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The presence of persistent left superior vena cava to the left atrium connection without an innominate vein may give rise to technical challenges during intracardiac repair. In this report, the end-to-side anastomosis technique of the persistent left superior vena cava to the right superior vena cava is discussed in a patient with tetralogy of Fallot associated with persistent left superior vena cava draining directly into the left atrium. A successful end-to-side anastomosis between the persistent left superior vena cava and the right superior vena cava was performed and short-term anastomosis patency was documented via angiography.

Purpose: In this study, we aim to report our early and midterm results of endovascular replacement of abdominal aortic aneurysms with Anaconda stent graft. Material and Methods: Between January 2014 and June 2016, a total number of 32 patients who underwent endovascular aortic replacement (EVAR) with Anaconda stent graft electively or emergently were retrospectively analysed. Twenty-nine patients undergoing elective, 2 patients were processed as urgent. Average follow-up was 16.3 months (range, 1-28 months). Mortality, morbidity, survival rates, mean duration of operation, mean length of intensive care unit and hospital stays, the type and incidence of endoleaks, contrast nephropathy rates, the impact on leakage of the aortic diameter, complication rates and secondary intervention rates were recorded. Results: Early term hospital follow-up no mortality was observed, mortality was observed in one patient due to myocardial infarction one and a half months later. A leg thrombosis of stent occurred in two patients. Embolectomy was performed for one patient, ilio-ileal bypass applied for the other patients. Short-term results in terms of patient satisfaction with endovascular repair of aortic stent grafts anaconda and shows that good in terms of results. Conclusion: Endovascular aortic replacement (EVAR) can be selected as a treatment option in abdominal aortic aneurysm patients with co-morbidities and high mortality risk. We have received successful results in early and midterm results in our patients with abdominal aortic aneurysm endovascular treatment with Anaconda stent graft. [Cukurova Med J 2016; 41(4.000): 754-761]

Küçük ve Orta Büyüklükteki İşletmeler (KOBİ) ekonomik canlanma, teknolojik gelişmelere ayak uydurma ve yeni istihdam alanları oluşturma konusundaki katkıları sebebiyle tüm ülke ekonomileri için önemli bir yere sahiptir. KOBİ'lerin faaliyetlerini sağlıklı bir şekilde sürdürebilmeleri, bilgiyi üretme ve etkili bir şekilde kullanabilmeleriyle mümkün olmaktadır. Küreselleşen dünyada işletmelerin yoğun rekabet ortamında ayakta kalmaları zorlaşmış, bu da bilgiye ulaşma ihtiyacını artırmıştır. İhtiyaç duyulan bu bilgilerin birçoğu muhasebe bilgi sistemi tarafından üretilmekte ve raporlar halinde karar alıcılara sunulmaktadır. Muhasebe bilgi sistemi tarafından üretilen bilginin kalitesi işletmelerin daha sağlıklı kararlar alması açısından önem teşkil etmektedir. Ülkelerin kalkınmasında büyük öneme sahip olan KOBİ'lerin daha etkili ve verimli kararlar almaları için muhasebe bilgi sistemi tarafından üretilen bilgileri stratejik olarak kullanabilmeleri gerekmektedir. Bu çalışma Sivas Organize Sanayi Bölgesinde 2018 yılında faaliyet gösteren KOBİ'leri kapsamaktadır. Araştırma verilerinin elde edilmesi anket formu aracılığıyla gerçekleştirilmiş olup, 81 KOBİ'ye uygulanmıştır. Elde edilen verilerin analiz edilmesinde SPSS 23 paket programı kullanılmıştır. Çalışma ile muhasebe bilgi sisteminin etkinliği ölçülmeye ve karar alma sürecinde kullanım düzeyi tespit edilmeye çalışılmıştır. Bununla birlikte muhasebe bilgi sistemi tarafından üretilen bilgilerin karar alma sürecindeki önemi vurgulanmaya çalışılmıştır. Araştırma sonuçlarına göre muhasebe bilgi sisteminin KOBİ'lerde etkin bir şekilde çalıştığı ve işletmelerin karar alma süreçlerinde ihtiyaç duydukları kaliteli bilgileri ürettiği görülmüştür. KOBİ yöneticilerinin üretim, pazarlama, satın alma, insan kaynakları, yatırım, finans gibi birçok alanda verecekleri kararlarda, genellikle bu bilgilerden yararlandıkları tespit edilmiştir. Ayrıca KOBİ'ler, muhasebe işlemlerini sadece vergisel yükümlülüklerin yerine getirilmesi için bir unsur olarak görmeyip aynı zamanda işletmenin mali durumuyla ilgili her türlü bilgiye ulaşmak için bir araç olarak görmektedirler. Bu anlamda KOBİ'ler, muhasebe bilgilerinin önemini kavradıklarını ve faaliyetlerini devam ettirebilmeleri için gerekli olduğunu düşünmektedirler. Small and medium-sized enterprises (SMEs) occupy an important place in the economy of all countries due to their economic revival, adaptation to technological development and new areas of employment. SMEs can continue their activities in a healthy way, receive information and use it effectively. In a globalized world, enterprises find it increasingly difficult to survive in an intense competitive environment, which increases the need for access to information. Most of this information is produced by the accounting information system and is presented to decision makers in reports. The quality of the information produced by the accounting information system is important for companies to make healthier decisions. SMEs that are important for the development of countries should be able to strategically use the information generated by the accounting information system to make more efficient and effective decisions. This study covers SMEs operating in 2018 in the Organized Industrial Zone Sivas. Research data was obtained using a questionnaire and applied to 81 SMEs. For the data analysis, the SPSS 23 batch program was used.The effectiveness of the accounting information system was measured by the study, and tried to determine the level of use in the decision-making process. However, the importance of the information produced by the accounting information system in the decision-making process was emphasized. According to the results of the research, it is clear that the information accounting system works effectively for SMEs, and enterprises produce high-quality information that they need in decision-making processes. It was found that SME managers typically use this information in their decisions in many areas, such as manufacturing, marketing, procurement, human resources, investment and finance.In addition, SMEs consider accounting operations not only as an element to fulfill tax obligations, but also as a means to obtain any information related to the financial situation of an enterprise. In this sense, SMEs believe that they understand the importance of accounting information and are obliged to continue their activities. 147

