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Öğe 99mTc-MIBI SPET in non-small cell lung cancer in relationship with Pgp and prognosis(Springer, 2002) Yüksel, M; Çermik, TF; Doganay, L; Karlikaya, C; Çakir, E; Salan, A; Berkarda, SHigher technetium-99m methoxyisobutylisonitrile (MIBI) uptake in non-small cell lung cancer (NSCLC) has been reported to be associated with a positive response to chemotherapy. It has previously been found that in tumour cells, P-glycoprotein (Pgp) expression is of importance for tracer uptake. However, some studies have indicated that Pgp expression does not play an important role in Tc-99m-MIBI uptake in NSCLC; indeed, a negative correlation between 99mTc-MIBI uptake and Pgp expression has been reported. Against the background of conflicting results, our aim was to evaluate the relationship between Tc-99m-MIBI uptake, prognosis and Pgp expression in NSCLC. A total of 37 patients with NSCLC underwent Tc-99m-MIBI single-photon emission tomography (SPET) before chemotherapy. In 19 patients both Pgp and p53 expression, and in two patients only p53 expression (due to the limited biopsy material), were measured with immunohistochemical staining. Tc-99m-MIBI uptake was significantly higher in responders than in non-responders: 3.09+/-1.14 vs 2.24+/-0.88 (P<0.03) and 3.09+/-1.08 vs 2.37+/-1.06 (P<0.05) for the early ratio (ER) and the delayed ratio (DR), respectively. The wash-out rate (WR) of responders was not significantly different from that of non-responders. We found no significant differences in ER, DR and WR among the groups positive or negative for Pgp and p53 status. There was a significant positive correlation between the survival rate and both ER and DR: r=0.49 (P=0.003) and r=0.40 (P=0.018), respectively. Patients with ER and DR values above 3 showed significantly longer survival than those with values below 3: 14.7+/-8.5 months vs 7.3+/-5.1 months (P<0.009) and 13.2+/-8.4 months vs 7.4+/-5.3 months (P<0.04) for ER and DR, respectively. However, interestingly, and in contrast to expectations, patients with a Pgp score of +2 showed significantly longer survival (12.9+/-6.7 months) than those with Pgp scores of +1 (4.4+/-3.0 months) or - (negative) (3.8+/-2.2 months) (P<0.009 and P<0.02, respectively). Our results suggest that in NSCLC, patients with higher Tc-99m-MIBI uptake tend to show a positive response to chemotherapy, and patients with ER and DR values above 3 have a significantly better prognosis. We also found that Pgp expression seems to play only a minor role in Tc-99m-MIBI uptake. Our finding that patients with ER and DR values above 3 have a better prognosis needs to be confirmed in larger series of patient.Öğe Bone metastasis from primary splenic angiosarcoma to the sacrum demonstrated by Tc-99m-labeled red blood cell and Tc-99m MDP bone scintigraphy(Lippincott Williams & Wilkins, 2001) Çermik, TF; Yüksel, M; Demir, M; Özyilmaz, F; Kaya, M; Vural, Ö; Berkarda, S[Abstract Not Available]Öğe Comparison of alloplastic implants for facial bones by scintigraphy and histology(Springer Verlag, 1999) Aygit, AC; Sarikaya, A; Candan, L; Ayhan, MS; Çermik, TFReconstruction of bone defects and contour irregularities in the craniofacial region is difficult and often requires complex solutions. This study investigated the tissue response, vascularization and bone ingrowth, in hydroxyapatite, porous polyethylene and silicone elastomer when used as bone graft substitutes. 