endoscopic diagnosis number of blood transfusion and drug treatment methods were noted Results There was no difference between APC applied patients and the patients treated with sclerotherapy in respect to the age of the patients gender presence of hematemesis and melena complaints during application NSAI drug use acetyl salicylic acid and warfarin use Hb level during application and discharge number of blood transfusion length of hospital stay surgical and mortality rate (p>0 05) APC was applied endoscopically diagnosed as hemorrhagic erosive gastritis in addition to the patients applied for peptic ulcer Conclusion APC application is an effective method in endoscopic treatment of nonvariceal upper GI bleeding The ease of application of procedure in APC applied patients a noncontact and controllable depth of coagulation observation of the cessation of bleeding during application endoscopically applicability in patients with hemorrhagic erosive gastritis are the advantages

Today endoscopic examination is the best diagnostic method for the visualization of the upper and lower gastrointestinal system. In many countries endoscopic interventions have become better tolerated and more comfortable using sedoanalgesia and because it causes amnesia in patients repeated examinations are easier. Sedation during endoscopy is a conscious sedation that provides patient cooperation to verbal and and tactile stimuli. In gastroenterology sedation is applied in diagnostic and therapeutic endoscopic interventions for esophagus, stomach, duodenum and colon and during cholangiopancreaticography. The procedure of gastrointestinal endoscopy contains multiple standardized diagnostic and therapeutic procedures and has provided a perfect source for IV sedation studies. In gastrointestinal endoscopy sedation is applied safely by endoscopists that are experienced in sedation and analgesics. Especially in the pediatric group, in the presence of cardiac and pulmonary diseases and prolonged duration of the procedure, that the sedation is applied by anesthetists using standard moniterization is most appropriate.

Amaç: Bu çalışmada Abant İzzet Baysal Üniversitesi Düzce Tıp Fakültesi Gastroenteroloji Kliniği’nde Mayıs 1998-Mart 2005 tarihleri arasında yapılan üst gastrointestinal sistem endoskopi tetkiklerinin bulgularını analiz etmeyi amaçladık. Gereç ve Yöntem: Endoskopik incelemeler GIF- XQ30 Olympus marka cihaz ile gerçekleştirildi. Endoskopik bulgular retrospektif olarak değerlendirildi. Bulgular: Değerlendirmeye, 2720’si kadın toplam 5551 hastanın endoskopi incelemesi alındı. Hastalar, 18-90 yaş- ları arasında idi (ortalama 52±16 yıl). Hastaların 694’ünde (%12.5) özofajit, 253’ünde (%4.6) gastrik ülser, 479’unda (%8.6) bulber ülser, 1301’inde (%23.4) safra reflüsü, 101’inde (%1.8) polip ve 129’unda (%2.3) malignite tanısı konduğu saptandı. Sonuç: Özofajitin sık olması gastroözofageal reflü hastalığının toplumdaki yaygınlığını göstermektedir. Serimizde özofagus ve gastrik malign tümör oranı %2.3 idi ve bu durum kuşku uyandıran alarm semptomlarının varlığında endoskopik incelemenin geciktirilmemesi gerektiğini ortaya koymaktadır. Aim: In our study, we aimed to document the macroscopic diagnosis of upper gastrointestinal endoscopic (UGE) examination which were performed from May 1998 to March 2005 in gastroenterology clinic of Duzce medical faculty of A.I.B.U. Materials & Methods: All of examinations were performed using the endoscopic device with trademark Olympus GIF – XQ30. Findings of UGE were evaluated retrospectively. Results: Total 5551 (2720 female, 2831 male) upper gastrointestinal endoscopic examinations were performed in our endoscopy unit. Mean age of the patients was 52 ± 16 (minimum 18 - maximum 90 ) years. We determined 694 (12.5%) patients with esophagitis, 253 (4.6 %) gastric ulcer, 479 (8.6 %) bulber ulcer, 1301 (23.4 %) bile reflux, 101 (1.8%) polypoid lesion and 129 (2.3%) malignant tumor. Conclusion: The high frequency of bile reflux and esophagitis have shown that gatrointestinal reflux disease is important. The rate of gastrointestinal malignant tumor have been determined as 2.3%. It shows the need for an endoscopic examination as soon as possible in case of the presents of these alarm symptoms which arouse suspicion.

