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Öğe Clearance of technetium-99m-labeled DTPA in hyperthyroidism without clinical evidence of lung disease, and relation to pulmonary function(Springer, 2005) Guldiken, S; Tugrul, A; Altiay, G; Hacimahmutoglu, S; Durmus-Altun, GObjective: The mechanisms of dyspnea and exercise intolerance have not been fully elucidated. We aimed to investigate the clearance rate of technetium-99m diethyltriaminepentaaceticacid (Tc-99m DTPA) from lungs in hyperthyroid patients without clinical evidence of lung disease and to explore the interactions between their Tc-99m DTPA radioaerosol lung scintigraphy, spirometric measurements, and the levels of thyroid hormones. Methods: We studied 19 hyperthyroid patients and 16 sex- and age-matched controls. Thyroid hormone levels were assessed. Spirometric lung function tests, diffusing capacity of the lung for carbon monoxide (DLCO) and the clearance rate of Tc-99m DTPA were performed in all participants. Ratio of DLCO value to the alveolar ventilation (DLCO/VA) and the means of half-time (T-1/2) of Tc-99m DTPA clearance rate, which were used to evaluate alveolar-capillary membrane permeability, were calculated. Results: There were no statistical differences between spirometfic parameters (VC, FVC, FEV1/FVC, FEF 25-75) of the two groups (p > 0.05). Although the mean FEV1 level was significantly lower in the hyperthyroid patients than the control subjects (p < 0.01), in five patients FEV1 was only less than 80 percent of the predicted value. No significant difference in the means of DLCO, DLCO/VA or T-1/2 values of Tc-99m DTPA clearance was observed between the two groups (p > 0.05). In hyperthyroid patients, there was a positive relation between DLCO/VA, DLCO/VA % and T-1/2 values of Tc-99m DTPA clearance (p < 0.01, r = 0.732, p < 0.01, r = 0.742, respectively). The lung volumes and the levels of thyroid hormones did not show a significant relationship to T-1/2 values of Tc-99m DTPA clearance in hyperthyroid group (p > 0.05). Conclusions: We conclude that increased thyroid hormones have no effect on permeability of alveolar-capillary membrane in hyperthyroid patients.Öğe Comparison of regional cerebral blood flow in early and late onset alcoholic patients(Springer, 2004) Vardar, E; Durmus-Altun, G; Erdogan, E; Firat, MF; Tuglu, C; Caliyurt, O; Abay, E[Abstract Not Available]Öğe Comparison of Tc99m MIBI lung and liver uptakes during dipyridamole stress test with or without aminophylline(Springer Verlag, 1999) Yüksel, M; Durmus-Altun, G; Altun, A; Berkarda, S[Abstract Not Available]Öğe Confirmation of alleged falanga torture by bone scintigraphy - Case report(Springer-Verlag, 2003) Altun, G; Durmus-Altun, GAny objective persisting signs of previous torture would be very valuable in the late assessment of the individual claiming such abuse of human rights. We present the case of a 32-year-old man referred to our hospital for an opinion on alleged torture by the falanga method. Magnetic resonance imaging and bone scintigraphy were evaluated and compared as methods of confirming such torture.Öğe Distal sensorimotor polyneuropathy affects skeletal muscle perfusion and metabolism by Tc-99m sestarnibi leg scintigraphy in patients with type 2 diabetes(Lippincott Williams & Wilkins, 2005) Ugur-Altun, B; Durmus-Altun, G; Ustun, F; Turgut, N; Altun, A; Tugrul, AWe evaluated the effects of distal symmetric sensorimotor polyneuropathy (DSP) on skeletal muscle perfusion and metabolism in patients with type 2 diabetes. Twenty-three patients with type 2 diabetes under-went electrophysiological and Tc-99m sesta-mibi leg scintigraphic studies. The study patients were divided into 2 groups: group I (n = 14) with DSP and group 11 (n = 9) without DSP. We found decreased Tc-99m sestamibi uptake ratios (UR) of both legs in patients with DSP (right UR 7.98 +/- 6.85, left UR 7.78 +/- 7.01 vs. right UR 8.91 +/- 7.98, left UR 8.67 +/- 8.23, respectively) than without DSP, although it did not reach statistical significance. The regression equation of right UR was (Tc-99m sestarnibi UR = [1.927 X velocity of tibial nerve] - [0.942 X amplitude of sural nerve] - 81.94). In conclusion, electrophysiological variables of tibial motor and sural sensory nerves predict Tc-99m sestarnibi UR at leg scintigraphy in patients with type 2 diabetes. Additionally, decreased Tc-99m sestarnibi UR in patients with type 2 diabetes with DSP was found.