24 albino rabbits (8 rabbits for each implant) were used in this investigation. Hydroxyapatite 500 particles, silicone rubber and porous high-density polyethylene were placed in the cavities formed with a drill in the rabbit frontal bones. As a part of a prospective study the vascularization rates of all implant materials were analyzed 10 days and 2 months after surgery using (99m)Technetium-MDP (Methylene diphosphonate) scintigraphy of the skull. The scintigraphic studies were performed 2 hours after intravenous injection of 4 mCi (148 MBq) Tc-99m-MDP. The frontal bone was excised on the 10th and 60th days. All tissue specimens were placed first in 10% formalin and then in 10% nitric acid solution for decalcification. The vascularization, connective tissue ingrowth, foreign body reaction and bone regeneration around the implant were evaluated. Results of this study suggested that hydroxyapatite and porous polyethylene were stabilized in bone while as expected silicone was mobile, also hydroxyapatite implants are vascularized better and are more biocompatible than porous polyethylene.Öğe Diffuse uptake of Tc-99m tin colloid in extramedullary Hematopoiesis of the lungs(Lippincott Williams & Wilkins, 2003) Çermik, TF; Turgut, B; Gultekin, A; Çakir, B; Berkarda, S[Abstract Not Available]Öğe Evaluation of dysthymic disorder with technetium-99m hexamethylpropylene amine oxime brain single-photon emission tomography(Springer, 1999) Sarikaya, A; Karasin, E; Çermik, TF; Abay, E; Berkarda, SDysthymic disorder is a chronic disorder characterised by the presence of a depressed mood and is classified as a distinct category in DSM-IV, separately from major depression. Although brain imaging studies have been performed in major depressive disease, there have to date been no reports of such studies in dysthymic disorder. In this study 36 patients with dysthymic disorder were compared with 16 normal subjects using technetium-99m hexamethylpropylene amine oxime brain single-photon emission tomography. A relative blood now ratio was calculated for each region of interest using the average tissue activity in the region divided by activity in the cerebellum. There were significant differences in the bilateral inferior frontal, bilateral parietal, right superior frontal and left posterior temporal regions in the patients with dysthymic disorder compared with the healthy controls. These findings support the hypothesis that the biological bases for dysthymic disorder and major depression are similar. Recognition of these regional abnormalities may have clinical utility in both the diagnosis and the treatment of dysthymic disorder. Further studies are needed to confirm our results and to assess the influence of treatment in patients with dysthymic disorder.Öğe Evaluation of skeletal muscle metabolism and erythropoietin treatment response in patients with chronic renal failure with 99mTc-sestamibi leg scintigraphy(Springer Verlag, 1999) Sarikaya, A; Sen, S; Çermik, TF; Birtane, M; Berkarda, S[Abstract Not Available]Öğe Evaluation of skeletal muscle metabolism and response to erythropoietin treatment in patients with chronic renal failure using 99Tcm-sestamibi leg scintigraphy(Lippincott Williams & Wilkins, 2000) Sarikaya, A; Sen, S; Çermik, TF; Birtane, M; Berkarda, SIt is well known that uraemia affects skeletal muscle metabolism. This has been attributed to a variety of causes, including anaemia, vitamin D, carnitine deficiency and hyperparathyroidism. The aim of this study was to ascertain whether Tc-99(m)-sestamibi leg scintigraphy is useful in the evaluation of skeletal muscle metabolism and the monitoring of treatment response in uraemic myopathy. Forty patients with chronic renal failure and 24 normal controls underwent examination. Fifteen patients with chronic renal failure received erythropoietin treatment. Tc-99(m)-sestamibi leg scintigraphy was performed in all subjects and in 15 patients after therapy. The calf-to-ankle uptake ratio was calculated by semi-quantitative analysis and normalized to lean body mass. The normalized uptake ratios were significantly different between patients and controls. After erythropoietin therapy, there was a significant increase in the normalized uptake ratios compared with pre-therapy. Our results suggest that Tc-99(m)-sestamibi leg scintigraphy is useful in the assessment of muscle metabolic abnormalities and the effect of treatment in uraemic myopathy. ((C) 2000 Lippincott Williams & Wilkins).