Background: Cardiopulmonary bypass is known to cause inflammatory events. Inflammation occurs due to many known important biological processes. Numerous mechanisms are known to be responsible for the development of inflammatory processes. Currently, there are many defined mediators as a tumor necrosis factor-α (TNF-α) playing an active role in this process. Aims: This research was to investigate the effects of preoperative steroid use on inflammatory mediator TNF-α and on time to extubation postoperatively in ventricular septal defect patients undergoing cardiopulmonary bypass surgery. Study Design: Controlled clinical study. Methods: This study included 30 patients. These patients were assigned into two groups, each containing 15 patients. 5 micrograms/kg methylprednisolone was injected intravenously 2 hours before the surgery to Group I, whereas there was no application to the patients in Group II. TNF-α (pg/mL) level was measured in arterial blood samples obtained at four periods including: the preoperative period (Pre TNF); at the 5th minute of cross-clamping (Per TNF); 2 hours after termination of cardiopulmonary bypass (Post TNF); and at the postoperative 24th hours in cardiovascular surgery intensive care unit (Post 24 h TNF). Results: The mean cross-clamp time was 66±40 and 55±27 minutes in Group I and Group II respectively. No significant difference was found between the groups in terms of cross-clamp time (p>0.05). The mean time to extubation was 6.1±2.3 hours in Group I and 10.6±3.4 hours in Group II. Group I extubation time was significantly shorter than Group II. Group I TNF-α levels at Post TNF and Post24h TNF was lower than Group II. These differences are also statistically significant (p

