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    An analysis of clinical features of pulmonary giant hydatid cyst in adult population
    (Excerpta Medica Inc-Elsevier Science Inc, 2009) Koçer, Bülent; Gülbahar, Gültekin; Han, Serdar; Durukan, Elif; Dural, Koray; Sakıncı, Ünal
    BACKGROUND: We performed an analysis of giant hydatid cysts (GCHs) detected in the adult Population by comparison with the features of other simple hydatid cysts (CHs) in the light of the relevant literature. METHODS: The records of 74 adult patients who were operated on in our clinic for pulmonary CHs between 2001 and 2005 were retrospectively evaluated. Cysts that were 10 cm or larger in diameter on any plane were considered GCHs. The cysts were classified into 2 groups as GCHs (group A) and other (group 13). The groups were then compared for age, sex, symptom, cyst location, preoperative complications, Surgical procedure performed, operative morbidity, and mortality. RESULTS: Of 74 patients, 10 (13.5%) were in group A and 64 were in group B. No differences were detected between the clinical presentation, gender distribution, surgical procedure performed, and postoperative morbidity and mortality rates of GCHs and other cysts in adults. In both groups, there were no significant differences between the rates of involvement of 2 lungs (P = .527). However, both groups had lower lobe involvement, more markedly in group A (81.8% and 45.5% respectively; P = .023). Two patients in group A (20%) and 19 patients in group B (28.1%) had complicated cysts. CONCLUSIONS: The tendency of GCH to involve the lower lobe of the lung compared to smaller cysts suggests underlying mechanisms other than lung elasticity in the late onset of the symptoms parallel to cyst growth. (C) 2009 Elsevier Inc, All rights reserved.
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    Ankara Numune Hastanesi acil servisi’ne 2002-2004 yılları arasında başvuran kesici-delici alet yaralarının retrospektif değerlendirilmesi
    (2006) Tümer, Ali Rıza; Koçer, Bülent; Han, Serdar; Dural, Koray
    Yakın zamanlarda, saldırgan eğilimler ve şiddet gittikçe daha sık görülmekte, sorun çözme yöntemi olarak karşılıklı konuşma ve diyalogun yerini, ateşli silah ve bıçağa dayalı şiddet almaktadır. Sonuçta, özellikle acil servislerde çalışan hekimlerin sıklıkla aeşli silahlar ve bıçak gibi kesici ve delici alet yaraları ile karşılaştıkları bilinmektedir. Bu çalışmamızda Ankara Numune Hastanesi Acil Servisi'ne 2002 - 2004 yılları arasında yaralanma yakınması ile başvuran adli olgular, geriye dönük olarak incelenmiş, bu süre içinde 3055 olgunun adli olarak değerlendirildiği, bunların içinden 829 olguda şiddete bağlı insizyon yarası bulunduğu saptanmıştır. Olguların yaralanma biçimleri, cinsiyeti, yaşı, alkollü olup olmadığı, yara sayısı, yaranın şiddeti ve tedavisi, yaralanan lezyon bölgesi ve lezyon bölgelerine göre tedavi yaklaşımları araştırılmıştır. Bıçakların yasal boşluktan yararlanarak artan bir eğilimle yaralamalarda kullanılmasına dikkat çekilmek istenmiştir.
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    Elastofibroma dorsi management and outcomes: review of 16 cases
    (Oxford Univ Press, 2014) Karakurt, Ozgur; Kaplan, Tevfik; Gunal, Nesimi; Gulbahar, Gultekin; Kocer, Bulent; Han, Serdar; Sakinci, Unal
    Elastofibroma dorsi (ED) is a rare, benign lesion arising from connective tissue, usually found at the inferior pole of the scapula. To date, only a few small series have been reported in the English literature and there are few data about the long-term outcomes after surgery. Our goal is to contribute a better understanding of this tumour and to determine the long-term outcomes after surgery. Sixteen patients with a diagnosis of ED were identified from the unit's database. The clinical presentation, diagnosis, pathological evidences and long-term outcomes were evaluated. There were 11 females and 5 males with a mean age of 61.1 years (range 38-78 years). The tumour was located on the right in 5 (31.2%) patients, on the left in 6 (37.5%) patients and bilaterally in 5 (31.2%). Six patients had painful scapular swelling resulting in restriction of movement of the shoulder whereas 10 reported only painful scapular mass. All 16 patients underwent complete resections. The tumour size ranged from 3 to 15 cm. The mean hospital stay was 3.1 +/- 1.4 days with a morbidity of 18.75% (seroma observed in 3 patients). The mean follow-up was 58.4 +/- 29.5 months (range 11-92 months). In 2 patients (12.5%) a new occurrence on the contralateral side was observed at the follow-up. Elastofibroma dorsi is a rare, ill-defined, pseudotumoural lesion of the soft tissues. Surgical treatment can be proposed if the lesion is symptomatic. Furthermore, at the follow-up, the possibility of new occurrences on the contralateral side should be kept in mind.
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    Long thoracic nerve injury: Report of two cases
    (2006) Bodur, Hatice; Eser, Filiz; Akbulut, Lale; Han, Serdar; Atan, Çiğdem
    Scapular winging is lateralization of the medial border of scapula from the posterior chest wall. The main causes of winging are serratus anterior, rhomboid and trapezius muscle paralyses. The most dramatic one is serratus anterior paralysis due to long toracic nerve injury. Herein, we present two cases with long thoracic nerve injury, discuss the diagnosis and differential diagnosis of scapular winging.
