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Biomedical subjects

B Onal

Publications and source records attributed to B Onal.

At least 19 recordsLinked to original sources
PubMed2006

Fine needle aspiration cytology: a survey of current European practice.

Fine needle aspiration cytology (FNAC) is practised widely throughout Europe. The majority of countries have dedicated cytopathologists as well as histopathologists practicing cytology. Despite this, FNAC is performed mostly by clinicians and radiologists except in the larger centres with dedicated staff with a special interest in cytopathology. The advent of One-Stop diagnostic services and image-guided procedures are prompting further development of FNAC clinics where cytopathologists take their own samples, issue reports in the same clinical session and take extra material for ancillary tests to complete the diagnosis. The volume of FNAC work varies accordingly; in dedicated centres FNAC represents up to 80% of the workload whilst, in the majority of countries, it represents one quarter or less. Hence, the rate of inadequate FNAC varies widely, depending on the local sampling policies and the organ, but does not exceed 25% in any of the countries. The most sampled organs are breast and thyroid, followed by lymph nodes. Most countries have dedicated training in cytopathology for pathology trainees, the duration varying between 6 months and 2 years of the total training time. This discussion, focusing on European practices, highlights the heterogeneity of FNAC activity but also its success in many centres where it is practiced to a high standard, particularly in breast, thyroid and lymph node pathology. The relatively high rate of inadequate material in some centres reflects local policies and calls for greater uniformity of FNAC practice, particularly specimen sampling. To achieve this, the future direction should concentrate on specialist training, to include performing as well as interpreting FNAC, as part of the curriculum. Current emphasis on web-based training may not provide first hand experience of the FNAC procedure and should be supplemented by attending FNAC clinics and developing the technique to its full potential.

Biopsy, Fine-Needle↗
PubMed2005

Endovascular treatment of obstructive iliac artery dissections.

PURPOSE: To report our results from a study of the endovascular treatment of flow restricting chronic atherosclerotic or catheter-induced segmental iliac artery dissections with bare stents. MATERIAL AND METHODS: Thirty symptomatic patients with 32 lesions, including chronic atherosclerotic (n = 21) and catheter-induced (n = 11) segmental arterial dissections, were treated with primary stenting. The common iliac artery was involved in 19 lesions and the external iliac artery in the remaining 13. Two patients had two lesions in the same vessel. Technical success was defined as restoration of the smooth contoured luminal patency with no more than 20% residual stenosis in diameter in atherosclerotic dissections associated with plaque formation or total obliteration of the false lumen in catheter-induced dissections. Complete relief of, or marked improvements in, presenting symptoms, or at least single category improvement, was assessed for clinical success. RESULTS: Technical success rate was 100%. No procedure-related complications such as distal emboli or early occlusions were observed. Complete symptom relief was achieved in all patients with catheter-induced dissection and in all but three cases with chronic spontaneous atherosclerotic dissection. In two cases, occlusion of the stents occurred during the follow-up period. Clinical and radiological mean follow-up for 24 months (range 3-55) revealed patency of all other stented segments. Cumulative primary patency rate was 97% over 12 months and 90% over 24 months. CONCLUSION: Endovascular treatment of chronic atherosclerotic and catheter-induced short obstructive iliac arterial dissections with bare stents is safe and effective. Patency of the diseased arterial segment with a smooth lumen can be sustained for an extensive period.

Adult↗
PubMed2005

The efficacy of three desensitizing agents in treatment of dentine hypersensitivity.

PURPOSE: The purpose of this study was to evaluate the efficacy of three desensitizing agents vs. placebo. MATERIALS AND METHODS: One hundred and six hypersensitive teeth of 26 patients were included in this study, and the baseline hypersensitivity level of all teeth was established as 'moderate' by using Visual Analogue Scale (VAS). The teeth were divided into four groups: to the first group 5% potassium nitrate bio-adhesive gel, to the second 2% sodium fluoride bio-adhesive gel and to the third one step adhesive system Prompt L-Pop were applied as desensitizing agents. Group 4 was the control group in which a desensitizer-free bio-adhesive gel was used as placebo. Post treatment and eighth week control measurements were recorded on VAS. RESULTS: It was observed that the efficacy of three desensitizing agents did not differ from each other (P >0.05) and except for placebo all reduced moderate dentin hypersensitivity effectively (P <0.05). CLINICAL RELEVANCE: Five per cent potassium nitrate, 2% sodium fluoride bio-adhesive gels and one-step bonding agent Prompt L-Pop were effective in reducing moderate dentine hypersensitivity.