Öğe Extensive bone metastases in a patient with prostatic adenocarcinoma and normal serum prostate-specific antigen and prostatic acid phosphatase(Lippincott Williams & Wilkins, 2001) Yuksel, M; Çermik, TF; Kaya, M; Salan, A; Ustun, F; Salihoglu, YS; Yigitbasi, ÖN[Abstract Not Available]Öğe The incidence of recurrence and hypothyroidism after radioiodine treatment in patients with hyperthyroidism in Trakya, a mild iodine deficiency area, during the period 1991-2003(Springer, 2005) Ustun, F; Yuksel, M; Durmus-Altun, G; Kaya, M; Çermik, TF; Sarikaya, A; Berkarda, SObjective: The purpose of this retrospective study was to evaluate the incidence of recurrence and the success of radioiodine treatment (RIT) in the Trakya region of Turkey, an area with mild iodine deficiency, and to compare the effect of dose regimen selection (fixed (FD) or calculated dose (CD)) on treatment success. Material and Methods: The study sample included 148 patients (40 male, median age 50) treated with radioiodine between the years 1991-2003. Patients were categorized into three diagnostic groups: Graves' disease (GD) (n = 65), solitary toxic adenoma (TA) (n = 29), and toxic multinodular hyperthyroidism (TMH) (n = 54), and each divided into two subgroups according to treatment method; the first group was treated with a FD of 370 MBq (10 mCi), and the second with CD. Results: The largest group was GD (44%), followed by TMH (36%). Median duration of follow-up was 28 months (range 6-147). FD was given to 52.7% of all patients and CD was given to 47.3%. There was a partial difference in the dose regimen between all groups, but did not reach statistically significant levels (FD vs. CD: 65%-35%; 38%-62%; 46%-54%; GD, TA, TMH respectively, p > 0.05). Total cure rate in FD and CD was 46 (59%) and 37 (52.9%), respectively. The rates of hypothyroidism for GD, TA, and TMH groups were 28 (43.1%), 6 (20.7%) and 16 (29.6%), respectively. The incidence of hypothyroidism did not vary significantly between any groups (p > 0.05). At the end of the follow-up period, a total of 104 patients (70.3%) were treated successfully. There was no significant difference in the cure rate between any groups (p > 0.05). Conclusions: The treatment success in all groups and subgroups did not differ significantly between FD and CD. Our lower cure rate than in previous studies may be related to iodine deficiency. Higher doses of radioiodine may be required to increase final treatment success in endemic goiter areas. If this true, dosimetry and calculated dose regimen would be required in all groups of patients instead of an FD concept. However, our findings should be verified in larger series of patients, with longer follow-up period, and urinary iodine concentration measurements.Öğe Incidental detection of single vertebral osteomyelitis in a patient operated on for parathyroid hyperplasia(Lippincott Williams & Wilkins, 2001) Çermik, TF; Yüksel, M; Yalniz, E; Kaya, M; Ugur, B; Tugrul, A; Berkarda, S[Abstract Not Available]Öğe Monitoring the chemotherapeutic response in primary lung cancer using 99mTc-MIBI SPET(Springer-Verlag, 2001) Yüksel, M; Çermik, TF; Karlikaya, C; Salan, A; Çakir, E; Gültekin, A; Berkarda, FPrediction and evaluation of the response to chemotherapy (CTx) are important for the correct and cost-effective treatment of patients with primary lung cancer. Although fluorine-18 fluorodeoxyglucose. positron emission tomography (FDG-PET) is accepted as the most useful and accurate nuclear medicine technique for this purpose, its expense and limited availability restrict its use. Compared with PET agents, technetium-99m methoxyisobutylisonitrile (MIBI), which is used in nuclear oncology, is cheaper