Thymectomy with videothoracoscopic surgery demonstrated a more comfortable and faster recovery period without deterioration in myasthenic status.

Background: The purpose of the present study was to determine how long superior screws alone or in combination with posterior placement of metaglene screws protruding and penetrating into the scapular spine in reverse total shoulder arthroplasty affect the strength of the scapular spine in a fresh cadaveric scapular model.Methods: Seven fresh cadaver scapulas were allocated to the control group (short posterior and superior screws) and seven scapulas to the study group (spine base fixation with a 4-inch-long superior screw, three with both long superior and long posterior screws).Results: The failure load was lower in the spine fixation group (long screw [869 N] vs. short screw [1,123 N]); however, this difference did not reach statistical significance (p>0.05). All outside-in long superior or superior plus posterior screws failed due to scapular spine base fracture; failures in the short screw group were due to acromion fracture. An additional posterior outside-in screw failed to significantly decrease the failure load of the acromion spine.Conclusions: The present study highlights the significance of preventing a cortical breach or an outside-in configuration when a superior or posterior screw is inserted into the scapular spine base.

The patients with pathological stage 3 disease, with large cell histology or who had undergone pneumonectomy have a higher risk of mortality within 1 year. These patients require detailed preoperative work up in terms of metastatic disease and cardiopulmonary physiological status.

Bu araştırmada, Türkiye'de gelişen insan kaynakları yönetimi literatürü, özellikle 1923'lerden itibaren alanda ortaya çıkan değişimlerle etkileşimi bağlamında incelenmektedir. Çalışma öncelikle insan kaynakları yönetiminin ABD kökenli gelişim çizgisi tanıtılmakta daha sonra da söz konusu disiplinin Türkiye'de izlediği sürece yer verilmektedir. Çalışma özellikle Amme İdaresi Dergisinde yayınlanan makalelerden yararlanarak, Türkiye'de bu konudaki çalışmaları özetleyerek Türkçe alan yazınına katkıda bulunma amacı taşımaktadır.

This prospective study was done between February 2001 and December 2002 on 84 non-small cell lung cancer patients who were apparently operable. We selectively performed mediastinoscopy to 46 patients (54.76%, group 1) with the following indications: clinical T4 tumor, high operative risk, radiologically enlarged mediastinal lymph nodes, clinical T3 tumors with central location, radiologically identified mediastinal lymph nodes of any size with adeno or large cell carcinoma histology. Other 38 patients (45.23%, group 2) underwent thoracotomy without mediastinoscopy. Sensitivity, specificity, negative predictive value and positive predictive value of the indications were calculated. Cost analysis was done in the 84 patients and the results were compared with alternative mediastinal staging strategies (vs. routine, and vs. selectively to patients with radiologically positive mediastinal lymph nodes) if they had been applied to our population. Group 1 had higher selectivity to differentiate N2 patients (p=0.02). Sensitivity, specificity, negative predictive value and positive predictive value of indications were calculated as: 0.85, 0.54, 0.92 and 0.36, respectively. Our approach was most economical in terms of total cost per patient and money spent unnecessarily per patient. Mediastinal evaluation in operable lung cancer patients should decrease the number of surgical procedures, N2 disease found at thoracotomy and cost.