Objective: In chronic renal patients undergoing dialysis, calculations of left ventricular diameter and mass may be inordinately large and valve regurgitation may be develop to a high degree as a result of volume overload. In our study, we investigated the effect of ultrafiltration on left ventricular and atrial diameters, as well as on the collapsibility of the inferior vena cava and severity of valvular regurgitation present before dialysis. Material and Methods: A total of 30 patients, 16 male and 14 female, with a diagnosis of end-stage renal disease with hypervolemia and scheduled to undergo ultrafiltration in addition to hemodialysis were included in our study. Before and after ultrafiltration, left ventricular diastolic and systolic diameters, interventricular septum and posterior wall diastolic and systolic thicknesses, left atrial and aortic root diameters, and the severity of pericardial effusion, if present, were noted. Mitral, tricuspid, aortic and pulmonary valve functions were measured and, if regurgitation was present, its severity was staged in 4 categories. Inferior vena cava expiratory and inspiratory diameters were measured and a collapsibility index was calculated. Results: There was a significant decrease in left atrial and ventricular diastolic and systolic diameters after hemodialysis. Although the severity of mitral and tricuspid regurgitation decreased significantly, aortic and pulmonary regurgitation was not affected. A significant decrease in IVC expiratory and inspiratory diameters and an increase in collapsibility were noted. Conclusion: Dialysis causes significant changes in hemodynamic and echocardiographic parameters due to a decrease in intravascular fluid. In particular, a decrease in the presence and severity of valvular regurgitation occurs as a result of this procedure. Copyright © 2005 by Türkiye Klinikleri.

Amaç: Bu çalışmada Abant İzzet Baysal Üniversitesi Düzce Tıp Fakültesi Gastroenteroloji Bilim Dalı Endoskopi ünitesinde Mayıs 1998- Mart 2005 yılları arasında alt gastrointestinal (AGİ) endoskopisi uygulanan hastaların sonuçlarının retrospektif olarak değerlendirilmesi amaçlandı. Gereç ve Yöntem: AGİ sistem yakınmaları ile başvuran 988’i erkek ve 1081’i kadın toplam 2069 hastaya, 197’si fleksibl, 383’ü rijit rektosigmoidoskopi ve 1489 total kolonoskopik tetkik yapıldı. Bulgular: En sık hemoroid (%33.4) saptanırken ülseratif kolit ve kolorektal kanserler sırasıyla %4.7 ve %3.7 sıklıkta saptandı. Sonuç: Literatürdeki diğer seriler ile karşılaştırıldığında ülseratif kolit ve karsinom vakaları belirgin olarak az saptanmış olup bu durumun olasılıkla yöresel epidemiyolojik faktörlere, beslenme alışkanlıklarına bağlı olabileceği düşünüldü. Purpose: We aimed to evaluate retrospectively the low gastrointestinal endoscopy (LGE) performed during may 1998- March 2005 in Department of Gastroenterology, Düzce medical school of Abant Izzet Baysal University. Materials and Methods: The reports of all LGE examinations were included in the study. They were composed of 197 flexible sigmoidoscopy, 383 rigid rectosigmoidoscopy and 1489 total colonoscopies. The gender differentiation of patient population is as 988 male and 1081 female. Results: While the hemorrhoids were being the most frequent abnormality, the colon cancer and ulcerative colitis cases were encountered with a frequency of 3.7% and 4.7% respectively. Conclusion: When compared with other reports in literature on this subject, we regarded that the ulcerative colitis and colon carcinoma were seen less frequency. We thought that these could be a result of different epidemiological factors and diet culture in our region.

