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Öğe 99mTc sestamibi muscle scintigraphy to assess the response to neuromuscular electrical stimulation of normal quadriceps femoris muscle(Springer-Verlag, 2001) Pekindil, Y; Sankaya, A; Birtane, M; Pekindil, G; Salan, A[Abstract Not Available]Öğe 99mTc-sestamibi muscle scintigraphy to assess the response to neuromuscular electrical stimulation of normal quadriceps femoris muscle(Japanese Society Nuclear Medicine, 2001) Pekindil, Y; Sarikaya, A; Birtane, M; Pekindil, G; Salan, AObjectives: Neuromuscular electrical stimulation (NMES) is widely used for improving muscle strength by simultaneous contraction in the prevention of muscle atrophy. Although there exist many clinical methods for evaluating the therapeutic response of muscles, Tc-99m-sestamibi which is a skeletal muscle perfusion and metabolism agent has not previously been used for this purpose. The aim of our work was to ascertain whether Tc-99m-sestamibi muscle scintigraphy is useful in the monitoring of therapeutic response to NMES in healthy women. Methods: The study included 16 women aged between 21 and 45, with a mean age of 32.7 +/- 6.4. Both quadriceps femoris muscles (QFM) of each patient were studied. After randomization to remove the effect of the dominant side, one QFM of each patient was subjected to the NMES procedure for a period of 20 days. NMES was performed with an alternating biphasic rectangular current, from a computed electrical stimulator daily for 23 minutes. After measurement of skinfold thickness over the thigh, pre- and post-NMES girth measurements were assessed in centimeters. Sixty minutes after injections of 555 MBq Tc-99m-sestamibi, static images of the thigh were obtained for 5 minutes. The thigh-to-knee uptake ratio was calculated by semiquantitative analysis and normalized to body surface area (NUR = normalized uptake ratio). Results: The difference between the pre and post NMES NUR values was Significant (1.76 +/- 0.31 versus 2.25 +/- 0.38, p = 0.0000). The percentage (%) increase in NUR values also well correlated with the % increase in thigh girth measurements (r = 0.89, p = 0.0000). Conclusion: These results indicated that Tc-99m-sestamibi muscle scintigraphy as a new tool may be useful in evaluating therapeutic response to NMES.Öğe Degenerative lumbosacral transitional articulation atypical increased sacral uptake on planar bone scintigraphy(Lippincott Williams & Wilkins, 2002) Pekindil, G; Pekindil, Y; Sarikaya, A[Abstract Not Available]Öğe Doppler sonographic assessment of posttraumatic reflex sympathetic dystrophy(Wiley, 2003) Pekindil, G; Pekindil, Y; Sarikaya, AObjective. To reveal the arterial Doppler sonographic findings in cases of posttraumatic reflex sympathetic dystrophy. Methods. Eleven patients had hand reflex sympathetic dystrophy, and 9 had foot reflex sympathetic dystrophy. The duration of symptoms ranged from 1 to 28 weeks, and the history of fracture ranged from 6 to 48 weeks. Bilateral brachial or popliteal arteries proximal to injuries were evaluated by Doppler sonography with a 7.5-MHz linear transducer All patients also had triphasic bone scintigraphy and extremity thermography. Results. Two patients had monophasic waveforms and 4 had low-pulsatility triphasic waveforms on the affected limbs when compared with the asymptomatic limbs. All opposite asymptomatic limbs had normal triphasic waveforms in these 6 cases. Spectral analysis revealed a loss or decrease of a normal reversed flow component with a reduced pulsatility index on the affected limb. Fourteen other patients had symmetric triphasic waveforms. We observed that the patients who had stage 1 reflex sympathetic dystrophy and warm limbs with durations of symptoms of more than 2 weeks had positive Doppler sonographic findings, whereas all patients with stage 2 reflex sympathetic dystrophy and all with normal skin temperature, regardless of stage, had normal waveforms. Conclusions. Doppler sonography revealed loss of normal triphasic arterial waveforms in some of the cases of stage 1 disease, whereas many cases of stage 1 disease and all cases of stage 2 disease had normal findings. Therefore, we think that Doppler sonography cannot be used for the diagnosis of reflex sympathetic dystrophy but may help in assessing hemodynamic stages of the disease.Öğe The evaluation of the median nerve in subclinical hypothyroidism by high-resolution sonography(Lippincott Williams & Wilkins, 2005) Arikan, E; Pekindil, G; Guldiken, S; Pekindil, YThe aim of this study is to evaluate whether subclinical hypothyroidism causes any alteration of the median nerve diameters by using sonography, and whether L-thyroxine treatment can improve the median nerve dimensions. Twenty-two female patients with subclinical hypothyroidism participated in this study. All patients were asked for the manifestations of carpal tunnel syndrome. They were examined and nerve conduction tests were performed. Right and left median nerve measurements (major and minor axis and cross-sectional area) were determined in all patients by high-resolution sonography before and after euthyroidism was achieved with L-thyroxine treatment. All sonographic measurements were within normal limits in 18 of 22 cases. Four patients had increased the measurements of the median nerve, but only 2 cases of 4 had increased cross-sectional area of median nerve and one of them had clinical symptoms simulating carpal tunnel syndrome. None of them has positive clinical signs of carpal tunnel syndrome. Nerve conduction velocities did not indicate carpal tunnel syndrome in patients with subclinical hypothyroidism. L-thyroxine treatment significantly decreased the mean cross-sectional area, minor and major axes of the right and left median nerves. Clinical symptoms were gradually improved. There was no correlation between the measurement of median nerve and thyroid hormones, thyroid-stimulating hormone, body mass index, and age. The duration of treatment with L-T-4 and dose did not correlate with the measurement of the median nerve. This study shows that subclinical hypothyroidism causes some alterations in the median nerve diameters in a few patients. L-Thyroxine replacement in subclinical hypothyroidism decreases the measurements of the median nerve.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 Magnetic resonance imaging in follow-up of treated clubfoot during childhood(Elsevier Sci Ireland Ltd, 2001) Pekindil, G; Aktas, S; Saridogan, K; Pekindil, YIn this study, we evaluated the short-term results of surgically treated clubfoot with magnetic resonance imaging (MRI). T1- and T2-weighted MRI images with 4-mm slices in the standard anatomic sagittal, transverse, and coronal planes were obtained in seven cases of clubfoot aged 4-11 years (mean 5.6 years old). The mean follow-up period was 3.6 years (ranged between 2 and 6 years). Sagittal talocalcaneal angle, talar head and neck axis internal rotation, calcaneal axis internal rotation, transverse talar neck and head/calcaneus angle and posterior calcaneus external rotation were measured. Three cases with dorsal talonavicular subluxation and a case of calcaneocuboid luxation were demonstrated by MRI. It was concluded that MRI may help to understand results of surgically-treated clubfoot by revealing hindfoot articular relationships and many complications. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.Öğe Tc99m sestamibi muscle scintigraphy to assess the response to electrical stimulation and isometric exercise of quadriceps femoris muscle(Springer-Verlag, 2001) Pekindil, Y; Birtane, M; Sankaya, A; Salan, A; Kokino, S[Abstract Not Available]