Amaç: Bu makalenin amacı tek merkezde arteriyel switch ameliyatı yapılan hastaların hastane mortalitesinin ve reoperasyon ihtiyacının nedelerini araştırdık. Büyük arter transpozisyonu ve Taussing bing anomalisi nedenisle arteriyel switch ameliyatı yapılan hastaların erken ve orta dönem sonuclarını ve 7 yıllık deneyimimizi değerlendirdik.Gereç ve Yöntem: Ocak 2009 ile Mayıs 2016 tarihleri arasında, Büyük arter transpozisyonu (TGA) ve Taussing Bing anomalisinde Arteriyel switch operasyonu (ASO) uygulanan 34 hasta bu retrospektif çalışmaya dahil edildi. Hastaların ameliyatları aynı cerrahlar tarafından yapıldı. Hasta bilgileri, cerrahi raporları ve ekokardiyografi raporları retrospektif olarak değerlendirildi. Medyan izlem süresi 1-7 yıl, 42.2 ay idi. Bulgular: Hastanede 2 (%5.9) ölüm olmuştur. Geç ölüm yaşayan 31 hastanın 1'inde (%2.9) meydana geldi. Bir hastaya (%2.9) yeniden girişim gerekti. Yeniden girişim gerektirmeme oranı 7 yılda %97 oldu. İki hastada (%5.9) takipte orta derecede neo-aortik yetmezlik görüldü ve bir hasta neo-pulmoner arter stenozu nedeniyle tekrar ameliyat edildi. Analizler gösterdi ki, kilo, kros-klemp zamanı, kardiyopulmoner by pass zamanı ve operasyondaki hastanın yaşı mortalitede güçlü faktörlerdir.Sonuç: Arteriyel switch operasyonları TGA'nın farklı formlarında kabul edilebilir erken ve orta dönem sonuçlarıyla uygulan bir tedavi prosedürüdür. Arteriyel switch operasyonu küçük hacimli merkezlerde dahi düşük mortalite riski ve tatminkar orta dönem sonuçlar ile uygulanabilmektedir Purpose: The aim of this paper was to describe the outcomes in patients submitted to arterial switch operation and to analyze the predictors of in-hospital mortality and further need of re-operation at a single-center institution. We reviewed our 7-year experience with arterial switch operation (ASO) for transposition of the great arteries (TGA) or Taussig-Bing anomaly (TBA) to assess the early and mid-term outcomes. Material and Methods: Between January 2009 and May 2016, 34 consecutive patients who underwent ASO for TGA with IVS (intact ventricular septum), TGA with VSD (ventricular septal defect) and Taussing bing anomaly were included in this retrospective study. The patients performed by same surgeons .Patients charts, surgical reports and echocardiograms were retrospectively reviewed. Median follow-up time was ranged from 1 to 7 years, 42.2 months. Results: There were 2 (5.9 %) in-hospital deaths. Late deaths occurred in 1 ( 2.9 %) of 31 survivors. One patient (2.9 %) required reintervention. The freedom from reintervention rate was 97.0 % at 7 years respectively. Two patients (5.9 %) had developed moderate neo-aortic regurgitation during the follow-up and one patient underwent reoperation mainly for neo-pulmonary artery stenosis. The analysis showed that weight, cross clamp (CC) time, cardiopulmonary bypass (CPB) time, age of operation are the strong predictors for mortality. Conclusion: ASO is a procedure performed for the treatment of various forms of TGA with acceptable early and midterm outcomes.ASO also can be performed with a low risk of early mortality and satisfactory mid-term outcomes even in a small volume center

WOS: 000326410100004 Background: This study aims to investigate the effects of controlled reoxygenation cardiopulmonary bypass on oxidative stress in children undergoing repair of cyanotic congenital heart defect. Methods: Thirty cyanotic children (mean age 24.2 +/- 17.4 month; range 6 month to 5 years) who underwent surgery using cardiopulmonary bypass for congenital heart defect (Tetralogy of Fallot) were included. The patients were randomly allocated into two groups as normoxic (PaO2: 80-150 mmHg) and hyperoxic (PaO2: 150-250 mmHg) cardiopulmonary bypass. Blood samples for serum malondialdehyde levels, glutathione peroxidase and glutathione reductase response to cardiopulmonary bypass were collected after induction of anesthesia, and at 30 minutes after placement of aortic cross clamp, and 10 minutes and 12 hours after removal of the aortic cross clamp. Results: Hyperoxic cardiopulmonary bypass in the group, serum malondialdehyde and antioxidant enzyme levels were found to be high, at 30 minutes after placement of aortic cross clamp, 10 minutes after removal of:the aortic cross clamp, indicating a statistical significance. Conclusion: High level of partial oxygen pressure which is routinely used in cardiopulmonary bypass leads to increased oxyradical damage in cyanotic children. Controlled reoxygenation strategy should be implemented to prevent or minimize this undesired condition.

WOS: 000321798900010 Background: In this study, we compared the short- and mid-term clinical and transthoracic echocardiographic results of bovine pericardial and Dacron patch materials used in repair of intracardiac defects. Methods: We compared the short (30 days postoperatively) and mid-term (up to 24 months postoperatively) results of 498 patients with intracardiac defect who underwent surgical correction using Dacron patch (group 1) between March 1993 and December 2003 with 533 patients who received a bovine pericardial patch (group 2) between January 2004 and April 2010. Results: The short- and mid-term postoperative echocardiographic studies showed no evidence of calcification, thrombus, aneurysmal dilatation around the patch in either group. Vegetation-endocarditis developed in three patients in group 1 and two patients in group 2. Residual ventricular septal defect developed in 15 patients in group 1 and in 14 patients in group 2. The incidence of these complications was not statistically significant between the groups. Conclusion: Our study results suggest that bovine pericardial patch is more appropriate in repair of simple and complex intracardiac defects thanks to its elasticity and easy-to-use nature, compared to Dacron patch.