Amaç: Diyalize giren kronik böbrek yetersizlikli hastaların vücut sıvısındaki artışa bağlı olarak ekokardiyografi sırasında kalp büyüklüğü ve sol ventrikül kitlesine ait ölçümler olduğundan farklı, kapak yetersizliğiyse olduğundan fazla olarak değerlendirilebilmektedir. Çalışmamızda diyalizle birlikte yapılan ultrafiltrasyonun, sol ventrikül ve sol atriyum büyüklüklerine, vena kava inferior çapları ve kollapsibilitesine etkisi ayrıca diyaliz öncesi kapak yetersizliği saptanan hastaların yetersizlik varlığı ve ciddiyetine olan etkisi incelendi. Gereç ve Yöntemler: Bu çalışmaya son dönem böbrek yetmezliği tanısı konmuş, hipervolemisi olan ve hemodiyalizle birlikte ultrafiltrasyon yapılacak 16’sı erkek, 14’ü kadın toplam 30 hasta alındı. Diyalizle birlikte yapılan ultrafiltrasyon öncesi ve sonrası ekokardiyografi ile sol ventrikül diyastolik-sistolik genişlikleri, septum ve arka duvar diyastolik-sistolik kalınlıkları, sol atriyum genişliği, aort çapı ve varsa perikardiyal sıvı ölçümleri yapıldı. Mitral, aort, triküspid ve pulmoner kapak fonksiyonları, varsa kaçak akımları 4 üzerinden derecelendirildi. Vena kava inferior inspiratuar ve ekspiratuar çapları ölçülüp, vena kava inferior çökebilirlik indeksi hesaplandı. Bulgular: Hemodiyaliz sonrası sol atriyum büyüklüğünde, sol ventrikül diyastolik ve sistolik genişliklerinde anlamlı azalma oldu. Hastaların mitral ve triküspid yetersizliği ciddiyetinde belirgin azalma olurken, aort ve pulmoner yetersizlikleri ciddiyetindeyse belirgin azalma saptanmadı. Vena kava inferior inspiryum ve ekspiryumdaki çaplarında anlamlı küçülme, çökebilirliğinde anlamlı artış saptandı. Sonuç: Diyalizde sıvı azaltılmasına bağlı hemodinamik ve ekokardiyografik parametrelerde anlamlı değişiklikler olmaktadır. Özellikle kapak yetersizliklerinin varlığında ve ciddiyetinde azalma olmaktadır. Objective: In chronic renal patients undergoing dialysis, calculations of left ventricular diameter and mass may be inordinately large and valve regurgitation may be develop to a high degree as a result of volume overload. In our study, we investigated the effect of ultrafiltration on left ventricular and atrial diameters, as well as on the collapsibility of the inferior vena cava and severity of valvular regurgitation present before dialysis. Material and Methods: A total of 30 patients, 16 male and 14 female, with a diagnosis of end-stage renal disease with hypervolemia and scheduled to undergo ultrafiltration in addition to hemodialysis were included in our study. Before and after ultrafiltration, left ventricular diastolic and systolic diameters, interventricular septum and posterior wall diastolic and systolic thicknesses, left atrial and aortic root diameters, and the severity of pericardial effusion, if present, were noted. Mitral, tricuspid, aortic and pulmonary valve functions were measured and, if regurgitation was present, its severity was staged in 4 categories. Inferior vena cava expiratory and inspiratory diameters were measured and a collapsibility index was calculated. Results: There was a significant decrease in left atrial and ventricular diastolic and systolic diameters after hemodialysis. Although the severity of mitral and tricuspid regurgitation decreased significantly, aortic and pulmonary regurgitation was not affected. A significant decrease in IVC expiratory and inspiratory diameters and an increase in collapsibility were noted. Conclusion: Dialysis causes significant changes in hemodynamic and echocardiographic parameters due to a decrease in intravascular fluid. In particular, a decrease in the presence and severity of valvular regurgitation occurs as a result of this procedure.

A 37-year-old man presented with a three-week history of chest pain. Transthoracic echocardiography demonstrated a mitral valve prolapse and mild mitral insufficiency. Coronary angiography showed normal left main, circumflex, left anterior descending and right coronary arteries; however, the right ventricular branch of the right coronary artery had a separate ostium. Concomitant congenital heart abnormalities have been observed with coronary artery anomalies. Primary congenital coronary and valvular anomalies may have genetic heredity. In the present case, mitral valve prolapse was accompanied by a right ventricular coronary artery origin anomaly which, to the best of our knowledge, is the first report in the literature in which both anomalies presented together.

WOS: 000221490800016, PubMed ID: 15090710, Coronary artery aneurysm (CAA) is. a rare disorder, characterized by abnormal dilatation of a localized portion or diffuse segments of the coronary artery. CAA may cause angina, myocardial infarction, sudden death due to thrombosis, embolisation, or rupture. In this report, a 63 year old Turkish male patient is presented who had an acute non-Q wave myocardial infarction due to spontaneous rupture of the left circumflex artery aneurysm. An extremely rare clinical presentation of rupture of a left circumflex CAA is discussed.

In this study we build solutions to three common challenges in the fields of bioinformatics through utilizing statistical methods and developing computational approaches. First, we address a common problem in genome wide association studies, which is linking genotype features within organisms of the same species to their phenotype characteristics. We specifically studied FHA domain genes in Arabidopsis thaliana distributed within Eurasian regions by clustering those plants that share similar genotype characteristics and comparing that to the regions from which they were taken. Second, we also developed a tool for calculating transposable element density within different regions of a genome. The tool is built to utilize the information provided by other transposable element annotation tools and to provide the user with a number of options for calculating the density for various genomic elements such as genes, piRNA and miRNA or for the whole genome. It also provides a detailed calculation of densities for each family and sub-family of the transposable elements. Finally, we address the problem of mapping multi reads in the genome and their effects on gene expression. To accomplish this, we implemented methods to determine the statistical significance of expression values within the genes utilizing both a unique and multi-read weighting scheme. We believe this approach provides a much more accurate measure of gene expression than existing methods such as discarding multi reads completely or assigning them randomly to a set of best assignments, while also providing a better estimation of the proper mapping locations of ambiguous reads. Overall, the solutions we built in these studies provide researchers with tools and approaches that aid in solving some of the common challenges that arise in the analysis of high throughput sequence data.