Administration, Topical↗
PubMed2001

The efficacy of extracorporeal shock wave lithotripsy for isolated lower pole calculi compared with isolated middle and upper caliceal calculi.

PURPOSE: We assess the efficacy of extracorporeal shock wave lithotripsy monotherapy for isolated lower pole nephrolithiasis, and compare it to that for isolated middle and upper caliceal calculi. MATERIALS AND METHODS: We treated 714 renal units in 687 patients with isolated caliceal stones using a Lithostar lithotriptor (Siemens Medical Systems, Erlangen, Germany). The stones were localized in the lower, mid and upper calices in 455, 104 and 128 patients, respectively. Stone load was recorded in cm.2. Patients were stratified into 3 groups based on stone burden. The energy and shock waves, use of anesthesia, number of treatment sessions, auxiliary measures and complications were noted. Patients were evaluated with intravenous urogram or plain film of kidneys, ureters and bladder, and ultrasonography when stone-free, or clinically significant residual fragment status, including nonobstructive and noninfectious insignificant fragments 4 mm. or less, was noted at the fluoroscopic control 2 to 4 weeks after the last session. Final clinically significant residual fragment decision was made 10 to 12 weeks after the last session. Extracorporeal shock wave lithotripsy was considered a failure if no fragmentation was noted after session 3 and continued if fragmentation was noted. Results regarding caliceal localization were compared. RESULTS: Complete data were available on 591 renal units. Auxiliary procedures were used in 81 (14%) units before treatment. Anesthesia was given to 101 (17%) patients. The mean number of shock waves and energy used were 2,022 and 17.4 kV., respectively. The difference in shock wave, energy and treatment rate among 3 caliceal locations reached statistical significance only for energy delivered to the lower and upper calices. The effectiveness quotient of extracorporeal shock wave lithotripsy was 36%, 46% and 41% for lower, middle and upper pole stone disease, respectively (p = 0.4). There was a highly significant correlation between stone-free and re-treatment rates, and stone burden. The overall stone-free rate was 66%, and 63%, 73% and 71% for lower, middle and upper caliceal stones, respectively (p = 0.1). For the group with stones greater than 2 cm.2 overall stone-free rate decreased to 49%, and 53%, 60% and 23% in lower, middle and upper caliceal locations, respectively. Overall, extracorporeal shock wave lithotripsy monotherapy failed in 46 (7.7%) renal units. Steinstrasse developed in 39 (6.5%) patients who were then treated with repeat lithotripsy. CONCLUSIONS: Extracorporeal shock wave lithotripsy appears to be successful for management of isolated caliceal stone disease. Treatment efficacy was not significantly different among stones localized in lower, middle and upper poles. We recommend it as the primary treatment of choice for stones less than 2.0 cm.2 in all caliceal locations. Treatment should be individualized for management of caliceal stones greater than 2.0 cm.2 until large prospective randomized trials comparing shock wave lithotripsy and percutaneous nephrolithotomy are available.

Adolescent↗
PubMed2001

Extracorporeal shockwave lithotripsy for stones in abnormal urinary tracts: analysis of results and comparison with normal urinary tracts.

PURPOSE: We reviewed our experience with SWL for stones in abnormal urinary tracts and compared the results with those in normal urinary tracts. PATIENTS AND METHODS: The study group was composed of 2566 renal units (RU) treated on the Siemens Lithostar lithotripter at our SWL unit whose treatment and follow-up at 10 to 12 weeks were completed. Sixty-eight RUs (2.7%) belonged to 52 patients who had congenital upper urinary tract abnormalities. Logistic regression analysis was performed to analyze the impact of age, stone size, location, and the type of abnormality on the outcome of the SWL in the abnormal RU. The student t-, chi-square, and Fisher's exact tests were used for the comparison of stone load, number of treatment sessions, catheter placement, and success rates of the patients with normal and abnormal RU. Results of long-term follow-up for available patients (38 RU; 56%) were also evaluated. RESULTS: Age, stone load, stone location, and the type of abnormality did not have a statistically significant impact on the outcome of SWL for abnormal RU. The average stone load was 2.1 +/- 2.8 cm2 in the abnormal and 1.4 +/- 1.3 cm2 in the normal RU. Thus, the stone load was significantly higher in the abnormal RU (P < 0.05). In the abnormal group, 56% of the RU became stone free, 37% had nonobstructive and noninfectious clinically insignificant residual fragments < or = 4 mm (CIRF), and SWL failed in 7%. In the normal group, 78% of the RU became stone-free, 18.5% had CIRF, and SWL failed in 4%. There was no significant difference in the success rates in the groups if success was defined as stone free and CIRF together (P > 0.05). However, there was significant a difference when stone-free, CIRF, and failure rates were evaluated separately (P < 0.05). Recurrence, regrowth, and retreatment rates in abnormal RU were 50%, 37%, and 34%, respectively. CONCLUSIONS: Although the fragmentation rates were similar, clearance of the fragments was hampered in abnormal urinary tracts. Thus, especially for large stones, other endourologic treatment options should be considered. High recurrence and regrowth rates warrant careful monitoring and consideration for medical treatment during follow-up.

