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  • Küçük Resim
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    Current radiological techniques used to evaluate unilateral partial ureteral obstruction: An experimental rabbit study
    (Springer, 2015) Yazıcı, Mehmet; Çelebi, Süleyman; Kuzdan, Özgür; Koçan, Hüseyin; Ayyıldız, Halil Suat; Bayrak, İlkay Koray; Bilgici, Meltem Ceyhan; Yapıcı, Oktay; Kefeli, Mehmet; Arıtürk, Ender
    The aim of this study was to evaluate functional and prognostic benefits of Doppler ultrasonography (DU), diuretic renal scintigraphy (DRS), and magnetic resonance urography (MRU) during diagnosis and follow-up of ureteropelvic junction obstruction (UPJO) and to examine apoptosis rates caused by UPJO in an experimental rabbit model. Twenty-four rabbits were divided randomly into two groups. The left kidneys of 15 rabbits from the first group underwent Ulm-Miller surgery to create UPJO, whereas the left kidneys of nine rabbits from the second group underwent sham surgery. A pressure flow study (Whitaker's test) was done during postoperative week 6. Based on the Whitaker test, the DU, DRS, and MRU findings were compared. The number of apoptotic renal cells was counted after death. The Whitaker test run during postoperative week 6 revealed obstructions in 15 rabbits from group 1; the nine rabbits of the sham group had no obstructions. Sensitivity and specificity of DRS were 93.3 and 88.8 %, respectively, and those of MRU were 93.3 and 88.8 %, respectively. The postoperative mean RI values were significantly higher than the preoperative values, associated with sensitivity of 86.6 % and specificity of 77.5 % for detecting UPJO. DRS, MRU, and RI could not predict UPJO in one (8 %), one (8 %), and two (16 %) kidneys, respectively. Likelihood ratio (LR) was 8.4 for MRU and scintigraphy, while for RI, LR was 3.9. Pathology specimens revealed that all kidneys with UPJO underwent apoptosis, and the number of apoptotic cells was significantly higher on the UPJO-created side than on the contralateral and in the sham group (p < 0.05). No test predicted all apoptosis related to UPJO. The RI, DRS, and DMRU results correlated with the pressure flow results for detecting UPJO. No single radiological technique predicted all initial UPJO-created kidneys that concluded with apoptosis. Further studies are required to seek with better methods for diagnosing an obstruction or to define a combination of radiological techniques aiding in the management decision.
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    What does the data of 354,725 patients from Turkey tell us about cervical smear epithelial cell abnormalities? - The epithelial cell abnormality rate is increasing - Quality control studies and corrective activity are musts
    (DeGruyter Open Ltd, 2017) Çetinaslan Türkmen, İlknur; Usubütün, Alp; Çakır, Aslı; Aydın, Özlem; Aka Bolat, Filiz; Akbulut, Metin; Altınay, Serdar; Arıcı, sema; Aslan, Figen; Astarcı, Müzeyyen; Kılıç Bağır, Emine; Baş, Yılmaz; Başsüllü, Nuray; Çelik, Betül; Çetiner, Handan; Çobanoğlu, Bengü; Aydın, Abdullah; Demir, Hale; Tatlı Doğan, Hayriye; Eken, Kamile Gülçin; Şengiz Erhan, Selma; Erdoğan, Gülgün; Eren Erdoğan, Kıvılcım; Eren, Funda; Ersöz, Şafak; Fırat, Pınar; Gürses, İclal; Haberal, Nihan; Solakoğlu Kahraman, Dudu; Harman Kemali, Gülçin; Yuyucu Karabulut, Yasemin; Kefeli, Mehmet; Koyuncuoğlu, Meral; Köseoğlu, R. Doğan; Müezzinoğlu, Bahar; Önal, Binnur; Önder, Sevgen; Özcan, Zuhal; Kımıloğlu, Elife; Özer, Hatice; Sönmez, F. Cavide; Şahin, Sevinç; Şahin, Nurhan; Yalta, Tülin
    Objective: There is no other screening program close to the success rate of PAP test. Cervical cytology constitutes a large workload so that quality control in cervical cytology is important for the quality assurance of pathology laboratories. Material and Method: In this study, we collected the cervical cytology results from all over Turkey and discussed the parameters influencing the quality of the PAP test. The study was conducted with Turkish gynaecopathology working group and 38 centers (totally 45 hospitals) agreed to contribute from 24 different cities. The study was designed to cover the cervical cytology results during 2013. The results were evaluated from the data based on an online questionnaire. Results: The total number of Epithelial Cell Abnormality was 18,020 and the global Epithelial Cell Abnormality rate was 5.08% in the total 354,725 smears and ranging between 0.3% to 16.64% among centers. The Atypical squamous cells/Squamous intraepithelial lesion ratios changed within the range of 0.21-13.94 with an average of 2.61. When the centers were asked whether they performed quality assurance studies, only 14 out of 28 centers, which shared the information, had such a control study and some quality parameters were better in these centers. Conclusion: There is an increase in the global Epithelial Cell Abnormality rate and there are great differences among centers. Quality control studies including the Atypical squamous cells/Squamous intraepithelial lesion ratio are important. Corrective and preventive action according to quality control parameters is a must. A cervical cytology subspecialist in every center can be utopic but a dedicated pathologist in the center is certainly needed.