Öğe Evaluation of morphine effect on tumour angiogenesis in mice breast tumour by using 99mTc-Tetrofosmin scintigraphy(Springer, 2004) Ustun, F; Durmus-Altun, G; Tuncbilek, N; Altaner, S; Uzal, MC; Berkarda, S[Abstract Not Available]Öğe High bone mineral density in loaded skeletal regions of former professional football (soccer) players: what is the effect of time after active career?(B M J Publishing Group, 2005) Uzunca, K; Birtane, M; Durmus-Altun, G; Ustun, FObjectives: Physical exercise is an important factor in the acceleration and maintenance of bone mineral density (BMD). Football is an impact loading sport and some studies demonstrate its site specific, bone mass increasing effect. We compared BMD at different skeletal regions in a group of former professional football players and in normal control subjects and evaluated the effect of demographic factors and time after active career on BMD. Methods: Twenty four former football players,70 years old who had retired from professional football at least 10 years previously and 25 non- athletic controls were recruited. The demographic characteristics, activity levels, and dietary habits of all subjects and the chronological history of the footballers' professional careers were noted. BMD was measured by DEXA at the calcaneus and distal tibia and at the lumbar spine, proximal femur, and distal and proximal radius, and compared between groups. Stepwise multiple linear regression analysis was used to determine the probable predictors of BMD in former football players. Results: In former players BMD values were found to be significantly higher at the lumbar spine, femur neck, femur trochanter, distal tibia, and calcaneus, but not at Ward's triangle ( femur) or the distal and proximal radius regions compared with controls. Time after active career was the only independent predictor of BMD at the lumbar spine, proximal femur ( neck, trochanter, and Ward's triangle), and distal tibia. Conclusions: Former footballers had higher BMD at weight loaded sites and time after active career seemed to be an important factor in determining BMD.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 diagnosis of asymptomatic pericardial effusion in uraemic patient by using 99mTc-MIBI perfusion SPEG(Schattauer Gmbh-Verlag Medizin Naturwissenschaften, 2003) Durmus-Altun, G; Ustun, F; Altun, A; Ustundog, S[Abstract Not Available]Öğe Increased P wave dispersion: A new finding in patients with syndrome X(Pulsus Group Inc, 2002) Altun, A; Erdogan, O; Tatli, E; Ugur-Altun, B; Durmus-Altun, G; Ozbay, GThe present clinical study was undertaken in patients with syndrome X, namely angina with normal coronary arteries, to investigate the presence of increased P wave dispersion by comparing patients with coronary artery disease (CAD) and healthy control subjects. Three groups were studied - group A, 21 patients (48 6 years) with syndrome X; group B, 16 patients (56 9 years) with CAD; and group C, 16 healthy subjects (49 8 years). Patients with CAD were older than those in groups A and C (P=0.005 and P=0.035, respectively). All groups demonstrated similar PQ, QRS and RR intervals. Group B had a lower minimum P wave duration than group C (P=0.05). P wave dispersion in group A was found to be higher than that in groups B and C (P=0.018 and P=0.0001, respectively). Patients with syndrome X demonstrated increased P wave dispersion compared to patients with CAD and healthy subjects. High sympathetic tone or autonomic imbalance observed in patients with syndrome X may affect intra-atrial and interatrial conduction times, and leave them prone to develop atrial arrhythmias.