Adult↗
PubMed2000

Spontaneous thrombosis of a vein of Galen aneurysmal malformation: possible effects of contrast media.

A 5-year-old boy with macrocephaly and mental retardation was referred for radiologic evaluation. After cranial CT and MR imaging, the diagnosis of mural type vein of Galen aneurysmal malformation was established by angiography. Two weeks later, preembolization angiography revealed complete thrombosis of the malformation. Although it is a very rare event, vein of Galen aneurysmal malformation may spontaneously thrombose following diagnostic angiography. Possible effects of contrast media on thrombosis were discussed.

Cerebral Angiography↗
PubMed1999

A comparative study of apical leakage of Apexit, Ketac-Endo, and Diaket root canal sealers.

The purpose of this study was to compare the apical leakage of Ketac-Endo, Apexit, and Diaket. Fifty freshly extracted human maxillary anterior teeth were used. The anatomical crowns were removed at the amelocemental junction, and step-back preparation of the roots canals was performed with K-type files to size 40 using 2 ml of 5.25% NaOCl irrigant after each file change. The roots were randomly divided into five groups of 10 roots each: three experimental and two control groups. The experimental groups were as follows: group 1, Apexit; group 2, Ketac-Endo; and group 3, Diaket. Root canals were filled with one of the sealers and gutta-percha using lateral condensation. After the specimens were stored in 100% humidity at 37 degrees C for 2 wk, the roots were covered with two layers of nail polish and immersed in 2% methylene blue for 7 days. Each tooth was split into two sections, and dye penetration was evaluated independently by three examiners using a stereomicroscope at x20 magnification. Mann-Whitney U analysis showed that there was no significant difference between Apexit and Diaket (p > 0.05). However, there was significantly more leakage with Ketac-Endo (p < 0.05).

Analysis of Variance↗
PubMed1999

Extracorporeal shockwave lithotripsy in the pediatric population.

BACKGROUND: Shockwave lithotripsy (SWL) is being used increasingly as a therapeutic modality for childhood urolithiasis. We reported our experience and results of SWL in the pediatric population. METHODS: The 59 renal units (RU) of 54 patients were retrospectively reviewed. The mean patient age was 10+/-3.5 years. All patients were treated with the Lithostar lithotripter in outpatient settings. Those with positive culture results were treated under appropriate antibiotic coverage. Seven patients were treated under general anesthesia and the rest under sedoanalgesia. Shielding of the lung fields or gonads was not used. For the upper pole stones, protection of the lungs was accomplished by elevating the upper half of the body with supportive pillows, thus moving the kidney away from the lung fields. Six RUs were catheterized via double-pigtail ureteral catheters or by percutaneous nephrostomy tube prior to treatment. The average stone load was 1.8+/-2.5 cm2. RESULTS: Patients were treated with an average of 2.5 sessions. A total of 1000 to 2500 shockwaves were delivered between 14.5 and 17.8 kV. Routine spasmolytic treatment was not initiated. The stone-free rate was 64%, and clinically insignificant residual fragments (CIRF) were present in 29% of RUs; thus, the success rate was 93%. Fever that necessitated hospitalization occurred in one patient. No other complications were seen except skin bruising and early hematuria. CONCLUSION: Shockwave lithotripsy is a safe and effective treatment modality for childhood stones of appropriate size and radiologic characteristics.

Child↗
PubMed1999

Lymph node revealing solution: is it effective on detecting minute lymph nodes?