and available in any nuclear medicine clinic. With this in mind, in this study we aimed to evaluate the role of Te-99m-MIBI in monitoring the chemotherapeutic response in primary lung cancer. Twenty patients with primary lung cancer underwent Tc-99m-MIBI single-photon emission tomography (SPET) at 15 min (early) and 3-4 h (delayed) after injection of the tracer. All patients underwent 99mTc-MIBI SPET study twice: before and after the 3rd cycle of CTx. Patients were divided into two groups, responders [R(+), n=10] and nonresponders [R(-), n=10], according to the change in tumour size on CT scan taken 2 weeks after the last cycle of the CTx. From the SPET images early and delayed tumour/lung ratios (ER and DR) were obtained before and after CTx. In the R(+) group, ER and DR decreased significantly after CTx, from 3.28 +/-1.55 to 1.78 +/-0.72 (P <0.04) and from 3.23 +/-1.55 to 2.0 +/-0.88 (P <0.05), respectively. However, in the R(-) group, while ER showed a slight and statistically insignificant increase after CTx (from 2.51 +/-1.23 to 2.65 +/-1.86), DR increased significantly, from 2.74 +/-1.37 to 3.27 +/-2.31 (P <0.03). The percentage decreases in ER and DR in the R(+) group after CTx was significantly higher than that in the R(-) group: 34.36%+/- 26.7% vs -13.78%+/- 27.58% (P <0.0002) and 29.45%+/- 25.23% vs -18.58%+/- 20.51% (P <0.0005), respectively. Using a decrease of greater than or equal to 10% as a threshold for monitoring the chemotherapeutic response, Te-99m-MIBI had a sensitivity of 90% and a specificity of 100%. We found a positive correlation in 14 patients between ER and DR and survival: r=0.6754 and P=0.008, and r=0.5755 and P=0.031, respectively. Our results suggest that Te-99m-MIBI might be used in routine practice to monitor the chemotherapeutic response in patients with primary lung cancer, especially when PET is not available.Öğe The relationship between 99mTc-HMPAO brain SPECT and the scores of real life rating scale in autistic children(Elsevier Science Bv, 2002) Kaya, M; Karasalihoglu, S; Üstün, F; Gültekin, A; Çermik, TF; Fazlioglu, Y; Türe, MChildhood autism is a developmental disability of unknown origin with probable multiple etiologies. The purpose of this study was to compare the changes of regional cerebral blood flow (rCBF) in autistic and non-autistic controls, and to determine the relationship between rCBF on Tc-99m-hexamethylpropylene amine oxime (HMPAO) brain SPECT and the scores of the Ritvo-Freeman Real Life Rating Scale (RLRS), IQ levels, and age of autistic children. Eighteen autistic children (four girls, 14 boys: mean age: 6.13 +/- 1.99 years) and I I non-autistic controls (five girls, six boys, mean age: 6.5 +/- 3.39 years) were examined using Tc-99m-HMPAO brain SPECT. All the children satisfying DSM-IV criteria for autistic disorder were taken into evaluation, and scored by the Ritvo-Freeman RLRS, IQ levels of these children were determined by Goodenough IQ test. Six cortical regions of interest (ROIs; frontal (F), parietal (P), frontotemporal (FT), temporal (T), temporo-occipital (TO), and occipital (0)) were obtained on transaxial slices for count data acquisition. The ratio of average counts in each ROI to whole-slice Counts for the autistic children was correlated with the scores of Ritvo-Freeman RLRS. Hypoperfusion in rCBF in autistic children compared with the control group were identified in bilateral F. FT, T, and TO regions. We found no relationship between rCBF on Tc-99m-HMPAO brain SPECT and the scores of the Ritvo-Freeman RLRS. There was a relationship between bilateral F regions perfusion on Tc-99m-HMPAO brain SPECT and the age of autistic children. There was also a negative correlation between IQ levels and the scores of sensory responses, social relationship to people, and sensory-motor responses. Our results suggest that Tc-99m-HMPAO brain SPECT is helpful to locate the perfusion abnormalities but no correlation is found between rCBF on Tc-99m-HMPAO brain SPECT and the scores of Ritvo-Freeman RLRS. (C) 2002 Elsevier Science B.V. All rights reserved.