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Öğe 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, ÜnalBACKGROUND: 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.Öğe Analysis of pulmonary hydatidosis according to their segmentary locations(2008) Koçer, Bülent; Gülbahar, Gültekin; Han, Serdar; İlhan, Mustafa Necmi; Dural, Koray; Sakinci, ÜnalThe objective of this analysis is to compare the pulmonary locations of lung hydatid cysts and their size with respect to their locations with available literature. The records of 82 patients who were operated for pulmonary hydatid cysts between January 2001 and December 2005 were retrospectively evaluated. One hundred eleven cysts detected in 82 patients were placed into 2 groups as those located in the right lung (group A, 55 cysts) and those located in the left lung (group B, 56 cysts), and the segments involved were investigated. The gender distribution of the patients was 40 male and 42 female, with a mean age of 35.2 ± 17.64 years (range: 7-82 years). No difference was detected with respect to involvement between the 2 lungs (P = 0.285). The most commonly involved segment was the posterior basal segment of the lower lobe with 15 cysts (27.3%) from group A and 20 cysts (35.7%) from group B. No involvement of the lower lobe medial basal and anteromedial basal segments was observed. The most common surgical procedures applied were cystotomy and capitonnage. The findings of the study showed that pulmonary hydatidosis were located in some segments of the lungs more frequently, primarily in the posterior segment of the lower lobe and the apicoposterior segment of the upper lobe. In addition, the higher prevalence of giant cysts in the lower lobe and their ability to produce symptoms only after being enlarged suggest a role of mechanisms other than elasticity of the lungs. © 2008 Lippincott Williams & Wilkins, Inc.Öğe 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, KorayYakın 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.Öğe Approaches for problem diagnosis via statistical process control charts(2004) Koçer, Bülent; Birgören, Burakİstatistiksel proses kontrol çizelgeleri, süreci etkileyen özel nedenlerin varlığına işaret eden kontrol-dışı sinyalleri saptamayı amaçlar. Böyle bir sinyal saptandığında bunun yorumlanması, diğer bir deyişle sinyale yol açan gerçek nedenlerin ortaya çıkarılması operatör ya da mühendislerin görevidir. Son zamanlarda bu yorumlama işlemini kolaylaştıracak bazı teknikler geliştirilmiştir. Çalışma, bu teknikleri üç ana başlık altında incelemektedir: geleneksel tek değişkenli kontrol çizelgeleri, yapay sinir ağı uygulamaları ve çok değişkenli kontrol çizelgeleri.Öğe Comparison of the postoperative first and fifth year outcomes in patients who had undergone thymectomy for Myastenia Gravis(2015) Dural, Koray; Günal, Nesimi; Koçer, Bülent; Gülbahar, Gültekin; Koçer, BilgeAmaç: Myastenia gravis hastalarının tedavisinde timektominin etkinliği tartışmalıdır. Bu çalışmada myastenia graviste uzun dönem takip sonuçlarına göre timektomi etkinliğinin araştırılması amaçlandı.Gereç ve Yöntemler: Ocak 1995 ile Ocak 2004 arasında myastenia gravis nedeniyle sternotomi ve ekstended timektomi uygulanan 27 hastanın birinci ve beşinci yıllardaki klinik sonuçları istatistiksel olarak karşılaştırıldı.Bulgular: Hastaların postoperatif birinci ve beşinci yıllardaki klinik sonuçları arasında istatistiksel fark saptanmadı.Sonuçlar: Uzun dönem sonuçlarının iyi olması nedeniyle timektomi myastenia gravis tedavisinde güvenilir bir yöntemdir. Timektomi sonrası birinci ve beşinci yıllar sonunda elde edilen sonuçlar arasında farklılık yokturÖğe Long-term survival after R0 resection of thymoma(SAGE Publications Inc., 2018) Koçer, Bülent; Kaplan, Tevfik; Günal, Nesimi; Koçer, Bilge Gönenli; Akkaş, Yücel; Yazkan, Rasih; Han, SerdarBackground: The aim of this study was to evaluate the results of R0 resection of thymoma to identify prognostic factors for long-term outcomes. Methods: Data of 62 patients (28 male, 34 female) with a mean age of 47.26 ± 14.42 years, who underwent R0 resection for thymoma and were followed-up between February 2004 and March 2016, were analyzed retrospectively. Results: Eight patients had a video-assisted thoracoscopic thymectomy and 54 had a transsternal extended thymectomy. During a mean follow-up of 128.67 ± 7.95 months, regional recurrence of thymoma was observed in 9 (14.5%) patients. Overall 5- and 10-year survival rates were 85.36% and 78.20%, respectively. The 5- and 10-year survival rates in patients aged < 50 years were significantly better than in those aged ? 50 years (92% and 72% vs. 88% and 39%, p < 0.0001). The 10-year overall survival of patients in Masaoka stage I and II was better than those in stage III (88.9%, 78.4%, 69.8%, respectively, log-rank p < 0.001). The 10-year survival of patients with World Health Organization histological type A, AB, and B1 thymomas was better than those with type B2 and B3 (log-rank test p < 0.001). In multivariate analysis, age < 50 years (p = 0.001), Masaoka stage (p = 0.006), histological type (p = 0.001), and recurrence (p = 0.04) were independent prognostic factors for survival. Conclusion: Our study indicates that age < 50 years, Masaoka stage, histological type, and recurrence are the determinants of survival in surgically resected cases of thymoma. © The Author(s) 2018.Öğe Meteorological Conditions Related to the Onset of Spontaneous Pneumothorax(Tohoku Univ Medical Press, 2009) Özpolat, Berkant; Gözübüyük, Alper; Koçer, Bülent; Yazkan, Rasih; Dural, Koray; Genç, OnurSpontaneous pneumothorax is defined as the rupture of bleb or emphysematous bullae that develop just beneath the pulmonary pleura. Weather changes may influence the incidence of spontaneous pneumothorax. The aim of this study was to examine the influence of rainfall, temperature and atmospheric pressure changes on the onset of spontaneous pneumothorax. The study involved 669 spontaneous pneumothorax admissions to three reference hospitals in Ankara, Turkey between 1996 and 2006 (612 males and 57 females with the mean age of 34.0 +/- 15.5 years). The meteorological data were obtained from Turkish State Meteorological Services for temperature, atmospheric pressure, and rainfall. The correlation between these values and spontaneous pneumothorax clusters, which was defined as the admission of at least two patients with pneumothorax within three days of each other, was evaluated. Among 669 episodes of spontaneous pneumothorax, 472 (70.5%) occurred in 188 clusters. When compared to days without spontaneous pneumothorax, the amount of average rainfall on the day of admission with spontaneous pneumothorax, one day before and two days before the admission was significantly high. Similarly, the atmospheric pressure on one day and two days before the admission of spontaneous pneumothorax patients was significantly low. In addition, maximum temperature level was significantly lower on admission day of spontaneous pneumothorax patients compared to those on the days without spontaneous pneumothorax. This largest series of the literature shows that spontaneous pneumothorax occurs in clusters and suggests that rainfall, temperature and falls in atmospheric pressure might play a role in the pathophysiology of spontaneous pneumothorax.