AIMS: The aim of this prospective study is to detect the efficiency of a previously described lymph node revealing solution (LNRS) in comparing with conventional lymph node dissection and re-dissection in colon, breast and urinary bladder carcinomas. METHODS: Total 30 cases in which less than 10 lymph nodes were found by conventional method, were immersed for 6-8 hours in LNRS, dissected and processed. Control group, 12 cases, was first dissected then a second conventional dissection was performed. At the end, specimens were again immersed in LNRS for 6-8 hours and last dissections were done. MAIN RESULTS: In the first group, a total of 150 lymph nodes, 46 of them with metastasis were detected. After using LNRS, 26 additional lymph nodes among which 10 were positive were detected. When compared with the results of conventional dissection, the increase in number of total and metastatic lymph nodes with LNRS was significant (p<0.01). The mean size of the lymph nodes detected by the conventional and LNRS methods was 6.8 and 4.2 mm, respectively. The pathologic lymph node stage was changed in three bladder carcinoma cases, and one breast carcinoma. In the control group, 75 lymph nodes (11 with metastases), 19 lymph nodes (3 with metastases), 14 lymph nodes (one with metastases) were detected after first and second conventional dissection and LNRS methods, respectively. CONCLUSION: LNRS enhanced the number of total and metastatic lymph nodes and is effective in detecting small lymph nodes. This method is useful for accurate staging where the number of detected lymph nodes is too small by the conventional method.

Adenocarcinoma↗
PubMed1998

Apical leakage of a new glass ionomer root canal sealer.

A new glass ionomer root canal sealer (Ketac-Endo) has been developed. The purpose of this study was to compare the apical leakage of Ketac-Endo and AH26 using two different filling techniques and a controlled vacuum procedure. Sixty-four extracted human maxillary anterior teeth were instrumented and divided into four groups of 15 roots each. The groups were obturated as follows: group 1, a single cone technique and Ketac-Endo; group 2, a lateral condensation technique and Ketac-Endo; group 3, a single cone technique and AH26; and group 4, a lateral condensation technique and AH26. After storage in 100% humidity at 37 degrees C for 1 wk, the root surfaces were coated with two layers of nail polish and sticky wax. All specimens were immersed in a vacuum flask containing 2% methylene blue dye solution. The air was evacuated with a vacuum pump. The roots were sectioned longitudinally, and the linear extent of dye penetration was measured. Statistical analysis revealed that there were no significant differences between any of the groups.

Bismuth↗
PubMed1996

Neurocranial morphology as determined by asymmetries of the skull base.

The goal of the current study was to provide an easy to use criterion to diagnose neurocranial asymmetries. An anatomical survey of the external aspect of the skull base was planned to correlate with radiological studies. In a sample of 239 skulls, variations of the angular relationship between the structures seen on a basilar view of the cranium were analysed. An anterior and a posterior transverse line were plotted with respect to the midline. Departures from 90 degrees to the midline for either of the transverse lines were less than 5 degrees in normal skulls, between 5 degrees and 7 degrees in skulls classed by independent inspection as asymmetric, and more than 7 degrees in obviously malformed skulls.

Adult↗
PubMed1995

Cost-effectiveness of computed tomography in the evaluation of patients with headache.

We report a retrospective study to determine the cost-effectiveness of cranial computed tomography in patients with headache without neurological finding. Five hundred ninety-two neurologically normal patients were examined between 1990 and 1993 for the complaint of headache. Examination results were reevaluated from written report and image archive systems. Results were divided into three groups. In group P0, we included patients with normal cranial computed tomography findings. In group P1, patients showed some minor pathologies like ischemic or atrophic changes. These findings neither explained the reason for headache nor changed the clinical or therapeutic approach. The third group (P2) was to include patients with gross intracranial pathology like space-occupying lesions or bleeding. Five hundred forty-six of 592 patients were in the P0 group (92%), and the remaining 46 patients were in the P1 group (8%). No patient was found to have serious intracranial pathology detected by computed tomography. Cost of detection of a case with significant pathology was calculated. It is our opinion that computed tomography is an unrewarding technique in the evaluation of patients with chronic headache whose neurological examinations are normal.

Adolescent↗
PubMed1993

Preliminary report on the application of pulsed CO2 laser radiation on root canals with AgCl fibers: a scanning and transmission electron microscopic study.

Fifteen maxillary central incisors were treated in vitro with pulsed CO2 laser radiation (wavelength:9.6-microns pulse duration:135-microseconds pulse energy:60 mJ energy density:12 J/cm2) delivered by an AgCl fiber into the root canal. Preliminary results show opening of dentin tubules as well as fused areas of hydroxyapatite in the root canal after laser treatment. Temperature measurement at the root surface showed that 40 degrees C was not exceeded. These preliminary results show the ability of this laser system to open dentin tubules and to fuse hydroxyapatite but further development in fiber technology is necessary to achieve predictable results.

Carbon Dioxide↗