Öğe Inferolateral myocardial perfusion defect caused by right ventricular outflow tract pacing(Wiley, 2004) Erdogan, O; Altun, A; Durmus-Altun, G; Ozbay, GThis case report describes a patient who was free of coronary artery disease and showed reversible inferolateral myocardial perfusion defect after having undergone a permanent dual chamber pacemaker implantation and an active-fixation ventricular lead insertion in the right ventricular outflow tract.Öğe Normalization of negative T waves in the chronic stage of Q wave anterior myocardial infarction as a predictor of myocardial viability(Karger, 2005) Altun, A; Durmus-Altun, G; Birsin, A; Gultekin, A; Tatli, E; Ozbay, GWe investigated whether spontaneous normalization of negative T waves ( TWN) on infarct-related ECG leads ( IRLs) in the chronic phase of Q wave anterior myocardial infarction ( MI) could be a predictor of residual viability in infarct areas. We prospectively studied 35 patients ( age 60 +/- 8.6 years) in the chronic phase of Q wave anterior MI. Spontaneous TWN ( group A, n = 23) were defined as negative T waves that became upright ( greater than or equal to0.15 mV) in 62 IRLs. The presence of negative T waves ( group B, n = 12) was defined as symmetric or biphasic negative T wave of greater than or equal to0.15 mV. All patients underwent same-day rest Tl-201-stress Tc-99m sestamibi dual-isotope myocardial perfusion SPECT and 24-hour Tl-201 reinjection imaging for ischemia and viability analysis. On scintigraphic examination, ischemic or viable myocardial segments were found in 18 patients ( 78%) with TWN and 4 patients ( 33%) of group B ( p = 0.013). The use of TWN as a parameter had a marked influence on the sensitivity ( 82%), specificity ( 62%), positive ( 78%) and negative ( 67%) predictive values and accuracy ( 74%) of the diagnosis of viable smyocardium. If we add the criterion of positive T waves in aVR with negative T waves to our criteria, we found that sensitivity ( 90%), positive ( 80%) and negative ( 80%) predictive values and accuracy ( 80%) increased. The results of our study suggest that analysis of TWN on IRLs is an accurate marker of residual viability and/or persistent peri-infarct ischemia in patients in the chronic stage of Q wave anterior MI, and therefore optimizes the diagnostic and therapeutic strategies after MI. Copyright (C) 2005 S. Karger AG, Basel.Öğe The protective effect of amifostine on radiation-induced acute pulmonary toxicity(Elsevier Science Inc, 2004) Uzal, C; Durmus-Altun, G; Caloglu, M; Ergülen, A; Altaner, S; Yigitbasi, NOPurpose: The purpose of this study was to determine by using Tc-99m-diethylenetriaminepentaacetic acid (DTPA) lung scintigraphy whether amifostine given before irradiation protects alveolocapillary integrity in a rabbit model. Methods and Materials: Twenty white New Zealand rabbits were randomly divided into 4 groups: (1) control (CONT), (2) amifostine alone (AMF), (3) radiation (RAD), and (4) radiation plus amifostine (RAD + AMF). The AMF and RAD + AMF groups received amifostine. The RAD and RAD + AMF groups were irradiated to the right hemithorax with a single dose of 20 Gy using a Co-60 treatment unit. Amifostine (200 mg/kg) was given i.p. 30 min before irradiation. The (99)mTc-DTPA radioaerosol study was performed 14 day after irradiation. Results: The mean clearance rate of Tc-99m-DTPA in control subjects was 140 +/- 21 min. The highest It, value was noted in the RAD group (603 105 min, p = 0.001). There were no significant differences between the Tc-99m-DTPA lung clearance rates of the CONT, RAD + AMF (238 +/- 24 min), and AMF groups (227 +/- 54 min). The mean penetration index values of CONT, RAD, AMF, and RAD + AMF are 63% 1.6%, 63% 2.5%, 60% 2.9%, and 63% 2%, respectively. Conclusions: We concluded that amifostine treatment before the lung irradiation protects the lung alveolocapillary integrity. This study confirms the protective effect of amifostine in an acute phase of radiation lung injury. (C) 2004 Elsevier Inc.