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Öğe Evaluation of alveolo-capillary permeability in thyrotoxicosis using Tc-99m DTPA aerosol scintigraphy(Springer, 2005) Gültekin, A; Yüksel, M; Mert, S; Berkarda, FSurfactant secreted from type II pneumocytes plays an important role in alveolo-capillary permeability. In thyrotoxicosis, high levels of T3 receptors detected at these cells might affect the alveolocapillary permeability due to increased serum thyroid hormone levels. The results by CO-diffusion capacity measurement in thyrotoxicosis are conflicting. Changes in alveolo-capillary membrane permeability resulting from thyrotoxicosis are not well established yet. This prompted us to investigate the alveolo-capillary permeability in thyrotoxic patients in comparison with CO-diffusing capacity. For this aim twenty-two non-smoking thyrotoxic patients (before treatment) and fifteen healthy voluntary controls underwent Tc-99m-DTPA aerosol scintigraphy. CO-diffusing and pulmonary function tests were performed in all subjects. After ventilation of radiotracer through a nebulizer for 15 minutes, 30 dynamic images (1 frame/minute) were taken from both lungs. ROI's were drawn over both lung areas, and the time-activity curves were generated. Then clearance half time (CT1/2) for radioaerosol was obtained. CT1/2 of thyrotoxic patients did not differ from that of the controls: 77.9 +/- 25.9 min vs. 79.4 +/- 22.3 min; p > 0.05. Similar result was found for CO-diffusion parameters. Also there was no significant correlation between CT1/2 and CO-diffusion parameters. We concluded that in patients with thyrotoxicosis, the alveolo-capillary permeability is unaffected. Further experimental research is needed to establish the possible effects of thyroid hormones on alveolo-capillary membrane.Öğe Lumbosacral transitional vertebral articulation(Lippincott Williams & Wilkins, 2004) Pekindil, G; Sarikaya, A; Pekindil, Y; Gültekin, A; Kokino, SIt has been suggested that low back pain (LBP) may arise from lumbosacral transitional vertebral articulation (LSTVA) itself. It is known that bone scintigraphy is a valuable tool for the recognition of pain arising from bone and articular diseases. Therefore we aimed to show planar and SPELT bone scintigraphic findings of LSTVA and compare them with the LBP and X-ray findings. Twenty-eight patients (aged 20-63 years) in whom LSTVA had been identified radiographically were evaluated with planar bone scintigraphy, utilizing Tc-99m methylene diphosphonate; and single photon emission computed tomography (SPELT) bone scintigraphy. Eighteen patients had LBP whereas 10 had not. There were 25 type IIA, one type IIB and two type IIIA LSTV articulation. On planar images, normal or non-focal minimally increased uptake superimposed on the upper sacroiliac joint was seen in patients without degenerative changes regardless of LBP whereas SPELT showed non-focal mild increased uptake on the area medial to the upper sacroiliac joint. Planar scans showed normal to non-focal mild, and mild-to-moderately increased uptake whereas SPELT demonstrated focal mild-to-moderately and markedly increased uptake in patients with degenerative changes without LBP and with LBP, respectively. The X-ray results showed an association of LBP degenerative changes, and the SPELT results showed a focal, markedly increased, uptake. We conclude that this focal, markedly increased, uptake may show the metabolically active degenerative changes of LSTV articulation and may help to reveal the pain arising from LSTVA. Therefore we propose that bone scintigraphy may be considered for the evaluation of patients with LBP thought to arise from LSTV articulation. ((C) 2004 Lippincott Williams Wilkins).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 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 Tc-99m HMPAO brain SPECT in children with Down's syndrome(Springer-Verlag, 2001) Kaya, M; Altay, S; Gültekin, A; Karasalihoglu, S; Yigitbas, ON; Berkarda, S[Abstract Not Available]