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    Management of gastrostomy to prevent perforation in acute severe corrosive esophagitis and gastritis: An experimental study
    (Aves, 2011) Han, Serdar; Han, Unsal; Atinkaya, Cansel; Osmanoglu, Gokhan; Cavusoglu, Tarik; Dikmen, Erkan
    Background/aims: Symptomatic treatment is still the most commonly preferred treatment modality for acute severe esophagitis and gastritis. Clinical results of this treatment range from pathologies like stricture formation to loss of life. In our study, we aimed to demonstrate the effect of immediate gastrostomy in preventing perforation due to corrosive trauma. Methods: We used 32 rats in two study groups. In Group I (n: 16 rats), 1 ml of corrosive agent (10% NaOH solution) was administered and immediate gastrostomies were performed within 2 hours. In Group II (n: 16 rats), 1 ml corrosive agent (10% NaOH solution) was administered and the rats were treated symptomatically; no operation was performed. Results: Acute death was observed in 5 rats just after the corrosive agent was administered at the beginning of the study. Three rats from Group II died due to esophageal and gastric perforation within one week (25%). Necrosis was reported in 5 non-gastrostomized rats; however, no necrosis was observed in the gastrostomized group (p=0.037). Conclusions: Severe acute corrosive esophagitis and gastritis may be fatal. Furthermore, survivors may suffer from lifelong associated problems. From this study, we concluded that immediate gastrostomy in acute corrosive esophagitis and gastritis may play an important role in preventing necrosis and perforation risk.
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    Painful Chest Wall Swellings: Tietze Syndrome or Chest Wall Tumor?
    (Georg Thieme Verlag Kg, 2016) Kaplan, Tevfik; Gunal, Nesimi; Gulbahar, Gultekin; Kocer, Bulent; Han, Serdar; Eryazgan, Mehmet Ali; Sakinci, Unal
    Background Tietze syndrome (TS) is an inflammatory condition characterized by chest pain and swelling of costochondral junction. Primary chest wall tumors may mimic TS. In this article, we report our experience of approximately 121 patients initially diagnosed as TS and determined chest wall tumor in some cases at the follow-up. Methods This is a retrospective review of patients diagnosed as TS by clinical examination, chest X-ray, electrocardiogram, routine laboratory tests, and computed tomography (CT) of chest: all treated and followed up between March 2001 and July 2012. There were 121 cases (41 males and 80 females; mean age, 39.6 +/- 3.2 years) of TS. Results In 27 patients with initial normal radiological findings, the size of swellings had doubled during the follow-up period (mean, 8.51 +/- 2.15 months). These patients were reevaluated with chest CT and bone scintigraphy and then early diagnostic biopsy was performed. Pathologic examination revealed primary chest wall tumor in 13 patients (5 malignant, 8 benign). CT had a sensitivity of 92.3% and a specificity of 64.2% in detection of tumors (kappa: 0.56, p = 0.002), whereas the sensitivity and the specificity of bone scan were 84.6 and 35.7%, respectively (kappa: 0.199, p = 0.385). Conclusion Primary chest wall tumors could mimic TS. Bone scintigraphy or CT is not specific enough to determine malignant and other benign disorders of costochondral junction. Therefore, clinicians should follow TS patients more closely, and in case of increasing size of swelling, early diagnostic biopsy should be considered.
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    Quantative computerized tomography assessment of lung density as a predictor of postoperative pulmonary morbidity in patients with lung cancer
    (Ame Publ Co, 2015) Kaplan, Tevfik; Atac, Gokce Kaan; Gunal, Nesimi; Kocer, Bulent; Alhan, Aslihan; Cubuk, Sezai; Han, Serdar
    Background: The aim of this study was to evaluate the pulmonary reserve of the patients via preoperative quantitative computerized tomography (CT) and to determine if these preoperative quantitative measurements could predict the postoperative pulmonary morbidity. Methods: Fifty patients with lung cancer who underwent lobectomy/segmentectomy were included in the study. Preoperative quantitative CT scans and pulmonary function tests data were evaluated retrospectively. We compare these measurements with postoperative morbidity. Results: There were 32 males and 18 females with a mean age of 54.4 +/- 13.9 years. Mean total density was -790.6 +/- 73.4 HU. The volume of emphysematous lung was (<-900 HU) 885.2 +/- 1,378.4 cm(3). Forced expiratory volume in one second (FEV1) (r=-0.494, P=0.02) and diffusion capacity of carbon monoxide (DLCO) (r=-0.643, P<0.001) were found to be correlate with the volume of emphysematous lung. Furthermore FEV1 (r=0.59, P<0.001) and DLCO (r=0.48, P<0.001) were also found to be correlate with mean lung density. Postoperative pulmonary morbidity was significantly higher in patients with lower lung density (P<0.001), larger volume of emphysema (P<0.001) and lower DLCO (P=0.039). A cut-off point of -787.5 HU for lung density showed 86.96% sensitivity and 81.48% specificity for predicting the pulmonary morbidity (kappa =-0.68, P<0.001). Additionally a cut-off point of 5.41% for emphysematous volume showed 84.00% sensitivity and 80.00% specificity for predicting the pulmonary morbidity (kappa = 0.64, P<0.001). According to logistic regression analyses emphysematous volume > 5.41% (P=0.014) and lung density <-787.5 HU (P=0.009) were independent prognostic factors associated with postoperative pulmonary morbidity. Conclusions: In this study, the patients with a lower lung density than -787.5 HU and a higher volume of emphysema than 5.41% were found to be at increased risk for developing postoperative pulmonary morbidity. More stringent precautions should be taken in those patients that were found to be at high risk to avoid pulmonary complications.