Öğe The relationship between 99Tcm-sestamibi uptake and ultrastructural cell types of thyroid tumours(Lippincott Williams & Wilkins, 2001) Sarikaya, A; Huseyinova, G; Irfanoglu, ME; Erkmen, N; Çermik, TF; Berkarda, SAlthough several hypotheses have been suggested regarding the accumulation of Tc-99(m)-sestamibi in rumours, the exact uptake mechanism is still a matter of discussion. We investigated ultrastructural cell type of thyroid tumours by electron microscopy (EM) and compared them with uptake of Tc-99(m)-sestamibi. Thyroid scintigraphy with Tc-99(m)-sestamibi was performed on 25 patients who displayed a cold nodule on previous pertechnetate scintigraphy. Tumour-to-thyroid (T/N) uptake ratio was measured semiquantitatively. Surgery was performed in all patients and cytological evaluations were done by EM. Histopathology revealed six papillary carcinomas, 16 follicular adenomas and three Hurthle cell tumours. Thyroid cells were classified as A and B cells using EM. The cytoplasm of an A cell has the normal amount of mitochondria, whereas cytoplasm of a B cell (mitochondria-rich oxyphilic cell) contains abundant mitochondria. The median T/N ratio on the early scan for an A-cell tumour was 1.21 (range, 0.74-3.2), late T/N ratio was 1.25 (range, 0.72-3.85). The T/N ratio for the B-cell tumours was 1.42 (range, 0.6-3.6) on the early scan and 1.18 (range, 0.64-5.58) on the late scan. There was no statistically significant difference between T/N ratios of A- and B-cell tumour groups. A significant difference was also not seen between early and late T/N ratios. According to our findings, Tc-99(m)-sestamibi accumulates in thyroid rumours with both A and B cells, therefore these results suggest that the mitochondrial content of tumours is not only responsible for sestamibi uptake and retention. ((C) 2001 Lippincott Williams & Wilkins).Öğe The relationship between Tc-99m MIBI uptake and chemotherapeutic response, metastasis, Pgp, p53, and prognosis in lung cancer(Springer-Verlag, 2001) Yüksel, M; Çermik, TF; Doganay, L; Karlikaya, C; Salan, A; Çakir, E; Ture, M[Abstract Not Available]Öğe Renal uptake on lung perfusion scintigraphy in a patient with primary pulmonary hypertension(Lippincott Williams & Wilkins, 2005) Kaya, M; Çermik, TF; Tabakoglu, E; Kutucu, YAn 18-year-old woman presented with primary pulmonary hypertension (PPH) and was hospitalized because of hemoptysis and was referred to our department for a differential diagnosis pulmonary thromboembolism. Doppler ultrasonography of the lower extremities was normal. Echocardiography and cardiac catheterization showed right ventricular dilatation and increased pulmonary artery pressure without anatomic (intracardiac) shunt. The mean pulmonary arterial pressure was 110 mm Hg. Tc-99m MAA lung perfusion scans showed nonsegmental patchy defects. Extrapulmonary renal uptake and increased systemic deposition of radiotracer were seen in the MAA scintigraphy. It could be related to a functional intrapulmonary shunt resulting in increasing pressure in the pulmonary artery in PPH.Öğe Salivary function in patients with chronic renal failure undergoing hemodialysis(Japanese Society Nuclear Medicine, 2002) Kaya, M; Çermik, TF; Üstün, F; Sen, S; Berkarda, SPurpose: The aim of this study was to evaluate the changes in salivary gland function in patients with chronic renal failure (CRF) undergoing hemodialysis. Methods: The group consisted of 23 patients with CRF (13 female, 10 males mean age: 40 +/- 13 yr) and 14 healthy control subjects (mean age: 40 +/- 13 yr). All underwent dynamic salivary gland scintigraphy with gustatory stimulation, After intravenous administration of Tc-99m pertechnetate, first. perfusion