Öğe Use of iodine-123 metaiodobenzylguanidine scintigraphy for the detection of amiodarone induced pulmonary toxicity in a rabbit model: a comparative study with technetium-99m diethyltriaminepenta acetic acid radioaerosol scintigraphy(Japanese Society Nuclear Medicine, 2005) Durmus-Altun, G; Altun, A; Aktas, RG; Salihoglu, YS; Yigitbasi, NOThe purpose of the study was; (i) to deter-mine whether I-123-MIBG scintigraphy is sensitive for detection of amiodarone induced pulmonary toxicity (AIPT) and (ii) to compare it with Tc-99m-DTPA radioacrosol. Twelve white New Zealand rabbit with initial mean body weight 4.24 +/- 0.47 g were divided into two groups. AIPT group (n = 7) was administered amiodarone (20 mg/kg BW). The control group (n = 5) received the same amount of 0.9% saline. All animals underwent I-123-MIBG and Tc-99m-DTPA radioaerosol scintigraphy at the end of the treatment period. I-123-MIBG static thorax images were obtained during 10 minutes at 15 minutes and 3-hours after 'intravenous injection of the radiopharmaccutical. Lung to heart ratios (LHR) and lung to mediastinum ratios (LMR), and retention index (LRI) of I-123-MIBG were determined. Two days after I-123-MIBG scintigraphy, 99mTc-DTPA radioaerosol scintigraphy was performed, and clearance from the lungs was measured for 10 min (1 min/frame) following termination of inhalation. I-123-MIBG lung retention index (LRI) was significantly higher in the AIPT group than the control (61 +/- 4.6 vs. 40 +/- 4.5, p = 0.01). Early LHR and LMR were significantly lower in the AIPT group than in the control group (p = 0.04, p = 0.01, respectively), whereas those of late LHR and LMR were not significantly different. T-1/(2) values of DTPA clearance were significantly increased in AIPT group according to the control group (55 +/- 7.2 vs. 86.6 +/- 18.5,p = 0.02). I-123-MIBG scintigraphy is a valuable tool for detecting AIPT in a rabbit model. Additionally, Tc-99m-DTPA radioaerosol scintigraphy is an excellent comprehensive investigational tool for detecting AIPT with the added advantage of lower cost.Öğe Value of technetium-99m diethyltriamine pentaaceticacid radioaerosol inhalation lung scintigraphy for the stage of amiodarone-induced pulmonary toxicity(Elsevier Ireland Ltd, 2004) Durmus-Altun, G; Altun, A; Salihoglu, YS; Altaner, S; Berkada, S; Ozbay, GBackground: Amiodarone is a potent antiarrhythmic agent that is limited in clinical use by its adverse effects, including potentially life threatening amiodarone-induced pulmonary toxicity (AIPT). The alteration of technetium-99m diethyltriaminepentaaceticacid (Tc-99m DTPA) radioaerosol lung clearance in AIPT was experimentally investigated. Methods: Eighteen white New Zealand rabbits (initial weight 4.1 +/- 0.2 kg) were divided into two groups. AIPT group (n = 13) was administered amiodarone (20 mg/kg BW) ip as a 5% aqueous solution for 6 week. The controls (n = 5) were administered the same amount of 0.9% saline ip. Four rabbits of AIPT group died due to AIPT. The reminders of AIPT group (n = 9) and controls underwent Tc-99rn DTPA radioaerosol lung scintigraphy at the end of the treatment period. AIPT group was divided into two subgroups according to histopathologic evaluation. AIPT-I had interstitial pneumonitis (n = 4) and AIPT-II had interstitial pneumonitis with fibrosis (n=5). Results: The mean T-1/2 values of in control, AIPT-I, and AIPT-II groups were found 54 +/- 4.4, 39.2 +/- 11.7 and 114.6 +/- 16.7 min, respectively. The mean T-1/2 values of Tc-99m DTPA significantly differ than other groups (chi(2) = 11.78, P=0.02). The significantly increased T-1/2 values was noted in AIPT-II group when compared with control (P=0.001). In contrast, AIPT-I group has significantly lower T-1/2 values than control group (P=0.03). Conclusion: We suggested that Tc-99m DTPA radioaerosol inhalation lung scintigraphy provides an accurate evaluation about stage of lung toxicity and therefore may be a useful tool for the monitoring of AIPT. (C) 2003 Elsevier Ireland Ltd. All rights reserved.
