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.

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.

The protective effect of single dose tadalafil in contrast-induced nephropathy: an experimental study.

OBJECTIVE: Contrast-induced nephropathy (CIN) is one of the most common causes of acute renal failure in hospitalized patients. The direct toxic effect of contrast media; ischemic damage caused by reactive oxygen species; increased perivascular hydrostatic pressure; high viscosity and changes in the activity of vasoactive substances play important roles in the pathogenesis. Tadalafil inhibits the phosphodiesterase enzyme which destroys nitric oxide. Nitric oxide causes renal vasodilatation, increases renal medullar blood flow and mediates the removal of free oxygen radicals. Drugs that increase levels of nitric oxide are expected to reduce the development of contrast nephropathy due to contrast media. We aimed to test the hypothesis that tadalafil reduces the development of contrast nephropathy due to contrast toxicity. METHODS: A total of 24 female Wistar albino rats, three groups of eight, were included in the study. After 48 hours of dehydration, contrast media (meglumine diatrozoate, 6 mL/kg) was administered to the first group, and contrast media with tadalafil (10 mg/kg) was administered to the second group. The third group served as the control group. Blood and tissue samples were taken 48 hours after this procedure. RESULTS: Serum cystatin C, serum creatinine and blood urea nitrogen (BUN) values were significantly lower in the contrast with tadalafil group compared to the group given only contrast. Serum and tissue malondialdehyde (MDA) levels were significantly lower in the contrast with tadalafil group than in the contrast only group. CONCLUSION: These results demonstrate the protective effect of tadalafil in the prevention of CIN in rats.

Intranodal palisaded myofibroblastoma; a case report and review of the literature.

Intranodal palisaded myofibroblastoma (IPM) also called as intranodal hemorrhagic spindle cell tumor with amianthoid fibers is a distinctive and rare mesenchymal neoplasm of lymph nodes. This entity generally misdiagnosed as intranodal Kaposi's sarcoma or schwannoma in past. In contrast to Kaposi's sarcoma, it behaves in a benign fashion and does not need any further therapy except total surgical resection of the mass. This neoplasm has a great predilection for the inguinal region. The lesion presents typically as a unilateral, painless, solitary mass. To our knowledge, approximately 53 cases of IPM have been reported in the English-language literature. We present a 43-year-old-male patient with IPM and discuss histological, immunohistochemical features and pathogenesis of this rare benign neoplasm.

Cervical partial hydatidiform molar pregnancy.

BACKGROUND: Cervical hydatidiform molar pregnancy is an exceedingly rare occurrence that has been reported only twice before. CASE: We report a 25-year-old, G4P1D&C2 woman with a positive pregnancy test and vaginal bleeding. A cervical pregnancy with hydatidiform mole was detected on transvaginal ultrasound and color Doppler examinations. Magnetic resonance imaging was used to localize the lesion. Dilatation and curettage was performed and bleeding that was initially brisk ceased after bimanual pressure. Histopathological examination revealed a partial hydatidiform molar pregnancy. Serial beta-hCG measurements showed a decline without need for adjuvant chemotherapy. CONCLUSION: Conservative fertility-sparing management was successful in this potentially fatal rare case.

Can spinal bupivacaine analgesia treatment make a difference on urinary bladder healing according to the intramuscular pethidine analgesia treatment in rats?

We designed a study to compare the healing levels found with intramuscular pethidine with those found with intrathecal local anesthetic treatments. The urinary bladder is suggested to be the most useful tissue in the evaluation of the effects of the drugs. Nineteen male, Sprague-Dawley rats weighing 200 C300 g were used in this study. A sagittal section was made in the urinary bladder after suitable anesthesia and laparotomy. Bladders were closed with 5-0 plain catguts 5 min later. There were nine rats in the control group and pethidine (0.5 g/kg) was administered intramuscularly in the gluteal muscle region to treat pain after the operations. There were 11 rats in the study group and each received a spinal injection of 0.25% bupivacaine after the operation. Rats were followed for 7 days to define pain. Specimens, particularly the incised region of the bladder, were evaluated for inflammation and fibrosis. Grading scales were used for this purpose. Statistical analyses of the data were performed using the Chi-square test. Statistical analyses were nonsignificant for inflammation (p

Osseous presentation of Hodgkin's disease: a case report and review of the literature.

The bone involvement in the later stages of Hodgkin's disease is an expected phenomenon, but it is very rare in early stages of the disease. About 49 cases of Hodgkin's disease presenting with bone involvement have been reported in the literature. We reported a 14-year-old boy initially evaluated with pain localized at the left ilium. Although all the radiological examinations suggested an osseous anomaly, histopathologic evaluation of the pelvic lymphadenopathies provided definite diagnosis of the disease. We discuss the possible differential diseases and review the literature regarding the osseous presentation of Hodgkin's disease.

A case of bladder exstrophy and thoracal intramedullary teratoma.

Exstrophic bladder and intramedullary teratomas are rare congenital anomalies. To the authors' knowledge, the coexistence of these 2 anomalies has not been reported previously. The authors report on a newborn with thoracal intramedullary teratoma and exstrophic bladder. The possible embryogenetic background also is discussed.