images at 2 seconds per frame were acquired for I minute, then dynamic images at 1 minute per frame were acquired for 45 minutes, At 30 minutes after injection, 10 ml lemon juice was given for 15 minutes as a gustatory stimulus. We obtained time-activity curves derived from regions of interest centered over the four major salivary glands. The following functional indices were calculated for each gland: the time of maximum radioactivity (T-max) for the prestimulated period, the time of minimum radioactivity (T-min), as an indicator of velocity of secretion after stimulation, and the Lem E-5% value as an indicator of the secretion function. Results: When the patients with CRF undergoing hemodialysis were compared to the controls, there were statistically significant differences in T-max, T-min and Lem E5% values for bilateral parotid glands, and Train values for bilateral submandibular glands (p < 0.05), there were no statistically significant differences in Tmax and Lem E5% values for bilateral submandibular glands. There were also significant differences in T-max and Lem E5% values for bilateral parotid glands between mild oral problems and severe oral problems in patients with CRF (undergoing hemodialysis). Conclusion: In this study, prolonged T-max and T-min values, and decreased Lem E5% values for parotid glands and prolonged T-min values for submandibular glands on salivary scintigraphy pointed out decreased parenchymatous and excretory function in patients with CRF undergoing hemodialysis.Öğe Scintigraphic assessment of pre- and postop nasal mucociliary clearence in patients (Pts.) with nasal septal deviation using Tc-99m MAA(Springer Verlag, 1999) Yüksel, M; Çermik, TF; Özel, ES; Koten, M; Üstün, F; Karasalihoglu, A; Berkarda, S[Abstract Not Available]Öğe Secretion of radioactivity in breast milk after Tc-99m DTPA aerosol and Tc-99m MAA lung imaging(Lippincott Williams & Wilkins, 2001) Kaya, M; Üstün, F; Gültekin, A; Çermik, TF; Yüksel, MA; Yigitbasi, ÖM[Abstract Not Available]Öğe Thallium-201 SPECT in advanced non-small cell lung cancer(Japanese Society Nuclear Medicine, 2003) Çermik, TF; Yüksel, M; Karlikaya, C; Doganay, L; Türe, M; Berkarda, SPurpose: The aim of this study was to evaluate the relationship between Tl-201 tumor uptake, chemotherapeutic response, metastasis, p53 status and survival in non-small cell lung cancer (NSCLC). Methods: A total of 23 patients underwent Tl-201 SPECT. In 9 patients, 2nd Tl-201 SPECT study were performed 1 week after the 3rd cycle of chemotherapy (ChT), and early (ER) and delayed (DR) tumor/normal lung ratios and retention indices (RI) were obtained. In 15 patients p53 status was assayed with immuno-histochemical staining. The patients were divided into subgroups after the 3rd cycle of ChT; responders [R(+) (n = 10)] and non-responders [R(-) (n = 13)], distant metastasis [(M-1) n =11] and [(M-0) n = 12], and mutant p53 status [p(+) n = 7, p53(-) n = 8]. Results: The differences for ER, DR and RI values between all of the subgroups were not statistically significant. ER and DR of responders decreased significantly after ChT; from to 2.46 to 1.36 (p = 0.04) and 2.29 to 1.53 (p = 0.04), respectively. In the non-responder group, both ER and DR slightly increased after ChT (p > 0.05). Conclusion: Our results suggest that in NSCLC, there was a weak correlation between higher Tl-201 ratios and positive response to chemotherapy, absence of distant metastasis, and p53(-) status. Significant Tl-201 uptake decrease after chemotherapy indicates that delayed Tl-201 uptake can be used in evaluating the chemotherapeutic response.Öğe Tl-201 uptake and its relationship with chemotherapeutic response, metastasis, p53 status, and survival in primary lung cancer(Springer-Verlag, 2001) Çermik, TF; Yüksel, M; Karlikaya, C; Doganay, L; Çakir, E; Salan, A; Ture, M[Abstract Not Available]